Review Article
Interventions utilising contact with people with disabilities to improve children's attitudes towards disability: A systematic review and meta-analysis

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Abstract

Background

Children with disabilities are often the target of prejudice from their peers. The effects of prejudice include harmful health consequences. The Contact Hypothesis has previously shown to promote positive attitudes towards a range of social groups.

Objective

To conduct a systematic review and meta-analysis on the effectiveness of school-based interventions for improving children's attitudes towards disability through contact with people with disabilities.

Methods

A comprehensive search was conducted across multiple databases. Studies were included if it evaluated an intervention that aimed to improve children's attitudes towards disability and involved either direct (in-person) or indirect (e.g., extended) contact with people with disabilities. Data were synthesised in a meta-analysis.

Results

Twelve studies met the inclusion criteria. Of these, 11 found significant effects: six used direct contact, two used extended contact, two used parasocial (media-based) contact and one used guided imagined contact. One parasocial contact intervention found no significant effects. Three meta-analyses showed direct contact (d = 0.55, 95% CI 0.20 to 0.90) and extended contact (d = 0.61, 95% CI 0.15 to 1.07) improved children's attitudes; there was no evidence for parasocial contact (d = 0.20, 95% CI -0.01 to 1.40).

Conclusions

Direct, extended, and guided imagined contact interventions are effective in improving children's attitudes towards disability; there was no evidence for parasocial contact.

Section snippets

Inclusion and exclusion criteria

Studies were included in the review if they:

  • •

    Focused on children aged under 18 years

  • •

    Evaluated changes in children's attitudes towards disability using quantitative outcome measures

  • •

    Evaluated a school-based intervention with a component that included either direct or indirect contact with people with disabilities

Studies were excluded if they:

  • •

    Were not reported in English language

  • •

    Were not published in a peer-reviewed journal

  • •

    Did not include a control group

Identification of studies

Four databases were searched systematically:

Study selection

Fig. 1 summarises the identification and selection of studies. A total of 3649 articles were located, from which 749 duplicates were removed. The titles and abstracts of 2900 retrieved studies were screened and 25 full text studies were read. Citation searching located two additional studies. Lastly, 15 studies were removed for not meeting the inclusion criteria, leaving 12 studies for inclusion in this review.

Study characteristics

The characteristics of studies are presented in Table 1, Table 2, Table 3, Table 4.

Discussion

The findings of this review provide evidence that direct and indirect contact with people with disabilities is effective at improving children's attitudes towards disability. Out of 12 studies that were included in this review, 11 reported a positive effect of contact on children's disability attitudes. Interventions involving extended contact had the largest effect size (d = 0.61), followed by direct contact (d = 0.55). Interventions based on parasocial contact had an effect size of d = 0.20;

Conclusion

This review demonstrates that contact with people with disabilities can be an effective component for intervention developers to use to improve children's attitudes towards disability. The most effective types of contact appear to be extended contact and direct contact; there was no evidence of the effectiveness for parasocial contact. The review has also highlighted a need to evaluate factors related to the wider implementation of the intervention and not just the effectiveness.

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    Conflict of interest statement: The authors report no conflict of interest.

    We acknowledge funding from the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care of the South West Peninsula (PenCLAHRC), and the charity Cerebra. The views and opinions expressed in this paper are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health, or Cerebra.

    1

    Present address: Division of Psychiatry, University College London, 6th floor, wing B, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.

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