The Evolution of Language Around Intellectual Disability: From Labels to Respect

Words carry weight. The language that is used to describe an individual with Intellectual Disability (ID)- the language that is written in their medical records, spoken by their teacher, printed in a government report- affects how they view themselves as well as how others view them. Throughout the 19th and 20th Centuries, the language used for people with intellectual disabilities was “clinical” on the surface, but dehumanising in its impact. The words “idiot,” “ignorant”, and “moron” were not originally insults, but rather medical terms. They turned into weapons over the course of history. The history of that language is not just a history of political correctness or changing words. It’s a tale of power, dignity and a long process of realisation that people with intellectual disabilities are just people first. In this article, we will follow the evolution from the label to the language that set people free. 

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When medical terms turned into weapons 

The diagnosis of intellectual disability was intricately linked during the later part of the 19th century and early 20th century with the new science of intelligence testing, and the controversial pseudoscience of eugenics (also known as human breeding), which held that certain groups should not be allowed to reproduce. As early as 1876, the American Association for the Study of the Feebleminded had formed a formal classification system. By 1910, psychologist Henry Goddard had suggested a three-tier classification of intellectual disability, according to IQ scores: “moron” (the highest functioning), “ignorant” (moderate) and “idiot” (the most severe) (Trent, 1994). 

These were not expressions of abuse in their clinical context, as they were supposed to be purely scientific, ‘neutral’ classifications. However, they were terms of contempt very quickly because they were describing something that was connected to shame, dependency, and difference, which were concepts that society equated with bad morals. In the decade or so, each of these three words has become an everyday term of insult, an epithet used to deride and scoff at anyone, even without any disability. This is a process which might be labelled as semantic derogation, the progressive negative emotional charge of a neutral term, not exclusive to disability. This has occurred several times in history, and about marginalised groups, terms have been coined to describe them (Garland-Thomson, 2002). 

Language as a Tool of Social Control

The impact was not just linguistic. They were used to create excuses for people with intellectual disabilities to be confined in institutions, for forced sterilisation, and to essentially remove them from the public sphere. Under the eugenics laws, compulsory sterilisation of more than 60,000 Americans was carried out between 1907 and the 1970s based on Goddard’s research, including his infamous report on the “Kallikak family” and its genetic inferiority (Lombardo, 2008). Language was now being used as a weapon of oppression. The labels that authorities assigned to people determined the rights, freedoms, and opportunities they received. 

While these extreme practices have waned, stigmatising language stuck around in professional and popular culture till the late 1980s. The previous three-tier classification system was replaced by the term “mental retardation”, and from the 1960s it had a more neutral and precise clinical usage in formal medical and legal terminology. Within a generation, the terms “retard” and “retarded” also made it into common usage as insults, much like the terms they replaced (Schalock et al., 2007). 

Person-First Language: putting the person first, not the condition 

The change to more respectful language came not in medical committees or government offices. It started with the disability rights movement of the 1960s and  1970s, when a burgeoning community of persons with disabilities, their families, and advocates demanded equal citizenship and insisted that the language used to describe people with disabilities should also reflect that (Shapiro, 1993). One of the key concepts developed in this movement was what was later called “person-first language”, which was a style of speaking and writing that prioritises the name of the person over their diagnosis or condition. 

In actual use, the term person-first language would be used when referring to a person with an intellectual disability, and not a person who is intellectually disabled, or even worse, an intellectual. It’s a simple one: the actual disability is only part of a person, not the person. Just like many other medical situations, person-first language requires a grammatical structure in which the human being comes first: “a person with diabetes” instead of “a diabetic person”. This is a subtle change of word order. But a powerful statement of philosophy: this person is not “the person with the disability” (Blaska, 1993).

Read More: Breaking Language Barriers in Mental Health: Why Psychology Needs More Regional Diversity in India

From Advocacy to Official Recognition

Since the 1980s and 1990s, the use of person-first language has become more common in professional contexts. In 1992, the then-dominant professional body in the area, the American Association on Mental Retardation (AAMR), redefined and reframed intellectual disability, moving away from the focus on cognition and towards “adaptive behaviour and environmental supports” (Luckasson et al., 1992), establishing the foundation for a broader and less deficit-based understanding of intellectual disability. This year in 2007, the organisation took a step further and renamed itself to the American Association on Intellectual and Developmental Disabilities (AAIDD), making the change from “mental retardation” to “intellectual disability” explicit in their title and in all their publications (Schalock et al., 2007). 

