Column Editor: Michelle K. Hahn (Disability Advocate and Librarian)
Against the Grain V38#3
Accessibility isn’t a checklist — compliance is only the floor, and disability inclusion means going beyond the minimum. This column explores how we get there, one win at a time.
Have you ever suffered from foot-in-mouth disease? Oh wow, did you just see that? I did it again. And maybe again. Let’s get into what I did and why it matters.
When I proudly shared the link to the first Access Granted column on the Charleston Hub blog with my accessibility advocate friends, I read through it again to refresh my memory on how I told my story. And then I was horrified.
Right there, clear as day, I used “paralyzed” as a shorthand. I even suggested that paralysis is an excuse. In the moment of writing, it didn’t occur to me that I was using a physical condition to mean something inherently negative, as though it were something to fear. So many other words and phrases were available to me to convey the intended meaning without reaching into a human medical reality and repurposing it for dramatic effect.
I did the same thing I did when I started writing this column: I asked whether you have ever suffered from a disease. I used “foot-in-mouth disease” as a funny way to say having to put your foot in your mouth. But even that phrase borrows from a medical reality; foot-and-mouth disease is a real viral illness that affects livestock. It also treats having a disease as inherently humiliating — the joke only works if illness is seen as something terrible.
I hadn’t submitted the column yet; I could have just changed it, and no one would have known, just kept on proselytizing about accessible language as though I didn’t keep stumbling on it myself.
But then there was my next line — “did you just SEE that?” Does that disenfranchise the blind and low vision community? Is all body-rooted language ableist?
Not necessarily. Here’s where it gets interesting.
It turns out that metaphors aren’t just figures of speech; they’re how we think. In cognitive linguistics, the connection between seeing and understanding is one of the oldest conceptual metaphors in any language. Lakoff and Johnson’s conceptual metaphor theory, introduced in Metaphors We Live By, identifies UNDERSTANDING IS SEEING as one of these fundamental structures of thought.1
The shift is even older than English. Eve Sweetser traced how vision verbs shifted into cognitive meanings across languages.2 The word “see” has meant “understand” for over a thousand years; so long that most people don’t even register the visual origin when they say “I see what you mean.”
Here’s what clinches it: blind individuals understand vision-based metaphors as readily as sighted people do.3 The connection between “see” and physical sight has faded almost entirely and is no longer dependent on physical reality.
This isn’t about banning words; it’s about awareness of when language reduces someone to their disabilities versus when it’s just language. Not every use is harmful, but some are, and the difference is worth noting.
“See” is an under-standing so old and universal, being so fully absorbed in the vernacular that the connection to the body has faded. But other words like “paralyzed” haven’t made the same leap. They draw on a person’s lived experience, which they may or may not consider negative. But an abled audience is likely to consider it undesirable, making the metaphor effective.
A good question to ask is whether the metaphor depends on the disability being stigmatized. Does it only work if the audience believes the disability is something to fear or pity? If so, every use quietly tells the disabled members of the audience: your body is the worst thing we can imagine. And that belief is reinforced every time it’s used, including to the people who experience the disability.
Metaphors like that only work because of implicit and explicit ableism.
Then there are the ways we frame disability. I asked whether you had ever “suffered from” a disease, presenting it as something undesirable. “Suffered from” isn’t a metaphor; it’s a worldview. It imposes a narrative of suffering onto people who may not experience their disability that way. In situations where I would reflexively say “suffered from,” I could say “have the lived experience of.”
And on the other side of that coin is inspiration porn (which we shorten to inspo porn), portraying disabled people as heroic or brave for simply living their lives. One imposes tragedy; the other, triumph. Neither asks the person what their experience actually is; it’s only ever what someone else thinks the disabled person should feel: pride in existing at all.
There’s no master list that works in every context. Preferences vary from person to person and community to community, and the language keeps evolving. But here are some common patterns worth noticing, with alternatives to try. Think of it less as a rulebook and more as a starter kit.4
• Crazy / insane / psycho → wild, unexpected, over-the-top
• Lame → boring, disappointing, weak
• Tone deaf → oblivious, out of touch, insensitive
• Turn a blind eye → ignore, look past
• Fall on deaf ears → go unheard
• Paralyzed (as in stuck) → frozen, stalled, unable to act
• Wheelchair-bound, confined to a wheelchair (imposes a narrative of imprisonment) → wheelchair user, person who uses a wheelchair
• Suffers from, afflicted with, victim of → has, lives with, has the lived experience of
• Normal (as the opposite of disabled) → non-disabled, able-bodied
• Challenged (dismissive, minimizes the disability to just an obstacle to overcome) → disabled, has a disability
Then there’s a distinct category of words that deserve their own call-out. “Special needs,” “differently abled,” and “handi-capable” are all linguistic versions of inspiration porn. They don’t insult disability; they do something sneakier and romanticize it. They exist because the plain word “disabled” has been treated as something too uncomfortable to say, so well-meaning people reach for softer alternatives that end up doing the same work inspo porn does: rewriting disabled people’s reality into something more palatable to non-disabled audiences.
