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Editor's Note

Language as Advocacy

Field-Fote, Edelle [Edee] PT, PhD, FAPTA; Editor-in-Chief

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Journal of Neurologic Physical Therapy: January 2018 - Volume 42 - Issue 1 - p 1
doi: 10.1097/NPT.0000000000000212
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In most physical therapy programs in the United States, students have some opportunity to develop their scientific writing skills. For many, this experience comes as part of a research project that must be reported in the format of a scientific paper. At the very least, all student physical therapists are exposed to scientific writing in classwork, wherein they read original research that informs clinical practice. Looking back over the 3 decades since I was a student physical therapist, it is gratifying to note the change in the way we use language to describe members of the disability community. While it was once common talk about the man in the wheelchair “stricken with” Parkinson disease, to write about “stroke victims,” to pass a “handicapped” bathroom, or to drive by a hospital for “crippled children,” our language has evolved along with our thinking. Respect for all persons is reflected in our emphasis on language, wherein we describe persons “living with health condition,” wheelchair users, and accessible bathrooms.

While acknowledging that persons with disability may self-identify as “disabled” and accordingly may choose identify-first language to describe themselves,1 I would argue that as rehabilitation scientists we have an obligation to use person-first language. Likewise, studies include participants or subjects. Describing individuals as patients subjugates their personhood by defining them according to a role wherein they are cared for by a healthcare provider. While this term is appropriate when describing clinical care, it is not appropriate when referring to individuals who have freely consented to participate in our studies. The language we use in our scientific presentations and publications offers opportunities for advocacy. Rehabilitation journals have led the way in these efforts; however, readers of journals outside our field may have noted that many of those journals still need to catch up in terms of appropriate and respectful language. Physical therapist researchers routinely publish in science journals outside of rehabilitation. It has been gratifying to note that they persist in their use of respectful language even when not required by the journal. These presentations and publications are accessed by others outside our field, thus serving as a teachable moment.

As health professionals, we have many opportunities for advocacy through the language we use, beginning early in our interactions with patients/clients and their families. In my own work as a neurorehabilitation scientist, I routinely receive calls from family members of individuals who have recently experienced a spinal cord injury. Since persons with physical disability are a minority in the US population at large, most often family members have had little prior involvement with the disability community. This is an occasion when we can support families not only with our clinical skills but also with our ability to offer the perspective that our backgrounds give us. While experiencing a neurologic health conditions certainly is a life-altering event in many cases, we know that a rich, joyful, and full life is possible for persons with disability. Keeping that frame of reference, and using respectful language, has value for adjusting the lens through which a future life is viewed. When a person with disability acquires this frame of reference, it sets the stage for inclusion and full participation, representing the first step in achieving those expectations.


1. Liebowitz C. The Body is Not an Apology. March 20, 2015. Available at Accessed November 3, 2017.
© 2018 Academy of Neurologic Physical Therapy, APTA.