'Not seeing people as capable': Disability professionals' mis/understandings of ableism.

BACKGROUND: Knowledge about how disability professionals understand ableism may provide insight into the production of inequalities. The aim of this study was to examine how disability professionals understand ableism. METHODS: We asked 347 disability professionals, all of whom worked with people with intellectual and developmental disabilities, among other populations, to define ableism and then analysed those definitions using content analysis. RESULTS: The themes about how participants understood ableism were: discrimination; differential treatment; individualization; norms and othering; ableist language; microaggressions; and systems and environments. It was also not uncommon for participants to say ableist things, and express misconceptions in their definitions. This included these themes: avoiding disability; using ableist language; framing disability as in/ability; centring people without disabilities; ignoring invisible disabilities; believing only people without disabilities have bias; and believing ableism does not exist. CONCLUSIONS: Knowing disability professionals' understandings of ableism is necessary to intervene biased attitudes and reduce ableism.

The Influence of Blind Tennis on Subjective Inclusion Experiences-An Ableism-Critical Analysis.

In this paper, we analyze the subjective inclusion experiences of visually impaired (VI) adult tennis players from an ableism-critical perspective. The primary focus of this research is the inclusive potential of blind tennis from the perspective of VI individuals. Episodic interviews were conducted to capture subjective perspectives. A qualitative text analysis revealed that the interviewees were confronted with multiple ability assumptions by sighted people in their everyday lives. Deficit notions on the performance of VI people included sports, work, and general activities. Participation in blind tennis helped the interviewees build a "competent identity" and acquire various skills useful for their everyday lives as participation in blind tennis was a pathway for competence in sports. Further research is needed to identify exclusion experiences from the perspective of disabled people to recognize the potential of different sports in reducing barriers to participation.

Addressing Ableism in Physician Well-Being Planning.

This Viewpoint discusses the importance of physician well-being for optimizing patient care and current efforts to improve physician well-being, describes how structural ableism affects the well-being of physicians with disabilities, and calls for further efforts to address ableism in the health care workforce.

Challenging Disability Discrimination in the Clinical Use of PDMP Algorithms.

State prescription drug monitoring programs (PDMPs) use proprietary, predictive software platforms that deploy algorithms to determine whether a patient is at risk for drug misuse, drug diversion, doctor shopping, or substance use disorder (SUD). Clinical overreliance on PDMP algorithm-generated information and risk scores motivates clinicians to refuse to treat-or to inappropriately treat-vulnerable people based on actual, perceived, or past SUDs, chronic pain conditions, or other disabilities. This essay provides a framework for challenging PDMP algorithmic discrimination as disability discrimination under federal antidiscrimination laws, including a new proposed rule interpreting section 1557 of the Affordable Care Act.

The study of ableism in population health: a critical review.

Over the past three decades, health equity has become a guiding framework for documenting, explaining, and informing the promotion of population health. With these developments, scholars have widened public health's aperture, bringing systems of oppression sharply into focus. Additionally, some researchers in disability and health have advocated for utilizing socially grounded frameworks to investigate the health of disabled people. Yet, naming ableism, much less operationalizing it for the empirical study of health, remains scant. This paper critically reviews the study of ableism as a social determinant of disabled people's health within population health research. First, we provide an orientation to the present state of this literature by looking to the past. We briefly trace a history of traditional approaches to studying disability and health and alternatives that have emerged from critiques of the individualized lens that has dominated this work. Next, we delineate the operation of ableism across social levels. We characterize how ableism has been studied in population health in terms of levels of analysis (intrapersonal, interpersonal, institutional, and structural) and measures of interest. To conclude, we discuss hinderances to and promising avenues toward population health research that advances health equity for disabled people.

Ableism, Code-Switching, and Camouflaging: A Letter to the Editor on Gerlach-Houck and DeThorne (2023).

