Date Presented 04/22/2023

In this study, we investigated how implicit bias in early intervention is related to service disparities and perceptions of service quality. This research informs practitioners and service systems of the consequences of implicit bias.

Primary Author and Speaker: Samantha Cohen

Additional Authors and Speakers: Kayla Millan, Heather Foxworthy, Obiora Nnam, Lauren Little

Under the Individuals With Disabilities Education Improvement Act (IDEA), states are required to provide Early Intervention (EI) services for children younger than 3 years who have developmental delays; however, previous research shows that disparities exist within EI services with regard to child race and ethnicity, child diagnosis, eligibility, and various other family characteristics (e.g., McManus et al., 2019). Research has not yet investigated the cause of these disparities. The purpose of this study was to investigate the extent to which implicit bias in EI is related to access disparities and perceptions of service quality. This study is necessary as the role of implicit bias in medicine and education is extremely evident, as are the social disparities in EI services. In this mixed-methods, cross-sectional study of children that received EI services between 2015-2022 (n=15), caregivers provided Individualized Family Service Plans (IFSPs), demographic information, and a completed Measure of Processes of Care. IFSPs were then scored for positive, neutral, and negative language according to a coding scheme developed from previous studies on Individualized Education Programs (IEPs) and language in medical records. Preliminary results show that negative and/or biased language is more prevalent in the IFSPs of Black, non-Hispanic and Hispanic children when compared to their White, non-Hispanic counterparts. Further, biased language in an IFSP is associated with fewer hours of services received per month and decreased perceptions of quality. These results demonstrate the presence of implicit bias in EI and the need for provider training to counteract the presence of bias. Findings point to the role that occupational therapy practitioners may play in addressing implicit bias in EI systems.


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