A quick note on “special needs” specifically, because most of us grew up hearing it and “special education” as the same thing. They’re not. “Special education” is a legal and professional category that covers students whose learning needs differ from the standard, often referred to as “mainstream,” classroom. It is used in the field of education without the condescension that the phrase carries in everyday speech. The critique here is about “special needs” as a euphemism applied to a person’s identity, not about special education as a field or the teachers, families, and students who live and work within it.
And the r-word has no replacement because it has no good use. Ever.
These conversations aren’t new, though they’ve gained wider attention lately. Communities on the receiving end of systemic barriers have long identified an entire category of phrases whose origins lie in someone else’s oppression. Those expressions are rooted in slavery, anti-immigrant mockery, and ethnic slurs. Most of us grew up saying them without being taught where they came from.
Our conversations absorbed the phrases while discarding the people.
Disability has its own version of this, and I have used every one of them myself. Some of the most ordinary words in English started as descriptions of real disabled people’s bodies and minds, then traveled across decades into insults that nobody consciously connects back to anyone:
• Basket case = WWI-era slang tied to soldiers said to have lost all four limbs; now repurposed for emotional dysregulation, echoing “hysterical”
• Spaz / spastic = from spasticity, a neurological condition causing involuntary muscle contractions, common in the lived experiences of people who have cerebral palsy, multiple sclerosis, or strokes
• Moron, imbecile, idiot = early 20th century clinical classifications for intellectual and developmental disabilities (I/DD)
• Lame = a literal description of mobility disability long before it became shorthand for “bad”
The people those words came from are still here. The words just traveled without them.
Beyond the words we choose as metaphors, there’s an ongoing debate within the disability community about how disabled people should be described at all. The debate is about word order: do you say “a person with a disability” or “a disabled person?” The former is person-first language (PFL). Person-first language emerged from the People First movement in 1974, when people with disabilities demanded to be seen as people rather than by their diagnoses.5 It became the standard, written into federal law through Rosa’s Law in 20106 and embraced by well-meaning people everywhere.
But not everyone in the disability community agrees. Critics argue that if you need language to distance someone from a trait, you’re treating that trait as something shameful.7 Think of it this way: I’m “left-handed.” I’m not “a person with left-handedness.” (I am, though, very proud to be in that exclusive club!) Or, I’m a librarian. Not a person with librarianism.
Many in the d/Deaf and autistic communities prefer identity-first language (IFL) because they view their disability as central to their identity, not a medical problem to be cured, but part of who they are.8 Identity-first language recognizes disability as a culture, a neutral or even positive human attribute, not a condition requiring a cure.9
In many contexts, though, either person-first or identity-first language can be linguistically awkward, making it less appealing to some. Current guidance across major style guides, including APA, MLA, AP, Chicago, and the National Center on Disability and Journalism, has converged on a single principle: endorsing both approaches and ultimately deferring to the preference of the person or community being described.10 The real answer isn’t a rule, it’s a question: ask, and honor what you’re told.
There’s an even sharper critique underneath. Person-first language, some argue, has been co-opted by non-disabled people who believe they have the authority to determine how disabled people should declare their identity. That, in itself, is ableism.11 In the autism community specifically, research shows that 87% of autistic adults prefer identity-first language, while professionals working with them are more likely to default to person-first.12 The people most loudly advocating for person-first language are often not disabled themselves.13
The autism community offers another vivid example of this dynamic. In the 1960s, a board member of the UK’s Autistic Children Association (now the National Autistic Society) designed a puzzle piece as the symbol for autism.14 The original logo was a puzzle piece with a crying child inside, signifying that autism was a tragedy and a condition that needed to be solved.
The parents who created it weren’t acting out of malice; they were fighting to ensure their children were educated, accepted, and included.15 But the symbol they chose framed autism as suffering and isolation; and it was the parents’ suffering and isolation they were expressing, not necessarily their children’s. If you want a really visceral account of that history, check out The Ability Toolbox post cited later in this column!
Autism Speaks later adopted it and made it ubiquitous through campaigns such as “Light It Up Blue,” which represents the search for answers.16 In all instances, the implication is that autistic people are a problem to be figured out. But for many autistic people, the puzzle piece suggests they are incomplete, mysterious, or broken.17
What it comes down to is who gets to choose the symbol: “They chose the puzzle piece, not us.”18 Autistic people have since embraced a rainbow infinity symbol, chosen by them, for them, to represent neurodiversity.19 It’s the disability community’s motto at work: Nihil de nobis, sine nobis = nothing about us without us.
For my part, I choose identity-first language (IFL). I am disabled, and I am not ashamed of it. In fact, I wasn’t always disabled, but I’m honored to have become part of this community. My disabilities are no more separable from me than being left-handed or being a librarian, and I consider them part of my identity.
