Mapping the scientific knowledge and approaches to defining and measuring hate crime, hate speech, and hate incidents: A systematic review

Background

The difficulties in defining hate crime, hate incidents and hate speech, and in finding a common conceptual basis constitute a key barrier toward operationalisation in research, policy and programming. Definitions disagree about issues such as the identities that should be protected, the types of behaviours that should be referred to as hateful, and how the 'hate element' should be assessed. The lack of solid conceptual foundations is reflected in the absence of sound data. These issues have been raised since the early 1990s (Berk, 1990; Byers & Venturelli, 1994) but they proved to be an intractable problem that continues to affect this research and policy domain.

Objectives

Our systematic review has two objectives that are fundamentally connected: mapping (1) original definitions and (2) original measurement tools of hate crime, hate speech, hate incidents and surrogate terms, that is, alternative terms used for these concepts (e.g., prejudice-motivated crime, bias crime, among many others).

Search Methods

We systematically searched over 19 databases to retrieve academic and grey literature, as well as legislation. In addition, we contacted 26 country experts and searched 211 websites, as well as bibliographies of published reviews of related literature, and scrutiny of annotated bibliographies of related literature.

Inclusion Criteria

This review included documents published after 1990 found in academic literature, grey literature and legislation. We included academic empirical articles with any study design, as well as theoretical articles that focused specifically on defining hate crime, hate speech, hate incidents or surrogate terms. We also reviewed current criminal or civil legislation that is intended to regulate forms of hate speech, hate incidents and hate crimes. Eligible countries included Canada, USA, UK, Ireland, Germany, France, Italy, Spain, Australia and New Zealand. For documents to be included in relation to research objective (1), they had to contain at least one original definition of hate speech, hate incidents or hate crimes, or any surrogate term. For documents to be included in relation to research objective (2), they had to contain at least one original measurement tool of hate speech, hate incidents or hate crimes, or any surrogate term. Documents could be included in relation to both research objectives.

Data Collection and Analysis

The systematic search covered 1 January 1990 to 31 December 2021, with searches of academic databases conducted between 8th March and 12th April 2022 yielding 35,191 references. We carried out country-specific searches for grey literature published in the same time period between 27th August and 2nd December 2021. These searches yielded a total of 2748 results. We coded characteristics of the definitions and measurement tools, including the protected characteristics, the approaches to categorise the 'hate element' and other variables. We used univariate and bivariate statistical methods for data analysis. We also carried out a social network analysis.

Main Results

We provide as annex complete lists of the original definitions and measurement tools that met our inclusion criteria, for the use of researchers and policy makers worldwide. We included 423 definitions and 168 measurement tools in academic and grey literature, and 83 definitions found in legislation. To support future research and policy work in this area, we included a synthetic assessment of the (1) the operationalisability of each definition and (2) the theoretical robustness and transparency of each measurement tool. Our mapping of the definitions and measurement tools revealed numerous significant trends, clusters and differences between and within definitions and measurement tools focusing on hate crime, hate speech and hate incidents. For example, definitions and measurement tools tend to focus more on ethnic and religious identities (e.g., racism, antisemitism, Islamophobia) compared to sexual, gender and disability-related identities. This gap is greater in the definitions and measurement tools of hate speech than hate crime. Our analysis showed geographical patterns: hate crime definitions and measurement tools are more likely to originate from Anglophonic countries, especially the USA, but hate speech definitions and measurement tools are more likely to originate from continental Europe. In terms of disciplinary fragmentation, our social network analysis revealed that the collaboration and exchange of conceptual frameworks and methodological tools between social sciences and computer science is limited, with most definitions and measurement tools clustering along disciplinary lines. More detailed findings are presented in the results section of the report.

Authors' Conclusions

There is an urgent need to close the research and policy gap between the protections of 'ethnic and religious identities' and other (less) protected characteristics such as gender and sexual identities, age and disability. There is also an urgent need to improve the quality of methodological and reporting standards in research examining hate behaviours, including transparency in methodology and data reporting, and discussion of limitations (e.g., bias in data). Many of the measurement tools found in the academic literature were excluded because they did not report transparently how they collected and analysed the data. Further, 41% of documents presenting research on hate behaviours did not provide a definition of what they were looking at. Given the importance of this policy domain, it is vital to raise the quality and trustworthiness of research in this area. This review found that researchers in different disciplinary areas (e.g., social sciences and computer science) rarely collaborate. Future research should attempt to build on existing definitions and measurement tools (instead of duplicating efforts), and engage in more interdisciplinary collaborations. It is our hope that that this review can provide a solid foundation for researchers, government, and other bodies to build cumulative knowledge and collaboration in this important field.

Relegated to the Sidelines: A Qualitative Inquiry of Gatekeepers' Perspectives and Values of Physical Education for Disabled Children

Several institutional aspects within the U.S. public school system impede the delivery of adapted physical education (APE) services to disabled children, including a lack of understanding and prioritization of these services by the special education team and a lack of qualified APE professionals to deliver these services. Thus, we conducted a qualitative inquiry grounded in a critical-ableism perspective to explore special education gatekeepers' experiences and perspectives of APE. Gatekeepers included parents, physical educators, and school administrators. Using a reflexive thematic analysis, we developed four interrelated themes: (a) disregard, negative, and charity mindsets toward disability; (b) systemic challenges in valuing and prioritizing APE; (c) presence as inclusion: (un)intentional marginalization in physical education; and (d) physical education for my child was a nightmare. These findings illustrate the complexities around the provision of physical education and APE to disabled children.

Athletes' Perspectives of the Classification System in Para Alpine Skiing for Those With Visual Impairment

This study explored the classification experiences and views of Para Alpine skiers with visual impairment. Data from 11  interviews were analyzed using reflexive thematic analysis to generate three themes: Suitability-The skiers questioned the suitability of the visual measurements, testing environment, and the information they received regarding classification; Exclusivity-Skiers felt certain aspects of the system remain exclusive due to the restrictions of sport classes and lack of the athlete voice; and (Dis)trust-Skiers felt distrust in those implementing the system and in other athletes due to intentional misrepresentation. Speculation surrounding this resulted in the skiers' feeling doubt in their own classification. While there is not a "one size fits all" approach to classification, understanding skiers' experiences can be a vital first step and will help to guide future research into the evolution of this sport's classification.

