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Implicit and Unconscious Bias in Children with Optic Nerve Hypoplasia is Real: Some Thoughts on How to Address It

Jan 21, 2021 at 03:29 pm by Christopher

George Floyd, Breonna Taylor, Tamir Rice, Eric Garner . . . If you live in the United States, these are household names that have been etched into our national consciousness as symbols of police brutality and violence against African Americans. Each major city also has its own set of names. Where I live, there is Sam DuBose, Timothy Thomas, Everett Howard, and several others.


In July, Tom Brennaman, a well-known local radio announcer for the Cincinnati Reds Baseball team, was fired from his job after uttering a homophobic slur on a hot mic during a live broadcast of the second game of a double header against the Kansas City Royals. The media is replete with accounts of others who have been caught posting offensive and inappropriate posts on social media, publishing them on Internet sites or uttering them during live broadcasts.


While disparate treatment of racial and ethnic minorities and acts of violence by law enforcement have led to large scale protests and shaped much of the historical context surrounding race, sex and other minority characteristics in 2020, bias and prejudice against minorities is an insidious and all-encompassing aspect of our daily lives. According to Robin DeAngelo's Seminal book, White Fragility, bias against racial minorities--particularly African Americans--is so intricately woven into the fabric of our society that it is impossible for race to be defined in unbiased, objective terms.


At the heart of the insidious and pervasive nature of racial prejudice in what most of us view as a progressive modern society is unconscious or implicit bias. According to the Kirwan Institute at Ohio State University, unconscious or implicit bias is the result of direct and indirect mental associations between certain groups of people and perceived positive or negative attributes that operate outside of a person's conscious awareness. For example, while it is easy to deny open racism or hostility toward specific racial or ethnic groups, bias against people originating from mainly minority communities, wearing specific hairstyles or speaking with a particular accent or pattern of speech is extremely common. it can shape our institutions, laws, hiring practices, and the way we interact with each other in our daily lives. It is ever-present, and since it operates mainly outside of our conscious awareness, it is difficult, if not impossible, to eradicate completely.


The professional literature and our general knowledge about unconscious and implicit bias in the Blind community and among children and adults with Optic Nerve Hypoplasia and related conditions is all but nonexistent. However, as an adult with ONH whose life's discipline is managing his own ONH related characteristics and offering support to families, I believe it is all too real.


Children with Optic Nerve Hypoplasia have a number of fairly unique characteristics that make them especially susceptible to strong and entrenched biases--not only against racial or ethnic minorities, but also people with different accents, speech patterns, and vocal inflections as well as those who speak other languages. We tend to have rigid, black-and-white, all or nothing thinking that is deeply rooted in limitations in how we perceive our environment from earliest childhood. We tend to have intense and pervasive areas of interest predicated on cravings for specific stimuli or intolerance or aversion to others.


Though children with ONH often possess a whole range of strengths and abilities that are unique to them, attributes like empathy, tolerance and perspective taking are often not among them. Concepts like racism, bigotry and intolerance are often too abstract for some children and adults with ONH. The fact that a person can be denied housing in a desirable neighborhood, refused employment, subject to violence and even death by a police officer, or separated from children and loved ones at a national border because of the color of their skin, language or cultural or religious background may be beyond comprehension for many of us.


While research into unconscious bias in children with ONH is nonexistent and there is almost know study of bias in Blind children or those with Autism characteristics, the literature that does exist as well as available anecdotes suggest that Blind and Autistic children are at least susceptible to unconscious bias as the general population. However, I believe that the limited ability for many of us to understand, process or incorporate appropriate social filters makes implicit bias a particular challenge for us.


I initially thought of writing an article on this topic after speaking with the father of one of my ONH clients. The child received a speech / language evaluation at a children's hospital in a city in the Western United States. Though the hospital serves families from throughout the West, including those whose primary language is Spanish, the city and state where the hospital is located is not especially diverse. Neither is the child's home community. During the session, upon hearing Spanish spoken in the hallway, the child said to the therapist, "No Spanish!" This incident brought to mind some memories from my childhood where I remember uttering several inappropriate comments about a person's accent within earshot of that person. In another instance when I was completing a summer daily living skills assessment when I was in high school at the Cleveland Sight Center, I remember making a negative comment about the neighborhood surrounding the campus. Of course, my mother called me out on this.


It was that experience in particular that made me realize that I needed to make a concerted effort to improve my ability to filter my comments--just as I also needed to address my other behaviors. This is still an area that takes concerted effort on my part to this day, and I am the last person to admit that I am free of any kind of unconscious bias.


It is important for me to disclose that I am a Caucasian male. Aside from having Optic Nerve Hypoplasia, I consider myself relatively middle class and educated. I graduated college with Honors and attended a majority middle and upper middle class high school. I never attended a school for the Blind.


