ABBREVIATIONS
CATCHChedoke-McMaster Attitudes Towards Children with Handicaps STROBE Strengthening the Reporting of Observational Studies in Epidemiology AIM The aim of this review was to systematically review and synthesize observational evidence of associations between children's naturally varying contact with people with disabilities and their attitudes towards disability.METHOD A comprehensive search was conducted across multiple databases. Studies were included if they measured children's contact with people with disabilities and their attitudes towards disability. Qualitative research and studies that experimentally varied the amount of contact children had were excluded. Data were synthesized in a narrative review.RESULTS There were 35 studies that met the inclusion criteria: 22 of these reported a statistically significant association between contact with people with disabilities and more positive attitudes towards disability; two studies reported a negative association between contact and attitudes; and 11 studies reported no association. Incomplete reporting of the methods and results across studies limited the conclusions that could be drawn.
INTERPRETATION Studies identified in this review generally indicate that children's contactwith people with disabilities is associated with more positive attitudes towards disability. There is a need for more rigorous research to examine the effect of children's contact with people with disabilities on their attitudes towards disability.Children with disabilities are often the targets of negative attitudes. Parents of children with disabilities have described how negative attitudes are more disabling than their child's impairments. 1 A meta-analysis of studies published between 1990 and 2000 found that, generally, children have better attitudes towards children without disabilities than they do towards those with physical or intellectual impairments.2 Furthermore, in a cohort study conducted over 3 years, between 21% and 30% of children with disabilities experienced peer victimization, as reported by their parents.3 Experiencing negative attitudes and being victimized by peers is associated with self-blame, loneliness, anxiety, and low self-worth. 4 Therefore, it is important to understand negative attitudes towards disability and the factors associated with those attitudes.A series of psychological interventions derived from the 'contact hypothesis' 5 have been designed to promote positive attitudes towards a range of social groups. By creating positive interactions (contact) between members of different social groups, negative attitudes may be reduced. 6 Positive contact can break down psychological group boundaries, reduce anxiety, and elicit emotions such as empathy directed towards outgroup members who are otherwise often inhibited in intergroup contexts.7 A systematic review and meta-analysis of studies involving a range of intergroup contexts suggested that contact is nearly always successful in improving attitudes and reducing prejudice. 6 However, the re...