Adolescents' implicit and explicit attitudes toward their peers with genetic conditions

INTRODUCTION

Previous research has demonstrated that children lacking knowledge about genetic disorders may have harmful attitudes toward people with disabilities, but disability awareness can successfully modify these attitudes. We explored adolescents' implicit and explicit attitudes toward peers with genetic conditions to determine whether improved genetics/genomics literacy can mitigate the impact of ableism in this population.

METHODS

English-speaking adolescents (10-18 years) from British Columbia were invited to complete a Disability Attitudes Implicit Association Test (DA-IAT) and participate in a semi-structured focus group centering on a fictionalized vignette about an adolescent with Down syndrome. We used pragmatism as an analytical paradigm. Descriptive and inferential statistics were used to analyze DA-IAT and sociodemographic data; phronetic iterative analysis with constant comparison as a coding strategy for transcripts; and interpretive description to develop a conceptual model.

RESULTS

Twenty-two adolescents completed the DA-IAT and participated in one of four focus groups. Participants had a statistically significant implicit preference for non-disabled people (D-score = 0.72, SD = 0.44; t = 7.18, p < .00001). They demonstrated greater diversity in their explicit attitudes during the focus groups. Although participants articulated a positive attitude toward improved genetics education, results demonstrate their belief that social and personal interactions with disabled peers would be essential to address negative perceptions.

CONCLUSIONS

This study lays important groundwork to understand, explain, and influence the negative attitudes of adolescents toward individuals with disabilities. Findings will be used to inform the design of interventions that address biased perceptions of people with genetic disorders, with the goal of reducing prejudices and improving social interactions.

'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 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.

A Systematic Literature Review of the Impact of COVID-19 on the Health of LGBTQIA+ Older Adults: Identification of Risk and Protective Health Factors and Development of a Model of Health and Disease

It is important to understand the differential impact of COVID-19 on the health of older lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and people with other sexual orientations and forms of gender expression (LGBTQIA+). The objective of this study is to systematically review the impact of COVID-19 on LGBTQIA+ older adults' health including risk and protective factors. We reviewed a total of 167 records including LGBTQIA+ older adults published since 2019. Two independent reviewers screened titles and abstracts and extracted information of 21 full-text records meeting inclusion criteria using COVIDENCE software. The results show that the negative health consequences are exacerbated by personal risk (e.g., perceived homo/transphobia and ageism in LGBTQIA+ communities) and environmental factors (e.g., heterosexism within health services). The negative impact seems to be reduced by personal protective (e.g., resilience, spirituality, and hobbies) and environmental factors (e.g., technology use to increase social participation and social rituals). In conclusion, the health of LGBTQIA+ older adults has been disproportionately affected during the pandemic associated to the latest coronavirus (COVID-19). The experiences of LGBTQIA+ older adults during the pandemic are integrated in a Model of Health and Disease for LGBTQIA+ older adults. Specific strategies to promote health and well-being in this community are provided.

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.

Twelve tips for including disability education in undergraduate medical education

Disability is a large and growing minority population worldwide. People with disabilities continue to experience health and healthcare disparities. Despite multiple calls to action to provide disability education within undergraduate medical education as a strategy to mitigate ongoing inequities, robust disability education is not routinely provided across medical schools. This article provides twelve tips that any medical school faculty can utilize to integrate meaningful disability education within existing core medical education.

NICU Language, Everyday Ethics, and Giving Better News: Optimizing Discussions about Disability with Families

The Neonatal Intensive Care Unit (NICU) has a language and culture that is its own. For professionals, it is a place of intense and constant attention to microdetails and cautious optimism. For parents, it is a foreign place with a new and unique language and culture. It is also the setting in which they are introduced to their child and parenthood for this child. This combination has been referred to as an emotional cauldron. The neonatal ethics literature mainly examines complex ethical dilemmas about withholding/drawing life sustaining interventions for fragile children. Rarely are everyday ethics or mundane ethics discussed. Microethics describe the mundane, discrete moments that occur between patients/families and clinicians. A key piece of these microethics is the language used to discuss patient care. Perception of prognoses, particularly around long-term neurodevelopmental outcome, is shaped with the language used. Despite this, clinicians in the NICU often have no specific training in the long-term neurodevelopment outcomes that they discuss. This paper focuses on the microethics of language used to discuss long-term neurodevelopmental outcomes, the developmental neuroscience behind language processing, and offers recommendations for more accurate and improved communication around long-term outcomes with families with critically ill neonates.

The double bind of social legitimacy: On disability, the sick role, and invisible work

During the last few decades, the human rights paradigm has shifted the normative status of disabled people, providing, in principle, the right to full and equal participation. Particularly in neoliberal economies, however, participation in work life is a major constraint on social legitimacy, creating a predicament for people who cannot adhere to the ideal of the 'productive member of society'. In this article, I explore this predicament at the intersection of disability studies and the sociology of health and illness, reviewing literature and discussing key concepts. I argue that in neoliberal societies, two distinct and largely incompatible pathways to social legitimacy depend, respectively, on (a) a version of the classical sick role and (b) a more recently constituted able-disabled role. Of these, the first pathway has mainly been explored and critiqued in the sociology of health and illness, while the second features mainly in disability studies. However, both pathways can be understood (1) as ableist mechanisms for maintaining adherence to values of productivity and by (2) imposing on disabled people an unequal burden of invisible work-a key feature of ableism, driving inequality both within the group of disabled people and for the group as a whole.

Effects of a disability-simulating learning unit on ableism of final-year dental students - a pilot study

OBJECTIVES

This study aimed to describe a disability-simulating learning unit (DSLU) to raise dental students' awareness of the special needs of patients with disabilities as well as to measure the effect of the DSLU on ableism.

METHODS

A DSLU among final-year undergraduate dental students (n = 33), was developed and evaluated. The students were randomly divided into two groups (Group I, n = 17; Group II, n = 16). Group II only received conventional teaching (control group), whereas Group I was additionally exposed to the DSLU (intervention group). In the DSLU, typical physical restrictions and the associated difficulties in attending dental appointments were simulated with the help of simulation suits. Four different stations offered the opportunity to experience typical signs of disability in a dental context. About 2 months after the DSLU, both groups were asked to answer the Symbolic Ableism Scale (SAS). An analysis was conducted to examine the participants' average total score and several subscores. The Mann-Whitney U Test was employed to control the differences between the study groups.

RESULTS

Overall, the students in the intervention group had a significantly (p = .001) lower mean SAS summary score (median = .37; IQR .32-.42) than the students in the control group (median = .50; IQR .39-.53). For the components "individualism" (p < .0001) and "excessive demands" (p = .002) significant group differences could be observed.

