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Becoming an Ally: Shifting Mindsets and Action Towards Inclusive Practices Session One

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1/13/22 Session I: Perceptions of Disability The What and Why of Inclusion

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Thanks again for joining us for this workshop! Please take the next couple minutes to reflect on your learning by answering the following questions. These are also questions you can take back to you school community to engage about disability inclusion.

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How Do We Move Forward? (Google Survey #2)

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How Do We Move Forward? (Google Survey #2)

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Thanks again for joining us for this workshop! Please take the next couple minutes to reflect on your learning by answering the following questions. These are also questions you can take back to you school community to engage about disability inclusion.

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https://youtu.be/a0idil4JHuk

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Becoming an Ally: Shifting Mindsets and Action Towards Inclusive Practices Session Two

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1/19/21 Session II: Putting New Perceptions into Actions- the how of inclusion

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Ableism: The Medical Versus Social Model of Disability 

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Ableism: The Medical Versus Social Model of Disability 

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In this bulletin, we will be discussing the topic of Ableism. You'll be able to find sections including definitions involving ableism, history, videos, articles/handouts, statistics, and questions to ponder.
When discussing ableism it is important to not label people either able or disable. Because someone can become disabled or overcome disabilities (physical or mental) in their lifetime we use the terms temporarily able and temporarily disable. In the same breath, it is also important to refer to people with disabilities as people with disabilities notdisabled people because the person comes before the disability.
DEFINITIONS
Ableism: Ableism is the intentional or unintentional discrimination or oppression of individuals with disabilities.

Disability: Having a physical or mental impairment that substantially limits one or more major life activities. This is includes people who have a record of such an impairment, even if they do not currently have a disability. It also includes individuals who do not have a disability but are regarded as having a disability.

Inclusion: Inclusion, comparatively, means that all products, services, and societal opportunities and resources are fully accessible, welcoming, functional and usable for as many different types of abilities as reasonably possible.

Accessibility: The quality of being possible to get into, use, make use of.

Equity: The quality of being fair, impartial, even, just.

The Americans with Disabilities Act of 1990: states that someone is disabled if he or she "a) has a physical or mental impairment that substantially limits one or more major life activities; b) has a record of such an impairment; or c) is regarded as having such an impairment."

(SOURCE: U.S. Department of Labor Employment Standards Administration Office of Federal Contract Compliance Programs)

The ADA's broad, three-pronged definition of disability focuses on functional ability rather than specific medical diagnosis to extend its legal protections to the full range of persons with disabilities. A person with a disability is defined as someone who experiences a physical or mental condition that limits the ability to perform a major life activity, such as walking, breathing, seeing, hearing, thinking, or working. The second prong of the ADA definition goes further in defining people who might be discriminated against on the basis of disability by saying that people who have a record or history of a disability are also protected from discrimination under this law. In addition, the third prong protects people who have no disability at all but who are perceived to have a disability. The second and third prongs of the ADA definitions were established in recognition that disability discrimination is a phenomenon unto itself and that disability discrimination results from misconceptions and prejudice that are partly or wholly unrelated to the reality of disability itself.
TYPES OF DISABILITIES AND EXAMPLES

Mobility: Spinal Cord Injuries, Disease, Paralysis, Amputation

Psychiatric: Depression, Bipolar Disorder, Schizophrenia, Post Traumatic Stress

Auditory: Deaf, Hearing Impaired

Cognitive/Developmental/Intellectual: Autism Spectrum, Learning Disabilities

Speech: Speech Impediment, Vocal Paralysis

Environmental: Allergies, Chemical Sensitivities

Medical: Cancer, AIDS, Epilepsy, Asthma, Diabetes, Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Cystic Fibrosis, Severe Arthritis

VIDEOS I'm Not Your Inspiration Thank You Very Much
Talk to Me: Physical Disability Awareness
Including Samuel Preview Social Justice Project- Ableism We're More Alike than Different

According to the US census bureau people with severe disabilities working full time earn approximately $1,000.00 less per month than non-disabled workers.

54 million Americans have a disability.

13.3 million people with disabilities age 16-64 have experienced difficulty finding employment because of their disability.

In 2008, only 98% of all transit buses were equipped with a wheelchair ramp or lift.

In 2008, only 13% of people age 25 or older had a bachelor's degree or higher.

In 2010 the Equal Employment Opportunity Commission (EEOC) reported that 25,165 charges of disability discrimination were filed.

HISTORY Brief Perspective on the Historical Treatment of People with Disabilities:

Belief that "mentally ill" people were possessed by the devil or evil spirits

Regularly whipped, tortured and burned at stake.

Ejected from hospitals and shelters - forced to beg on streets - and given a cap in which to collect alms - this is the origin of the name "handicap" and why many contemporary people are offended by that title.

1860s

1800- Science begins to replace religion as the main authority guiding leaders in the west. Instead of being seen as having a spiritual deficit, people with disabilities are seen as having a genetic deficit. Thus they are placed under the care of medical professions, educators and social workers.

1800- State mental hospitals were the first formal system of public care for the "mentally ill" in the U.S.

1817 - first school for the deaf in the U.S.: American Asylum for the Deaf and Dumb, Hartford, CT

1832- The Perkins School for the Blind in Boston admits its first two students.

1848-The first residential institute for people with mental retardation is founded in Boston

1849- MA legislatures appropriate funds to create MA School for Idiotic Child and Youth in Boston.

1850 - Eugenics Movement begins. Goal to improve the quality of the human gene pool. People with disabilities were segregated and hidden (institutions, asylums, hospitals, segregated schools, sheltered workshops, attics) or placed on display as entertainment (freak shows, circuses).

Eugenics - Sterilization

1860 - The Braille System was introduced to America

1864 - The enabling act giving the Columbia Institution for the Deaf and Dumb and Blind the authority to confer college degrees is signed by President Abraham Lincoln, making it the first college in the world expressly established for people with disabilities.

1867 - every American school for the deaf was taught in sign language

1883- The Eugenics movement, taken up by Americans, leads to the passage in the United States of laws to prevent people with disabilities from moving to this country, marrying or having children. In many instances, it leads to the institutionalization and forced sterilization of disabled people, including children.

1907- Indiana became the first of 29 states to pass compulsory sterilization laws directed at people with genetic illness or conditions.

1920 - institutionalization of people with disabilities is seen as best for them and for society. People with disabilities seen as a "drag on civilization."

1922 - Harry Laughlin (part of the eugenics movement) drew up a model sterilization law, which served as an example for numerous state legislators. "It required the sterilization of the following "defective" classes: 1) feebleminded; 2) insane; 3) criminalistics; 4) epileptic; 5)inebriate; 6) diseased; 7) blind; 8) deaf; 9) deformed; 10) dependent"

1924- The Commonwealth of Virginia passed a state law that allowed for sterilization (without consent) of individuals found to be "feebleminded, insane, depressed, mentally handicapped, epileptic and other."

1927 - The Buck v Bell Supreme Court decision ruled that forced sterilization of people with disabilities was not a violation of their constitutional rights. The decision removed all restraints on eugenicist. By the 1970s, over 60,000 disabled people where sterilized without their consent.

The U.S. Supreme Court upheld Commonwealth of Virginia as constitutional.

1937 - Poll in the U.S. indicates that 45% of the population favor euthanasia for "defective infants"

1938 - 33 States pass sterilization laws

1939 - Germany - 70,000 adults and 5,000 children put to death in initial phase and 200,000 killed in total (get rid of people who polluted Aryan race)

1942 - An article in the professional journal of the American Psychiatric Association calling for killing all "retarded children under the age of five": F. Kennedy, "The problem of Social Control of the Congenital Defective: Education, Sterilization, Euthanasia." American Journal of Psychiatry, 99(1), 13-16.

Congress enacts the Hill- Burton Act, authorizing federal grants to the states for he construction of hospitals, public health centers and health facilities for rehabilitation of people with disables.

The National Mental Health Foundation was founded by WWII conscientious objectors who served as attendants at state mental institutions rather than the war. The foundation exposed the abusive conditions at these facilitates that became an impetus towards deinstitutionalization.

1950- Congress enacts the Hill- Burton Act, authorizing federal grants to the states for he construction of hospitals, public health centers and health facilities for rehabilitation of people with disables.

1950- The National Mental Health Foundation was founded by WWII conscientious objectors who served as attendants at state mental institutions rather than the war. The foundation exposed the abusive conditions at these facilitates that became an impetus towards deinstitutionalization.

1950 Laws still on the books in some states prohibiting persons "diseased, maimed, mutilated or in anyway deformed so as to be in unsightly or disguising object" from appearing in public.

1954- Brown v. Board of Education passed

1954, 1956, 1958 amendments made to social security - retirement, age 50-64, insurance for dependents.

1961- President Kennedy appoints a special President's Panel on Mental Retardation.

1963- President Kennedy address congress calling for reduction of institutionalization over the next few years of mentally ill and retarded.

1964- Urban Mass Transportation Act

1965- Medicare and Medicaid are established

1968- Buck v Bell repealed, but sterilization under it continued until 1972

1970- Independent Living movement begins

1970- The Urban Mass Transit Act requires all mass transit vehicles to be equipped with wheelchair lift.

1970- Education of the Handicapped Act - state granted programs were expanded for children with disabilities. Higher education institutes given money to train Special Education Teachers.

1971- The Caption Center is founded at WGBH Public Television in Boston - it begins providing closed captioned programming.

1971- U.S. District Court decided in Wyatt V Stickney that disabled people were no longer to be locked away in custodial institutions without treatment or education.

1973- Rehabilitation Act of 1973 omitted the word "vocational" from rehabilitation legislation for the first time in 53-year history - 501, 503, 504 changed.
"Curb cuts in sidewalks, specially designated handicapped parking spaces, accessible public transportation, ramps into public buildings, universities with special services for disabled students, equal employment practices and many other changes are either partially or wholly result of section 504."

1975 - Education for All Handicapped Children Act passes.

1975- O'Connor v Donaldson, rules that people cannot be institutionalized against their will in a psychiatric hospital unless they are determined to be a threat to themselves or to others.

1979- Southeastern Community College v Davis - programs receiving federal funds must make "reasonable modifications" to enable the participants of otherwise qualified disabled individuals.

1981- Reagan Administration terminates the Social Security benefits of hundreds of thousands of disabled recipients.

1984- Congress passes the Social Security Disability Reform Act in response to complaints to hundreds of thousands of people who's benefits were terminated.

1985-Burlington School Committee v Department of Education

1990- American with Disabilities Act becomes federal law. Extends protection to the private sector.

1990- Technology advances result in greater freedom, access and independence.

1990- Deinstitutionalization - "mentally retarded and mentally ill allowed to live and work in the community"

1993- Holland v. Sacramento City Unified School District - affirms the right of disabled children to attend public school classes with non-disabled children.

Social Model of Disability versus Medical Model:

2002- No Child Left Behind

2004 - Individuals with Disability Education Improvement Act

Adopted from: © Teaching for Diversity and Social Justice, Second Edition, Routledge, 2007 QUESTIONS TO PONDER
The NCCJ supports the Social Model of Disability as it does not see the individual as the problem but instead societal barriers.
ARTICLES Legislation PEOPLE FIRST LANGUAGE and More

What are situations where you have heard/used ableist language?

What are the individual, cultural, institutional, or any other changes that can create a more inclusive society?

How do you think your reactions to people with disabilities affect people with disabilities?

In what ways is the world/environment designed to benefit your learning style, physical ability or psychological needs?

15 Crazy Examples Insanely Ableist Language
Doing Social Justice: 10 Reasons to Give Up Ableist Language

The Transcontinental disability choir, What ableist language and why you should care

Ableist words and terms to avoid (also included alternative words to use)
Disability RESOURCES Brown University: Student and Employee Accessibility Services - Appropriate Terminology
It's Not Only Steps us out mainstream feminism must stop ignoring disabled women
*All definitions and information provided is United States based.
An Introductory Guide to Disability Language and Empowerment

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In this bulletin, we will be discussing the topic of Ableism. You'll be able to find sections including definitions involving ableism, history, videos, articles/handouts, statistics, and questions to ponder. When discussing ableism it is important to not label people either able or disable.

