Autism and dentistry.
Terminology
Autism is a lifelong neurodevelopmental difference. In clinical and diagnostic contexts in the UK, the term autism spectrum disorder (ASD) is still commonly used. However, in everyday practice it is increasingly recommended to use autism and autistic rather than the abbreviation “ASD” or phrases that emphasise “disorder”.
Many autistic people in the UK report preferring to be described as “autistic” rather than as a person who “has autism” or “suffers from ASD”. This reflects the understanding that autism is a natural part of a person’s identity – much like saying “she is left-handed” or “he is tall” – rather than a separate illness.
As a practical rule in dentistry, use the terminology that the person (or their parent/carer) uses for themselves, and when in doubt, terms such as “autistic person” or “person on the autism spectrum” are usually accepted and considered current.
Neurodivergent
“Neurodivergent” is a term used to describe individuals whose brains function or process information differently from what is considered “typical”. It is often used for people with differences such as learning disabilities, ADHD, autism, dyslexia or dyspraxia. This term is gaining popularity as it is seen as more neutral and less pathologising than language that focuses on “deficits” or “disorders”.
At the same time, many people identify positively as disabled, and the term “disability” remains important in legal, rights-based and accessibility contexts. “Neurodivergent” does not replace “disability”; the two terms are often used alongside one another. Because labels in this area have often acquired stigma over time, it is likely that language will continue to evolve. For now, many people actively choose and value words such as “autistic” and “disabled”, so it is important not to assume that these are negative terms.
Learning disability
According to the UK National Health Service (NHS), learning disability is defined as “a reduced intellectual ability and difficulty with everyday activities – for example household tasks, socialising or managing money – which affects someone for their whole life. People with a learning disability tend to take longer to learn and may need support to develop new skills, understand complex information and interact with other people.”
This doesn’t include people with conditions such as dyslexia, in which they have a difficulty with one type of skill but not a wider intellectual impairment.
The term "learning disability" is used specifically in the UK, while other countries may use different terms such as "intellectual disability" or "developmental disability."
Learning difficulty
In the UK, there is a difference between learning disability and learning difficulty.
Learning disability is a long-term condition that affects a person's ability to learn new skills and to cope independently. It is usually diagnosed in childhood or early adulthood and is caused by an impairment in intellectual functioning. People with a learning disability often have difficulty with everyday activities such as self-care, communication, and socialising.
On the other hand, learning difficulty is a broader term that encompasses a wide range of conditions that can affect a person's ability to learn. It can refer to a specific learning difficulty such as:
- dyslexia,
- dyspraxia more…
- attention deficit hyperactivity disorder (ADHD),
- or it can refer to a more general difficulty in acquiring new knowledge and skills.
People with learning difficulties may struggle with specific areas such as reading, writing, or mathematics, but they may also have strengths in other areas.
The main difference between learning disability and learning difficulty is that learning disability is a specific condition caused by impaired intellectual functioning, while learning difficulty is a more general term that can refer to a range of conditions that affect learning.
ESN, SEN, SEND, and Special Needs
ESN (Educationally Subnormal), SEN (Special Educational Needs), SEND (Special Educational Needs and Disabilities), and "special needs" have also been used historically to describe learning disabilities or differences.
- ESN was a term used in the UK to refer to students with significant intellectual disabilities who required additional educational support, but the term is now considered outdated and offensive.
- SEN is a more recent term used to describe students with a range of learning difficulties or disabilities, and it is still in use today.
- SEND, Special Educational Needs and Disabilities, is increasingly replacing SEN in common parlance.
- "Special needs" is a more general term that has been used to describe individuals with various disabilities or differences, including learning disabilities, but it is not a specific or diagnostic term.
Overall, there has been a shift towards using more person-centred and inclusive language in recent years.
Living with, or suffering from?
"Suffering from" can imply that someone is defined solely by their condition and that their life is dominated by suffering. The same effect can arise from juxtaposing a condition, e.g. "a cancer patient", or using the disease as a personal description, e.g. "a diabetic". It is becoming more common now to say that people "live with" a condition, or to describe the condition in a more neutral way.
New terminology should be developed in collaboration with affected individuals and their communities, in order to ensure that it is respectful, accurate, and empowering.
The future
Because of the historical tendency of many such terms to become pejorative or disrespectful, it is likely that the language will evolve further. New terms like Diverse learners, Learning variability, Cognitive diversity, Learning differences, Diverse cognitive abilities, and Cognitive variance are already appearing and may become more commonplace.