CONCLUSION

The DSLU is a potentially feasible and effective method for influencing students' ableism attitude.

Individuals experiencing disability and the ableist physical literacy narrative: critical considerations and recommendations for practice

Physical literacy (PL) has been readily accepted and integrated globally, including organizations affording services to individuals experiencing disability. Despite its uptake, recent research has illustrated that understandings of PL reflect the normative standards of those who do not experience disability, leading to practices that diminish the unique and embodied capability of others while simultaneously validating ableism. While a shift towards recognizing and valuing the heterogeneity associated with PL has recently occurred, the ableist narrative persists. As a result, the operationalization of PL directly contradicts its conceptualization, fostering a physical activity climate that continues to marginalize individuals experiencing disability. With this in mind, this paper critically unpacks PL, challenging the existing ableist narrative and offering suggestions to heighten the level of inclusivity that underscores PL. Pathways, where physical activity professionals contribute to reproducing ableism, will be discussed.

Drawing on critical disability and universal design perspectives within occupational therapy

BACKGROUND

Critical perspectives which focus on socio-political influences on occupation have gained increased attention within the occupational therapy profession. Critical disability studies (CDS) question prevailing assumptions about disability and how disabling ideologies and practices are perpetuated in society. Universal Design (UD) is a design approach that aims to operationalise issues of inclusion and justice.

AIM

To identify and discuss how the tenets of CDS and UD can contribute to occupational therapy practice and research.

METHODS AND RESULTS

Drawing on the writings of leading scholars within CDS, UD and occupational therapy, we demonstrate the intertwined barriers faced by disabled children, youth, and adults who have participated in our studies and provide ideas on how practice can be guided by the tenets of CDS and UD to promote social equity.

CONCLUSIONS

Incorporating CDS and UD perspectives in occupational therapy practice and research requires a change in mindset and ways of working. Occupational therapy knowledge needs to be expanded to scrutinise disabling hindrances hidden within social and structural spaces, and implemented in services. We recommend working with disability communities to raise awareness and combat disabling barriers at various level of society, as mandated by policy.

Anti-ableism and scientific accuracy in autism research: a false dichotomy

It was recently argued that autism researchers committed to rejecting ableist frameworks in their research may sacrifice "scientifically accurate" conceptualizations of autism. In this perspective piece, we argue that: (a) anti-ableism vs. scientific accuracy is a false dichotomy, (b) there is no ideology-free science that has claim to scientific accuracy, and (c) autism science has a history of false leads in part because of unexamined ableist ideologies that undergird researcher framings and interpretations of evidence. To illustrate our claims, we discuss several avenues of autism research that were promoted as scientific advances, but were eventually debunked or shown to have much less explanatory value than initially proposed. These research programs have involved claims about autism etiology, the nature of autism and autistic characteristics, and autism intervention. Common to these false leads have been ableist assumptions about autism that inform researcher perspectives. Negative impacts of this work have been mitigated in some areas of autism research, but these perspectives continue to exert influence on the lives of autistic people, including the availability of services, discourses about autism, and sociocultural conceptualizations of autistic people. Examining these false leads may help current researchers better understand how ableism may negatively influence their areas of inquiry. We close with a positive argument that promoting anti-ableism can be done in tandem with increasing scientific accuracy.

Disability Is Not a Burden: The Relationship between Early Childhood Disability and Maternal Health Depends on Family Socioeconomic Status

Narratives rooted in ableism portray disabled children as burdens on their families. Prior research highlights health disparities between mothers of disabled children and mothers of nondisabled children, but little is known about how socio-structural contexts shape these inequities. Using longitudinal data from the Future of Families and Child Wellbeing Study (n = 2,338), this study assesses whether the relationship between early childhood disability and maternal health varies by household socioeconomic status (SES). Findings reveal that, on average, mothers of children disabled by age five report worse health than mothers of nondisabled children; however, this pattern is only evident among lower SES mothers and disappears for higher SES mothers. Contextualizing the findings within the systemic ableism literature highlights how-instead of portraying disabled children as burdens on their families-scholars and policymakers should focus on how ableism and poverty burden disabled people and their families in ways that pattern health risks.

A call to action for disability and rehabilitation research using a DisCrit and Disability Justice framework

PURPOSE

Disability and ableism exist within a societal context that does not ignore the many facets of a person's identity, however often our disability research does not recognize how experiences vary based on the intersecting identities individuals hold. This article utilizes Intersectionality, Dis/ability Critical Race Studies (DisCrit), and Disability Justice to identify ways for rehabilitation researchers to adapt their research practices for maximum inclusivity and representation.

MATERIALS AND METHODS

Using these three frameworks, we have developed a call to action including recommendations for rehabilitation researchers to consider as they design and implement research projects.

RESULTS

Incorporating these frameworks provides an opportunity to reimagine current research practices.

CONCLUSIONS

An accessible approach can help researchers better understand and report on the nuances of intersecting identities on the lives of disabled people.Implications For RehabilitationDisability identity and ableism must be viewed intersectionally, and disability related research must attend to the many facets of a person's identity.Intersectionality, DisCrit, and Disability Justice provide useful frameworks through which we can conduct more inclusive and accessible disability research.We present a call-to-action including seven general considerations that researchers can implement to guide the development of intersectional and inclusive disability research.

The Meaning of Physical Literacy for Instructors of Children Experiencing Disability, from an Ecological Systems Perspective

With the rapid and widespread uptake of physical literacy (PL), there is potential for instructors to devalue participation of children who experience disability. The aim of the investigation was to understand how instructors who facilitate physical activity for children experiencing disability make sense of PL, and more specifically, how these instructors bring meaning to PL. Using interpretive phenomenological analysis, six instructors engaged in individual, semi-structured interviews. The study rationale was underpinned by the conceptual framework of ecological systems theory, which provided a foundation for the research, guided the structure of the interview guide, and facilitated a reflexive interpretation of the findings. Four themes were generated: Recognizing unique embodiments, The importance of context, Beyond physical competence, and Navigating PL's dominant discourse. The instructors' meaning of PL, impacted by relational and environmental influences, reflected the importance of movement skill development, while also embracing diverse embodiment and pedagogical flexibility by giving value to exploratory play, partial participation, family involvement, and willingness to abandon rigid lessons plans.

