Frontline Initiative: Advocacy and Voting

Language Matters


John Raffaele , MSW, is Director of Educational Services at NADSP. He can be reached at

We like things. They fixate on objects.

We try to make friends. They display attention- seeking behaviors.

We take a break. They display off-task behavior.

We stand up for ourselves. They are non-compliant.

We have hobbies. They self-stim.

We persevere. They perseverate.

We love people. They have dependencies on people.

~Excerpt from the poem The Language of Us/Them by Mayer Shevin

Our society’s view of people with intellectual and developmental disabilities are is deeply rooted in moral and medical stereotypes. Historically, people with disabilities have been viewed as good or bad, as sinners or saints, or as sick patients needing to be cured. In more recent times, we began to see disability differently, not as something we should necessarily change but as part of the human condition. As direct support professionals, our job is to work with people as they are and ensure they have the opportunities and accommodations necessary to become welcomed members in a society that struggles to see disability as part of human diversity. We may provide physical or emotional supports, but we are not in this profession to change or cure anyone. Ours is a profession of advocacy, justice, and partnership.

Our historical moral and medical models of disability include vocabulary that continues today. In the early 20th century, Henry Goddard, research director of a large institution in New Jersey, used the terms imbecile and idiot to categorize people with intellectual and developmental disabilities based on IQ. These words were used as insults long before, but Dr. Goddard made them into medical classifications, further devaluing people with disabilities. He coined the term moron” to replace feebleminded,” a term in use today as a common slur.

A man wearing wire-fameless glasses and a black shirt. He is smiling at the camera. He has short black and white hair and a beard.

John Raffaele

We have adopted many phrases in our profession that devalue the people we support; wheelchair-bound, attention-seeker, high-functioning, low-functioning, and retarded.

Actions are referred to in shorthand with terms like elopement, feeding, toileting, passing meds, and having behaviors.

When we reflect on this language and accept that current usage devalues our profession and the people we support, we have an obligation to choose our words carefully. In a profession dedicated to inclusion and belonging, we should not use words that convey “us” and “them,” “we” and “they.”

When we use language that is negative, institutional, or disrespectful, we perpetuate prejudice toward the people we support.

The NADSP Code of Ethics speaks of our commitment to respect the human dignity of the people we support. It mandates that, as direct support professionals, we practice our craft with integrity and responsibility. A big part of our work involves communication and documentation. In those functions, we must choose language that promotes respect, dignity, and positivity. This is particularly important in how we communicate the duties of our job outside of work. When we use language that is negative, institutional, or disrespectful, we perpetuate prejudice toward the people we support.

To illustrate the power of language, consider a phrase that is common in the world of direct support – "I love my guys." Although this may sound endearing, it is ultimately harmful and offensive. Of course, we have affection for the people we support, but this should not be the foundation of, or condition for, our work. Relationships between DSPs and people supported should be based on professional competence and ethics; they should never be based on love of the people they are paid to support.

"My guys" implies ownership and control over people. This goes against the NADSP Code of Ethics and is a slippery slope into servitude.

Even when it comes from the heart, phrases like "I love my guys" objectify people with disabilities and diminish the profession of direct support. No other profession allows for this type of language. And "my guys" implies ownership and control over people. This goes against the NADSP Code of Ethics and is a slippery slope into servitude. One may grow to love and respect a person supported but direct support professionals need to understand that their role is not family or friend but assistant, and ally.

The moral and medical language doesn’t only apply to the people we support. Direct support professionals are often referred to as "angels," “heroes,” “God’s hands on Earth," "working in the trenches,” and so on.

Two graphic novel bubbles. The first is a speech bubble that says "I love my guys!" the second is a thought bubble that says, "Please stop and reflect"

Many see the work of direct support as courageous or noble, something that not just anyone can do. True, the work is rewarding, but DSPs are no more angelic, noble, or heroic than other professionals. (Would we call DSPs angels and heroes if they were paid a living wage?) Direct support is a profession. For many, it is a wonderful and meaningful career choice, rooted in knowledge, skills, and values where one may develop close relationships. If you’re saying, “I love my guys," please stop, reflect, and reconsider your role in the lives of the people you support. Your words can reinforce old stereotypes that view people with disabilities as “less than,” or they can elevate the profession of direct support and those you have the responsibility and privilege of supporting. As an alternative, say " I love my profession!"

When our language is respectful and inclusive, we erase the lines between we and they, us and them. We can more easily let go of the paternalism and belief that we should have power over someone. As DSPs, we can better advocate with, and not for, the people we support. Will our language change our actions? Not overnight, but yes, it will help us to consider the power our words have and how we value the people we support. And this is the foundation for strong advocacy.

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