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Information and Technical Assistance on the Americans with Disabilities Act

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Information and Technical Assistance on the Americans with Disabilities Act

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Disability rights are civil rights. From voting to parking, the ADA is a law that protects people with disabilities in many areas of public life.

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IDEA: Individuals with Disabilities Education Act (IDEA) 

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IDEA: Individuals with Disabilities Education Act (IDEA) 

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Individuals with Disabilities Education Act

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Individuals with Disabilities Education Act (IDEA)

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The U.S. Department of Education’s Individuals with Disabilities Education Act website brings together department and grantee IDEA information and resources. The IDEA makes available a free appropriate public education to and ensures special education and related services to eligible children with disabilities.

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What is Neurodiversity? Article from Understood

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What is Neurodiversity? Article from Understood

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At a glance

Neurodiversity is a viewpoint that brain differences are normal, rather than deficits.

Neurodivergent people experience, interact with, and interpret the world in unique ways.

This concept can help reduce stigma around learning and thinking differences.

What would happen if the world viewed neurodevelopmental differences like ADHD, autism, and learning disabilities differently? If everyone noticed the strengths that can come from these differences first, instead of the challenges?

That's the basic idea of neurodiversity - that differences don't have to only be looked at as weaknesses. They're not problems that need to be "fixed" or "cured." They're simply variations of the human brain.

The neurodiversity view is also personal. Being neurodivergent can help shape identity and how people see themselves and their value in the world. Neurodivergent people experience, interact with, and interpret the world in unique ways. That can sometimes create challenges. But it can also lead to creative problem-solving and new ideas - things that benefit everyone.

The concept of neurodiversity isn't new. Judy Singer, a sociologist on the autism spectrum, began using the term in the 1990s. Singer rejected the idea that people with autism are disabled. Her view was that their brains just work differently from others.

About the author

About the author

Amanda Morin is the author of "The Everything Parent's Guide to Special Education" and the former director of thought leadership at Understood. As an expert and writer, she helped build Understood from its earliest days.

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Neurodiversity is a viewpoint that brain differences are normal, rather than deficits. Neurodivergent people experience, interact with, and interpret the world in unique ways. This concept can help reduce stigma around learning and thinking differences. What would happen if the world viewed neurodevelopmental differences like ADHD, autism, and learning disabilities differently?

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California Education Facts: Special Education Data 

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California Education Facts: Special Education Data 

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Special education services were provided to 813,528 individuals, newborn through twenty-two years of age, in 2022-23. California provides specially designed instruction, at no cost to parents, to meet the unique needs of children with disabilities. This instruction is provided in a variety of settings that allow infants and their families, preschoolers, students, and young adults to be educated with their peers as much as possible; that is, in the least restrictive environment. Special education services are available in a variety of settings, including day-care settings, preschool, regular classrooms, classrooms that emphasize specially designed instruction, the community, and the work environment. The California Department of Education (CDE) works with colleges and universities to deliver staff development and training that ensures that teachers and other service providers are qualified to work with children with disabilities.

The CDE provides state leadership and policy direction for school district programs and services for students who have disabilities. This leadership includes providing families with information on the education of children with disabilities. The CDE works cooperatively with other state agencies to provide everything from family-centered services for infants and preschool children to planned steps for transition from high school to employment and quality adult life. These efforts are supported by evaluation of student outcomes and analysis of current research. The CDE responds to consumer complaints and administers the federal Individuals with Disabilities Education Act for students with disabilities in California.

The disability categories and enrollment breakdown in California for individuals (newborn through twenty-two years of age) who received special education services in 2022-23 are as follows:

Autism: 149,925

Deaf-blindness: 87

Deafness: 2,851

Emotional disturbance: 21,593

Hard of hearing: 9,417

Intellectual disabilities: 40,401

Multiple disabilities: 8,147

Orthopedic impairment: 6,905

Other health impairment: 118,687

Specific learning disability: 279,200

Speech or language impairment: 172,422

Traumatic brain injury: 1,312

Visual impairment: 2,581

Advisory Commission on Special Education

The Advisory Commission on Special Education (ACSE) is mandated by both state and federal laws. The ACSE is required to study, assist, and provide recommendations at least annually to the Governor, the State Legislature, the State Board of Education, and the State Superintendent of Public Instruction on issues related to the education and unmet needs of individuals with disabilities. There are 15 public members of ACSE, who are appointed as follows: three by the Speaker of the Assembly; three by the Senate Committee on Rules; four by the Governor; and five by the State Board of Education. In addition, ACSE includes two members from the State Legislature: one from the Assembly and one from the Senate.

Selected Projects and Programs

The CDE has many projects and programs to close the achievement gap, including technical assistance with least restrictive environments ( Supporting Inclusive Practices ), support for family engagement ( Seeds of Partnership ), support for birth to preschool assessments ( Desired Results Access Project ), technical assistance for students with low-incidence disabilities (visual and orthopedic disabilities), and focused monitoring projects. These projects provide technical services, research, training, conferences, and other services to many special education students.

The CDE also certifies more than a thousand nonpublic schools and agencies that provide special education services to students with disabilities. For more information regarding nonpublic schools and agencies, email npsa@cde.ca.gov or 916-327-0141.

Last Reviewed: Monday, March 27, 2023

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This content is part of California Department of Education's information and media guide about education in the State of California.

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factors Affecting the Perception of Disability: A Developmental Perspective 

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factors Affecting the Perception of Disability: A Developmental Perspective 

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Abstract

Perception of disability is an important construct affecting not only the well-being of individuals with disabilities, but also the moral compass of the society. Negative attitudes toward disability disempower individuals with disabilities and lead to their social exclusion and isolation. By contrast, a healthy society encourages positive attitudes toward individuals with disabilities and promotes social inclusion. The current review explored disability perception in the light of the in-group vs. out-group dichotomy, since individuals with disabilities may be perceived as a special case of out-group. We implemented a developmental approach to study perception of disability from early age into adolescence while exploring cognitive, affective, and behavioral components of children's attitudes. Potential factors influencing perception of disability were considered at the level of society, family and school environment, and the individual. Better understanding of factors influencing the development of disability perception would allow the design of effective interventions to improve children's attitudes toward peers with disabilities, reduce intergroup biases, and promote social inclusion. Based on previous research in social and developmental psychology, education, and anthropology, we proposed an integrative model that provides a conceptual framework for understanding the development of disability perception.

Keywords: perception of disability, childhood, development, personality, parental practices, culture

Introduction

Disability is defined as any impairment of the body or mind that limits a person's ability to partake in typical activities and social interactions in their environment ( Scheer and Groce, 1988). According to the most recent, albeit dated estimates, in the United States, about 16.7% of children have a developmental disability ( Boyle et al., 2011), whereas 5.2% of children live with a moderate or severe disability ( Brault, 2011; UNICEF, 2013). Since the Individuals with Disabilities Education Act, which mandated inclusive education in 1975, most children with disabilities receive their education in the general education setting, sharing classrooms with typically developing peers ( Causton-Theoharis and Theoharis, 2008; U.S. Department of Education, 2012). Interactions between children in such inclusive environments promote acceptance and social inclusion of individuals with disabilities within a classroom and in the society in general ( Vignes et al., 2009; de Boer et al., 2013). Social inclusion allows an individual with disabilities to make friends, participate in social activities, and become a contributing and valued member of society ( Murray and Greenberg, 2006; Mâsse et al., 2012).

Attitudes toward individuals with disabilities vary with the type of disability. For example, children with emotional or behavioral disabilities and those with multiple disabilities are perceived more negatively by their typically developing peers than children with a specific physical disability ( McCoy and Banks, 2012). Moreover, children with intellectual or physical/intellectual disability are perceived more negatively than children with a physical disability ( Nowicki, 2006; de Laat et al., 2013), with level of social inclusion being positively related to the mental age of the child with disability ( Carvalho et al., 2014). In the school context, with its high expectations to learn and negative future consequences of failing to do so, intellectual disability may have greater salience to typically developing children than physical disability.

The main goal of the current review was to explore factors influencing the formation of attitudes toward disability during childhood, and identify developmental trends that produce negative attitudes toward disability in typically developing children. Knowledge about these trends is important for designing timely, age-appropriate, and effective interventions to reduce the behaviors of stigmatization and social exclusion ( Abrams and Killen, 2014; Kayama, 2017). In addition to studying the development of attitudes toward individuals with disabilities, the current review examined the cognitive, affective, and behavioral1 aspects of attitudes ( Cook and Selltiz, 1964; Triandis, 1971; Olson and Zanna, 1993; Findler et al., 2007). Also, this review evaluated personality factors, family influences, as well as cultural norms and traditions in order to better understand the full context of these attitudes ( Bronfenbrenner, 1992; Bronfenbrenner et al., 1994).

Conceptual Models of Disability

Two competing conceptual models of disability have been used to define the origins of the abnormal physiological and psychological functioning ( LoBianco and Sheppard-Jones, 2008). The medical model considers disability a feature of the person, directly caused by diseases, disorders, traumas, or other health conditions, which would require medical treatment or intervention with the primary goal to "correct" the problem within the individual ( Johnston, 1996; Marks, 2000; Mitra, 2006; Forhan, 2009; Nind et al., 2010; Brandon and Pritchard, 2011; Palmer and Harley, 2012; Bingham et al., 2013).

However, neither medical nor social model acknowledge the complex nature of disability. Therefore, a comprehensive integration of the two approaches produced the biopsychosocial model, which considers disability in the context of an interaction between biological, psychological, and societal factors, each limiting the individual's functioning to some extent ( Engel, 1980; Borrell-Carrió et al., 2004; Thomas, 2004; Shakespeare, 2006; Le Boutillier and Croucher, 2010). In the light of this model, the World Health Organization defined disability as "the outcome or result of a complex relationship between an individual's health condition and personal factors, and of the external factors that represent the circumstances in which the individual lives" ( Peterson, 2005, p. 106). Importantly, the extent to which impairment becomes a disability depends not only on the severity of the impairment, but also on the individual's ability to participate in social life ( Hall and Hill, 1996; Peterson, 2005).

The biopsychosocial model can be viewed as an implementation of the ecological systems theory ( Bronfenbrenner, 1992; Bronfenbrenner et al., 1994) in the context of disability. Indeed, this theory examines ways the synergistic interaction between characteristics of the individual and features of the environment produces the individual's behavior and development. Functioning of the individual with disability in the society, as well as the perception of this individual by other members of the society may depend on an array of factors, such as the type and severity of disability, personality traits of the individual, available physical environment adaptations, financial resources, social inclusion practices, parental attitudes and practices, availability of inclusive education, teachers' attitudes and ability to scaffold positive interactions between students, cultural beliefs and traditions, as well as the historical context.

In-Group vs. Out-Group Perceptions and Attitudes

People tend to view others as belonging to either a familiar in-group or an unfamiliar out-group ( Allport, 1954; Hatemi et al., 2013). The out-group may consist of any individuals not belonging to the in-group; thus, racial minorities, sexual minorities, immigrants, and people with disabilities often are perceived as out-groups. The emotionally loaded process of groups' juxtaposition may result in a biased, more favorable perception of the in-group in comparison to out-groups ( Tajfel, 1982; Brewer and Kramer, 1985; Tajfel and Turner, 1986; Devine, 1995; Gramzow and Gaertner, 2005).

