Examining unconscious bias embedded in provider language regarding children with autism

Nurs Health Sci. 2020 Jun;22(2):197-204. doi: 10.1111/nhs.12617. Epub 2019 Jun 25.

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.

Keywords: autism spectrum disorder; bias; children; healthcare provider; stigma.

MeSH terms

  • Attitude of Health Personnel
  • Autism Spectrum Disorder / psychology
  • Autism Spectrum Disorder / therapy*
  • Bias*
  • California
  • Focus Groups / methods
  • Health Personnel / psychology*
  • Humans
  • Language
  • Professional-Family Relations*
  • Qualitative Research