Examining unconscious bias embedded in provider language regarding children with autism

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.

Differing interpretations of health care encounters: A qualitative study of non-Latinx health care providers’ perceptions of Latinx patient behaviors

“…For example, Latinxs cite experiencing health care discrimination from providers [ 8 , 9 ] and lack of access to helpful HCPs [ 10 ]. A sense of mistrust among Latinx patients for their providers [ 11 – 13 ] and provider bias toward their patients [ 14 , 15 ] are also reported throughout the literature. These racial and ethnic-related barriers have the potential to influence receipt of quality health care [ 11 , 16 ] as research suggests that Latinxs receive lower quality of care compared to non-Latinx white patients, as reported by patient self-report [ 17 ] and also consensus from a panel of experts on health disparities [ 18 ].…”

Factors influencing oral health behaviours, access and delivery of dental care for autistic children and adolescents: A mixed‐methods systematic review

“…A striking example was an older study 76 that referred to the inclusion of ‘mentally retarded’ autistic children, a term that is now startling and offensive. There is current research to evidence more subtle unconscious bias in the language used by dentists when talking about the treatment of autistic children 87 …”

“…There is current research to evidence more subtle unconscious bias in the language used by dentists when talking about the treatment of autistic children. 87 …”

“No one could calm him down”: Mothers’ experience of autism diagnosis and obtainment of resources in an urban public school district.

“…Implicit bias, that is, unintentional prejudice and stereotyping, may have contributed to the difficulties mothers' experienced in interacting with the schools. Como, Florindez, Tran, Cermak, and Stein Duker (2019) reported that implicit biases might be held by health care providers and manifest in language when health care language includes microaggressions, marginalization, and preconceptions, highlighting biases about patients (Como et al, 2019). Professionals might unconsciously use language that could negatively impact patient-provider rapport and increase stigma the already marginalized population of mothers of children with ASD and may effect quality of care (Como et al, 2019).…”