Individuals differ in their dispositional reaction toward potential threats posed by out-groups. Some exhibit a negativity bias while avoiding interactions, whereas others tend to respond in a more approach-oriented manner ( Hibbing et al., 2014). Previous research found a strong association between individuals' dispositional reaction to potential threats and their political views. Thus, individuals with conservative views tend to avoid uncertainty in order to reduce possible negative outcomes, while those with liberal views tend to approach the threatening stimulus in hopes to engender positive change ( Jost et al., 2003; Hibbing et al., 2014; Hatemi and McDermott, 2020). For example, when being exposed to pictures with ambiguous emotional expressions, self-reported conservatives perceive them to be angry and potentially threatening, whereas liberals perceive them as being confused and non-threatening ( Vigil, 2010). As a result, the negativity bias may lead people to discriminate against (socially exclude) members of an out-group as a source of uncertainty and potential threat.

Note that the negativity bias was observed not only on a psychological, but also on a physiological level. Thus, people who tend to protect the in-group against out-groups (those promoting military defense and anti-immigration policies), when being presented with threatening stimuli or images associated with out-groups, show greater attention to the threat ( Nail et al., 2009), as well as greater physiological arousal and sympathetic nervous system activity, measured via skin conductance ( Antony et al., 2005; Oxley et al., 2008; Dodd et al., 2012; Hatemi et al., 2013; Renshon et al., 2015; Garrett, 2019). Therefore, uncertainty and perceived threat may elevate levels of fear and anxiety in some individuals, making them less willing to embrace novel social situations or interact with new people, and be more intolerant toward members of an out-group ( Jost et al., 2003; Hatemi et al., 2013).

For this review, it is also important to distinguish between peer rejection and out-group exclusion. Peer rejection is often attributed to the individual characteristics and behavior of the rejected person, making the victim the source of the exclusion. By contrast, out-group exclusion arises from internal insecurities of the excluding individual, social attitudes, group norms, stereotypic expectations, and intergroup biases ( Killen et al., 2013). Unfortunately, it is often hard to distinguish the cause from the consequence in this complicated, dynamic process. For example, a child with disability may be socially excluded by peers as a member of an out-group; this experience may result in this child becoming socially withdrawn, timid, and shy; such attributes, in turn, would seemingly justify the resulting peer rejection based on personality characteristics.

Development of Disability Perception During Childhood

Intergroup biases become even more pronounced in 6-7-year-old children. Even when 6-7-year olds display a positivity bias while accepting positive testimonies about in-group and out-group members, this bias is disproportionately higher in the case of the in-groups ( Aldan and Soley, 2019). Also, while choosing to accept or reject someone's testimony about novel individuals, 6-7-year olds tend to trust an in-group informant more than an out-group one, especially when evaluating novel out-group individuals ( Kinzler et al., 2011; Aldan and Soley, 2019). This over-reliance on in-group informants during the evaluation process of novel individuals may further exacerbate the emerging intergroup biases. Thus, the developmental evidence suggests that children from 5 to 9 years of age tend to learn new information about novel members through the prism of the established intergroup biases ( Averhart and Bigler, 1997; Nesdale and Brown, 2004; Dunham et al., 2011; Baron and Dunham, 2015).

In summary, between the ages of 3 and 6 years, children's social awareness shifts from being individuals to being members of a social group ( Dunham and Emory, 2014). Increasing familiarity with individual characteristics of the immediate family and the surrounding social circle makes children aware of multiple ways people are grouped in the society. Children's experiences of being affiliated with, or rejected from, particular groups shape their sociocentric awareness and social cognition about in-groups vs. out-groups ( Aboud, 1988; Dunham and Emory, 2014; Nesdale et al., 2014). This social cognition uses the heuristics of "us" vs. "them" to automate social judgments; such automation of the evaluative system, though, comes at the cost of intergroup biases ( Bigler and Liben, 2007; Dunham and Emory, 2014). Thus, while becoming integrated into society, children first manifest social awareness and form group identity (3-5 years of age), then show in-group preference and in-group positivity (4-6 years of age), and finally display out-group prejudice and out-group derogation (by about 7 years of age) ( Brewer, 1999; Aboud, 2003; Nesdale, 2004, 2008).

Between 6 and 9 years of age, children experience a dramatic shift in their self-identity, which instead of being focused on group membership, becomes focused on group norms ( Abrams and Rutland, 2008). Thus, older children practice social exclusion based on the norms of the in-group. As a result, stronger self-identity and affiliation with the in-group, emphasis on the group membership, explicitly articulated negative messages about out-groups, expression of exclusion norms, and perceived threat from an out-group are associated with an increase in intergroup biases and stronger negativity toward out-group members in 6-11-year olds ( Bigler et al., 1997; Nesdale et al., 2005a, c; Nesdale and Dalton, 2011; Nesdale and Lawson, 2011; Durkin et al., 2012). Importantly, developing in socially homogeneous environments may speed up the emergence of negative biases toward out-groups, resulting in early onset between ages 3 and 5 years ( Rutland et al., 2005a). On the other hand, knowledge about out-groups and exposure to out-group members may allow children to include those in their own self-concept, resulting in inclusion and positive attitudes ( Wright et al., 1997).

During childhood, the development of intergroup biases seems to have an inverted U-shape: generally positive attitudes of 3-year-old children become increasingly negative by the age of 7-8 years, with negativity decreasing thereafter (for review, see Raabe and Beelmann, 2011). Depending on the context, this general timeline may shift either way. For example, some researchers reported a decrease in negative attitudes toward children with intellectual disabilities from the age of 4-10 years ( Nowicki, 2006). It was suggested that younger children may over-generalize the situation and take into account only most salient characteristics of an evaluated individual, whereas older children are capable of analyzing a situation from multiple perspectives and considering a complex array of factors ( Magiati et al., 2002). Moreover, with age, children learn to rely more on their experience rather than external instruction. For example, in a minimal group paradigm, when a negative, overt message contradicted their own positive personal experience with an out-group, 6-7-year olds relied on the external instruction for their out-group evaluation, whereas 10-11-year olds trusted their own experience ( Kang and Inzlicht, 2012).

Importantly, children's social development in the form of social attributions and in-group biases depends on their knowledge about different disabilities, understanding of disability, as well as general cognitive development ( Magiati et al., 2002; Diamond and Huang, 2005; Diamond et al., 2008; Diamond and Hong, 2010; Gasser et al., 2014). According to Piaget (1970), children at the age of 2-7 years are at the preoperational stage of cognitive development; their thinking is perception-based and symbolic; they typically attend to the most salient features, while ignoring less obvious attributes or the situational context. Thus, while evaluating peers with disabilities, typically developing 5-year olds tend to consider only the highly noticeable features of an individual, such as adaptive equipment, while disregarding less noticeable features related to the individual's dyslexia, hyperactivity, intellectual disability, or autism ( Conant and Budoff, 1983; Favazza and Odom, 1997; Diamond and Kensinger, 2002; Magiati et al., 2002). Therefore, not surprisingly, young children have better understanding of physical disabilities compared to intellectual ones ( Magiati et al., 2002; Laws and Kelly, 2005; Diamond et al., 2008; Diamond and Hong, 2010). Young children's heightened attention to saliency may have another negative effect: the use of salient identifying labels for an out-group can trigger intergroup bias in 3-5-year-old children ( Patterson and Bigler, 2006; Bigler and Liben, 2007; Hilliard and Liben, 2010).

At the age of 7-11 years, children are at the concrete operational stage of cognitive development; they begin thinking logically, decrease their overgeneralizing tendency ( Gasser et al., 2014), and are more capable of analyzing a situational context from multiple perspectives. Better understanding of disability makes typically developing children more likely to engage in play activities with peers having disabilities ( Diamond and Huang, 2005). Better knowledge about and understanding of disability also allows typically developing children to overcome a tendency to generalize deficits across different domains (e.g., assume that a child in a wheelchair would also be less cognitively competent) and, instead, select activities that do not involve the affected domains and allow a child with disability to fully participate ( Diamond et al., 1997; Diamond and Hong, 2010; Gasser et al., 2014). Better understanding of disability, as better understanding of any out-group, reduces fears about this group and facilitates positive attitudes ( Katz and Chamiel, 1989; Okagaki et al., 1998).

Personality Factors Affecting Perception of Disability

Roots of intergroup biases and social exclusion can be traced to early developing personality traits, as well as the features of the individual's social-emotional and social-cognitive development.

Temperament

Previous research points toward continuity in the development of personality traits from early childhood into adulthood. Thus, personality traits exhibited by children during preschool years are positively correlated with those manifested during young adulthood. Importantly, these personality traits to a large extent determine the person's beliefs, attitudes, and behaviors.

Empathy and Sympathy

Previous research found a significant, albeit gender-stereotyped, relation between children's and parents' empathy and sympathy: the child's empathy and sympathy are related to the corresponding attributes in the same-sex parent ( Barnett et al., 1980; Eisenberg et al., 1991; Eisenberg and McNally, 1993). Development of empathy in children seems to be advanced by parents' ability to be empathetic of their children's emotions. Furthermore, regular observations of parent's empathic reactions toward oneself make children more likely to model such empathic behaviors in their own interactions with others, thus, reinforcing their empathic skills. The quality of parent-child relationships (e.g., parental warmth and responsiveness, secure attachment3, parent-child synchrony, shared positive affect, parental use of reasoning) is positively related to children's and adolescents' empathy and sympathy levels, as well as their tendency toward prosocial behaviors ( Kestenbaum et al., 1989; Janssens and Gerris, 1992; Staub, 1992; Krevans and Gibbs, 1996; Kochanska, 2002; Van der Mark et al., 2002; Zhou et al., 2002; Kiang et al., 2004; Davidov and Grusec, 2006; Spinrad and Stifter, 2006; Feldman, 2007; Moreno et al., 2008).

Empathy and sympathy are also associated with social competence measures, such as peer sociocentric status, perspective taking, cooperation, conflict resolution skills, as well as socially appropriate behaviors ( Adams, 1983; Eisenberg and Miller, 1987; Eisenberg and Fabes, 1995, 1998; Eisenberg et al., 1996; Zhou et al., 2002; Sallquist et al., 2009; Carlo et al., 2010). Empathy and sympathy direct a person's attention toward others' feelings, situation, and needs; this other-oriented approach inhibits aggressive responses, motivates non-egoistic prosocial behavior, and facilitates the development of moral reasoning ( Eisenberg, 1986; Miller and Eisenberg, 1988; Batson, 1991; Hoffman, 2000; Eisenberg et al., 2001).

Empathy-associated decrease in aggressive behavior may inhibit bullying tendencies ( Kaukiainen et al., 1999; Albiero and Lo Coco, 2001). Indeed, starting at the age of 6 years old, high levels of empathy and sympathy are associated with low levels of children's aggression and bullying behavior, as well as a higher likelihood of defending a victim ( Cohen and Strayer, 1996; Warden and Mackinnon, 2003; Strayer and Roberts, 2004; Mayberry and Espelage, 2007; Gini et al., 2008; Stavrinides et al., 2010; Barchia and Bussey, 2011; Jolliffe and Farrington, 2011). By contrast, a lack of empathy and sympathy may negatively affect children's socioemotional development and result in bullying behavior. This trend continues into adolescence: low empathy is related to bullying behavior in 13-16-year olds ( Endresen and Olweus, 2002; Jolliffe and Farrington, 2006).

Theory of Mind

Theory of mind (ToM) is defined as the ability to understand that others' perspective, knowledge, beliefs, thoughts, and intentions may differ from one's own ( Wellman, 1990; Frith and Frith, 2005; Eisenberg et al., 2006). ToM is sometimes referred to as cognitive empathy ( McDonald and Messinger, 2011). Using false belief tests4, developmental researchers found that by about 4 years of age children are capable of seeing a situation from the perspective of others, making inferences about the beliefs and intentions of others, and interpreting others' behavior in the light of those beliefs ( Wellman, 1991; Wellman and Bartsch, 1994; Wellman et al., 2001). Further improvement of ToM skills continues during the preschool years ( Wellman et al., 2001); older age is associated with more advanced ToM skills ( Walker, 2005; Lapan and Boseovski, 2016); girls reportedly develop ToM sooner than boys ( Walker et al., 2002; Walker, 2005).