The law followed. Rosa’s Law, signed in the USA in 2010, phased out the term ‘mental retardation’ from all federal legislation, substituting it with the term ‘intellectual disability’. Lawmakers passed the law in honour of Rosa Marcellino, a young girl with Down syndrome whose parents successfully lobbied for the name change. Rosa’s mother, Nancy Marcellino, appeared before Congress saying the term “retarded” is hurtful and outdated and that language in law “communicates an important message about the value of the most vulnerable members of society” (Rosa’s Law, 2010). Many other countries have since introduced similar legislative changes. 

Why Language Matters: The Psychological Impact of Labels 

Debating language may seem like talking pretty talk. It may appear to be something of a nicety, and not an issue of principle. But the psychology studies say otherwise.  Language used to refer to an individual with an intellectual disability will impact both how others treat them and the expectations they have, as well as the opportunities they provide or deny. A teacher who thinks in terms of the student as “a retarded child” and a teacher who thinks “a child with an intellectual disability who learns differently” are not just using different terms. They have different mental models, and they are mentally modelling different things, which makes a difference in behaviour (Goffman, 1963; Corrigan et al., 2001). 

Sociologist Erving Goffman (1963) described social stigmatisation as the process through which society labels individuals based on a single trait, often leading to harmful psychological and social consequences (1963). Individuals with a stigmatised condition internalise lower expectations, suffer from an increased sense of social exclusion, have limited access to employment and participation in the community, and are more likely to develop co-occurring mental health issues like anxiety and depression (Corrigan et al., 2001). Labels often prevent people from getting the opportunities to demonstrate what they can do. 

Respecting Individual Identity and Choice

This also has a strong connection to the notion of dignity- the innate value that resides within every person, regardless of their talents, physical features, or situation. Language that cuts off a person from his limitations is an attack on his dignity. Language affirming the whole person affirms it. When it comes to intellectual disability, and even more so when it comes to other intellectual disabilities, research with ID people and their families constantly shows that using language that is respectful and person-first is correlated with increased feelings of belonging, increased self-esteem and increased community integration, not just because it feels nicer, but because it reflects and reinforces a core belief of equality. (Simplican et al., 2015) 

Also notable is a developing debate in the disability community. The use of identity-first language (“an intellectually disabled person”) is preferred by some self-advocates, for they do not view their disability as separate from who they are. But rather as part of their identity, and person-first language can at times seem to suggest otherwise. This view is not novel to the autistic community. It is gaining traction in the intellectual disability community as well (Kenny et al., 2016). Rather than any particular construction being adopted universally, many advocates say, what’s important is that people are asked what they prefer, and then their preference is respected. 

Where Things Stand Today 

Professionals and policymakers around the world now use the term intellectual disability in clinical practice and legal or policy settings. In 2019, the World Health Organisation (WHO) adopted the International Classification of Diseases (ICD-11), which labels “disorders of intellectual development” a language shift from deficit and permanence towards development and support needs. (World Health Organisation, 2019). In 2013, the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5) officially changed the terminology of mental retardation to intellectual disability (ID) in all its criteria, and adopted person-first language (American Psychiatric Association, 2013). 

There has been an increasing number of guidelines and suggestions to students in healthcare, education and social work professions on the use of person-first language and the history of stigmatising words. There are more countries today that have specific laws and protections against the use of derogatory language in official communications regarding people with disabilities. These are important steps. Language change at the official level does not necessarily seep into everyday speech, into social media and into the school playground where the words do the most direct damage to individuals. 

Beyond Terminology: The Challenge of True Inclusion

Stigma exists at the social level too, as revealed by research into public attitudes towards intellectual disability. Society continues to perpetuate this stigma despite changes in the language used by professionals and in the law. Research in several countries has repeatedly shown that individuals with intellectual disabilities experience discrimination and discrimination at high rates compared to the general population in the areas of employment, housing, health and social relationships (Simplican et al., 2015).  Language reform is not enough. It needs to be accompanied by real inclusion in school or work, or it will not happen in a person’s life.

Conclusion 

The change to “person with an intellectual disability” is more than a mere semantic adjustment. It represents a basic change in the way society thinks about people and their diagnosis. It is no longer a model that defines a person’s identity solely based on what they can no longer do. But rather starts with who they are. That change did not come from the medical authorities. People with disabilities demanded it, their family members demanded it, advocates demanded it. No one could say that a label meant the difference between a life.

English is not the only language. A courteous word in an exclusionary system makes little difference, in practice. But words are a first step- a signpost of a society’s attitude toward its people. Its expectations of them, and what it will provide for them. People have fought for the use of different words to describe people with intellectual disability, and the words have changed. Educators, healthcare professionals, policymakers, and communities must work together to sustain this change. We should speak about each individual using language that recognises them as a whole person. It is not nice; it is a courtesy. It is a right.  

References +

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