PURPOSE: This letter to the editor is in response to the Gerlach-Houck and DeThorne (2023) epilogue regarding their proposal for speech-language pathologists to offer Autistic code-switching (Autistic masking and camouflage) as a viable, non-ableist social communication tool that Autistic clients may choose to use in "high-stakes" social situations. In connection with Autistic code-switching, the authors reference "the debate" regarding code-switching in "African American Vernacular English speakers," specifically, whether "standard" English should be encouraged as a way to access "conventional forms of success." CONCLUSION: Professionally training Autistic clients to "code-switch" with the goal of improving the client's chances of accessing conventional forms of success is essentially training Autistic masking and camouflaging. This type of therapy reinforces to both the Autistic client, as well as society, the position that hiding a person's Autistic traits is a pathway to acceptance and success. Autistic camouflaging has detrimental ramifications for mental health outcomes; perpetuates both internalized and societal stigma; hinders bias and discrimination deconstruction; reinforces ableist values; and fails to dismantle power inequities and social barriers that lead to marginalization, oppression, and exclusion.

Social-cognitive biases underlying the development of ableism.

Disabled people are the largest minority group in the world. Like members of many minority groups, they face considerable prejudice and discrimination-known as ableism. Ableism reflects entrenched beliefs about what human bodies and minds should be like and a devaluation of individuals who deviate from that ideal. There is surprisingly little psychological science about ableism, and even less about its development. This chapter considers how social-cognitive biases evident in early childhood could contribute to its development. The chapter is structured around four biases: Prescriptive reasoning, promiscuous teleology, psychological essentialism, and the positivity bias. For each bias, we review foundational research about how it manifests in early childhood, speculate about its connection to ableism, and outline avenues for additional research. Understanding how social-cognitive biases contribute to the development of ableism is an important first step in efforts to equip children (and adults) with the tools to reject it.

Ableism differs by disability, gender and social context: Evidence from vignette experiments.

Existing research on prejudice and discrimination towards disabled people (i.e. 'ableism') has conceptualized it as a general attitude, obscuring the role of social context in its manifestation. We aimed to investigate whether and how ableism manifests differently depending on the nature of the disability, the disabled person's gender and the social context of the interaction. A nationally representative sample of 2000 adults read a series of vignettes about issues faced by disabled people (e.g. employment, relationships). Vignettes varied by presence and type of disability and the disabled person's gender. Judgements about how a disabled person was treated showed clear evidence of ableism towards some conditions (e.g. autism) but not others (e.g. a spine disorder). Judgements about the actions of a disabled person were more nuanced. A disability-gender intersectionality effect was observed for judgements about romantic relationships, with physically disabled women penalized compared to men but no gender difference was observed for intellectual disability. No intersectionality or ableism was observed on a vignette about refusing poorly paid work. We find clear evidence that ableism manifests differently depending on the nature of the individual's disability, their gender and the social context, questioning previous conceptualizations of ableism as a general attitude.

More than just double discrimination: a scoping review of the experiences and impact of ableism and racism in employment.

PURPOSE: Research has shed light on the employment barriers faced by individuals with disabilities, and by racialized people. The challenges faced by people belonging to both marginalized groups are less well-understood. The purpose of this scoping review was to examine existing research on labour market and workplace experiences of racialized people with disabilities, and to identify how ableism and racism intersect to shape employment experiences and outcomes. METHODS: Seven international databases were searched, covering the period from 2000 to April 2022. Four reviewers independently conducted the screening, and data extraction and analysis were performed on 44 articles that met our inclusion criteria. RESULTS: The findings highlighted rates of workplace ableism and racism (including discrimination allegations and perceived discrimination); types and forms of experiences arising from the intersection of ableism and racism (including unique individual stereotyping and systemic and institutional discrimination); and the role of other demographic variables. The intersection of ableism and racism impacted labour market outcomes, well-being in the workplace, and career/professional advancement. CONCLUSIONS: Our review highlights the need for greater in-depth research focusing explicitly on the intersection of ableism and racism (and of other forms of discrimination), to better understand and address the barriers that racialized people with disabilities face in employment.IMPLICATIONS FOR REHABILITATIONThe experiences of racialized people with disabilities have been under explored, and clinicians and rehabilitation specialists should consider incorporating intersectionality into their practices to better understand and serve these populations.Ableism and racism do not operate in isolation, and clinicians and other professionals need to be aware that racialized people with disabilities may face unique challenges and barriers as a result.Service providers should aim to address gaps and inequities in services faced by racialized people with disabilities which may prevent them from finding and/or maintaining meaningful employment.