Previous research found a significant relation of the ToM level to children's perceptions and trait attributions of typically stigmatized individuals ( Lapan and Boseovski, 2016). Sensitivity to others' internal states (beliefs, emotions, and intentions) makes their external characteristics less salient ( Lapan and Boseovski, 2016). Therefore, well-developed ToM skills enable children to appreciate individual differences and correctly evaluate others' beliefs and abilities within the situational context ( Miller, 2002; Diamond and Hong, 2010). In this case, children with disabilities would be viewed in the light of their internal dispositions rather than, for example, visible orthosis or a wheelchair. Indeed, advanced ToM skills are associated with less hostile, more positive or neutral, and more sophisticated attributions of typically stereotyped characters; as well as more positive behavioral predictions about them ( Weiner et al., 1982; Thompson, 1989; Erdley and Dweck, 1993; Choe et al., 2013; Lapan and Boseovski, 2016). As a result, children with well-developed ToM skills are more likely to include a child with physical disability into play activities after appropriate evaluation of the task demands and the child's previous experience ( Diamond and Hong, 2010).

Self-Esteem

Individuals' self-esteem is another important factor influencing attitudes toward out-groups and people with disabilities. Self-esteem defines the extent to which an individual approves of, likes, and values oneself (e.g., Blascovich et al., 1991). Evaluation of others and behaviors toward them start with the evaluation of self, and, thus, other-evaluation may be explored through the prism of self-esteem. The ability to satisfy the fundamental need to belong through positive social interactions with others improves the individual's self-esteem ( Baumeister and Leary, 1995; Leary and Baumeister, 2000). On the other hand, adequate self-esteem is associated with better mental health and more positive interpersonal dynamics ( Greenberg et al., 1992; Denissen et al., 2008). Thus, there is a bidirectional link between self-esteem and attitudes/behaviors toward others.

Quality of the parent-child relationships is positively related to children's and adolescents' self-esteem and social competence ( Simons and Robertson, 1989; Riggio et al., 1990; Allen et al., 1994; Arbona and Power, 2003; Kim and Cicchetti, 2004). For example, children of supportive parents, who encourage independence, are more likely to have a high self-esteem and better social skills ( Riggio et al., 1990; McCormick and Kennedy, 1994). Also, being securely attached may serve as a protective factor for self-esteem: priming a person with a secure base (exposure to the name of a supportive other) leads to a more positive self-evaluation ( Baldwin, 1994). Attachment to the in-group has a similar protective effect: in-group membership allows individuals to maintain high self-esteem through intergroup comparisons that favor the in-group and often devalue members of out-groups ( Tajfel and Turner, 1986; Crocker and Luhtanen, 1990; Hogg and Abrams, 1990; Mikulincer and Shaver, 2001).

Previous research experimentally manipulated the perceived threat to a person's self-esteem in order to evaluate how that affected their behavior toward others. Exposure to false negative feedback, which signals failure and threatens the person's self-esteem, increases authoritarian5 responses and negative reactions toward out-groups; by contrast, a false positive feedback results in lower authoritarian tendencies and more positive attitudes toward others ( Sales and Friend, 1973; Fein and Spencer, 1997). High self-esteem is associated with more advanced social skills. For example, high self-esteem reportedly protects children and adolescents from involvement in bullying, both as victims or bullies ( O'Moore and Hillery, 1991; Byrne, 1994; Rigby and Cox, 1996; O'Moore and Kirkham, 2001; but also see Olweus, 1993; Slee and Rigby, 1993; Kaukiainen et al., 2002). Importantly, children with better self-beliefs concerning their social competence have more positive attitudes toward peers with disabilities ( Hellmich and Loeper, 2019).

Gender Differences

Gender has been considered one of the factors potentially influencing perception of disability, although previous research on this topic produced mixed findings. Some studies showed no difference between self-identified boys and girls in their attitudes toward peers with disabilities ( Tamm and Prellwitz, 2001; Nikolaraizi et al., 2005; Hong et al., 2014). However, most studies reported that 4-14-year-old girls manifest more positive attitudes and higher levels of acceptance toward children with disabilities compared to boys ( Sigelman et al., 1986; Nikolaraizi and De Reybekiel, 2001; Laws and Kelly, 2005; Nowicki, 2006; Siperstein et al., 2007; Diamond et al., 2008; Vignes et al., 2009; Gökbulut et al., 2017; Ersan et al., 2020).

In terms of the disability type, 9-12-year-old girls, compared to boys, showed more positive attitudes toward children with hearing or visual impairments, as well as those with physical impairments; whereas no gender differences were found in children's attitudes toward peers with behavioral difficulties ( Nikolaraizi and De Reybekiel, 2001; Laws and Kelly, 2005). In terms of the attitude components, Nowicki (2006) found that 4-10-year old girls were more accepting toward children with disabilities than boys, but only on the cognitive, and not on the emotional or behavioral levels. By contrast, Armstrong et al. (2016) reported that 7-16-year-old girls demonstrated more positive affective and behavioral components of attitudes than boys.

Parental Factors Affecting Perception of Disability

Family plays a significant role in shaping children's beliefs and attitudes toward others: parenting styles and children's attachment styles may determine the child's future attitudes toward individuals with disabilities. Importantly, there is an intricate interplay between parental factors and children's personality factors.

Parental Influences

Importantly, parents may communicate their beliefs and attitudes to children explicitly - through discussions or explicit teaching, or implicitly - by modeling their values in daily interactions with other people or by providing their children opportunities to interact with out-group peers ( Dunn, 1993; Castelli et al., 2007; Hellmich and Loeper, 2019). While this differentiation is important, it still does not lead to consensus. Thus, some researchers reported that children's attitudes toward out-groups were related to their parents' explicit, rather than implicit, expression of out-group attitudes ( Holub et al., 2011; Costello and Hodson, 2014). By contrast, others showed the effectiveness of implicit communication: parents' implicit stereotyping facilitated children's intergroup biases ( Endendijk et al., 2013, 2014), whereas parents' intergroup friendships reduced children's intergroup biases ( Vittrup and Holden, 2011; Pahlke et al., 2012). Explicit parent-child discussions of disabilities increase children's knowledge regarding disabilities ( Innes and Diamond, 1999) which, in turn, reduces the child's intergroup biases ( Magiati et al., 2002; Diamond and Huang, 2005; Diamond et al., 2008; Diamond and Hong, 2010; Gasser et al., 2014).

Children's age may play a significant role in the relation between parents' and children's attitudes. For example, young children may have fewer opportunities to explicitly discuss intergroup biases with their parents because the latter do not believe their children are ready for such conversations ( Pahlke et al., 2012; Hong et al., 2014). Moreover, young children may not be socially savvy enough to effectively process the implicit beliefs and attitudes communicated by their parents in daily interactions. Finally, older children may be more susceptible to social desirability concerns that would limit the explicit expression of prejudices and intergroup biases and make their explicitly expressed attitudes toward out-groups more similar to those of their parents who have been functioning under the same social desirability pressures. In accord with these notions, previous research found that children's attitudes appeared to be more associated with parents' attitudes as children become older, at least from the age of 5-6-years ( Katz and Chamiel, 1989; Roberts and Lindsell, 1997; Hong et al., 2014).

Parenting Styles

Parenting practices to a large extent affect children's personality traits and attitudes toward others. Parenting can be classified according to responsiveness and control dimensions, resulting in four parental styles: authoritarian, authoritative, permissive, and uninvolved ( Baumrind, 1994). Authoritarian parents are demanding, but not responsive; they promote over-control, obedience to authority, rigidity, and use of punishment. Authoritative parents show high responsiveness and high control; they are warm but demanding, they set rules and provide guidance, but also promote respect and autonomy. Permissive parents are warm and responsive, but not demanding; they do not set rules, but provide ample autonomy. Uninvolved parents are cold and undemanding; their children receive no warmth, no rules, and very little attention or guidance.

Research on permissive and uninvolved parenting styles in relation to children's views and attitudes produced inconclusive results. By contrast, the authoritarian parenting style has been shown to be associated with conservative views in grown-up children, whereas authoritative parenting is associated with liberal views ( Adorno et al., 1950; Jost et al., 2003; Oesterreich, 2005; Fraley et al., 2012; Wegemer and Vandell, 2020). In general, under-controlled children tend to grow up to be adults with liberal views, while over-controlled children often become conservatives ( Block and Block, 2006). Strict, unaffectionate, and punitive parenting produces social conformists who perceive the world as hostile and threatening, promote authoritarian sociopolitical attitudes and are more likely to display intergroup biases ( Duckitt et al., 2002; Holub et al., 2011; Costello and Hodson, 2014; Jugert et al., 2016).

Furthermore, authoritative parenting, use of inductive reasoning, and healthy limit setting are all associated with higher levels of children's empathy ( Bryant, 1987; Janssens and Gerris, 1992; Krevans and Gibbs, 1996; Hoffman, 2000), whereas authoritarian parenting, excessive parental control, power assertion, and harsh punishment are associated with lower levels of children's empathy ( Hastings et al., 2002). Since empathy promotes the development of social skills ( Diamond, 2001; Eisenberg et al., 2006; Mestre et al., 2019; Portt et al., 2020), authoritative parenting yields the best outcomes in terms of children's emotional intelligence, social-behavioral skills, and social competence ( Ladd and Pettit, 2002; Wang et al., 2019); the latter, in turn, may increase children's positive peer relationships and acceptance of peers with disabilities (e.g., Diamond, 2001). By contrast, authoritarian parenting, which is related to decreased emotional understanding ( Wang et al., 2019), may result in more negative attitudes toward peers with disabilities.

Attachment Styles

Securely attached infants actively explore their surroundings, maintain contact with the mother, approach the stranger, become distressed when separated from the mother and easily comforted upon her return ( Ainsworth et al., 1978). As adults, these individuals are approach-oriented, dependable, and trustworthy ( Hazan and Shaver, 1987; Collins, 1996). By contrast, avoidantly attached infants show less exploration and avoid contacting the mother or the stranger; they do not demonstrate strong positive or negative emotions upon the mother's departure or return. Adults with avoidant/dismissive attachment style have a hard time trusting others and getting into close, intimate relationships. Finally, anxious-ambivalent infants show low levels of exploration, are reluctant to initiate contact with the stranger, become visibly distressed when separated from the mother, and display inconsistent emotions upon her return. As adults, they worry excessively about their relationships with others and tend to get too close to others, often scaring them away ( Hazan and Shaver, 1987). Moreover, individuals scoring high on the anxiety dimension tend to have lower self-esteem and less positive self-views than their more securely attached peers ( Bartholomew and Horowitz, 1991; Mikulincer, 1998).

Societal Factors Affecting Perception of Disability

In addition to personality and parental factors, societal factors add another layer of influences shaping children's attitudes toward individuals with disabilities.

Exposure

According to the "contact hypothesis" ( Allport, 1954), prejudice may result from the incomplete or incorrect information about out-groups, which leads to overgeneralization and social exclusion; however, positive contact with out-group members may reduce stereotypes and intergroup biases. Familiarity with an out-group allows identification of similarities between the in- and out-group members, advances understanding of others, reduces anxiety and perceived out-group threat, as well as improves perspective taking and empathy ( Dovidio et al., 2005; González and Brown, 2006; Pettigrew and Tropp, 2008; Pettigrew et al., 2011). In this case, inclusive education, that places typically developing children and those with disabilities in the same classroom, should reduce intergroup biases and improve attitudes toward children with disabilities.

