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For a long time in film, theater, and television, when a work called for a character with a disability, it was the norm to cast perfectly abled actors in those roles, especially if the role was one of the leads (you still want to cast a big name star in the lead role, despite the character's disability, after all). This was such a norm that the casting of authentically disabled actors as disabled characters has only become more commonplace since the late 1980s, though normally such actors are in supporting or background roles.
This is about when an authentically disabled person is cast, rather than an able-bodied performer.
- In I Am Sam, Sean Penn, of course, is not really developmentally disabled -- but many of the actors who play his housemates are.
- The Farrelly Brothers movie The Ringer is both a satire and a partial aversion. The plot centers around a guy who pretends to be developmentally disabled to get into the Special Olympics as part of a bar bet... and quickly ends up being discovered as a fake by the Special Olympians. Those Special Olympians were actually all played by disabled actors. One became Johnny Knoxville's friend, cameoing in Jackass 3D.
- In Children Of A Lesser God, every deaf character is played by an actual deaf actor.
- Any role Marlee Matlin plays, notable as she's often the lead.
- The only role that Oscar winning actor Harold Russell ever played that was intentionally written as disabled was his role in The Best Years of Our Lives. He played a sailor who lost both hands during World War II (just as Russell himself had in real life). In all his other roles, he played men who just happened to be disabled, but the disability wasn't the point of the character.
- One Flew Over the Cuckoo's Nest used actual inmates of the asylum they filmed in as extras.
- Stuck On You obviously did not feature real conjoined twins (they were played by Greg Kinnear and Matt Damon), but it did feature Ray Valliere, an actor who really does have Downs Syndrome.
- The 1932 movie Freaks featured many legitimately disabled actors, including "Prince Randian" (who was born without limbs), Simon Metz (born with microcephaly, a smaller skull and brain) and Minnie Woolsey (who suffered from Virchow Sekel Syndrome, a combination of skeletal malformation and dwarfism).
- In the opening scene of Saving Private Ryan, a soldier who had just had his legs blown off was played by an actor who had lost his legs years before.
- The anti-drug Jesusplotation horror film Blood Freak has a scene where a guy's leg gets cut off, which they managed to make a bit more convincing by hiring a guy with a prosthetic leg to play the victim.
- In Monty Python and The Holy Grail they hired a man with only one leg to play the Black Knight after Arthur chops one of his legs off.
- The Evil Albino in End of Days was played the genuinely albinistic actor Victor Varnado.
- Jade Callegory, who played the disabled main character in Mac and Me suffers from spina bifida in real life.
- In the remake of Dawn of the Dead 2004, real amputees were used to play some of the zombies. The jogger zombie in the beginning, when the survivors are just arriving at the mall, has lost his arm in real life, and the zombie in the parking garage is actually missing both of his legs.
- In Soul Surfer it is averted and played straight. Bethany Hamilton, whose life story the film was depicting, was played by Anna Sophia Robb in the dialogue scenes. However, when they wanted a stuntwoman to play a one-armed surfer they of course got a one-armed surfer. Guess who she was...
- In the 2010 film of True Grit, a woman missing her left forearm was hired to play the older version of Mattie (whose arm was amputated due to a snake bite near the end) in shots where her face is not seen. She wound up having more screen time than the actress credited with playing older Mattie.
- The Thing has a particularly infamous scene where a man's arms are suddenly bitten off by the titular monster. For two shots that each lasted only a few seconds, there was an actual amputee standing in the actor's place wearing a mask in his likeness.
- Deaf actor Russell Harvard plays an adult H.W. Plainview (rendered deaf from an explosion) in There Will Be Blood.
- An in-universe example: In the novel Dream Park by Larry Niven, Jerry Pournelle, and Stephen Barnes, during the course of an amazingly elaborate Live Action Roleplaying Game that utilizes high-tech special effects, the players encounter (among other things) a one-armed, one-legged zombie played by a one-legged, one-armed actress. The fact that she's real and not a special effect (most of the zombies are holographic) shocks one of the players into inaction enough to allow the amputee zombie to "kill" her.
- Clark Middleton, whose struggle with juvenile rheumatoid arthritis retarded his growth and prevents him from having full range of motion, spent two years on Law and Order as Doctor Ellis, one of the show's Medical Examiners. Ellis's lab has access ramps, lower counters and examination tables, and is built to "little person" scale, something once remarked upon by Lennie Briscoe. Most of Middleton's other roles, however, were characters who just happened to be disabled.
- Geri Jewell, who played Jewel on Deadwood and Geri on The Facts of Life, actually has cerebral palsy.
- S. Robert Morgan, who played Butchie on The Wire, is actually blind.
- Corky from Life Goes On had Down Syndrome, as did Chris Burke, the actor who portrayed him.
- Darryl Mitchell: paraplegic in real life as well as on Ed and Brothers.
- Christopher Reeve's appearances as Doctor Virgil Swann on Smallville.
- Actor Michael Patrick Thornton, who is partially paralyzed and uses a wheelchair regularly (though he can walk for short distances) can regularly be seen playing a doctor who just happens to be in a wheelchair on Private Practice.
- Sue Thomas FB Eye, based on the true story of a deaf FBI agent, features numerous deaf actors playing deaf characters. Most of them, excepting Deanne Bray in the title role and Sue Thomas in a cameo, act entirely in American Sign Language.
- Grandma Esther Walton was depicted as suffering a stroke on The Waltons, after Ellen Corby, the actress who played her, suffered one in 1976.
