Exploring Pediatricians' Implicit Bias Related to Newborns' Intellectual Disability Risk: Merged Vignette and...

This pilot study was designed to assess pediatricians' bias about intellectual disability (ID); whether symptoms suggesting Down syndrome (DS), meconium aspiration syndrome (MAS), cerebral palsy (CP), and fetal alcohol effects (FAE) predict lower ratings of infant potential versus controls; and whether proposed advice to parents of a likely DS diagnosis versus another diagnosis (such as meconium aspiration syndrome) would be more negative. Pediatricians (N = 56) completed an implicit association test (IAT) for intellectual disability (ID) plus an experimental vignette survey about a few days' old infant with apparent DS, MAS, FAE, or CP in Qualtrics. Measured outcomes were bias about ID, ratings of expected development, and advice for parents. Data were assessed using d-score frequencies, ANOVAs, and Tukey's HSD plus Cohen's d, and narrative analysis. Pediatricians (93%; n = 52) had high negative bias about persons with ID (d-scores < = -0.36). For DS versus MAS, pediatricians expected ID to be higher (p < 0.001, d _Cohen  = 3.05) and childhood, adolescent, and adult daily living skills to be lower (p < 0.05, d _Cohen  = 1.64; p < 0.05, d _Cohen  = 2.47; p < 0.05, d _Cohen  = 1.70). For DS versus CP, pediatricians expected early developmental skills quality to be higher (p = 0.012, d _Cohen  = 1.14); later developmental skills quality did not differ between groups. Less reassuring advice was considered for parents of the infants with DS versus MAS. In this pilot study, pediatricians generally exhibited a negative bias for infants with ID, and their perceptions about the infant's ability, as well as their associated advice for parents, were related to the postnatal diagnosis. Future research can expand and more extensively explore the use of IAT for intellectual disabilities within obstetric and pediatric practices.