As you can see (see what I did there?), I started this column by making the very mistakes I set out to write about, and I kept making them as I wrote. But that’s the point. The use of ableist language is so deeply woven into our communication that even I, as a disabled advocate, can’t write about it without stepping into it. And honestly, I’ll probably step in it again — please call me out on it when I do so that we can continue the conversation together!
But this isn’t about getting it perfect. It’s about noticing, caring enough to look closer, and being willing to course-correct when someone tells you it matters to them. That’s it. That’s the whole thing. When you know better, do better.
If there is a particular topic you would like to see covered or you’d like to share an experience improving accessibility in your corner of the world, please get in touch! I could fill every issue with my own perspective, but that would miss the point. We’re all in this, whether disabled or temporarily able-bodied. So let’s make something incredible together.
Endnotes
1. George Lakoff and Mark Johnson, Metaphors We Live By (Chicago: University of Chicago Press, 1980), 103-104.
2. Eve Sweetser, From Etymology to Pragmatics: Metaphorical and Cultural Aspects of Semantic Structure (Cambridge: Cambridge University Press, 1990).
3. Ricardo A. Minervino et al., “The Understanding of Visual Metaphors by the Congenitally Blind,” Frontiers in Psychology 9 (2018): 1242, https://doi.org/10.3389/fpsyg.2018.01242.
4. “Words Matter! Disability Language Etiquette,” National Education Association, https://www.nea.org/words-matter-disability-language-etiquette.
5. Michael Wehmeyer et al., “Riding the Third Wave: Self-Determination and Self-Advocacy in the 21st Century,” Focus on Autism and Other Developmental Disabilities 15, no. 2 (2000): 106–15, https://doi.org/10.1177/108835760001500206.
6. Amy F. Crocker and Susan N. Smith, “Person-First Language: Are We Practicing What We Preach?,” Journal of Multidisciplinary Healthcare 12 (2019): 125–29; https://doi.org/10.2147/JMDH.S140067; Rosa’s Law, Pub. L. No. 111-256, 124 Stat. 2643 (2010).
7. Cara Liebowitz, “I Am Disabled: On Identity-First Versus People-First Language,” The Body Is Not an Apology, 2015. https://web.archive.org/web/20180710033140/https://thebodyisnotanapology.com/magazine/i-am-disabled-on-identity-first-versus-people-first-language/
8. Shannon Wooldridge, “Writing Respectfully: Person-First and Identity-First Language,” National Institutes of Health, April 12, 2023, https://web.archive.org/web/20240710131420/https://www.nih.gov/about-nih/what-we-do/science-health-public-trust/perspectives/writing-respectfully-person-first-identity-first-language.
9. Krista L. Best et al., “Language Matters! The Long-Standing Debate Between Identity-First Language and Person-First Language,” Assistive Technology 34, no. 2 (2022): 127-28, https://doi.org/10.1080/10400435.2022.2058315.
10. See, for example, American Psychological Association, Publication Manual, 7th ed. (2020), sec. 5.4; Chicago Manual of Style, 18th ed. (2024), secs. 5.255-67; and the National Center on Disability and Journalism’s Disability Language Style Guide at https://ncdj.org/style-guide/.
11. Amy Sequenzia, “Person First Language and Ableism,” Ollibean, March 3, 2016, https://ollibean.com/person-first-language-and-ableism/.
12. Amanda Taboas et al., “Preferences for Identity-First Versus Person-First Language in a US Sample of Autism Stakeholders,” Autism 27, no. 2 (2023): 565–570, https://doi.org/10.1177/13623613221130845.
13. Michelle Diament, “’Autistic’ or ‘Person with Autism’? It Depends,” Disability Scoop, December 2, 2022, https://www.disabilityscoop.com/2022/12/02/autistic-or-person-with-autism-it-depends/30154/.
14. HeyASD, “Autism Puzzle Piece Explained: History, Harm, and Why Many Autistic Reject It,” HeyASD, January 14, 2026, https://www.heyasd.com/blogs/autism/autism-puzzle-piece-controversy.
15. Helen Green Allison, “Perspectives on a Puzzle Piece,” Communication, 22, no. 1 (1988): 6–9, http://web.archive.org/web/20070714093137/http:/www.nas.org.uk/nas/jsp/polopoly.jsp?d=364&a=2183.
16. HeyASD, “Autism Puzzle Piece Explained.”
17. Richard Coffey, “The Problem with the Autism Puzzle Piece,” The Mighty, May 15, 2023, https://themighty.com/topic/autism-spectrum-disorder/autism-puzzle-piece-problem/.
18. Olivia Jayne, “Why the Autism Puzzle Piece Is Bad, and What to Use Instead,” The Ability Toolbox, September 19, 2025, https://theabilitytoolbox.com/autism-puzzle-piece-alternative/.
19. “Why the Autism Puzzle Piece Is Bad.”
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