IDEAS home Printed from https://ideas.repec.org/a/wly/nuhsci/v22y2020i2p197-204.html

Examining unconscious bias embedded in provider language regarding children with autism

Author

Listed:
  • Dominique H. Como
  • Lucía I. Floríndez
  • Christine F. Tran
  • Sharon A. Cermak
  • Leah I. Stein Duker

Abstract

In healthcare settings, language used by healthcare providers can influence provider–patient encounters with individuals with autism spectrum disorder, impacting feelings of stigma and marginalization. This study highlights the unconscious biases healthcare providers might have regarding their patients with autism spectrum disorder and how those beliefs are articulated. Seven pediatric dentists participated in two focus groups to describe strategies to improve oral care for children with autism spectrum disorder. While completing the primary analyses, additional codes emerged related to healthcare provider biases; these data are the focus of this study. Three themes were identified: (i) “healthcare microaggressions” describe how healthcare providers portray their patients in subtly negative ways; (ii) “marginalization” denotes the use of exclusionary language identifying children with autism spectrum disorder as different; and (iii) “preconceptions” include comments that highlight biases about patients. The findings provide insight into the implicit biases that might be held by healthcare providers and how they manifest in language. Despite increased emphasis on cultural competency, healthcare providers might unconsciously use language that could negatively impact patient–provider rapport and increase stigma in already marginalized populations. Further research is necessary to explore how these biases could relate to quality of care.

