Autism and Identity-First Language

26 June

Autism is a neurodevelopmental difference in the brain, meaning Autistic people experience the world differently compared to non-Autistic people.

At The Kidd Clinic, we work hard to create a space that is welcoming, safe, and affirming for all neurodivergent people. A neurodiversity-affirming approach involves understanding, accepting, and supporting brain-based disability. We believe Autistic people do not need fixing or changing; they need to be accepted, supported, and celebrated, and language is a very important and valuable way to do this.

The language we use when talking about Autism is a powerful tool to communicate respect for and understanding of the Autistic community, however it can also be the cause of significant pain and damage if used in a non-affirming way. The language we use reflects our knowledge, beliefs, and views of the neurodivergent community, so we feel it’s important to evaluate how you would like to be representing this community and educating yourself accordingly.

Autistics are unique individuals who present in all different ways! It is important we affirm the experience of Autistics as a human with individual strengths and difficulties, before reducing them to a disorder or level of functioning. Take a look at the information below to consider affirming vs. non-affirming language when discussing Autism or jump straight to the end of the blog to see a table summary of this language.

Lets take a look at different types of language currently used to describe an Autistic person…

Medical/psychiatric language – “Autism Spectrum Disorder, ASD”, as per the Diagnostic Statistical Manual – Fifth Edition, Revised (DSM-5R). Using “ASD” when referring to an autistic person directly implies that autism is a disorder. We know however that Autism is a neurodevelopmental difference in the way someone’s brain is wired, not a disorder. Autism cannot be cured, reduced, or changed, unlike other disorders – nor should it be.
Person-first language – “person with autism” or “on the spectrum”. Person-first language has previously been preferred in the disability sector as it separates the disability from the person. Some people prefer this use of language as they do not identify with their diagnosis, rather they prefer to be recognised as a person first. However, autistic advocates have explained how person-first language insinuates that ‘their Autism’ can be separated from their person, which is not true. One cannot be separated from being Autistic, nor is Autism an accessory that they can choose to have, or not have.
Identity-first language - “Autistic person”, “Autistics” or “I am Autistic”. Using identity first language acknowledges that Autism is an integral part of someone’s identity, recognising that it is not a lesser or secondary part of them. Use of identity-first language reduces shame and stigma regarding Autism, and embraces Autistic people with pride, celebrating their neurodivergence.

A note on “levels of functioning”:

Language involving levels of functioning is common, particularly when considering diagnostic or assessment reports. However, the issue with using language that describes levels of functioning for an autistic person is that not only is an individual’s functioning ever-changing depending on context, but it does not consider the individual’s strengths and difficulties.

Calling an Autistic person “low functioning” or “severe” dismisses that person’s abilities and strengths.
Calling an Autistic person “high functioning” or “less severe” dismisses that person’s disabilities and difficulties, and in turn implies they are less disabled than someone “low functioning”.
- This is particularly prevalent for Autistics who mask, and therefore are perceived as “high functioning” as there may be little external presentation of their difficulties. These individuals are no less disabled and can have equally high needs.

A note on “male or female presentation”…

Historically, allied health and medical professionals used to use the terms “female presentation” to describe masking behaviours, such as “shyness”. Currently, the Autistic community prefer the language of “internalised presentation” and “external presentation” to describe different Autistic presentations. This is due to the fact not everyone identifies with a binary gender, and that all genders can mask, and all genders can externalise.

So, after all that, what language do we use?

Ask the individual how they prefer to identify with being Autistic and use that term when communicating with them. Regardless of the language they select, we affirm their identity by using this language. This opens conversation regarding self-identity, and a general discussion around Autism and language which is a great opportunity to learn and educate.
Majority of the neurodivergent community prefer identity-first language, and as such, neurodiversity-affirming clinicians should also be using identity-first language, unless your client/friend/loved one has suggested otherwise as indicated above.

See the table below for some examples of affirming language.