Conceptualising the everyday harm experienced by people with cognitive disability: A scoping review of microaggression and emotional and psychological abuse

Figures & data

Figure 1. PRISMA Everyday harm experienced by people with cognitive disability – a scoping review of microaggression, emotional and psychological abuse.

Table 1. Reviewed articles.

Article	Author/Year	Population (see Table 2)	Method	Summary of everyday harm
1	Broome (2020)	People with intellectual disability	Historical	Lack of government financial support to maintain property and quality services. Segregated living, locked rooms and lack of daily care.
2	Calder-Dawe et al. (2020)	D/deaf people; with sensory and/or physical impairments and their families	Mixed method	Everyday ableism, stereotyping, invasive questions. Medicalising the body. Mundane acts of prejudice. Body as a “site of intervention” or comment. Staring, judging.
3	Canel-Çinarbaş et al. (2022)	Adults with disability	Qualitative	False characterisations, name-calling, bullying, mimicking, sabotaging, insensitive remarks, excluding, avoiding, staring, patronising, invasion of personal space and privacy.
4	Carr et al. (2019)	People with mental health issues, practitioners	Mixed method	Service users not reporting abuse/violence as they feel they are regarded as lacking credibility. “Mate hate” – abusive friends and family. Safeguarding and support workers inconsistent and the source of abuse and neglect.
5	Coalson et al. (2022)	People who stutter	Qualitative	Patronised, treated as helpless and second-class citizen. Self-doubt due to microaggressions and exonerating others for their behaviour. Policing of bodies/disability – “lazy”. Exhaustion from educating others – convincing them of disability.
6	Conover et al. (2017)	People with physical disability, psychologists	Mixed method	Microaggression scale with four factors: Helplessness, Minimisation, Denial of Personhood and Otherisation.
7	Conover and Israel (2019)	People identifying as sexual minority with physical disability	Quantitative	Interpersonal barriers to social support.
8	Conover et al. (2021)	People with and without sensory or physical disability, chronic illness or medical condition	Mixed method	Dismissing rights to everyday life (have children, sexual partners), make own decisions, staring, and not accepting disability that is not visible. Comments such as living with disability “is not a worthwhile existence”, disability and achievement viewed as “inspirational”.
9	Corrigan et al. (2019)	Adults with fetal alcohol spectrum disorder (FASD) and mothers and other relatives of children with FASD, Health Care Providers (HCPs)	Qualitative	Social exclusion, stereotyping of children with FASD and parents, diagnostic criteria reinforces stereotyping. HCPs fail to understand/disrespect/avoid mothers, inadequate care of children. Children removed from families, structural discrimination.
10	Cortis and Van Toorn (2022)	Disability support workers	Quantitative	Detecting and reporting harm requires worker competence and ease of reporting. Disability support workers acknowledge harm but underreport due to reporting mechanisms. Market driven providers focus on profit.
11	Eisenman et al. (2020)	People with intellectual disability	Qualitative	Feeling misunderstood, insulted/overprotected and denied personal identity. Spoken down to, insulted and excluded.
12	Ellem et al. (2020)	Young people with complex support needs	Qualitative	Positive impact of support worker actions on young people during transitions. Young people subject to invisible systems of control (“Everyone knows about me but me”)
13	Eun-Jeong et al. (2019)	Adults with Multiple Sclerosis	Qualitative	Microaggression in the workplace. Unpredictable/uncertainty of symptoms and job security. Workplace lack of awareness, denial. Need for organisational policies and strategies to counter discrimination.
14	Ezer et al. (2020)	People with brain injury and disorders of consciousness	Qualitative	Neglect of rights to life, health, benefit from scientific progress, education, freedom of expression, community, family, equality and barriers to care.
15	Fraser-Barbour et al. (2018)	Workers in disability and violence response services	Qualitative	Disempowering attitudes and misconceptions.
16	Friedman (2021)	74 human services organisations supporting 8264 people with intellectual disabilities	Quantitative	Links staff training and development with decrease in abuse and neglect.
17	Fyson and Patterson (2020)	Support staff and managers in supported living services for adults with intellectual disabilities	Qualitative	Staff understanding of abuse and “poor practices” focus on individual acts. Abuse understood through guidelines, and poor practice through relational in/actions and organisational failures. Overlap between abuse and poor practice.
18	Gjermestad et al. (2017)	Systematic review of 12 studies	Systematic review of qualitative studies	Harm included neglect of people’s rights to make choices, self-determination and control of their everyday lives.
19	Kattari (2020)	People with disability	Quantitative	Microaggression as “everyday interactions between individual and groups work to maintain stereotypes and inequalities that harm individuals already existing within marginalised communities.” Correlates visibility of disability with more ableist microaggressions. Impact of microaggression on mental health.