"It just makes you more vulnerable as an employee": Understanding the effects of disability stigma on employment in Parkinson's disease

OBJECTIVE

Parkinson's disease (PD) is one of the most common neurodegenerative diseases in the United States, affecting approximately 1 million Americans. However, there is a dearth of research on the employment experiences of individuals with PD. This research article makes a crucial contribution to the literature by examining the role of disability stigma in shaping employment options in PD, with relevance to the experiences of adults with chronic and/or progressive diseases more broadly.

METHODS

The author conducted individual semi-structured interviews with 23 adults under the age of 65 with PD. Interviews were audio-recorded and transcribed. The author utilized an integrated approach to analysis, primarily employing a thematic analysis approach. Additionally, a narrative analysis strategy, the Listening Guide, was integrated into the broader thematic analysis to deepen analysis of discrimination and stigma.

RESULTS

Findings demonstrate how internalized, anticipated and/or experienced disability-related stigma profoundly affects employment experiences, influencing participants' work outcome expectations and acting as an employment barrier.

DISCUSSION

Findings have implications for health care practice and education, disability policy, early intervention strategies after the onset of PD and priorities for future research.

Home Care in America: The Urgent Challenge of Putting Ethical Care into Practice

Home care is one of the fastest-growing industries in the United States, providing valuable opportunities for millions of older adults and people with disabilities to live at home rather than in institutional settings. Home care workers assist clients with essential activities of daily living, but their wages and working conditions generally fail to reflect the importance of their work. Drawing on the work of Eva Feder Kittay and other care ethicists, we argue that good care involves attending to the needs of another out of a concern for their well-being. Such care should be standard in the home care system. Yet, because of the pervasive racial, gender, and economic inequalities that the home care industry perpetuates, home care workers and their clients cannot reasonably be expected to care about each other. We endorse reforms aimed at enabling home care workers and their clients to form and maintain professional relationships that cultivate care..

Transforming normative, ableist, and biomedical orientations to living well and quality of life in nursing: Reimagining what a ventilated body can do

A goal of living as well as possible is central to practice and research with young adults living with home mechanical ventilation (HMV). Significant effort has been put into conceptualizing and measuring the quality of life (QOL) as a proxy for living well. Yet, dominant understandings of QOL have been influenced by normative, ableist, and biomedical discourses about what constitutes a good life that, when applied in practice and systems with those living with HMV, can contribute to exclusion and constrain opportunities to live well. Inquiry into what certain understandings of living well can do is critical to opening up possibilities to reimagine living well with HMV. This paper draws on findings from a critical narrative inquiry that explored the experiences of five young adults (ages 18-40 years) living with HMV. Data were co-constructed virtually through an initial interview and photo-elicitation using participant-generated photographs. A critical narrative analysis of participants' stories made visible the ideological effects of ableist, biomedical, and individualist discourses and how the young adults reproduced and resisted these dominant discourses. Their stories further opened up possibilities for nurses and other healthcare providers to see living well and QOL differently.

To Understand Inequity, Bioethics Needs to Sort Things Out

Bioethics is reexamining how to implement diversity, equity, inclusion, and justice concerns into scholarship. However, bioethicists should question the categories used to define diversity. The act of categorization is value laden, and classification systems confer power and benefits and generate harms. For example, what conditions count as disabilities? We should consider the equity implications of offering only "male" and "female" options for self-identification in health records. However, we should also interrogate all ideas about categorization, including how categories are formed, why they are formed, and who decides. Bioethicists cannot comprehend fully what equity and justice mean for underrepresented, underserved, or marginalized people until there is an understanding of how the boundaries of marginalization are created.

Ableism, racism, and the quality of life of Black, Indigenous, people of colour with intellectual and developmental disabilities

BACKGROUND

Research indicates Black, Indigenous, people of colour (BIPOC) with intellectual and developmental disabilities face disparities in quality of life outcomes. This study's aim was to examine how ableism and racism impacted the quality of life of BIPOC with intellectual and developmental disabilities.

METHODS

Using a multilevel linear regression, we analysed secondary quality of life outcome data from Personal Outcome Measures® interviews with 1393 BIPOC with intellectual and developmental disabilities and implicit ableism and racism data from the 128 regions of the United States in which they lived (discrimination data came from 7.4 million people).

RESULTS

When BIPOC with intellectual and developmental disabilities lived in regions of the United States which were more ableist and racist, they had a lower quality of life, regardless of their demographics.

CONCLUSION

Ableism and racism are a direct threat to BIPOC with intellectual and developmental disabilities' health, wellbeing, and overall quality of life.

Identifying and removing ableism from Tier 1 school-wide positive behaviour support practices

Across Australia, almost one third of schools have been trained to implement school-wide positive behaviour support (SWPBS). As part of a Tier 1 approach, students are expected to demonstrate expected behaviours. By defining these behaviours in conjunction with students and families, and explicitly teaching these to students, schools implementing SWPBS can create climates where students can thrive both academically and behaviourally. However, many students with disability continue to be over-represented in discipline data in all schools, including those implementing SWPBS. We argue this is because defining the behaviours we want to see and celebrate is only part of the solution. Implementation is destined to fail if we do not, in tandem, address the conditions we created that act as barriers for students with disability. Further, through an analysis of Australian SWPBS matrices, we show that structural ableism exists in the way some expected behaviours are framed by requiring a greater response effort from students with disability if they are to meet the standard expected. We offer suggestions for schools to both recognise and remove ableism from Tier 1 SWPBS practices.

Louisiana's "Medically Futile" Unborn Child List: Ethical Lessons at the Post-Dobbs Intersection of Reproductive and Disability Justice

Ableist attitudes and structures are increasingly recognized across all sectors of health care delivery. After Dobbs, novel questions arose in the United States concerning how to protect reproductive autonomy while avoiding discrimination against and devaluation of disabled persons. In this essay, we examine the Louisiana Department of Health's emergency declaration, "List of Conditions That Shall Deem an Unborn Child 'Medically Futile,'" issued August 1, 2022. We raise a number of medical, ethical, and public health concerns that lead us to argue that the declaration should be rescinded. Analysis of this ethically objectionable declaration provides valuable lessons about how to uphold both reproductive and disability justice in a post-Dobbs landscape.

A cross-sectional study examining perceptions of discriminatory behaviors experienced and witnessed by veterinary students undertaking clinical extra-mural studies

Introduction

Recent research showed that 29% of respondents in a survey of veterinary professionals reported experiencing self-described discrimination in their workplaces. Senior colleagues and clients were responsible for discriminatory behaviors. As part of their training, veterinary students are expected to undertake extra-mural study (EMS) within these same workplaces and are likely to be vulnerable to discrimination from senior colleagues and clients. This study's objectives were to identify and characterize the pattern of perceived discriminatory behaviors (i.e., belief of being treated unfairly) that veterinary students encounter while seeing practice and explore students' attitudes toward discrimination.