Cultural Differences

The definition of disability depends on the traits and capacities valued in a particular culture or social context ( Whyte and Ingstad, 1995). For example, Tuareg in Sahara consider excessive freckles and small buttocks as impairment, since these features are socially disapproved and may prohibit marrying and, thus, fully participating in social life ( Halatine and Berge, 1990). By contrast, on the island of Martha's Vineyard in Massachusetts, deafness was not considered impairment, but rather as a normal human variation: over generations, individuals with hereditary congenital deafness were so common that the majority of hearing population became fluent in sign language, which allowed deaf residents to become fully integrated into society ( Groce, 1985). These two examples demonstrate the way culturally shaped values arbitrarily define disability. Moreover, in "simple" societies, such as Martha's Vineyard, where individuals have wide-spread kinship ties, regular face-to-face contact, considerable interconnection, and integration into community life, a single characteristic, such as a physical impairment, does not define one's social identity ( Scheer and Groce, 1988).

In contrast to simple societies, in complex societies individuals are not so interrelated; social relationships beyond the immediate family are often task-oriented and rather impersonal ( Wright, 1983). In a complex society with a large number of impersonal social interactions, heuristics become handy to avoid cognitive overload; as a result, salient personal characteristics that deviate from the norm may define one's social identity for an easy in-group vs. out-group classification and approach vs. avoidance behavior. Indeed, the 18-19th centuries' industrialization and urbanization led to a more complex society and significantly increased social exclusion of individuals with disabilities ( Stone, 1984).

Beliefs about the perceived cause of a disability to a large extent determine attitudes and behaviors toward individuals with disabilities within a family and society ( Groce and Zola, 1993). For example, some societies (e.g., Navajo in US; Chagga in Tanzania; Ga in Ghana; some communities in Benin) perceive individuals with disabilities as divine beings, possessing sixth sense, protected by supernatural powers, or being pacifiers of the evil spirits; these beliefs result in awe, special care, kind treatment, and social inclusion of such individuals ( Wright, 1960; Medina et al., 1998). On a negative note, in such communities, individuals with disabilities do not receive treatment for their impairment since it may question the God's will or interfere with supernatural powers.

Furthermore, the concepts of fairness, equality, and human rights differ significantly between traditional6 and modern societies: perception of disability as a divine punishment, fate, or karma seemingly justifies social exclusion and eliminates the necessity of intervention ( Coleridge, 2000). Previous research showed that participants from China, Taiwan, and Hong Kong (traditional societies) had more negative attitudes and higher propensity of social exclusion toward individuals with disabilities than participants from the United States, United Kingdom, and Germany (modern societies) ( Westbrook et al., 1993; Chan et al., 2002; Chen et al., 2002; Wang et al., 2003; Brown et al., 2009). Thus, in Asian countries, the impairment seems to become the single salient characteristic defining the identity and social life of the individual. Shame and stigma associated with disability alienates individuals with disabilities from the rest of the society, limits interpersonal contacts and opportunities to get more knowledge and understanding of disability for typically developing individuals.

However, being individualistic, developed, and modern, does not necessarily place a society among socially inclusive toward disability. For example, kindergartners from the Netherlands reportedly had much more negative attitudes toward peers with disabilities compared to children from the United States or Greece ( de Boer et al., 2012a). A possible explanation to this phenomenon could be a lagging behind implementation of inclusive education programs in Dutch schools. Fewer opportunities to communicate with peers having disabilities may exacerbate intergroup biases and prevent social inclusion; instead, being perceived as different and unfamiliar, individuals with disabilities may be treated with caution, fear, and avoidance ( Scheer and Groce, 1988).

Importantly, children acquire the culturally defined concepts of ability vs. disability through everyday interactions with peers and adults, as well as from the media ( Hodkinson, 2007; Chen et al., 2012; Varenne, 2018). Depending on cultural beliefs, norms, and traditions, children are socialized in a particular way, which shapes their own beliefs, attitudes, and behaviors towards individuals with disabilities. For example, children socialized to respect individual differences may be more accepting of individuals with disabilities ( Crystal et al., 1999; Shweder et al., 2007). By contrast, Japanese children are socialized to become highly sensitive to any differences that would potentially stigmatize themselves or others ( Haight et al., 2016; Kayama et al., 2016). This sensitivity may have dual outcomes: on the one hand, it increases empathy and compassion, making people more understanding and willing to help; on the other hand, it leads to stigmatization, marginalization, and social exclusion ( Sano and Kuroishi, 2005; Kayama and Haight, 2014; Sato et al., 2015; Kayama, 2017). Thus, many Japanese families with individuals having disabilities traditionally felt stigmatized and socially excluded by others ( Sato et al., 2015), which resulted in hiding family members with disabilities and declining special education opportunities and services available to them ( Tachibana and Watanabe, 2004; Jegatheesan, 2009; Kayama and Haight, 2014).

In summary, cultural differences in attitudes toward individuals with disabilities represent a multidimensional construct, which includes traditional values and socialization practices, causal beliefs about disability, collectivistic vs. individualistic tendencies, as well as religious traditions. Importantly, cultures are non-homogenous: different strata in the same society may have different beliefs, depending on the level of education and religious affiliations, among other factors. Moreover, cultures are dynamic: what was a cultural norm 20 years ago may not be such today; for example, the widespread implementation of inclusive education programs may dramatically change attitudes toward disabilities over one generation.

Conclusion

The main purpose of the current review was to identify factors that affect perception of disability in the developmental context. When and how do children develop positive vs. negative attitudes toward individuals with disabilities? What factors are imperative in this developmental process?

The current review explored disability perception in the light of the in-group vs. out-group dichotomy. Development of social identity shapes the individual's beliefs about self and others, leading to classification of others into "us" vs. "them," in-groups vs. out-groups ( Allport, 1954; Tajfel and Turner, 1979; Hatemi et al., 2013). Attitudes toward out-groups are often infused with feelings of uncertainty, discomfort, anxiety, and fear ( Ward et al., 1994; Killen et al., 2013). Lack of knowledge about an out-group may lead individuals to perceive it as a potential threat, triggering a self-protective defense reaction manifested in negative attitudes toward members of an out-group, stigmatization, and discrimination ( Stephan and Stephan, 1993; Ybarra and Stephan, 1994). Thus, intergroup biases lead to social exclusion of out-groups and social isolation of their members. Since individuals with disabilities may be perceived as a special case of out-groups, the mechanisms involved in out-group perception should also apply to the perception of disability.

To provide a comprehensive model of disability perception, the current review explored cognitive, affective, and behavioral components of children's attitudes. Previous research suggests that cognitive aspects of disability perception determine affective components, which, in turn, translate into behavioral outcomes. Thus, children with a better understanding of disability tend to have more positive attitudes toward individuals with disability ( Katz and Chamiel, 1989; Okagaki et al., 1998; Magiati et al., 2002; Diamond and Huang, 2005; Diamond et al., 2008; Diamond and Hong, 2010; Gasser et al., 2014); positive attitudes, in turn, make children more likely to exhibit approach-oriented behaviors, initiating interactions with peers having disabilities, and practicing social inclusion ( Diamond, 1993; Okagaki et al., 1998; Roberts, 1999; Roberts and Smith, 1999; Favazza et al., 2000; Gaad, 2004). Importantly, exposure to individuals with disabilities informs typically developing children's knowledge about disability ( Nikolaraizi et al., 2005; Gasser et al., 2014; Yildirim Hacıibrahimoğlu and Ustaoğlu, 2020), thus, establishing a bidirectional connection among the cognitive, affective, and behavioral aspects of disability perception.

Furthermore, following the principles of the ecological systems theory ( Bronfenbrenner, 1992; Bronfenbrenner et al., 1994), the current review explored a multilevel structure of potential factors influencing perception of disability at the level of society, family, and school environment, as well as the individual. Importantly, disability is a socially constructed concept: the extent to which impairment becomes a disability depends to a large extent on the cultural norms and traditions ( Shweder and Sullivan, 1993; Hall and Hill, 1996; Coleridge, 2000; Gollnick and Chinn, 2002; Narayan, 2002; Mandell and Novak, 2005). In turn, cultural norms and traditions affect attitudes toward disability which are broadcast by the media, exhibited by teachers in schools, and modeled by parents to their children. Then, school environment and parental practices shape children's individual characteristics (e.g., temperament, empathy, sympathy, ToM, self-esteem) that affect their perception of disability.

In terms of cultural differences, simple societies are more likely to produce positive attitudes toward disability since the individual's impairment is perceived as one of many, and not the defining, characteristic of the individual ( Groce, 1985). By contrast, complex societies may create more conditions in which the impairment becomes a disability, thus preventing the individual's full participation in the society; the use of heuristics in such societies often triggers response to the most salient characteristic of the individual, which may be impairment ( Wright, 1983). Moreover, individualistic societies typically exhibit more positive attitudes toward disability than collectivistic ones, since the former respect individual differences, whereas the latter impose pressure for uniformity ( Black et al., 2003; Kuroishi and Sano, 2007; Yamada, 2009; Rao et al., 2010; Benomir et al., 2016; Huppert et al., 2019; Ersan et al., 2020). It seems that in both simple vs. complex and individualistic vs. collectivistic dichotomies, societal factors that make impairment a salient feature of the individual lead to more negative attitudes toward individuals with disabilities.

Furthermore, cultural norms determine the availability of inclusive eduction and school-based interventions, which play an important role in shaping children's perception of disability. School-based interventions are effective if they are structured, increase knowledge about disability, promote cooperation rather than competition, focus on similarities rather than differences between children, and are implemented in early childhood ( Pettigrew and Tropp, 2000; Diamond, 2001; London et al., 2002; Kurtz-Costes et al., 2011; Kang and Inzlicht, 2012; Vezzali et al., 2012, 2015; Yu et al., 2012; Berger et al., 2015; Armstrong et al., 2016).

A comprehensive review of the research allowed us to create an integrative model, encompassing complex relations among cultural, parental, and individual factors affecting perception of disability ( Figure 1 ); this model may provide a conceptual framework for understanding the development of disability perception. We would like to emphasize here the power of education to change: (1) children's knowledge, understanding, attitudes, and behaviors; (2) parental beliefs, attitudes, and practices; and even (3) cultural norms and traditions in respect to disability perception. Furthermore, for each level (cultural, parental, individual), we outlined specific factors that affect perception of disability in a positive vs. negative way ( Table 1 ).

TABLE 1

Factors Effect on attitudes toward individuals with disabilities

Positive Negative

Societal factors:

Parental practices:

Educational environment:

Interventions:

Child's personality:

Child's attitudes:

In conclusion, future interventions, aiming to improve perception of disability during childhood and adolescence, should target not only educational, but also parental practices. We propose that parental education should be added as an important component of such interventions. Parents should understand that the way they treat their children early on will become the way their children will treat out-groups and individuals with disabilities later on: if parents are responsive to their children's needs, show empathy and respect toward their children, promote autonomy, provide guidance, impose an adequate amount of control, and use inductive reasoning, their children will become self-confident and well-adjusted social beings, exhibiting high levels of empathy, social competence, and moral reasoning, which would translate into positive attitudes toward others, out-groups, and individuals with disabilities. Whereas people's individual characteristics may determine their attitudes toward out-groups and disability, importantly, the former are shaped by parental practices and educational environment which, in turn, are the product of cultural norms and traditions.

Strengths, Limitations, and Future Directions

The current review provides a comprehensive analysis of the contemporary research on the developmental aspects of disability perception that allows for deeper understanding of the ways in which cultural, parental, educational, and personality factors can either positively or negatively affect the formation of the individual's emotional, cognitive, and behavioral aspects of disability perception. The proposed conceptual model of the disability perception development may guide future research on this topic. Based on this model, effective, age-appropriate interventions to improve perception of disability could be designed and tested.