Confronting the Legacy of Eugenics and Ableism: Towards Anti-Ableist Bioscience Education.

Society and education are inherently ableist. Disabled people are routinely excluded from education, or have poorer outcomes within educational systems. Improving educational experiences and outcomes for people of color has required educators to design antiracist curricula that explicitly address racial inequality. Here, we explore parallel antiableist approaches to bioscience education in an essay coauthored by a disabled bioscience student and able-bodied faculty member in bioscience. Our work is underpinned by Critical Disability Theory and draws on disability and pedagogical scholarship as well as our own experiences. The biosciences has a unique need to confront its history in the discredited pseudoscience of eugenics, which has led to discrimination and human rights abuses against disabled people. We provide a brief history of the relationship between biological sciences research and eugenics and explore how this legacy impacts bioscience education today. We then present a recommended structure for antiableist biology education. Our approach goes beyond providing disability access, to a model that educates all students about disability issues and empowers them to challenge ableist narratives and practices.

The Next Critical Turn for Ageism Research: The Intersections of Ageism and Ableism.

BACKGROUND AND OBJECTIVES: Aging includes multidimensional and multidirectional changes in biology, psychology, and social roles. With aging, individuals experience physiological changes that affect ability, stamina, and reserve capacity. Given the natural occurrence of physical decline accompanying aging, it is essential to understand if fear and prejudice toward disability (ableism) intersect and influence fear and anxiety about aging (ageism). RESEARCH DESIGN AND METHODS: A cross-sectional survey study was conducted using ResearchMatch for study recruitment, 913 individuals responded to questions regarding 3 types of ageism, including affinity for older people, internalized ageism, and relational ageism, as well as internalized and relational ableism. RESULTS: Internalized ageism was significantly associated with relational ageism, fear of physical disability, fear of cognitive disability, and affinity for older people. Relational ageism was associated with internalized ageism, relational ableism, fear of physical disability, fear of sensory disability, fear of cognitive disability, and affinity for older people. DISCUSSION AND IMPLICATIONS: Examining the intersection of ageism and ableism represents the next pivotal juncture to developing effective anti-ageism interventions that address the root anxieties influencing negative attitudes about aging and fears of growing older. Public policy initiatives to address community-level interventions and targeted training to inform discourse that addresses the intersection between ageism and ableism are critical to addressing these issues and promoting age and ability inclusivity.

Examining Ableism Through the Physical Activity Experiences of Blind and Visually Impaired Women.

PURPOSE: This study examined how ableism influences blind and visually impaired women's experiences accessing and engaging in exercise, physical activity, and sport. METHODS: Ten women between the ages of 27 and 45 years completed a one-on-one audio-recorded virtual interview where they reflected on the meaningfulness of their exercise, physical activity, and/or sport experiences, as well as described any experiences related to direct, indirect, systemic, or internalized ableism within or when attempting to access those physical activity experiences. The interview transcripts were analyzed using reflexive thematic analysis. FINDINGS: The analysis resulted in the construction of 2 themes that depicted the participants' experiences: (1) "It's exhausting": navigating inaccessibility and (2) "You feel like a fish out of water": internalized ableism. DISCUSSION: The themes highlight the participants' experiences which were largely focused on being forced to navigate inaccessible environments which resulted in exhaustion and expressions of internalized ableism. These findings provide insight into what makes and does not make a physical activity space accessible and welcoming for blind and visually impaired adults.