Date Presented 04/22/2023

OTs demonstrated lower levels of explicit and implicit bias toward individuals with attention deficit hyperactive disorder (ADHD) than other school-based professionals. Implications for education regarding stigma are described.

Primary Author and Speaker: Karen Hebert

Contributing Authors: Sidney McReynolds

PURPOSE: Occupational therapists (OTs) work with individuals with diagnoses that are subject to stigma including Attention Deficit Hyperactivity Disorder (ADHD). Measures have been developed to assess implicit bias related to individuals with disabilities broadly (Pruett & Chan, 2006) but bias towards specific diagnoses has not been examined. Furthermore, little work has explored differences in bias between professionals working with this population.

DESIGN: This cross-sectional study recruited educational professionals via school-based message boards. Forty-seven individuals (24 OT, 23 other) participated in the online questionnaires, 28 also completed the author developed online implicit bias test.

METHOD: The ADHD Stigma Questionnaire (ASQ; Kellison et al., 2010) was used to assess explicit bias towards ADHD. An author developed Implicit Relational Assessment Procedure (IRAP; Kelly & Barnes-Homes, 2013) focusing on stigma words related to ADHD was designed. Group differences were examined using between-subjects ANOVAs and correlations between bias on explicit and implicit measures were calculated.

RESULTS: Occupational therapists displayed lower rates of both explicit bias (F[1,56] = 7.41, p<.01) and overall implicit bias on the IRAP (F[1,27] = 10.36, p<.05). OTs were less likely to associate individuals with ADHD with labels that are more negative (F[1,27] = 27.76, p<.001) as well as less positive (F[1,27] = 9.92, P<.05). Correlations exist between lower ASQ scores and lower implicit bias scores on ADHD negative words (r = −.482, p<.05).

CONCLUSION: OTs are less likely to display bias towards individuals with ADHD than other school based professionals. This project demonstrates that measures can be designed to specifically assess implicit biases towards a given diagnosis. This project introduces an important tool for assessing the impact of educational training regarding diversity, equity, and inclusion for occupational therapists.


Pruett, S. R. & Chan, F. (2006). The development and psychometric validation of the disability attitude implicit association test. Rehabilitation Psychology, 51(3), 202-213.

Kellison, I., Bussing, R., Bell, L., & Garvan, C. (2010). Assessment of stigma associated with attention-deficit yperactivity disorder: psychometric evaluation of the ADHD stigma questionnaire. Psychiatric Research, 178, 363-369.

Kelly, A. & Barnes-Holmes, D. (2013). Implicit attitudes towards children with autism versus normally developing children as predictors of professional burnout and psychopathology. Research in Developmental Disabilities, 34, 17-28.