Some factors potentially influencing the development of disability perception (e.g., genetic factors) were beyond the scope of this review. Moreover, some aspects of development (e.g., the embeddedness of emotions in language development; the role of early attachment to a caregiver, among the person's other social relationships, in social development) discussed in the current review would require more deliberation due to controversies highlighted by previous research. Furthermore, previous research did not provide clear mechanisms behind some of the relations discussed in this review, such as the continuity of temperamental patterns across the person's lifetime, the transition from early emotion mirroring to self-awareness of emotional states to empathy, and the potential role of puberty in the development of ToM. Extensive deliberation on these topics was beyond the scope of this review, but future research should address these issues.

Author Contributions

IB conceptualized the manuscript. IB and EG wrote the manuscript. Both authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We would like to thank a team of undergraduate students of Boise State University who helped us manage the references: Jitka Elizarraras, Andrew Lahren, Azia Zajanc, Kyle Dumpel, Maddie Blew, and Caitlin Sommer.

Funding. This work was supported by the Undergraduate Research and Creative Activities (URCA, Boise State University) Grant awarded to EG.

References

Carlo G., Knight G. P., McGinley M., Goodvin R., Roesch S. C. (2010). "The developmental relations between perspective-taking and prosocial behaviors: a meta-analytic examination of the task-specificity hypothesis," in [Self and Social Regulation: Social Interaction and the Development of Social Understanding and Executive Functions, eds Sokol B. W., Müller U., Carpendale J. I. M., Young A. R., Iarocci G. (New York, NY: Oxford University Press; ), 234-269. 10.1093/acprof:oso/9780195327694.003.0010 [CrossRef] Google Scholar]

Hanvey L. (2002). [Children with disabilities and their families in Canada: a discussion paper by the National Children's Alliance for the First National Roundtable on Children with Disabilities. Available online at: https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.457.3999&rep=rep1&type=pdf [accessed on Sep 12, 2006] Google Scholar]

Nesdale D. (2013). ""Social acumen: its role in constructing group identity and attitudes,"," in [Navigating the Social World: What Infants, Children, and Other Species Can Teach Us, eds Banaji M. R., Gelman S. A. (New York, NY: Oxford University Press; ), 323-326. 10.1093/acprof:oso/9780199890712.003.0059 [CrossRef] Google Scholar]

Rutland A. (2013). ""How do children learn to actively control their explicit prejudice?"," in [Navigating the SocialWorld: What Infants, Children, and Other Species Can Teach Us, eds Banaji M. R., Gelman S. A. (New York, NY: Oxford University Press; ), 336-340. 10.1093/acprof:oso/9780199890712.003.0062 [CrossRef] Google Scholar]

Articles from Frontiers in Psychology are provided here courtesy of Frontiers Media SA

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Factors Affecting the Perception of Disability: A Developmental Perspective

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Perception of disability is an important construct affecting not only the well-being of individuals with disabilities, but also the moral compass of the society. Negative attitudes toward disability disempower individuals with disabilities and lead to ...

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What is in a Name? The Power of Labels in Disability, Identity, Societal Perceptions 

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What is in a Name? The Power of Labels in Disability, Identity, Societal Perceptions 

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After obtaining a law degree from UW-Madison, Nicki Vander Meulen attempted to find work as a lawyer, but received rejection after rejection.

"The minute any law firm found out I was disabled or autistic no one hired me," she explained.

These firms had concluded that since she was unable to perform simple office tasks - like making copies - she would also be an ineffective lawyer.

After being turned down from 300 other opportunities Vander Meulen - who was diagnosed with cerebral palsy and Aspergers syndrome when she was 3-and-a-half - opened her own practice and now spends her days representing juveniles.

"I can argue a legal case very easily but it will take me forever to fold, staple and line things up because my hands are impaired," she said. "They made the wrong assumption."

In this sense, the label "disabled" opened the door for potential employers to lower their expectations of Vander Meulen's competency.

The language our society uses surrounding disability is powerful and always changing. While some of these developments aim to improve accommodations and reduce assumptions, they maintain the ability to reinforce negative stigmas and stereotypes.

Defining disabilities

Labels - like "disabled" and the many words our society has to discuss disabilities - can be key to helping humans make sense of society as long as they are used correctly, explained Dr. Will Cox, a social psychologist in stereotyping and bias at UW-Madison.

"Generally speaking, a label itself isn't a bad thing," he said. "If you're using a label without taking that label and generalizing it to more negative things or to make assumptions about people, they can be useful."

However, how people perceive and understand disability depends on the time period, culture and society's perspective, said Kate Lewandowski, an access consultant at the McBurney Disability Resource Center.

Lewandowski herself identifies as culturally Deaf and part of the linguistic minority who use ASL to communicate. She does not identify as disabled.

Our society has words to describe many different disabilities - and these words and definitions continue to develop with time.

In the past, the Deaf community, for example, were labeled as deaf and dumb, then hearing imparied and now deaf or hard of hearing, Lewandowski explained.

Likewise, people with intellectual disabilities used to be called feeble-minded, then mentally retarded, then cognitive disabilities until they reached their current classifcation.

"Definitions and how people are identifying can push the society [to change language], but it takes time," she said through an ASL interpreter. "It definitely takes time for the larger society to accept those words and those identities."

With any stigmatized group, especially as they become more visible in society, there is always a learning curve with what labels to use, Cox said.

Even now phrases like hearing impaired, mentally retarded, handicapped and other words and labels that have been deemed offensive are still part of everyday vocabulary.

Lewandowski argued that we need to look at who is most perpetuating the use of these words and the perception that comes with them - whether it's the news, medical professionals, legal framework or society as a whole.

"The hardest [word] is still the R word. That's the one I want to get rid of completely," Vander Meulen shared. "It has been used in such a negative context and some words you just can't get back."

After repeated demand, Wisconsin removed "mentally retarded" from all legislation earlier this year.

Often changes in language are driven by the community of people the labels are meant to describe, but it takes cooperation from broader society to implement these changes.

"The reason for all this change in language, all this back and forth is because until 10 years ago no one ever asked individuals with disabilities what they wanted to be called. They just named us," Vander Meulen said.

Impact on individual identity

There are two broad ways in which labels are applied with regard to disability identity - person-first or identity-first language - but disability is a spectrum and individuals have different perceptions of their disabilities and their identity as disabled.

Person-first language means putting the person before the disability, explaining what a person has and not who a person is. For example, a person who has a disability instead of a disabled person.

In contrast, identity-first language is used to take back the word and is often embraced when people see their disability as a key part of their identity. It is most common in the Deaf and Autistic communities.

Both Vander Meulen and Lewandowski use identity-first language, but recognized this is more common in their own communities - Autitsic and Deaf, respectively - than in others.

Lewandowski clarified that many individuals might not identify one way or the other because they haven't ever had the opportunity to decide due to our society's overall lack of conversation regarding disability identity.

"It's really hard to say you're in one camp or the other camp because honestly I feel like exposure and awareness of that concept is not typically talked about," she said.

Vander Meulen shared her Autism is not only a source of pride, but her identity as an Autistic Adult or an "Aspy" - her preferred labels - has helped her find a community.

"When people ask why we want to be labeled it's because we want to be seen as a whole. We want to exist, shall we say, instead of just a scatter of people," she said. "We got sick of identifying ourselves as other. This is a way to say we are part of a community as a whole."

However, she clarified that every autistic - and every person with a disability - is different.

More than just a word

While labels can help build communities of people with shared experiences and help others know what to expect from a person with a certain disability, the development of these expectations can also lead people to make incorrect assumptions.

"Labels are complicated because on the one hand we need words and labels for things to just be able to talk about issues but then also they can kind of bring with them stigma or stereotypes," Cox said.

We gain these associations from a young age so they become well rehearsed, he added.

And these stigmas are more than just how we think about people - an individual's identity and behavior can be influenced by the way society labels them, according to the American Psychological Association.

Human brains absorb messages so depending on how a label is interpreted, individuals can internalize expectations of their identity and competency, Cox explained.

While labels do contribute to the assumptions people make, these same labels are necessary to providing individuals with accommodations they may need in school, work or everyday life.

"Absolutely it's a double-edged-sword one hundred percent," Vander Meulen expressed.

The Americans with Disabilities Act defines disability as a physical or mental impairment that substantially limits one or more major life activities.

Originally signed into law in 1990, the ADA was amended in 2008 to expand the definition of disability in order to provide accommodations and protections to more people.

But in order to receive these accommodations people who wouldn't otherwise identify themselves as disabled - like Lewandowski - must apply the label to themselves in order to receive any accommodations they might need whether they want to or not.

"There is so much history and stigma with disability and that's very powerful. I still think stigma is happening today," she said. "When you identify as disabled, I think naturally able-bodied people have a reaction to it - they have a reaction to the word 'disabled.'"

As people begin to recognize the stigma around the label disabled, they - especially able-bodied people - want to be sensitive to the language they're using and have tried to make changes. Instead of disabled, the terms "differently abled" or "disAbled" are on the rise.

Lewandowski believes the intention was to change the stigma, but argues it does the opposite because it reinforces that having a disability is a negative thing.

"You're still not saying they're an able-bodied person. You're still saying this is a person with a disability - it has the exact same meaning behind it [as disabled]," she said. "But you're saying 'differently abled' as a way to cover up 'disabled.'"

Changing language, changing perception

In response to this delineation between able and disabled and the systematic establishment of able as the default identity, a new term - neurodiversity - has gained traction, most prominently in the autistic community.

Neurodiversity - also expressed as neuro-typical versus neuro-divergent - is a way to counteract the word "normal" as applying to able-bodied or able-minded people.

"What is normal? We don't know," Vander Meulen said. "Normal is not a person - it's a concept."

With neurodiversity, it's possible for neuro-diverse people - often meaning people with intellectual disabilities - to argue that their way of seeing the world is not abnormal but just another way of looking at things.

Language is dynamic, but it is not enough to only change the words we use. We must also change the connotations and perceptions behind these words, Lewandowski explained.

One in four Americans have a disability, according to a 2018 CDC report, which implies that the chances of having or knowing someone who has a disability at some point in one's life is high.

"[Having a disability] is part of what it means to be human," Lewandowski said. "Until the attitude changes, why not use the word disabled? Why does it have to be perceived as a bad thing?"

Cox believes it is possible to make this change if we can take the time to listen to each other and pay attention to the meaning behind our words.

"There's always going to be room for development and recognizing the way labels might bias the way we talk about or think about someone else," he said. "Being open to changing the labels that by default pop into mind is always a good thing and just working to show that you care about other people's experiences."
This article, written by Sonya Chechik, originally appeared in The Daily Cardinal's Action Project Issue in the Fall of 2019.

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What's in a name? Power of labels in disability identity, societal perception

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After obtaining a law degree from UW-Madison, Nicki Vander Meulen attempted to find work as a lawyer, but received rejection after rejection. "The minute any law firm found out I was disabled or autistic no one hired me," she explained.

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Five Ableist Phrases to Stop Using Immediately 

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Five Ableist Phrases to Stop Using Immediately 

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5 Ableist Phrases to Stop Using Immediately

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Here are 5 ableist phrases you may have recently said that you should stop using right now.

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The UDL Guidelines are a tool used in the implementation of Universal Design for Learning, a framework to improve and optimize teaching and learning for all people based on scientific insights into how humans learn. Learn more about the Universal Design for Learning framework from CAST. The UDL Guidelines can be used by educators, curriculum developers, researchers, parents, and anyone else who wants to implement the UDL framework in a learning environment. These guidelines offer a set of concrete suggestions that can be applied to any discipline or domain to ensure that all learners can access and participate in meaningful, challenging learning opportunities.

Reenvisioning the UDL Guidelines

Because the UDL Guidelines are meant to be informed by feedback from the field as well as new research, they have been updated several times in the past. We are in the process of updating the Guidelines once again in our UDL Rising to Equity initiative.

