Language Use Preferences in a Culturally Diverse, Multiethnic, and Multilingual Autism Community in Singapore

There is an emerging understanding of diverse language preferences in autism among stakeholders, including that for identity-first language (IFL) versus person-first language (PFL). We aimed to understand preferences regarding language use in racially and culturally diverse Singapore. A cross-sectional study was completed by autistic adults, caregivers of autistic individuals, and professionals working in the autism field. The questionnaire comprised commonly used terms in autism, which respondents rated from 1 (uncomfortable/I do not like this term) to 7 (very comfortable/this would be my preference). The sample comprised 320 individuals (82.8% females; Chinese 75.9%, Malay 9.4%, Indian 8.8%). Respondents comprised 38 (11.9%) autistic individuals, 86 (26.9%) caregivers/relatives, and 196 (61.3%) professionals. Differences in language preferences were observed between respondent types. Autistic individuals preferred terms like 'autistic' (M ± SD = 5.00 ± 2.25) unlike caregivers/relatives (3.66 ± 2.41) or professionals (3.30 ± 1.94, p < .001). PFL terms like 'person with autism' and 'person with ASD' were preferred by caregivers/relatives (4.47 ± 2.19; 4.33 ± 2.25) and especially professionals (5.32 ± 1.58; 4.89 ± 1.84) but disliked by autistic individuals (3.11 ± 2.09; 2.39 ± 1.99; p < .001). Different language preferences were observed between those with lived experience versus professionals. Sensitivity to the preferences of stakeholders fosters better inclusion and acceptance of neurodiversity.Lay AbstractLanguage shapes how autism is perceived and understood by society. Research on language preferences in the autism community has been mostly from Western sources. The primary consideration has been in identifying the preference between identity-first language (IFL), such as 'autistic person', and person-first language (PFL), such as 'person with autism'. These studies suggest that professionals and caregivers prefer PFL while autistic individuals favor IFL. Little is known about these preferences in a culturally diverse setting like Singapore. This study aimed to explore the language preferences among the stakeholders in the autism community in Singapore. In this study, 320 participants were surveyed anonymously online; participants were asked to rate their comfort level with certain autism-related terms. The survey findings revealed significant differences in preferred language-autistic individuals expressed a strong preference for IFL and for terms that conveyed autism as a part of their identity and did not prefer clinical terms such as 'symptoms of autism' or PFL terms such as 'person with ASD'. In contrast, caregivers and professionals tended to prefer PFL terms and medicalized language. It is likely that societal factors, including Singapore's relatively conservative culture and societal views on autism, influenced these preferences. Awareness of the variations in language preferences among stakeholders in the autism community will help to foster inclusivity, acceptance, and sensitivity toward autistic individuals and their families.