Language has an impact on the way people feel and are perceived. Often, people with a disability are described in discriminatory and demeaning ways impacting a person with a disability’s sense of self, how they navigate society and interact with other people. Using appropriate language is not politically correct, it is respectful.

People with disability are not one homogenous group and while this language guideline aims to assist SJWA staff and volunteers in identifying appropriate language it is important to remember that language preferences are deeply individual and what may be acceptable for one person with a disability, might not be acceptable for another. For example, people with disability have strong preferences for using either person-first language (people with a disability) or identity-first language (disabled people). Where possible, St John WA staff and volunteers should ask the person how they would like to be described (PWDA, 2021).

In all instances, avoid the use of ableist language. Ableism is the systemic exclusion and oppression of people with disability by people without disability and is often expressed and reinforced through language (PWDA, 2021). you can read more about ableist language here.

General Guidance:

• Respect the preferences of the individual
• Do not describe a person as 'being' their condition
• Avoid descriptions that suggest pity such as "afflicted by" or "victim of"
• If you slip up with your language, acknowledge your mistake and apologise

A list of commonly used phrases is detailed on the table below. Further information can be found here.

Autism is a lifelong developmental disability that is neurological in origin and affects how a person thinks, feels, interacts with others, and experiences their environment (Autism Spectrum Australia [ASA], n.d; Western Australia Department of Health [WADOH], 2019). Every autistic person is different as are their specific challenges and needs which is why it is described as a spectrum.

A person with autism spectrum disorder may;

• Panic if yelled at, and lash out if touched or physically restrained
• Misinterpret verbal communication
• Not be able to answer questions
• Appear not to be listening or paying attention
• Tend to interpret statements literally
• Appear rude or say things that sound tactless (especially when anxious or confused)
• Have difficulty making eye contact
• Speak too loudly, too softly or with unusual intonation (ASA, n.d)

A person with autism spectrum disorder may experience what is commonly referred to as a meltdown in response to a stressor such as a change to routine or sensory overload. A meltdown might look like crying, physical aggression, pacing, thrashing about, running away, dropping to the floor, and rocking back and forth (ASA, n.d). If safe, allow the meltdown to pass.

Take the time to speak with the patient and family members or support workers to identify sensory sensitivities and calming strategies to better understand the patient’s needs.

Strategies:

• Clearly state who you are
• Be patient and do not rush (unless life threatening)
• One person speaking at a time – keep language concise and direct
  • Provide clear, step by step instructions

If you have limited understanding of how a patient experiences their world from a sensory perspective, assume sensitivity and create a low-stimulus environment as much as possible. Minimise noise and consider the use of visual aids and distraction techniques.

Finally, if a person with autism spectrum disorder becomes fixated on an object or has the need to perform repetitive body movements, do not interrupt unless necessary or unsafe. This may be a way for the person to calm down and self-regulate sensory needs.

Intellectual disabilities are characterised by limitations in intellectual functioning and adaptive behaviour with an onset prior to 18 years old (DDWA, 2023). Adaptive behaviours relate to a person’s ability to perform everyday activities such as self-care, the ability to socialise and skills such as reading and writing (DDWA, 2023).

Common causes:

• Down Syndrome
• Fragile X syndrome
• Prader-Willi Syndrome
• Rett Syndrome
• Foetal alcohol spectrum disorder
• Premature birth

Cognitive disability is caused by an acquired brain injury and can impact a person’s memory, problem solving skills and ability to regulate emotions.

A person with a cognitive disability may experience;

• Attention and concentration difficulties
• Impulsiveness
• Poor planning and inability to consider future implications
• Difficulty understanding the points of view of others
• Impaired social communication skills (Department of Communities, 2023)

Several factors can influence the extent of the cognitive impairment such as type of injury sustained, part of the brain impacted and a person’s prior level of functioning and developmental stage (Department of Communities, 2023).

Common causes:

• Trauma (MVA, falls, assault)
• Infection, metabolic disorders
• Hypoxia (suffocation, near drowning)
• Substance abuse (alcohol, amphetamines, solvents)
• Cerebrovascular Accident
• Dementia

Considerations:

• Gain an understanding of the patient’s decision-making ability and ability to communicate concerns such as pain or discomfort
• Engage with their family / support workers but do not forget to involve the patient in their own care
• Give the patient the time required to understand and to respond, where necessary.
• Gain insight into objects or situations that may cause the patient distress and avoid them where possible