This update will focus specifically on addressing systemic barriers that result in inequitable learning opportunities and outcomes. CAST aims to develop a transparent, inclusive, and community-driven process. If you are interested in collaborating and staying updated on our progress, we invite you to complete a brief survey.

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The UDL Guidelines are a tool used in the implementation of Universal Design for Learning, a framework to improve and optimize teaching and learning for all people based on scientific insights into how humans learn. Learn more about the Universal Design for Learning framework from CAST. The UDL Guidelines can be used by educators, curriculum developers, researchers, parents, and anyone else who wants to implement the UDL framework in a learning environment. These guidelines offer a set of concrete suggestions that can be applied to any discipline or domain to ensure that all learners can access and participate in meaningful, challenging learning opportunities.

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Understanding Empathy: What is it and Why is it Important in Counseling? 

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Understanding Empathy: What is it and Why is it Important in Counseling? 

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Displaying empathy shows that you, as the counselor, are listening, understanding, and experiencing what the client is sharing.

After all, building a complete appreciation of clients' experiences, triggers, and behaviors is essential to counseling. Recognizably sharing their feelings encourages them to dig deeper, strengthen the therapeutic alliance, and boost the likelihood of a successful treatment outcome.

And yet, "you must experience empathy before you can express it," writes counseling experts Jeff and Nancy Cochran (Cochran & Cochran, 2015, p. 48).

This article explores the skills and techniques counselors can adopt in session with their clients to develop and show empathic understanding.

Before you continue, we thought you might like to download our three Emotional Intelligence Exercises for free. These science-based exercises will enhance your ability to understand and work with your emotions and have empathy. It will also give you the tools to foster the emotional intelligence of your clients, students, or employees.

Defining Empathy in Counseling

"Providing a therapeutic relationship will always involve deep caring, respect and empathy for the anxiety and suffering of another human being" (Cochran & Cochran, 2015, p. 17).

And yet, expressing empathy within a counseling session involves more than just words; the counselor must communicate a deep understanding and display a personal connection with the client.

It requires more than providing solutions. Focusing too early on what you, as a counselor, can do to address your clients' problems may get in the way of sharing experiences and showing empathy. If you find yourself searching for a solution as they talk, you may have strayed too far from empathizing and listening (Cochran & Cochran, 2015).

Instead, the client's emotional pain must be allowed and accepted, as only then will it change. The relationship between counselor and client must be one of empathy, presence, and acceptance (Greenberg, 2011).

Why Is Empathy Important in Counseling?

Therapeutic relationships formed during counseling guide clients to a safe place where they can face, experience, and own their anxiety and upset.

And yet they need to experience empathy and acceptance to find the motivation and peace they need to be empowered to make choices and take responsibility (Cochran & Cochran, 2015).

Indeed, that relationship "is seen as being curative in and of itself in that the therapist's empathy and acceptance promote breaking of the isolation, validation, strengthening of the self, and self-acceptance" (Greenberg, 2011, p. 68).

And yet, empathy starts outside the session with how we view ourselves.

To have the capacity for empathy, we must not, as counselors, shape who we are based on the person we believe others want us to be. Seeking external validation limits our potential and self-actualization. Valuing ourselves through our being allows us to become who we want and create a therapeutic environment and experience for clients to learn naturally and rediscover themselves (Cochran & Cochran, 2015).

Indeed, research reported by the American Psychological Association confirmed that empathy, defined as a "sensitive understanding of the patient's feelings and struggles; seeing them from the patient's point of view," is one of several factors crucial to a strong therapeutic alliance (American Psychological Association, 2019).

Empathy & Positive Psychology - A Good Fit?

Positive psychology recognizes the importance of emotional intelligence to our psychological wellbeing and growth and the potential of developing emotional skills and empathy through related interventions. After all, emotional awareness and expression are building blocks for creating that understanding and strengthening our feelings for one another (Lomas, Hefferon, & Ivtzan, 2014).

Empathy is vital for all our valued relationships. Positive psychologist Tim Lomas and colleagues describe it as "the ability to communicate understanding of another person's experience from that person's perspective" (Lomas et al., 2014, p. 159).

The Oxford Handbook of Positive Psychology also recognizes its value in making lives worth living, defining empathy as "an other oriented emotional response elicited by and congruent with the perceived welfare of someone else" (Snyder, Edwards, Marques, & Lopez, 2021, p. 418).

While not the easiest of definitions, we can further break down positive psychology's view of empathy as:

Taking a strong interest in the other person's positive wellbeing

Experiencing joy at another's good fortune

Evoking altruistic motivation

Belonging to other-oriented feelings, including tenderness, soft-heartedness, and sympathy

Involving feelings 'for' another person

At times, positive psychology appears to distance itself from some of the more populous interpretations of empathy, including inferring another's psychological state, projecting oneself onto their situation, and feeling what another feels (Snyder et al., 2021).

And yet, the difference is subtle and possibly 'academic' for the counselor in session. We may not be undergoing the very same upset, sorrow, or fear as our clients, but by being empathic, we are most likely experiencing our interpretation of such feelings. And in doing so, forming a stronger, more helpful connection, boosting the therapeutic alliance and the potential for a successful treatment outcome.

Examples of Empathic Responses, Skills & Barriers

Agreeing on the tasks and goals of therapy requires a thorough understanding of the client and what might be helpful to them-it is ultimately the "enactment of empathy" (Greenberg, 2011, p. 69).

Empathy skills

Empathy is more than just communication; it is about challenging self-perceptions, finding joy in making connections, and furthering communication. And it requires you as a counselor to become more open to your own and your client's feelings and to make them visible in your relationship with them (Greenberg, 2011; Cochran & Cochran, 2015).

- Finding ways to express empathy

Empathy can be expressed in many ways, yet is typically a combination of the following (Cochran & Cochran, 2015):

Matching the client's tone: if they say they feel hurt and show it, then match it with your tone.

Facial expression and body language: don't maintain a poker face. Let your client see what they have said affects you by indicating it in your face, hand gestures, and how you hold your body.

Naming feelings: words are powerful tools. Use them to name the feelings your client is experiencing. For example:

"You are so angry; you can hardly sit still."
"I can hear the pain and upset in your voice."
"You feel so mad about this."
"It's like you are battling uphill every day."

- Self-reflection

Self-reflection can be a powerful way of developing loving-kindness. Indeed, techniques and tools such as gratitude journals and focusing on three good things from the last twenty-four hours encourages us to open up to the positive impact others have had on our lives and create the openness required to develop empathy (Lomas et al., 2014)

- Advanced reflection of feelings

Closely observing and actively listening to clients can help the counselor or therapist become aware of subtle, underlying messages. After all, clients, like the rest of us, may repress, suppress, or otherwise avoid feelings-especially uncomfortable ones.

Deep empathy helps clients articulate what they are experiencing. Richard Nelson-Jones suggests counselors and therapists ask themselves (modified from Nelson-Jones, 2014, p. 184):

What is our client only half telling us?
What are they hinting at or toward?
What might they be saying in a confusing way?
What is hiding behind, or implied by, this explicit message?

Sometimes the therapist acts on 'hunches,' intervening to help the client share more than they intended. At other times, they hold back, letting the client's story unfold uninterrupted.

- Therapeutic listening

A large percentage of the counselor's time is spent listening - a vital skill for building and maintaining empathy. Demonstrating to each client that the counselor knows and understands them-in increasing depth-must be communicated with feeling.

The following communication skills do's and don't's help improve communication, build on the therapeutic alliance, and develop empathy (modified from Cochran & Cochran, 2015):

Use your body language
Listening with empathy is a way ofbeing. When doing so, it is apparent in your body language. For example, leaning in, arms and legs uncrossed, communicates you are interested in what the client is saying and empathizing with their feelings.

Share your perception of their communication
You cannot fully know what the client is going through, yet reflecting back how you perceive their emotional position shows empathy.

Show understanding using declarative statements
When the client is clear in what they say, make sure that you respond with equally transparent declarative statements, such as "I understand that you are irritated by your partner's actions."

Be prepared to accept corrections
You are demonstrating empathy if you have decided you have nothing more to learn. Even if your understanding is justified based on what your client has told you, and they later reject your thoughts, showing respect and letting them correct you will create a deeper bond and improve your understanding of their position.

Interrupt your client with care
Consider whether your interruption will help your client share how they feel - perhaps by paraphrasing what they have said so they can move forward. Reflections, while often helpful, can harm communication when excessive or if their tone does not signal empathy.

Let your client own their silences
Following a reflection, the client maygo silent - let them own it. They may be readying themselves to go deeper and share very personal experiences or feelings or may be considering what you have said - having been taken by surprise.

Allow a hierarchy to form
Counseling builds on equality - your observations and reflections are not more important than what the client has to share. Only they truly know how they feel.

Ask questions
Use questioning only in rare circumstances, and do not end reflections by asking for something. Questions typically focus more on the counselor's needs than the clients - satisfying their desire not to be misunderstood. Otherwise, when asked something, the client may try to answer whether or not it is something they need to communicate.

Suggested read: Things therapists should not do.

Types of empathy

At least three types of empathy can help you build stronger and healthier relationships with clients. They include (Jeffrey, 2016; Cochran & Cochran, 2015):

Cognitive empathy
Improves our ability to communicate because it focuses on what the other person may be thinking.

Emotional empathy
Or 'affective empathy' is our capacity to share what the other person is feeling. Taking on another's emotions can help us build stronger emotional connections with them.

Compassionate empathy
Or 'empathic concern' is about helping the other person take the actions required to move forward. It might be about the client adopting coping mechanisms orworking together to set goals.

Cultural empathy

Inclusive cultural empathy is described as having two defining features (Garcia, Yuhwa, & Maurer, 2012):

An "empathic counseling relationship values the full range of differences and similarities of positive and negative features as contributing to the quality of that relationship in a dynamic balance" (Garcia, Yuhwa, & Maurer, 2012, p. 2).

Culture is defined broadly as the client's ethnographic nationality and ethnicity, demographic (age, gender, lifestyle, etc.), status (educational, economic, and social), and formal and informal backgrounds (Garcia, Yuhwa, & Maurer, 2012).

And while research has shown clinical skills to be essential, cultural empathy ensures counselors understand the factors that influence client identity.

Empathy barriers

Empathy can be as limited by what we do as much as what we do not do:

- Quietening our minds

Unless we quieten our minds during client sessions, our thoughts will impede forming empathic therapeutic bonds. Practicing mindfulness can help us focus on the client's feelings and experiences rather than our inner chatter and self-doubt (Cochran & Cochran, 2015).

- Inappropriate reflection

Repeating back to your client what you have understood is important. "When you feel strong emotion hit you from your client, let that be the prompt to reflect" (Cochran & Cochran, 2015, p. 43; Nelson-Jones, 2014).

- Worrying if you are liked

The therapeutic bond is vital in counseling. Yet, time spent wondering if the client likes us will not help reach a positive outcome - indeed, it may get in the way of building and maintaining empathy. After all, if your client is eager to share, they most likely already respect and value the bond created (Cochran & Cochran, 2015; Nelson-Jones, 2014).

Understanding Empathy vs Sympathy vs Compassion

While empathy, sympathy, and compassion have many different definitions, it is broadly accepted that they have elements shared with other prosocial behavior (modified from Jeffrey, 2016):

Empathy
Whether cognitive, emotional, compassionate, or behavioral, empathy involves understanding a person from their frame of reference rather than our own.

Sympathy
Sympathy is a broad term that signals experiencing another's feelings rather than empathizing with them. Sympathy can take a self-oriented perspective.

Compassion
Compassion has been described as "a deep awareness of the suffering of another coupled with the wish to relieve it." Like sympathy, it can arise when something bad happens to another person (Jeffrey, 2016).

Whether empathy is part of compassion or vice versa, they are closely related. Either way, many in social sciences treat them as variations of a broad affective phenomenon and collectively refer to them as empathy (Jeffrey, 2016).