Methods

Students at British and Irish veterinary schools who undertook some clinical EMS completed a survey of closed and open questions as part of a cross-sectional study. Demographic data and experiences of discrimination with details of incidents and reporting were collected, alongside respondent attitudes. Quantitative data were analyzed using Pearson's chi-squared analysis to analyse respondents' characteristics and their experiences of discriminatory behaviors and subsequent reporting. Qualitative content analysis was used for open-question data.

Results

Of the 403 respondents, 36.0% had perceived behavior they believed was discriminatory. The most frequent form of discrimination was based on gender (38.0%), followed by ethnicity (15.7%). There were significant associations between respondents' experience of discriminatory behaviors and the following characteristics: age (p = 0.0096), disability (p < 0.00001), race/ethnicity (p < 0.0001), gender/sex (p = 0.018), and LGBTQ+ status (p = 0.001). Supervising veterinarians were the most commonly reported perpetrators of discriminatory behaviors (39.3%) compared with clients (36.4%). Only 13.9% of respondents who experienced discrimination reported the event(s). Respondents with a disability were the least likely to agree with the statement that professional bodies are doing enough to tackle discrimination (p < 0.0001). Most respondents agreed that sexism is still an issue (74.4%), but men were more likely to disagree (p = 0.004). Most respondents felt that ethnic diversity needed to be increased (96.3%).

Discussion

Discriminatory behavior is a problem for students seeing practice, especially those with one or more protected characteristics (as defined by the UK Equality Act 2010). Improved education would need to include perspectives from minority groups to help remove discriminatory behavior from veterinary practice.

The co-conditioning of dis/ability and gender: An intersectionality study of Powerchair Hockey

This paper aims at initiating scholars to consider dis/ability as a category of analysis when doing intersectionality in sociology of sport. First, it introduces a conceptual framework that allows researchers to engage with the issue of the body and its physical and cognitive functions, as well as to address how the ability-disability system intersects with various other salient systems of oppression and privilege. I call this concept the intersectional co-conditioning of dis/ability, whereby experiences of dis/ability are fundamentally conditioned by (and also condition in return) other systems of difference and inequality. The framework provides scholars with theoretical tools that will help them to investigate body-related issues while avoiding the pitfall of essentializing dis/abilities. Second, this work offers an application of the abovementioned conceptual framework, focusing on the co-conditioning of dis/ability and gender. Based on a multi-sited ethnography of Powerchair Hockey in Switzerland, I investigate different aspects of this sport practiced by people living with so-called "severe" physical dis/abilities. The results highlight the tensions, contradictions and paradoxes that both male and female players face as they (re)negotiate their positions within the matrix of domination. This application demonstrates the explanatory power of considering the intersectional co-conditioning of dis/ability.

Postmortem Diagnostic Overshadowing: Reporting Cerebral Palsy on Death Certificates

Postmortem diagnostic overshadowing-defined as inaccurately reporting a disability as the underlying cause of death-occurs for over half of adults with cerebral palsy. This practice obscures cause of death trends, reducing the effectiveness of efforts to reduce premature mortality among this marginalized health population. Using data from the National Vital Statistics System 2005 to 2017 U.S. Multiple Cause of Death files (N = 29,996), we identify factors (sociodemographic characteristics, aspects of the context and processing of death, and comorbidities) associated with the inaccurate reporting of cerebral palsy as the underlying cause of death. Results suggest that inaccurate reporting is associated with heightened contexts of clinical uncertainty, the false equivalence of disability and health, and potential racial-ethnic bias. Ending postmortem diagnostic overshadowing will require training on disability and health for those certifying death certificates and efforts to redress ableist death certification policies.

Intersectionality Within Critical Autism Studies: A Narrative Review

The aim of this narrative review was to examine intersectionality within critical autism studies. A growing body of evidence has demonstrated the importance of intersectional frameworks in highlighting the diverse experiences of marginalized communities. Many disability studies researchers investigated intersectionality to elucidate the impact of race, gender, sexuality, class, and other constructs on disability identification. Within critical autism studies, a field that emerged to challenge the deficit-laden, pathologizing autism discourses favored by the medical community, intersectionality has started to become an integral component of the literature. This review highlights intersectional frameworks utilized to explore autism in both academic and nonacademic contexts, to provide a foundation for future study. Upon analysis, we found overarching themes regarding the explicit, implicit, and descriptive approaches to intersectionality, racial and gender biases within critical autism studies, and the multidisciplinary nature of intersectionality and critical autism studies. We finish the review with recommendations for how to more fully address the experiences of all autistic people-particularly of racial, gender, and sexual minority individuals-in future study. Our recommendations include utilizing intersectionality as an analytical lens for describing previously overlooked phenomena and questioning central tenets of methodology and processes, including developing research questions, analyzing data, and writing results.

Cost-Effectiveness and the Avoidance of Discrimination in Healthcare: Can We Have Both?

Many ethical theorists believe that a given distribution of healthcare is morally justified only if (1) it is cost-effective and (2) it does not discriminate against older adults and disabled people. However, if (3) cost-effectiveness involves maximizing the number of quality-adjusted life-years (QALYs) added by a given unit of healthcare resource, or cost, it seems the pursuit of cost-effectiveness will inevitably discriminate against older adults and disabled patients. I show why this trilemma is harder to escape than some theorists think. We cannot avoid it by using age- or disability-weighted QALY scores, for example. I then explain why there is no sense of "discrimination" on which discrimination is both unjust, and thus something healthcare rationing must avoid, and something cost-effective healthcare rationing inevitably involves. I go on to argue that many of the reasons we have for not favoring rationing that maximizes QALYs outside the healthcare context apply in healthcare as well. Thus, claim (1) above is dubious.