- During the fourth season of Law and Order: Criminal Intent, Captain Deakins suffered through a bout of Bell's Palsy and was forced to wear an eyepatch for several episodes. This was because the actor playing Deakins, Jamey Sheridan, was actually suffering through a bout of Bell's palsy and was forced to wear an eyepatch.
- All the major deaf characters in Switched at Birth are played by actors with some sort of hearing impairment, most being profoundly deaf.
- Breaking Bad: RJ Mitte has mild cerebral palsy in real life. Walt Jr. was conceived from the start as having it, and Mitte had to learn to walk with crutches and speak less clearly to portray the level of affectation that the show's creator had in mind.
- Robert David Hall, who lost his legs in 1978 when an 18-wheeler crushed his car, plays Dr. Al Robbins on CSI. His character's legs were lost when he was hit by a drunk driver; both Hall and Robbins walk using prosthetics and a cane.
- Both CSI and CSINY have starred Marlee Matlin in roles as deaf characters. On CSI, she played the head of a school for the deaf and Grissom's ex girlfriend, while on CSI NY, she played the deaf mother of a murdered deaf girl.
- Similarly, there's Jim Byrnes on Highlander the Series; both he and his character, Joe Dawson, are double amputees. Byrnes lost his legs in an accident similar to Robert David Hall's, though Joe lost his in Vietnam.
- Star Trek: The Next Generation featured an episode called Loud as a Whisper, about a deaf mediator named Riva. Riva was played by deaf actor Howie Seago, who had petitioned the producers of the show to make an episode about deaf people, mostly to dispel myths about them.
- Actor Mitch Longley was paralyzed in a car accident his senior year in high school. Despite this, he went on to be a very successful actor, with roles on several TV shows and Soap Operas, including one where he played a physician. He was written as "normally" as possible. Any difficulties in mobility were also incorporated into the show--a narrow-minded supervisor was reluctant to let him participate in a surgical rotation, and he was given a groundbreaking storyline in which his character embarked on a romance with another--it was made clear that his injuries had not affected his sexual abilities.
- Actress Amy Ecklund, who was deaf, was hired to play deaf Amish girl Abigail on Guiding Light. She was given typical soap opera storylines, though an attempted rape was made all the more frightening by the fact that she could not hear her attacker creeping up on her. Towards the end of her tenure on the show, both the actress--and consequently her character--had a cochlear implant.
- Glee has both played this trope straight with Becky and Jean (both actresses do have Down Syndrome) and (to much controversy) averted it with Artie.
- In My Name Is Earl, Didi the one-legged woman that Earl slept with (and stole a car and prosthesis from) is played by an actress that does, indeed, have only one real leg.
- Actor J. Grant Albrecht, who uses a wheelchair due to a spinal condition, plays an Assistant District Attorney on In Plain Sight who just happens to be in a wheelchair. His disability has never been mentioned on the show.
- This trope is discussed in-universe and played with in Martin McDonagh's The Cripple of Inishmaan, where the disabled main character attempts to get cast in a film about a crippled boy. He doesn't get the part because the filmmakers would rather "cast a normal fella who can act crippled, than a crippled fella who can't act at all." It's also a moment of Leaning on the Fourth Wall, as the actor who plays Cripple Billy is almost always able-bodied.
- In Unintentionally Pretentious, the actress playing Mia is blind, and that it was simply written into her character.
- In Family Guy episode, Extra Large Medium, the character, Ellen, has Down syndrome, which Andrea Fay Friedman, who provided the voice, also has the condition. When it aired, Sarah Palin called out the writers of the shows for being callous because she’s a grandmother of a Down syndrome sufferer. Friedman called out Palin for using the disabled for political props since she understood the humor in show because everybody is fair game.
- Actor/musician Jim Byrnes lost both his legs in a car accident. Most of his roles are of the "a guy who just happens to not have his legs" type.
- Robert David Hall, who plays the coroner on the original CSI. He also lost his legs in a car accident. The only time in his entire career he was ever hired for a role because of his disability was when he played the amputee Mobile Infantry recruiter in Starship Troopers.
- In a notable inversion of this trope, the late great supporting actor and Hey, It's That Guy! alumnus Dana Elcar played a lot of sighted characters late in his career, after he went completely blind due to glaucoma (though he often played blind characters as well - most notably on MacGyver, when his condition was written into the show). He was just that good an actor.
- Another inversion: veteran British actor Eric Sykes went deaf in the early 1960s, and has been registered blind since the early 1990s. (His distinctive glasses have no lenses, and are a bone-conducting hearing aid.) This hasn't stopped him appearing in post-2000 films like The Others and Harry Potter and the Goblet of Fire, and on the West End stage.
- Some of Michael J. Fox's later work skirts this territory.
- Kurt Dykhuizen, who was born deaf, played Jason on Barney and Friends. He shared some ASL, but his hearing aid never came up in conversation.
- Deaf actress Marlee Matlin is pretty much the go-to person when a female deaf character is wanted (although her deafness is often just a character trait and not the whole point of her being there - she has also inverted this trope by playing a hearing person at least once, in the TV movie Against Her Will: The Carrie Buck Story).
- Deanne Bray does a lot of this as well.
- Alvin Law was born without arms. You may have seen him on an episode of The X-Files wherein he played a minister who... had no arms.
- Amputees In Action is a casting agency specialising in amputee actors and stuntmen, including the actor from the Saving Private Ryan example above. In their words, "The graphic reality of our amputations translates to stunning results on-screen."
- Professional Wrestler Gregory Iron genuinely has Cerebral Palsy, Most bad guys he feuds with will either mock his disability, or claim he is faking his condition.