Suggested Citation

  • Dominique H. Como & Lucía I. Floríndez & Christine F. Tran & Sharon A. Cermak & Leah I. Stein Duker, 2020. "Examining unconscious bias embedded in provider language regarding children with autism," Nursing & Health Sciences, John Wiley & Sons, vol. 22(2), pages 197-204, June.
    • Handle: RePEc:wly:nuhsci:v:22:y:2020:i:2:p:197-204
    DOI: 10.1111/nhs.12617
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/nhs.12617
    Download Restriction: no
    File URL: https://libkey.io/10.1111/nhs.12617?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Mojtaba Vaismoradi & Hannele Turunen & Terese Bondas, 2013. "Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study," Nursing & Health Sciences, John Wiley & Sons, vol. 15(3), pages 398-405, September.
    2. Hall, W.J. & Chapman, M.V. & Lee, K.M. & Merino, Y.M. & Thomas, T.W. & Payne, B.K. & Eng, E. & Day, S.H. & Coyne-Beasley, T., 2015. "Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review," American Journal of Public Health, American Public Health Association, vol. 105(12), pages 60-76.
    3. Mitchell, D.A. & Lassiter, S.L., 2006. "Addressing health care disparities and increasing workforce diversity: The next step for the dental, medical, and public health professions," American Journal of Public Health, American Public Health Association, vol. 96(12), pages 2093-2097.
    4. Tajeu, G.S. & Cherrington, A.L. & Andreae, L. & Prince, C. & Holt, C.L. & Halanych, J.H., 2015. ""We'll get to you when we get to you": Exploring potential contributions of health care staff behaviors to patient perceptions of discrimination and satisfaction," American Journal of Public Health, American Public Health Association, vol. 105(10), pages 2076-2082.
    5. Sabin, J.A. & Greenwald, A.G., 2012. "The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: Pain, urinary tract infection, attention deficit hyperactivity disorder, and asthma," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 988-995.
    6. Green, Sara E., 2003. ""What do you mean 'what's wrong with her?'": stigma and the lives of families of children with disabilities," Social Science & Medicine, Elsevier, vol. 57(8), pages 1361-1374, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Dominique H. Como & Lucía I. Floríndez-Cox & Leah I. Stein Duker & Sharon A. Cermak, 2022. "Oral Health Barriers for African American Caregivers of Autistic Children," IJERPH, MDPI, vol. 19(24), pages 1-14, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Penner, Louis A. & Harper, Felicity W.K. & Dovidio, John F. & Albrecht, Terrance L. & Hamel, Lauren M. & Senft, Nicole & Eggly, Susan, 2017. "The impact of Black cancer patients' race-related beliefs and attitudes on racially-discordant oncology interactions: A field study," Social Science & Medicine, Elsevier, vol. 191(C), pages 99-108.
    2. Freda F. Liu & Jessica Coifman & Erin McRee & Jeff Stone & Amy Law & Larissa Gaias & Rosemary Reyes & Calvin K. Lai & Irene V. Blair & Chia-li Yu & Heather Cook & Aaron R. Lyon, 2022. "A Brief Online Implicit Bias Intervention for School Mental Health Clinicians," IJERPH, MDPI, vol. 19(2), pages 1-19, January.
    3. Ursula Meidert & Godela Dönnges & Thomas Bucher & Frank Wieber & Andreas Gerber-Grote, 2023. "Unconscious Bias among Health Professionals: A Scoping Review," IJERPH, MDPI, vol. 20(16), pages 1-28, August.
    4. Maina, Ivy W. & Belton, Tanisha D. & Ginzberg, Sara & Singh, Ajit & Johnson, Tiffani J., 2018. "A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test," Social Science & Medicine, Elsevier, vol. 199(C), pages 219-229.
    5. Drewniak, Daniel & Krones, Tanja & Sauer, Carsten & Wild, Verina, 2016. "The influence of patients’ immigration background and residence permit status on treatment decisions in health care. Results of a factorial survey among general practitioners in Switzerland," Social Science & Medicine, Elsevier, vol. 161(C), pages 64-73.
    6. Jose David Martinez Otalora & Jie Shen & Anyela Piedad Rojas Celis, 2025. "Knowledge graph-enhanced pattern language for biodiversity integration in architectural education," Humanities and Social Sciences Communications, Palgrave Macmillan, vol. 12(1), pages 1-13, December.
    7. Emmanuel Songsore & Michael Buzzelli, 2016. "Ontario’s Experience of Wind Energy Development as Seen through the Lens of Human Health and Environmental Justice," IJERPH, MDPI, vol. 13(7), pages 1-18, July.
    8. Ana Cristina Lindsay & Sherrie F. Wallington & Faith D. Lees & Mary L. Greaney, 2018. "Exploring How the Home Environment Influences Eating and Physical Activity Habits of Low-Income, Latino Children of Predominantly Immigrant Families: A Qualitative Study," IJERPH, MDPI, vol. 15(5), pages 1-13, May.
    9. repec:plo:pone00:0219761 is not listed on IDEAS
    10. Borch, Kristian & Munk, Anders K. & Dahlgaard, Vibeke, 2020. "Mapping wind-power controversies on social media: Facebook as a powerful mobilizer of local resistance," Energy Policy, Elsevier, vol. 138(C).
    11. Caro Wolfner & Corilyn Ott & Kalani Upshaw & Angela Stowe & Lisa Schwiebert & Robin Gaines Lanzi, 2023. "Coping Strategies and Help-Seeking Behaviors of College Students and Postdoctoral Fellows with Disabilities or Pre-Existing Conditions during COVID-19," Disabilities, MDPI, vol. 3(1), pages 1-25, February.
    12. Christopher Mulwanda & Vincent R. Nyirenda & Ngawo Namukonde, 2024. "Traditional ecological knowledge, perceptions and practices on insect pollinator conservation: A case of the smallholder farmers in Murundu ward of Mufulira mining district of Zambia," Journal of Environmental Studies and Sciences, Springer;Association of Environmental Studies and Sciences, vol. 14(1), pages 24-35, March.
    13. Warren Kealy-Bateman & Georgina M. Gorman & Adam P. Carroll, 2021. "Patient/Consumer Codesign and Coproduction of Medical Curricula: A Possible Path Toward Improved Cultural Competence and Reduced Health Disparity," SAGE Open, , vol. 11(2), pages 21582440211, June.
    14. Chapman, Mimi V. & Hall, William J. & Lee, Kent & Colby, Robert & Coyne-Beasley, Tamera & Day, Steve & Eng, Eugenia & Lightfoot, Alexandra F. & Merino, Yesenia & Simán, Florence M. & Thomas, Tainayah , 2018. "Making a difference in medical trainees' attitudes toward Latino patients: A pilot study of an intervention to modify implicit and explicit attitudes," Social Science & Medicine, Elsevier, vol. 199(C), pages 202-208.
    15. Brian D. Schwartz & Alexis Horst & Jenifer A. Fisher & Nicole Michels & Lon J. Van Winkle, 2020. "Fostering Empathy, Implicit Bias Mitigation, and Compassionate Behavior in a Medical Humanities Course," IJERPH, MDPI, vol. 17(7), pages 1-15, March.
    16. Rebecca A. Johnson & David L. Albright & James R. Marzolf & Jessica L. Bibbo & Hayley D. Yaglom & Sandra M. Crowder & Gretchen M. Carlisle & Karen Grindler & Nathan Harms & Amy Willard & Marita Wassma, 2021. "Experiences of Military Veterans in a Therapeutic Horseback Riding Program," Clinical Nursing Research, , vol. 30(7), pages 923-933, September.
    17. Hideyo Tsumura & Wei Pan & Debra Brandon, 2024. "Exploring Differences in Intraoperative Medication Use Between African American and Non-Hispanic White Patients During General Anesthesia: Retrospective Observational Cohort Study," Clinical Nursing Research, , vol. 33(6), pages 470-480, July.
    18. Carla Brailey & Brittany C. Slatton, 2024. "Centering Black Women’s Voices: Illuminating Systemic Racism in Maternal Healthcare Experiences," Societies, MDPI, vol. 14(5), pages 1-12, May.
    19. Oliver Laasch & Dirk C. Moosmayer & Frithjof Arp, 2020. "Responsible Practices in the Wild: An Actor-Network Perspective on Mobile Apps in Learning as Translation(s)," Journal of Business Ethics, Springer, vol. 161(2), pages 253-277, January.
    20. Grazia Salvo & Bonnie M. Lashewicz & Patricia K. Doyle-Baker & Gavin R. McCormack, 2018. "Neighbourhood Built Environment Influences on Physical Activity among Adults: A Systematized Review of Qualitative Evidence," IJERPH, MDPI, vol. 15(5), pages 1-21, May.
    21. Chilombo, Andrew & Van Der Horst, Dan, 2021. "Livelihoods and coping strategies of local communities on previous customary land in limbo of commercial agricultural development: Lessons from the farm block program in Zambia," Land Use Policy, Elsevier, vol. 104(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:nuhsci:v:22:y:2020:i:2:p:197-204. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://doi.org/10.1111/(ISSN)1442-2018 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.