The Multidimensional Impacts of Inequities for Tāngata Whaikaha Māori (Indigenous Māori with Lived Experience of Disability) in Aotearoa, New Zealand

People with lived experience of disability have poorer health and socioeconomic outcomes than people without it. However, within this population, certain social groups are more likely to experience poorer outcomes due to the impacts of multiple intersecting forms of oppression including colonisation, coloniality and racism. This paper describes the multidimensional impacts of inequities for Indigenous tāngata whaikaha Māori (Māori with lived experience of disability). Semi-structured in-depth interviews were conducted with 28 tāngata whaikaha Māori and their whānau (extended family) using a kaupapa Māori Research methodology. An equity framework was used to analyse the data. The results describe: (1) inequitable access to the determinants of health and well-being; (2) inequitable access to and through health and disability care; (3) differential quality of health and disability care received; and (4) Indigenous Māori-driven solutions. These data confirm that tāngata whaikaha Māori in the nation-state known as New Zealand experience racism, ableism and disablism, compounded by the intersection between these types of discrimination. Recommendations from the data support the inclusion of tāngata whaikaha Māori in decision-making structures, including all policies and practices, along with equal partnership rights when it comes to designing health and disability systems and services.

Precarious Employment during the COVID-19 Pandemic, Disability-Related Discrimination, and Mental Health

Drawing on separate strands of research documenting the psychological consequences of (a) precarious employment and other challenges associated with the COVID-19 pandemic and (b) ableism, this study incorporates both into an examination of disability-based differences in the joint significance of discrimination and work precarity during the pandemic for mental health. Analyses utilizing data from a regional survey of people with and without disabilities in the Intermountain West (N = 2,012) provide evidence that precarious employment, greater discrimination, and disability independently predict depressive symptoms. Further, in the context of greater discrimination, more precarious employment is found to have greater significance for people with disabilities compared to those who are not currently disabled. These findings challenge us to think about how we engage in research concerning ableism and macro-level stressors, and underscore the role of power structures and positionality in shaping the psychological impact of employment challenges experienced during the pandemic.

Emotionally focused therapists' experiences serving interabled couples in couple therapy: An interpretative phenomenological analysis

Interabled couples navigate various systems of care as they respond to the needs of the disabled partner. Interabled couples are defined as one disabled partner and one nondisabled partner. Emotionally focused therapy (EFT) has shown benefits in reducing relationship distress and increasing the experience of security within couples. The study used interpretative phenomenological analysis to address how EFT therapists make sense of their lived experience working with interabled couples in couple therapy. The purpose of the study was to examine the experiences of therapists' serving interabled couples. The study explored the experiences of 10 EFT therapists who served at least one interabled couple in couple therapy. Findings resulted in four superordinate themes, (a) ableism; (b) self-of-the-therapist; (c) reported relationship dynamics of interabled couples; and (d) the "fit" of EFT approach with interabled couples. The themes demonstrate a need to further identify disability-responsive practices within EFT in serving interabled couples.

Call to Action: Eliminate Barriers Faced by Medical Students With Disabilities

When physicians have a disability or chronic condition, they can offer deeper insight and ability into managing the needs of patients with similar conditions. Yet an alarming 2021 survey found that only 40.7% of physicians feel confident that they provide the same level of care to people with disabilities (PWD) as those without. This may contribute to troubling health care disparities for the over 61 million Americans living with disabilities. In a recent report, The American Medical Association (AMA) recognized that increased concordance between patients and physicians with disabilities is key to resolving health care inequities for PWD, yet although 1 in 5 patients reports a disability, only 1 in 33 physicians identifies as such. This is because prospective medical students with disabilities face many barriers in medical education and practice. We call for specific changes to medical school admission processes and curricula to promote a more just and diverse workforce which includes more physicians with disabilities.

The lived experience of people with upper limb absence living in Uganda: A qualitative study

Background

The impact of upper limb absence on people's lived experiences is understudied, particularly in African countries, with implications for policy and service design.

Objectives

The objective of this study was to explore the lived experiences of people with upper limb absence (PWULA) living in Uganda.

Method

Informed by preliminary work, we designed a qualitative study employing semi-structured interviews to understand the experience of living with upper limb absence in Uganda. Seventeen adults with upper limb absence were individually interviewed and their interviews were analysed utilising thematic analysis.

Results

Seven themes illustrating the impact on the individual's life after amputation were identified and categorised into (1) living and adapting to life, (2) productivity and participation and (3) living within the wider environment. This study presents three main findings: (1) PWULA need psychological and occupational support services which are not available in Uganda, (2) PWULA want to work, but face multiple barriers to employment and has limited support, combined with the complex parenting and caring responsibilities, (3) the local Ugandan culture and social structures affect the everyday life of PWULA, both in positive and negative ways.

Conclusion

This study provides information on the lived experiences of PWULA in Uganda which are lacking in the literature. People with upper limb absence face ableism and hardship underpinned by a lack of formal support structures and policies, which may in turn exacerbate the impact of upper limb absence on multiple facets of life.

Is enhancement inherently ableist?

Transhumanists and other proponents of enhancement have been criticized for their attitude to disability. Melinda Hall argues that transhumanists denigrate disabled people by devaluing interdependence and vulnerability, and implying that disabled people are dangerous. It might also be thought that further development of enhancement technologies would have bad consequences within current, ableist and otherwise oppressive social contexts. This paper responds to these objections, arguing that enhancement needn't be in conflict with disability justice. While enhancements can be used and promoted in ways that reinforce ableism and other oppression, ways of mitigating these problems might be found by drawing on ideas from the disability rights movement, and social justice movements more broadly. The development of more accessible environments, and a general openness to surprises about which traits promote well-being, can help to create conditions under which people have genuine choice over which enhancement technologies, if any, to use.

If Not Now, Then When? Taking Disability Seriously in Bioethics

The impression of bioethicists as "dangerous," as articulated in Mouth Magazine in 1994, has continued to be a theme in the disability movement. We respond to three common responses by bioethicists to this impression-namely, this is from the past, and bioethicists are different now; this is an angry and extremist position; and the Americans with Disabilities Act and other disability rights and justice efforts have solved historical inequities. We draw on the historical record and on our collective experiences as bioethicists engaged in clinical consultation and education and as the founding, former, and current directors of a program focused on disability and rehabilitation ethics to argue that ableism and unexamined assumptions about people with disabilities have persisted in bioethics despite decades of counternarratives, research, and divergent perspectives. Ableism and such assumptions can lead to health care decisions that are prone to bias, mistreatment, and a lack of consideration of viable options for living with disability. As the field of bioethics moves toward certification examinations and as new generations join the field's ranks, these problems need to be rectified with solutions at the individual, interpersonal, and structural levels. It is past time to take disability seriously.