How to Show Empathy in Therapy

Empathy supports the building and maintenance of the therapeutic alliance and can be found in each of the following actions and techniques:

Self-disclosure

While sharing too much as a counselor can move the focus away from the client, a balanced approach to self-disclosure is a valuable empathy skill. Indeed, sharing experiences with the client can help 'normalize' their feelings while reminding the counselor they may have walked similar paths (Nelson-Jones, 2014).

Assigning tasks

Between-session tasks help clients practice what they have learned. When they report back on their successes (and failures), the counselor better understands what remains difficult; their growing empathy sheds light on helpful future exercises and techniques to employ (Nelson-Jones, 2014).

Role-playing

Conducting role plays with clients can help them share, even if indirectly, how they feel. For you, as a counselor, it can encourage greater understanding, awareness, and empathy for what they are going through. Alternating roles offer insight into how each 'player' feels and why such emotions are important (Nelson-Jones, 2014).

Live observation

During a session, it can be difficult for clients to explore feelings fully regarding situations they find difficult. Taking the clients into environments they find problematic-while maintaining an appropriate degree of control-can help the counselor empathize with their emotional responses and understand what is prompting unwanted behavior (Nelson-Jones, 2014).

PositivePsychology.com's Empathy Resources for Counseling

We have various resources available for counselors wishing to develop their empathy and use it within counseling sessions:

Free resources include:

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit©, but they are described briefly below:

Strength collisions
When our strengths collide with others, we may perceive the other person's strength as a weakness and ours as superior and absolute. We may also believe our behavior is the 'right' way to deal with the situation that confronts us. This exercise helps the client consider another person's perspective by stepping into their shoes and can increase empathy.

Transcending Pain: Using Personal Suffering to Benefit Others
Channeling our feelings into compassionate service and helping others who are suffering provides an enhanced sense of meaning that is positively associated with happiness, physical health, wellbeing, and increased prosocial behavior.

This exercise helps clients understand the value of their past emotional wounds, hurts, and disappointments and uses them to help others who are also suffering.

A Take-Home Message

When someone has decided to seek help, there is most likely no quick fix-attempting to find and implement one in a hurry will not create an environment conducive to empathetic listening.

Instead, showing that you are listening and understanding what the client has to share displays empathy and that you are engaged and invested in them as a person.

And yet, to express empathy in a counseling session, you must have experienced it first-hand. As a counselor, you need to have lived experiences of emotions before communicating a profound understanding and displaying a personal connection with the client.

Experiencing joy at the good times in another's life and emotional upset at the traumas they face shows a strong interest in their wellbeing. When evident in what we say and how we express ourselves, the client is encouraged to go deeper and share what has so far remained private and hidden.

We hope ‌this article helps counselors, in their professional and personal life, increase awareness of their own and others' emotions and create stronger relationships.

Don't forget to download our three Emotional Intelligence Exercises for free.

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Empathy in Counseling: How to Show Empathetic Understanding

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Displaying empathy shows that you, as the counselor, are listening, understanding, and experiencing what the client is sharing. After all, building a complete appreciation of clients' experiences, triggers, and behaviors is essential to counseling. Recognizably sharing their feelings encourages them to dig deeper, strengthen the therapeutic alliance, and boost the likelihood of a successful treatment outcome.

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The Educators' Attitude Toward Disability Scale (EADS) 

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The Educators' Attitude Toward Disability Scale (EADS) 

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Questionnaire for Adolescents to Evaluate Their Attitudes Toward Disability 

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Questionnaire for Adolescents to Evaluate Their Attitudes Toward Disability 

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Survey of Community Attitudes Toward People with Disabilities 

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Survey of Community Attitudes Toward People with Disabilities 

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Attitudes and Empathy of Youth Towards Disabled Persons

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Attitudes and Empathy of Youth Towards Disabled Persons

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Attitudes and empathy of youth towards physically disabled persons

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The present study aimed to investigate the attitude and empathy of youth towards physically disabled persons. This study followed a quantitative parad...

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Children's Literature Books to Foster Disability Awareness

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Children's Literature Books to Foster Disability Awareness

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IMO...sometimes it is easier to allow students to use their disability as an excuse for their behavior, at least at the high school level. We should be helping the students find ways to work with and around their disability in order to achieve their goals.

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IMO...sometimes it is easier to allow students to use their disability as an excuse for their behavior, at least at the high school level. We should be helping the students find ways to work with and around their disability in order to achieve their goals.

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Always allowed someone with a disability to challenge themselves when having a difficult time accomplishing something but always be willing to support them when needed. Give them encouragement.

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Helps understand ableism.

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It's important to be self aware.

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Research ways to include everyone will help.

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I agree. I never understood the term before. I do believe there are many that do it untentionally, but definitely there are those people that do it to be hateful. I believe power is knowledge. 

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I agree. I never understood the term before. I do believe there are many that do it untentionally, but definitely there are those people that do it to be hateful. I believe power is knowledge. 

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great presentation

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Inclusion is empathy.

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Create awareness

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Ableism and Mentalism. Article from verywellmind

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Ableism and Mentalism. Article from verywellmind

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What Is Ableism?

Ableism is discrimination against people with disabilities. The discrimination can be intentional or unintentional and is based on the belief that there is a correct way for bodies and minds to function and that anyone who deviates from that is inferior.

Ableism centers around the notion that people with disabilities are imperfect and need fixing. It can show up in ways ranging from personal to institutional, and it includes the many ways in which people with disabilities are considered "less than" non-disabled people.

The History of Ableism

The shift to recognize ableism began in the civil rights movements of the 1960s and 1970s, but the term wasn't coined until the 1980s by feminists in the United States. It was first used in writing in 1986 by the Council of the London Borough of Haringey in a press release.

Despite the term not being created until this past century, the history of ableism extends much further back. Back in the Middle Ages, disabled people were considered possessed by the devil or evil spirits. As a result, they weren't provided with the level of care or consideration that we now consider all people deserving of.

Connection to Eugenics

In the 1800s, the Eugenics movement was founded. Eugenics sought to further humanity by only breeding "desirable" characteristics into people. This idea that only certain people were deserving of carrying forth the human race was principal to the United States' own miscegenation and segregation laws, which Hitler took inspiration from to craft Nazi Germany's racial classification policies.

Eugenics is a racist and classist concept that encourages population control through mechanisms including forced sterilization and marriage screenings, and proponents of it consider White people the "best" race.

Progress has been made to help people understand that no one is inherently better than anyone else, regardless of the variety of ways our bodies and minds work and the states they exist in. However, the current world we live in is one that is still deeply ableist.

Read on to learn more about how ableism manifests in our culture, and what you can do about it.

The Two Main Types of Ableism

Ableism is generally broken down into one of two types: physical and mental. Though a person could possibly behave in an ableist way about a different area of identity, these are the two most common.

Physical Ableism

This form of ableism is centered around the intentional or unintentional discrimination of people with physical disabilities. However, for people who are not disabled, these forms of discrimination may not be noticeable. That's because when you don't have to think about how others are functioning, there's a greater chance you won't realize how infrequently disabled people are considered in the set up of public spaces.

Here are some examples of how physical ableism presents itself:

Buildings and signs that aren't accessible, such as ones that are not able to be traversed by people with mobility issues

Signs that aren't available in braille

The presumption that someone who appears to have a disability is less intelligent than others

Mental Ableism

Just like how physical ableism is discrimination against people with physical disabilities, mental ableism is discrimination, whether intentional or not, against people who are mentally ill, neurodivergent, and labeled as having developmental disabilities. These are some ways that people experience mental ableism.

Segregating students who are neurodivergent into separate classes and schools

Non-disabled people using words like "dumb," "crazy," "moron," "retarded," and "lame" in conversation

The legality of paying mentally disabled people below minimum wage

How to Know If You're Being Ableist

Ableism isn't always as obvious as a building that has no ramp for wheelchairs. It often shows up in subtle ways, and pretty much all people who aren't disabled take part in ableism, whether on occasion or regularly. Often, we have no idea we are doing it!

Here are some ableist behaviors that are common in our society, from the most obvious to the least.

Outright Discrimination

This form of ableism is the most overt. It is based on actions that specifically exclude disabled people.

Some examples of outright discrimination would be:

Not hiring a person for a job because of their disability

Choosing a meeting location that isn't accessible

Asking people invasive questions about their disabilities

Making a movie without closed captioning

Microaggressions

Unlike outright discrimination, which is fairly obvious to everyone, microaggressions are much more subtle.

Additionally, phrases that are ground into our lexicon so thoroughly that we don't even give them a second thought before saying them are also microaggressions.

Think of referring to a group of people you don't think have enough skills as "the blind leading the blind," or when you think someone didn't listen to you close enough so you commented that your words "fell on deaf ears." Saying things like, "That's so lame," "I'm so OCD when it comes to cleaning," or "That girl is a psycho," are also ableist microaggressions.

We usually mean no harm at all when we say things like that, but they are ableist statements that are harmful to disabled people.

Being a Part of Systemic or Institutional Ableism

It's tough not to be complicit in ableism when you live in a world that has it built into its very systems and structures.

To some extent, most non-disabled people are complicit in systemic ableism because we aren't all spending our time fighting against it. However, there are some ways that we can be particularly complicit. This includes not speaking up when you notice something ableist like a building that isn't accessible or an employer's hesitancy to hire a disabled person.

The Impact of Ableism

It should come as no surprise that ableism harms disabled people. It may harm them emotionally, such as when a blind person hears someone say that a situation is "like the blind leading the blind."

It can harm them physically, like when a disabled person has to go somewhere that hasn't been made accessible to them.

It harms them in academia, when a disabled person may lose the fight to be included with non-disabled classmates. And it can harm them in their livelihoods, as disabled people are presented with fewer job opportunities and lower wages, earning an average of 37% less annually.

How to be More Inclusive

Good news: you've already taken the first step to being less ableist just by learning about it! No changes can be made to be better until we know what we're doing wrong, and this is no exception.

Now that you understand ableism, what can you do when you are witness to it, and how can you avoid ableist behaviors in your life?

Here are some ideas:

If you're an employer, hire more people with disabilities

Stop using ableist language in your conversations

Don't assume that disabled people are less valuable than others, and speak to them just like you would anyone else

If you go to a place that isn't accessible to disabled people, talk to managerial staff at the location

Don't use accessible bathrooms or park in accessible parking spaces

Take stairs instead of elevators, so there is more space available for people in wheelchairs

Remember that disabled people aren't here to inspire others

Directly learn from disabled writers, creators, and activists by following them on social media, listening to their podcasts, and reading their articles, etc.

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Ableism is discrimination, whether intentional or not, against people with disabilities. Learn how to behave in ways that aren't ableist.

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perfect

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Increase POV, teaching with empathy

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I have watched love on the spectrum, but Speechless is new to me.

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Yes!

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I've completed all sections up to the padlet activity, but this training won't let me proceed to the resources or course completion pages. I'm not sure who to ask for help with this.

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like how redefined using the term neurodiversity

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like how redefined using the term neurodiversity

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Change can only happen when everyone involved has the same mindset.

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Change can only happen when everyone involved has the same mindset.

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mind blowing!

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I did not know about the term ablelism. I feel like now that I am aware, I will be able to provide a more welcoming environment.

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x

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Great article.

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Great stuff!

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Amazing

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these are so important to explore in order for MCS to move foward with inclusion- PD is vital.

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Looking forward in applying these concepts in the classroom 

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Looking forward in applying these concepts in the classroom 

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hi

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Great article!

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Yes!

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Yes!

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Yes

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Yes

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Great work on ableism

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Helpful information.

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Most of these websites are not working anymore. 

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Most of these websites are not working anymore. 

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There were a couple pages that were peaking my interest but are no longer linked or available :(

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This Session on Becoming An Ally was helpful in changing how I see people who have disabilities to all people have differing abilities that should be celebrated.