From Person With Autism to Autistic Person: Language Trends Reversed Over Four Decades

Should we say “a person with autism” or “an autistic person”? The question sounds like a matter of etiquette, but it sits at the heart of one of the most contested debates in mental health and disability advocacy. A new study published in PLOS Mental Health by Jemima Kang, Naomi Baes, Alsa Wu, and Nick Haslam has now delivered the most comprehensive historical analysis to date of how these two competing styles of language—known as person-first and identity-first language—have risen and fallen across four decades of books and news media. The findings reveal a striking reversal: the long dominance of person-first phrasing, once championed as the respectful standard, is now being actively counteracted by a resurgence of identity-first expressions.

Person-first language places the person before the condition, as in “person with schizophrenia” or “people with disabilities.” Its rationale is that a diagnosis should not define an individual, and that separating the person from the label preserves dignity and humanity. Identity-first language, by contrast, leads with the condition, as in “autistic person” or “disabled people.” Advocates of this style argue that conditions such as autism or deafness are integral to identity rather than detachable afflictions, and that framing them as something one “has” implies they are undesirable burdens to be shed. The debate is not merely semantic; it reflects deep disagreements about the nature of mental illness, disability, and selfhood.

To map these shifting preferences empirically, the research team turned to two of the largest text corpora available to linguists and social scientists. The first was Google Books, covering the years 1980 through 2019, which offers a broad window into published writing across genres and decades. The second was the News on the Web corpus, spanning 2010 to 2025, which captures the fast-moving language of contemporary journalism. Rather than tracking a handful of terms, the researchers evaluated the frequency of “X person” or “X people” expressions relative to “person with X” or “people with X” expressions across a wide collection of mental health conditions, disability categories, and other conditions, making this the largest investigation of its kind.

The analytical logic was straightforward but powerful. For each condition, the researchers computed the relative share of identity-first constructions compared with person-first constructions over time. If person-first language were simply winning the culture, its share would rise steadily. Instead, the data told a more nuanced story. Consistent with the team’s predictions, person-first language did become more popular from 1980 onward, reflecting decades of professional and institutional endorsement. Style guides, clinical organizations, and advocacy groups had long promoted formulations such as “person with a mental illness,” and the corpus data confirmed that this advice translated into actual usage in books and news.

But that upward trajectory did not continue unbroken. The study found that the early rise of person-first language was counteracted by a more recent swing back toward identity-first language, producing what statisticians call a curvilinear trend—an inverted pattern in which one style gains ground, peaks, and then cedes it. In other words, the linguistic pendulum has swung. What was once framed as outdated or stigmatizing phrasing has been reclaimed by many communities, particularly in the autism and Deaf worlds, where identity-first formulations such as “autistic person” and “Deaf people” are now widely preferred by self-advocates. The corpus evidence suggests this reclamation is not confined to activist circles but is visible in mainstream published and journalistic language.

One of the study’s more intriguing secondary findings concerned grammar. Identity-first language proved to be more prevalent in singular expressions than in plural ones. People write “an autistic person” more readily than “autistic people,” a pattern that may reflect how singular constructions foreground the individual and lend themselves to personal narrative, while plural forms are more common in epidemiological, policy, and clinical contexts where person-first conventions have historically been entrenched. This grammatical asymmetry hints that the two styles occupy different communicative niches rather than simply competing head-to-head across all contexts.

Perhaps the most important qualification the researchers emphasize is that broad trends conceal enormous diversity. Beyond the overall curvilinear pattern, there was substantial variation in terminological preferences and trajectories across individual conditions. Some conditions followed the general arc of person-first ascendancy followed by identity-first resurgence; others showed stable preferences in one direction or the other throughout the study period. Conditions with strong self-advocacy movements, such as autism, appear to have shifted more decisively toward identity-first usage, while other conditions may retain entrenched person-first conventions in professional writing. The lesson is that there is no single linguistic norm governing how society talks about mental health and disability—there are many, evolving at different speeds and in different directions.

These findings carry real implications for anyone who writes about mental health, from clinicians drafting reports to journalists covering breaking news. For decades, institutional style guides have prescribed person-first language as a universal rule, treating it as the neutral, respectful default. The corpus evidence now complicates that prescription. If the communities being described increasingly prefer identity-first terms, blanket adherence to person-first conventions may itself feel dismissive to those communities. The study suggests that language choices should be informed by the preferences of the people concerned, which vary by condition and community, rather than by a one-size-fits-all rule frozen in professional guidance.

The methodological achievement here is worth appreciating on its own terms. Historical claims about language are notoriously difficult to test, relying often on anecdote or on small surveys conducted at single points in time. By quantifying usage across forty years of books and fifteen years of news text, the researchers converted a heated normative debate into measurable empirical trends. The curvilinear result is especially valuable because it demonstrates that linguistic change in this domain is not linear progress toward one style but a dynamic process in which professional endorsement, community advocacy, and shifting cultural attitudes continually reshape usage. It also provides a baseline against which future shifts—driven by social media, self-advocacy, and evolving clinical practice—can be tracked.

The broader cultural story is one of contested ownership over labels. Person-first language emerged from a well-intentioned effort to see the individual before the diagnosis, and its rise through the 1980s, 1990s, and 2000s reflected genuine progress in humanizing clinical discourse. Yet the recent swing toward identity-first language shows that many people with mental health conditions and disabilities do not want their conditions treated as detachable accessories. For them, the condition is part of who they are, not merely something they have. The study by Kang, Baes, Wu, and Haslam gives that sentiment empirical weight, documenting in millions of published sentences how the balance of language has tipped, reversed, and diversified. As the debate continues, the evidence suggests that respectful language is not a fixed formula but a moving target—one that writers, clinicians, and institutions must follow with attention to the communities they describe.

Subject of Research: Historical trends in identity-first versus person-first language for mental health and disability conditions in books and news media

Article Title: Who you are or what you have: Historical trends in identity-first and person-first language in books and news media

Article References: Kang, J., Baes, N., Wu, A., & Haslam, N. (2026). Who you are or what you have: Historical trends in identity-first and person-first language in books and news media. PLOS Mental Health, 3(9), e0000684. https://doi.org/10.1371/journal.pmen.0000684

Image Credits: AI Generated

DOI: 10.1371/journal.pmen.0000684

Keywords: identity-first language, person-first language, autism, disability, mental health, corpus linguistics, Google Books, News on the Web corpus, language trends, stigma, self-advocacy, terminology