20	Kattari et al. (2018)	People with invisible disability	Qualitative	Experiences of ableism and microaggression – policing of bodies; tension in roles – how to react in the moment, educate or let the moment pass; desire for justice; internalised ableism.
21	Kattari et al. (2020)	School of Social Work members with disability, impairment, and/or medical condition	Mixed method	Ableist language/systems assumptions and implicit biases. Social work education needs to move toward social model of disability and empowerment. Microaggressions included minimising/dismissing, bullying, bad jokes/inappropriate comments, and unprofessional/unethical conduct.
22	Kattari (2019)	People with disability, disability rights activist or disability researcher. Any adults over 18	Mixed method	Development of a 65-item ableist microaggression inventory.
23	Lett et al. (2020)	University students with disability (n = 108)	Quantitative	Ableist microaggressions and overt discrimination correlated with poorer academic performance and mental health status. Institutional betrayal accounted for higher rates of depression but not anxiety.
24	Lourens (2021)	Author’s narrative	Autoethnography	Understanding of how disabled people learn to deny and protect abled others.
25	Matin et al. (2021)	Women with disabilities (WWD)	Systematic review of qualitative studies	Sociocultural discrimination – ignored, judged, insulted, violence, stigmatised. Barriers include personal factors, lack of communication tools by health care providers, social cultural factors such as age, marital status, access to transport, and financial barriers. Denied rights to parenthood.
26	Miller and Kurth (2022)	Disabled girls of colour aged 11-21, a teacher	Qualitative	School geographies and learning tools exclude and deny rights through spaces and surveillance, access to equipment.
27	Miller and Smith (2021)	University students with LGBTQ identities and disability	Qualitative	LGBTQ examples of microaggression that do not fit with existing taxonomy. Intersectional microaggressions, normalised microaggressions, identity management, passing and visibility/legibility of identities.
28	Moral et al. (2022)	#MeCripple twitter campaign 2018	Qualitative	Ablest discrimination and microaggression online. Twitter as a counter space to “help participants cope with ableist microaggressions and result in organised physical assemblies” and public exchanges. Raising awareness can help people unaware of ableist microaggressions better understand these forms of discrimination and mobilise them alliances to counter aggressions.
29	Morrison et al. (2020)	n = 206 people with Multiple Sclerosis (MS) with unpaid caregivers	Quantitative	People with MS who experienced abuse. Over 50% of American adults with advanced MS reported mistreatment by caregivers.
30	Rutland et al. (2022)	Para athletes	Qualitative	Described emotional and psychological abuse in the form of undue pressure from coaches and bullying from teammates.
31	Schroer and Bain (2020)	TV episode “Disabled but not really” Queer Eye	Qualitative	Conceptualising microaggression to understand mixed interpretation. Unintentional nature of some microaggressions, when the target, perpetrator and bystander experience different versions of the event leading to multiple readings of intentionality and harm.
32	Sullivan (2021)	People with Autism Spectrum Disorder	Qualitative	Organisational oversight, lack of accommodations for workplace participation.
33	Thorneycroft (2020)	Author and one participant	Autoethnography	The public body, queer theory and visible disability, stared at, forced intimacy and bodies under surveillance.
34	Wayland et al. (2022)	Young people with disability	Qualitative	Day-to-day discrimination, lack of care in organisations (safety cameras not working, ramps not available if train is crowded), abusive public transport staff, accessible seating contested by general public, and unwanted “help”.
35	Willis (2020)	Three reviews of care facilities for vulnerable adults (1967, 2011, 2019)	Qualitative	Staff playing games, incorrect documentation of incidents, lack of dignity and respect. Institution had suboptimal environments, lack of leadership and understaffing.
36	Wiseman and Watson (2022)	Adults with learning difficulties	Qualitative	Bullying in public, on transport, violence and assault at home, name-calling, kicking doors, shouting. Violence legitimised by lack of intervention by witnesses. Everyday victimisation of PWD is a public health concern, institutionalised disablism.

Table 2. Number of articles per population focus.

Population	Articles
People with specific disability (FASD, ASD, stutter, MS, Deaf, brain injury, invisible disability, learning disability, mental health, physical disability, visual impairment)	14
People with disability, their family, activists, service workers, stakeholders	7
People with disability (unspecified)	6
Women with disability (unspecified)	1
Young people with disability (all, girls of colour, complex needs, unspecified)	4
People with intellectual disability	3
People with disability who identify as sexual minority	2

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