Who decides what's beautiful?

This adorable little tot is the face of a new advertising campaign by Spanish swimwear designer Dolores Cortés according to Adweek. "People with Down syndrome are just as beautiful and deserve the same opportunities," Cortés is quoted as saying.

Amen. This was a bold step in a business that typically renders children and adults with disabilities invisible. How often do you see children with disabilities featured in ads or mainstream media? What about parenting magazines? And not as part of a 'niche' story about a particular type of disability, but as part of the broad 'landscape' of childhood, which, in reality, they are?

A couple of weeks ago I flew in to Toronto's International Airport and walked under a massive billboard featuring children from diverse cultures. The creators must have gone to great lengths to ensure this rich representation. But no child with disability was included. Why?

Turning Valentina (above) into a swimwear model proclaims loudly and clearly that children with differences are here, they're gorgeous, and they're valued. Disability is normal.

"Representation in media is a form of acknowledgement by society," disabled British model Shannon Murray writes in The Independent. "...Consider Cherylee Houston’s character, Izzy, in Coronation Street or Cerrie Burnell presenting on CBBC. Both received press attention because of their difference, but now that is barely mentioned, they are simply accepted by viewers as performers on television like their able bodied colleagues. I welcome the day when we might have a kick-ass Disney heroine who just happens to have a disability so disabled children can see representation from a young age."

I'd like to see a Disney heroine with an intellectual disability.

On an oddly related note, a friend posted a link to this San Francisco Chronicle story about a New York charity that offers free plastic surgery to typical children who have been bullied because of their appearance. No, you didn't read that wrong! Featured in a CNN video included with the online piece is Nadia, a typical 14-year-old girl who was bullied for her protruding ears. The Little Baby Face Foundation covered a $40,000US procedure to have Nadia's ears pinned back. But they didn't stop there. The surgeon who saw Nadia decided her nose and her chin needed some work too.

Some of you remember my blog about an otoplasty my son Ben had that wasn't successful. To be fair to Little Baby Face, the stated objective on their website is to offer free plastic surgery to children with craniofacial 'deformities' like my son -- not to those who are teased for typical features.

However, the idea that a solution to bullying for a girl like Nadia is to change her appearance -- rather than the perpetrators' behaviour -- reminded me of a trend in the 1990s to 'normalize' children with Down syndrome through plastic surgery. It wasn't uncommon then for children with Down syndrome to undergo procedures that included shortening the tongue, removing skin folds from the eyelids and pinning the ears.

And this is how the Little Baby Face plastic surgery story circles back to little Valentina's ad campaign above.

French research* published in April this year showed that adults evaluating photos of children with and without Down syndrome were more likely to rate children with Down syndrome less favourably if they had features 'highly distinctive' of the disorder. This would seem to suggest that children with Down syndrome whose features have been 'muted' through surgery will be better accepted socially.

Of course that's not a reason to do the surgery!

The same French researchers also had adults do implicit-association tests, which capture the strength with which certain groups of people are automatically, without conscious awareness, associated with positive or negative attributes.

They found that at this unconscious level, photos of children with Down syndrome were automatically associated with a negative trait, even by people who had openly rated the photos positively. "People may not have access to some of their thinking which is not conscious," said study researcher Claire Enea-Drapeau. Even when people are outwardly accepting of children with Down syndrome, negative "implicit associations may persist, proving that these associations can be retrieved from memory. These are the result of social attitudes and values carried by our cultural environment. As long as we don't know about them...we are trapped in automatic attitudes or associations. But when you are aware of it, then you can start to struggle."

Rather than excluding children with disabilities from media images -- or trying to make them more 'normal' through surgery -- and staying trapped in archaic stereotypes, I'd like to see kids with disabilities represented in popular culture so that we can begin 'the struggle' Enea-Drapeau speaks of. "If we know we are carrying implicit stereotypes, then we can choose to try to change them," Enea-Drapeau said.

Instead of expensive, painful surgical procedures I'd like to see investment in research on how to uncover and change hidden stereotypes.

*Enea-Drapeau C, Carlier M, Huguet P (2012) Tracking Subtle Stereotypes of Children with Trisomy 21: From Facial-Feature-Based to Implicit Stereotyping. PLoS ONE 7(4): e34369. doi:10.1371/journal.pone.0034369