“Why are those who are born or who become different referred to by all those various names? Why so many categories? Why even such dramatics in the face of what happens…so often, and which can happen to any of us?” - Henri Jacques Stiker

There is a long history of classifying impairments. In the past, impairments were seen as a result of anything from moral degeneration to genetic weakness, or as something to be recovered from or to be pitied for or to be helped with. There has often been a focus on hereditary, social, ethnic, psychological and familial factors.

It is only in recent years that a social understanding of these categories has become increasingly evident. Cerebral Palsy, for example, is a description of a physical impairment that affects movement. It is not a disease or an illness…it is a description. It is vague and general. It is a label. It is created by us to describe something we have understood in a particular way.

Why is this important? The language we use to talk about ourselves and other people affects the ways in which we think about ourselves and other people. The ways in which we talk and think about ourselves and other people affects our behaviour.

If we define people or refer to them by a label we generalise about them. It becomes harder to look beyond the label, to see the person first. It becomes all too easy to see our lives as normal and theirs as not. We create a paternalistic approach towards them, positioning them as different or ‘other’ and segregating them from their peers. The labels themselves imply that something is lacking in the individual. This is why they often come to be used as insults.

Once a label is applied to an individual it triggers other ways of thinking about and dealing with a person. The label, for example, commonly fixes the individual in a specific position within medical or legal processes, so that different procedures and ways of thinking apply to them.

Labels bring assumptions about worth, about behaviours, about other "symptoms". People are commonly described by their label as a starting point, and then find that other differences are submerged into it. Ironically, this can mean the individuals are not seen to be morally responsible for the difficulties that they face. So, for example, the person with Attention Deficit Hyperactivity Disorder (ADHD) can be excused their anti-social behaviour because the ADHD can be used to explain that behaviour.

The people who initially apply these labels are usually professionals, of course. The process of assessment and labelling, therefore, means professionals have a dominant role in the lives of disabled people, even though it is not uncommon for the assessments to prove false. In many instances the label can be seen to act as a self-fulfilling prophecy, undermining the confidence of the person on the receiving end and/or their family in their ability to deal with everyday life.

Of course none of this resolves the challenges an individual faces in society. There are people to whom society presents greater barriers, whether they are physical, social and/or behavioural barriers, or barriers to thinking, remembering and communicating. Labels are currently a key part of how society responds to social issues, including disability.

The labels can provide a solution to the problems an individual faces. They can facilitate access to resources and can allow service-providers to organise specific and appropriate support. The formal label can challenge negative informal labels, providing legitimacy to an individual, offering an explanation for characteristics and behaviours. They can also present the possibility of a new group membership for individuals and through this a more empowered self-identity.

The challenge we face is to recognise that the label has a function to fulfil in contemporary society, but that it does not describe the whole person. So what do you think when you are faced with a label…? When, for example you learn that a person has Down syndrome, or cerebral palsy, spina bifida or is deaf? What barriers do you put up? And where did those barriers come from? Does your thinking begin with you or with them? Do you consider barriers they face or the barriers you create for them?

Do you agree? Do you see the person and not the label? Share your thoughts and experiences in the health and living forum.

Content last updated: 14/11/2006

About the author

Jonathan Rix is a lecturer in Inclusion, Curriculum and Learning at the Open University.

Jonathan says: "My sister had Down syndrome and was brought up in a long stay hospital. My son has the same label and goes to his local primary school. I am very glad that things are improving. I really hope programmes such as Nobody's Normal will encourage even more improvements."