Dismantle Ableism, Accept Disability: Making the Case for Anti-Ableism in Medical Education

There currently exists an exciting impetus for increased diversity among medical trainees and improved equity in medical care received by patients. Yet, inclusion of disability within these efforts is often forgotten, allowing the current cultural narrative of ableism to shape medical training. National structural challenges as early as medical school admissions and ableist barriers throughout the educational pipeline have yielded 1) a concerningly low prevalence of medical students and physicians in the US who identify as disabled and 2) propagation of systemic misunderstandings on disability in our healthcare system. This perspective addresses the need for a re-evaluation of diversity in medicine which includes ability status and a commitment to anti-ableism as a critical part of the conversation. We propose reforms and important considerations that could have meaningful implications necessary for improving the culture of disability inclusion in medical education.

Navigating the Perfect Storm of Ageism, Mentalism, and Ableism: A Prevention Model

Many of society's systemic implicit biases against older persons predate COVID-19. A perfect storm of these biases now rages against older persons much more explicitly and visibly during the COVID-19 pandemic. They comprise of blends of discrimination based on age ("ageism"), multiplied by the prejudice against persons with mental symptoms (mentalism), and by notions against persons with disabilities (ableism). The collective result of this tragedy has caused a devastating impact on older persons' lives and flagrant violation of their human rights. We explore the evidence to better understand the drivers of these biases and ways to mitigate their impact. We also review strategies to alleviate the effects of ageism, mentalism, and ableism using a prevention model.

Academic, Activist, or Advocate? Angry, Entangled, and Emerging: A Critical Reflection on Autism Knowledge Production

There has been a focus on autistic-led and participatory research in autism research, but minimal discussion about whether the field is hospitable to autistic involvement. While the focus on participatory and/or autistic-led research is abundantly welcome, a wider conversation should also happen about how autistic people are treated in the process of knowledge creation. As such, I present a critical reflection on my experiences of academia as an autistic autism researcher. I open by questioning whether I am an academic, an activist, or an advocate before discussing my journey through academia, and my exposure to dehumanizing, objectifying, and violent accounts of autism. I highlight how the construction of objectivity has resulted in a failure to question the validity of these dehumanizing accounts of autism, which are regarded as "scientifically-sound" by virtue of their perceived "objectivity." Furthermore, I discuss how the idea of objectivity is used to side-line autistic expertise in disingenuous ways, especially when this knowledge challenges the status-quo. Despite claiming to be value-free, these dehumanizing accounts of autism embody social and cultural values, with a complete lack of transparency or acknowledgment. I then discuss how these dehumanizing accounts and theories-entangled in values-reverberate into autistic people's lives and come to be ways of constituting us. Following this, I discuss the rationality of the anger autistic people feel when encountering these accounts, and instead of urging people to distance themselves from these emotions, I discuss the value of "leaning-in" as a radical act of dissent in the face of research-based violence. I then make a call to action urging all those who write or speak about autism to engage reflexively with how their values shape their understanding and construction of autistic people. Lastly, I conclude by answering my opening question: I have emerged as an advocate, activist, and academic. For me, belonging to the autistic community, acknowledging our marginalization, and recognizing our suffering within society means that hope for a better and just future has always, and will always underpin my work.

Cultural conformity and cannabis care in the wake of intractable pediatric epilepsy

Biomedicine controls seizures for many children with epilepsy - but not all. In such cases, parents struggle in the wake of various structural, cultural, and corporeal ruptures. Continued use of ineffective medications can lead, iatrogenically, to frightening and serious symptoms and debilitations whose effects, along with those of uncontrolled seizures, ripple outward in challenging ways. Using data from 25 Californian (US) parents who favored providing cannabis to their ill children to meet the iatrogenic burdens of biomedical epilepsy treatments in 2015, well before cannabis's present destigmatization, this paper explores parental refiguration of the effects of clinical iatrogenesis as inevitable - and as productive of evidence necessary to finding better options. In attending to the generative dimensions of iatrogenesis, this paper strives to help clarify the dilemma for parents who critique biomedicine's isolating, materialist, and sometimes apparently haphazard approach to their children, but depend on biomedical and associated systems for their family's well-being nonetheless. Along the way, this paper underscores raced and gendered dimensions of their experiences. Rather than rejecting biomedicine, most hung on tightly, blaming the uncontrolled seizures and their aftermath on a lag in 'the science' and pointing to the cultural idea that every child is unique in explaining their own children's non-responsiveness to treatment thus far. Likewise, they worked to determine effective cannabis regimens with scientised rigour. However, in the end - and in keeping with a culture of (male) Whiteness - stigmatisation, fatigue from chronic care provision, faith in science, and a need for a biomedically-mediated form of social belonging underwrote a majority desire for cannabis's incorporation into the official biomedical pharmacopeia.

The Relationships Between COVID-19 Anxiety, Ageism, and Ableism

The COVID-19 pandemic is a source of anxiety globally, and lockdowns have increased anxiety symptoms, contributed to economic stress, and influenced an increase in prejudice, particularly prejudice directed at the elderly and people with disabilities. Terror management theory serves as an explanation for the association between COVID-19 anxiety, ageism, and ableism. Recruiting participants from Amazon MTurk, I assessed anxiety about COVID-19, ageism, and ableism. Hierarchical linear regression analyses demonstrate that COVID-19 anxiety is significantly associated with ageism, and with ableism, as well as age and gender. The results of this study have implications for the effect of COVID-19 anxiety on those who are most vulnerable in the current pandemic, particularly with regards to isolation and social connection; those who are most anxious about the pandemic might spend less time trying to connect with their older friends and relatives, and likewise for the people in their lives who might have a disability.

An inductive qualitative content analysis of stigma experienced by people with rare diseases

OBJECTIVE

There are more than 6,000 known rare diseases (RDs), which are often serious, chronic, and progressive conditions. Cumulatively, having a RD is actually common, impacting an estimated 300 million people worldwide. While the stigmatization of some specific RDs has been studied, examining stigma in a large sample of many RDs allows for a broader understanding of patterns.

DESIGN

We used inductive qualitative content analysis to analyze survey responses to an open-ended question about challenges of living with a RD among 384 people with 178 distinct RDs.

RESULTS

We identified eight codes which were organized under the following three themes: structurally enacted, interpersonally enacted, and felt stigma. People with RDs experience structurally enacted stigma in the forms of healthcare stigma, education/workplace stigma, and an overall lack of accessibility. They also face interpersonally enacted stigma, including insufficient social support, a lack of understanding from others, and capitalist norms of productivity and self-sufficiency. Additionally, they experience felt stigma related to shame and the pressure to pass as able-bodied.

