Relationships Between OT Students’ Understandings of Disability and Disability Attitudes

PURPOSE: Occupational therapy students enter programs with established attitudes informed in part by their own cultural backgrounds. Socio-cultural beliefs of disability often characterize people with disability (PWD) as incompetent and other negative stereotypes that devalue the person for their inabilities and create an environment perpetuating prejudice (Nario-Redmond, 2010). Despite grounding our professional philosophy in optimizing clients’ opportunity for full participation in society (AOTA, 2014, p. S4) ableism is embedded throughout interventions, making one reflect on traditional practice approaches aimed at eliminating individual impairment in order to eliminate disability (Hammell, 2015). Understanding student understandings of disability, including negative presumptions of disability, may help guide curriculum design decisions to more equally incorporate social level analysis. Therefore, the purpose of this study was to explore incoming occupational therapy graduate students’ understandings of disability and their implicit (unconscious) and explicit (conscious) attitudes towards it.

DESIGN: This study used mixed methodologies; qualitative content analysis of students’ definitions of disability via an online survey and the Disability Attitudes Implicit Association Test (DA-IAT) to collect quantitative data measuring their implicit attitudes. This allowed examination of relationships between participants’ understandings of disability and their unconscious attitudes towards it. Participants were recruited from three universities’ incoming occupational therapy graduate program student class email lists. Participants voluntarily accessed the study website and completed informed consent.

METHOD: A total of 67 participants completed the DA-IAT to examine implicit attitudes towards PWD using Greenwald et al.’s (2003) updated IAT scoring protocol to determine participants’ implicit disability biases. Participants also answered open-ended survey questions that asked about their demographics, their relationships with disabled people, and other viewpoints including how they define disability. Researchers used the qualitative approach of content analysis to identify themes that emerged from these survey questions. Use of a dialogical intersubjective framework of analysis through multiple rounds of code narrowing and grouping of codes with unifying concepts produced a final code book of themes and sub-themes. We then quantified participants’ definitions of disability using binary indicator coding and used a multiple regression model to explore the relationships between participant meanings of disability (IVs) and their implicit prejudice scores (DV).

RESULTS: Four major themes emerged from the analysis of students’ definitions of disability: (1) individualization; (2) dependence equates disability; (3) disability constructed; and (4) concepts of normal. Findings also revealed students who individualized disability had higher negative disability prejudice than those relating it to the environment or social norms. A multiple linear regression model between the definitions (IVs) and participants’ implicit scores (DV) was significant, F(6,56) = 3.96, p = .002, R ² = .30 and supports development of a theory to explain student attitudes of disability.

CONCLUSION: This presentation examines the themes and associated biases that emerged of student understandings of disability making theoretical links to themes to analyze and understand their implications. We will also describe how attitudes toward disability can be influenced by curriculum design with strategies educators can incorporate, such as methods of student self-reflection, to ensure professional development promotes understandings of disability identified by PWD.

References

American Occupational Therapy Association. (2014). Occupational therapy practice framework:domain and process (3rd ed.). Bethesda, MD: AOTA Press/American Occupational Therapy Association.

Greenwald, A., Nosek, B., Banaji, M. (2003). Understanding and using the implicit association test: I. An improved scoring algorithm. Journal of Personality and Social Psychology. 85(12), 197-216. http://dx.doi.org/10.1037/0022-3514.85.2.197

Hammell, K. R. (2015). Client-centred occupational therapy: the importance of critical perspectives. Scandinavian Journal of Occupational Therapy, 22(4), 237-243. https://doi.org/10.3109/11038128.2015.1004103

Nario-Redmond, M. (2010). Cultural stereotypes of disabled and non-disabled men and women: Consensus for global category representations and diagnostic domains. British Journal of Social Psychology, 49, 471-488. https://doi.org/10.1348/014466609X468411