Title

Language matters: Hidden assumptions of health care professionals caring for children with Autism

1

Location

Studio 1

Start Time

20-10-2017 3:00 PM

End Time

20-10-2017 4:30 PM

Session Type

Research Paper

Abstract

Background: (395 words, excluding headings)

Children with autism spectrum disorders (cASD) experience challenges when receiving medical care1 due to their sensory sensitivities and unique sets of occupational needs. Health care providers (HCPs) have direct contact with cASD and their families, and rely on communication to build relationships and create rapport.2 Language used by HCPs can influence provider-patient encounters, impact the stigma associated with being diagnosed with a disability, and change the way cASD experience health.

Statement of Purpose:

This paper will explore hidden assumptions held by some HCPs toward their patients with ASD, and how those beliefs are expressed in their language and actions.

Methods:

Two focus groups of 9 dental practitioners treating cASD were conducted to describe oral care related challenges experienced by cASD and identify strategies to address them. Each session lasted 2.5-3 hours and was transcribed verbatim. Thematic analysis and grounded theory were used to describe strategies to improve care, with codes developed inductively from the data and informed by sensitizing concepts from the literature. Having completed the analysis focused on strategies, it was clear that there were important aspects of the data that were not accounted for by the initial coding scheme. Additional codes driven by the data emerged related to the hidden biases of dentists when discussing children with ASD and their families.

Results:

Three themes were identified. The first, Healthcare Microaggressions, described instances when HCPs described their patients in a manner that communicated subtle negative opinions. The second theme, Marginalization, denoted the use of exclusionary language, such as “those kids,” which created a sense of otherness, specifically identifying children with ASD as different from “normal” patients. The last theme, Preconceptions, focused on HCPs comments that illuminated subtle biases and opinions they had about their patients, including assumptions about their patients’ cultural backgrounds.

Conclusions:

Focus group findings provide insight into the implicit biases held by HCPs, and how they manifest in their language and interactions with patients. Further research is necessary to understand how these assumptions relate to quality of care.

Relationship to Occupational Science

From an occupational justice perspective, everyone has a right to engage in meaningful occupations3 and be treated with respect. The lives of cASD are affected by the stigma they experience in health care settings. In presenting examples of assumptions embedded in HCPs language, we aim to raise awareness about the significance and consequences of biased communication in the patient-provider relationship, and how to decrease stigma in marginalized populations.

Key Words: Autism, health care provider, children, stigma

Discussion Questions:

  1. How does HCPs language impact how cASD experience health occupations?
  2. How does biased language with marginalized populations fit into our current approach to occupational justice?
  3. How do we reduce stigma in health encounters for cASD?

References

1. Vohra, R., Madhavan, S., Sambamoorthi, U., & St Peter, C. (2014). Access to services, quality of care, and family impact for children with autism, other developmental disabilities, and other mental health conditions. Autism, 18(7), 815-826.

2. Solomon, O., Angell, A. M., Yin, L., & Lawlor, M. C. (2015). “You can turn off the light if you'd like”: Pediatric health care visits for children with Autism Spectrum Disorder as an interactional achievement. Medical Anthropology Quarterly, 29(4), 531-555.

3. Durocher, E., Gibson, B. E., & Rappolt, S. (2014). Occupational justice: A conceptual review. Journal of Occupational Science, 21(4), 418-430.

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Oct 20th, 3:00 PM Oct 20th, 4:30 PM

Language matters: Hidden assumptions of health care professionals caring for children with Autism

Studio 1

Background: (395 words, excluding headings)

Children with autism spectrum disorders (cASD) experience challenges when receiving medical care1 due to their sensory sensitivities and unique sets of occupational needs. Health care providers (HCPs) have direct contact with cASD and their families, and rely on communication to build relationships and create rapport.2 Language used by HCPs can influence provider-patient encounters, impact the stigma associated with being diagnosed with a disability, and change the way cASD experience health.

Statement of Purpose:

This paper will explore hidden assumptions held by some HCPs toward their patients with ASD, and how those beliefs are expressed in their language and actions.

Methods:

Two focus groups of 9 dental practitioners treating cASD were conducted to describe oral care related challenges experienced by cASD and identify strategies to address them. Each session lasted 2.5-3 hours and was transcribed verbatim. Thematic analysis and grounded theory were used to describe strategies to improve care, with codes developed inductively from the data and informed by sensitizing concepts from the literature. Having completed the analysis focused on strategies, it was clear that there were important aspects of the data that were not accounted for by the initial coding scheme. Additional codes driven by the data emerged related to the hidden biases of dentists when discussing children with ASD and their families.

Results:

Three themes were identified. The first, Healthcare Microaggressions, described instances when HCPs described their patients in a manner that communicated subtle negative opinions. The second theme, Marginalization, denoted the use of exclusionary language, such as “those kids,” which created a sense of otherness, specifically identifying children with ASD as different from “normal” patients. The last theme, Preconceptions, focused on HCPs comments that illuminated subtle biases and opinions they had about their patients, including assumptions about their patients’ cultural backgrounds.

Conclusions:

Focus group findings provide insight into the implicit biases held by HCPs, and how they manifest in their language and interactions with patients. Further research is necessary to understand how these assumptions relate to quality of care.

Relationship to Occupational Science

From an occupational justice perspective, everyone has a right to engage in meaningful occupations3 and be treated with respect. The lives of cASD are affected by the stigma they experience in health care settings. In presenting examples of assumptions embedded in HCPs language, we aim to raise awareness about the significance and consequences of biased communication in the patient-provider relationship, and how to decrease stigma in marginalized populations.

Key Words: Autism, health care provider, children, stigma

Discussion Questions:

  1. How does HCPs language impact how cASD experience health occupations?
  2. How does biased language with marginalized populations fit into our current approach to occupational justice?
  3. How do we reduce stigma in health encounters for cASD?