CONCLUSION

Possible solutions to RD stigma include increased education about RDs for healthcare professionals, a societal shift towards prioritizing accessibility, strengthened legal protections for disabled people, and expanded disability justice-focused community organizing.

Social isolation continued: Covid-19 shines a light on what self-advocates know too well

Covid-19 has been an unprecedented time for social work as a profession and even more so for marginalized communities. This paper shares the reflections of three self-advocates (persons labelled/with intellectual disabilities engaged in advocacy and activism), a social worker, and a social work educator and researcher. It is intended as a rallying cry for social work to rethink how we deliver services to ensure that people who have already been made vulnerable through oppressive ableist practices and assumptions are not put at greater disadvantage at times like Covid-19. Hearing directly from self-advocates, we learn of their exclusion from pandemic planning, and of the ways that physical and social distancing protocols have worked to exacerbate the isolation, marginalization and inequities that people labelled/with intellectual disabilities have experienced over the years. We are called upon to more actively focus on advocacy efforts with people labelled/with intellectual disabilities to increase their involvement in planning, as well as access to supports, and to ensure that they do not remain "the left behind of the left behind" .

Avoiding Ableist Language: Suggestions for Autism Researchers

In this commentary, we describe how language used to communicate about autism within much of autism research can reflect and perpetuate ableist ideologies (i.e., beliefs and practices that discriminate against people with disabilities), whether or not researchers intend to have such effects. Drawing largely from autistic scholarship on this subject, along with research and theory from disability studies and discourse analysis, we define ableism and its realization in linguistic practices, provide a historical overview of ableist language used to describe autism, and review calls from autistic researchers and laypeople to adopt alternative ways of speaking and writing. Finally, we provide several specific avenues to aid autism researchers in reflecting on and adjusting their language choices.

Lay summary

Why is this topic important?: In the past, autism research has mostly been conducted by nonautistic people, and researchers have described autism as something bad that should be fixed. Describing autism in this way has negative effects on how society views and treats autistic people and may even negatively affect how autistic people view themselves. Despite recent positive changes in how researchers write and speak about autism, "ableist" language is still used. Ableist language refers to language that assumes disabled people are inferior to nondisabled people.What is the purpose of this article?: We wrote this article to describe how ableism influences the way autism is often described in research. We also give autism researchers strategies for avoiding ableist language in their future work.What is the perspective of the authors?: We believe that ableism is a "system of discrimination," which means that it influences how people talk about and perceive autism whether or not they are aware of it, and regardless of whether or not they actually believe that autistic people are inferior to nonautistic people. We also believe that language choices are part of what perpetuates this system. Because of this, researchers need to take special care to determine whether their language choices reflect ableism and take steps to use language that is not ableist.What is already known about this topic?: Autistic adults (including researchers and nonresearchers) have been writing and speaking about ableist language for several decades, but nonautistic autism researchers may not be aware of this work. We have compiled this material and summarized it for autism researchers.What do the authors recommend?: We recommend that researchers understand what ableism is, reflect on the language they use in their written and spoken work, and use nonableist language alternatives to describe autism and autistic people. For example, many autistic people find terms such as "special interests" and "special needs" patronizing; these terms could be replaced with "focused interests" and descriptions of autistic people's specific needs. Medicalized/deficit language such as "at risk for autism" should be replaced by more neutral terms such as "increased likelihood of autism." Finally, ways of speaking about autism that are not restricted to particular terms but still contribute to marginalization, such as discussion about the "economic burden of autism," should be replaced with discourses that center the impacts of social arrangements on autistic people.How will these recommendations help autistic people now or in the future?: Language is a powerful means for shaping how people view autism. If researchers take steps to avoid ableist language, researchers, service providers, and society at large may become more accepting and accommodating of autistic people.

The intellectual ableism of leisure research: Original considerations towards understanding well-being with and for people with intellectual disabilities

People with intellectual disabilities (IDs) are considered to be one of the most marginalized, isolated and disenfranchised groups in society. However, recent social prescription intervention programmes are being introduced to enhance the physical and mental well-being of these individuals through participation in leisure activities, thus increasing academic interest in research within the area. This article introduces the theoretical and methodological tensions in applying mainstream scholarly thinking of leisure and well-being to people with IDs and argues that by failing to acknowledge and address such tensions scholars are at risk of demonstrating intellectual ableism. Layering Kleiber's components of leisure over Seligman's Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment concept of well-being, this article poses critical questions of how each contributing element of well-being could be reconceptualized for people with neurological diversities. The intersection of leisure, well-being and ID is ripe for research development; however, many studies in the domain are falling short of suitable theoretical discussion and methodological rigour. This article concludes with suggestions on how scholars can reduce intellectual ableism through inclusive design, methodological reporting, acknowledging bias and grappling theoretical dissonance.

Fighting for survival: persons with disabilities’ activism for the mediatisation of COVID-19 information

Crises times have an uncanny way of giving salience to struggles for democracy. The new coronavirus – also known as COVID-19 – became a global public health issue that stirred other democratic concerns from persons living with disabilities who wanted access to health information for their survival. People living with various types of disabilities have special communication and information needs, some of which require specific technologies, formats and language. The pandemic got people concerned about their safety and survival. This article contextualises and critiques US, Britain and Zimbabwean activists representing persons living with disabilities’ reactions to the manner their public authorities availed COVID-19 health messages to disabled constituencies via mainstream television. It compares how suitable was televised content from US, Britain, Zimbabwean and New Zealand stations for the Deaf and Hard of Hearing, before exploring complaints and lawsuits from the disability constituency pertaining to access to COVID-19 health information.

The relationship between disability prejudice and disability employment rates

BACKGROUND

Despite the ability to and interest in work, people with disabilities are employed at significantly lower rates than nondisabled people. Employment disparities highlight persistent social and cultural stereotypes that equate disability with unemployability.

OBJECTIVE

The aim of this study was to explore the relationship between employment of people with disabilities and disability prejudice in the United States. This study had the following research question: how does disability prejudice impact state disability employment rates?

METHODS

To explore these questions, we used secondary data about state disability employment (2016), as well as disability prejudice data from 270,000 nondisabled people residing in all 50 states and the District of Columbia.

RESULTS

Findings from this study revealed states with higher disability prejudice scores have lower disability employment rates, suggesting employment disparities are intertwined with disability prejudice.

CONCLUSIONS

Cultures and systems must be rid of harmful disability stereotypes to ensure people with disabilities can truly partake in their human and civil rights.