Though my local school district had fairly few African Americans, I did have them in my classes and got along with them fine. I had a lot of interaction with people in the city where I live growing up. I spent most Saturdays at my grandmother's house in the city, where I honed many of my independent travel skills. I also attended three summers of training at the Clovernook Center for the Blind's Summer Youth Program, where there were quite a few students and teachers from diverse backgrounds. I believe this gave me more experience with diversity than many in my high school class. However, I don't think I really understood the experiences of many minority groups until I entered high school, and developing a working knowledge of human differences is something I consider a life long process.


In the case of my client, the therapist doing the evaluation for the child called her Spanish comment inappropriate, and she did receive a diagnosis of a learning disability in speech and language. However, the therapist made no recommendations regarding the potential for inappropriate comments based on bias, despite the fact that the child was entering adolescence and stated that she planned to start her own business after high school. As an adult with Optic Nerve Hypoplasia with experience helping families develop transition plans for students with disabilities, this concerned me greatly.


I believe implicit and unconscious bias training needs to be strongly reinforced for all students, but particularly children and adults like us whose social perception, cognition, and filters are compromised. With the availability of instant communication, the killings of unarmed African Americans by police officers and members of the public at large, and the instances of celebrities and others in high profile positions uttering slurs against racial minorities, women, the GLBTQ Community and people with disabilities, our society has a zero tolerance for the expression of bias. The word that nearly ended Tom Brennaman's illustrious, nearly 30-year career as a radio announcer was a term that I remember the boys in my fourth-grade class bantering about somewhat frequently--during no less a period than the height of the HIV / AIDS epidemic of the 1980's. It is still not uncommon to hear this term used on college campuses, locker rooms and workplaces to this day.


Blind and low vision students also need to recognize that they often can't see others around them, so having strong social filters and a keen awareness of the potential impact of their communications on others is a must. Like Tom Brennaman, the Blind person interacting in public is always potentially on a hot mic.


As an adult with Optic Nerve Hypoplasia, I believe that adults working with our children--particularly professionals--should recognize their own biases in order to better help eradicate them in our children. As books on the topic like "White Fragility" clearly point out, we all have implicit biases, particularly if we have a connection to the predominant culture. It is no wonder, I believe, that the speech language therapist evaluating my client merely referred to her "Spanish" comment as inappropriate, without making specific recommendations for implicit bias training based on the nonverbal learning disability she diagnosed as part of that evaluation.


There are many ways that families and professionals working with us can minimize the potential for inappropriate expressions of bias in our children. First, exposure to people of different racial, ethnic, socioeconomic, and cultural backgrounds--as well as people with disabilities and even gender identities--is key. This exposure should take into account that many children with ONH benefit most when information is presented in a multisensory format. This exposure should start as early as possible.


Parents, family members, and professionals who regularly interact with a child with ONH can begin by incorporating people from diverse backgrounds into their child's daily routine. Though strong aversions and negative reactions can and do occur when one of our children is exposed to an unfamiliar stimulus or is met with a new experience, most of us do well with repeated, ongoing exposure. In other words, while we might have a full-on, kicking, screaming meltdown, tune out or do something else inappropriate or unexpected when exposed to something new, we eventually, with time, get used to it.


Though children's television shows have taken great pains to incorporate diverse characters into their programs, I believe regular exposure to diversity in the child's background is key. Teaching our children about the experiences of diverse communities is also crucial, but sensory exposure to diverse voices, speech patterns, accents and physical features is just as crucial--if not more so.


Music in Spanish and other languages as well as exposure and tolerance of food from diverse cultures should also be a goal of behavioral interventions associated with eradicating bias. one benefit of doing this is that food aversions that many of our children demonstrate are typically targeted and specific, such as the mushy texture of a banana or the bitter taste of broccoli and some other vegetables. Exploring more exotic foods from different cultures--like mangos or jalapeno peppers could present opportunities for the child to receive similar nutrition in a form they can tolerate.


I believe professionals--such as speech / language pathologists and others providing behavior management supports to children with conditions such as Autism Spectrum and Nonverbal Learning Disorders connected with ONH need to view inappropriate behaviors associated with implicit bias as behaviors that need to be extinguished in the same way as some of the more Autism-oriented behaviors such as rocking or echolalia. After all, we are in a climate where employees and celebrities alike have lost their jobs and faced severe consequences to their lives because of a single tweet, social media post or utterance.


While there is little in the way of direct evidence from the professional literature on unconscious and implicit bias in children who are Blind, have nonverbal learning disabilities or operate on the Autism Spectrum, I believe that bias in our children is real. Children with Optic Nerve Hypoplasia are just as susceptible to it as other children without disabilities, and families and professionals working with our children should take proactive measures to address it.


Christopher Sabine
ONH Consulting, LLC

Sections: Adult Perspectives