Michelle Villeneuve

A critical examination of school-based occupational therapy collaborative consultation

Background Although collaborative consultation has been widely adopted in school-based occupational therapy practice, there is limited conceptual understanding of how collaboration contributes to educationally relevant outcomes for students with disabilities. Even without a clear understanding of the evidence related to school-based occupational therapy services, there continue to be decisions about funding and delivery of services. Purpose This paper synthesizes and critically appraises the research literature on collaborative consultation services in school-based occupational therapy in order to provide program administrators with direction for critically examining decision making for service deliveryin their districts. Key Issues Advancing occupational therapy practice in education settings requires a sound theoretical understanding of collaborative consultation. Distributed cognition offers a more robust understanding of the relationship between educator-therapist collaboration and outcomes of school-based occupational therapy services. Implications This review concludes with two fundamental conditions necessary for collaboration between educators and occupational therapists to flourish.

A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: self-management programs for stroke survivors

Abstract Purpose: A systematic review of stroke self-management programs was conducted to: (i) identify how many and what self-management support strategies were included in stroke self-management interventions and (ii) describe whether self-management programs effectively improved outcomes, focusing specifically on function and participation outcomes. Methods: Twelve databases were searched for the years 1986–2012 to identify self-management programs for stroke survivors. Pre-post, quasi-experimental and randomized controlled trial study designs were included. Descriptive information about the intervention was scrutinized to identify what self-management support strategies were present in the intervention and comparisons were made between programs using a group versus a one-to-one format. All outcomes were included and categorized. Results: The most prominent strategies identified in our review were goal setting and follow-up, and an individualized approach using structured information and professional support. There are indications that self-management programs can significantly increase participation and functional ability. However, the high level of clinical heterogeneity in program delivery, outcomes and level of stroke severity made it impossible to conduct a meta-analysis. Further examination of individual self-management support strategies, such as linking rehabilitation goal setting to post-acute self-management programs, the inclusion of family members and the contribution of peer-support is warranted. Implications for Rehabilitation Self-management programs for stroke survivors: Linking post-acute self-management programs to rehabilitation goal setting could improve outcomes. Involving family members in self-management programs may benefit stroke survivors.

Factors predicting applicant outcomes in occupational therapy education.

Background. Student selection for health science programs is a complex process designed to identify individuals who are most likely to succeed academically and professionally. There is limited evidence supporting specific admission criteria beyond the pre-admission GPA, and no strong evidence substantiating the need for specific academic prerequisites. Purpose. This study examined the predictive value of selected pre-admissions criteria relative to student outcomes in a master of occupational therapy program. Methods. The study involved analysis of data for 129 students admitted to a new master in occupational therapy program. Findings. Results show strong support for the pre-admission academic average as a selection criterion and limited support for referee ratings. No evidence was found linking pre-admission coursework to subsequent performance in courses of similar content. Implications. Results provide evidence upon which to ground admissions decisions, and point to the need for further examination of the value of extensive pre-admission course requirements.

The Sydney playground project- levelling the playing field: a cluster trial of a primary school-based intervention aiming to promote manageable risk-taking in children with disability

BackgroundProviding children and adults with opportunities to engage in manageable risk taking may be a stepping stone toward closing the gap in life conditions currently experienced by young people with disabilities. We aim to demonstrate the effectiveness of a simple, innovative program for 1) changing the way parents and teachers view manageable risk-taking for children with disabilities and 2) increasing the level of responsibility that children take for their own actions, as seen on the school playground.Methods/DesignWe will employ a cluster repeated measures trial with six Sydney-area primary-school-based programs for children with disabilities. The intervention comprises two arms. 1) Risk-reframing- teachers and parents will participate together in small group intervention sessions focusing on the benefits of manageable risk-taking; 2) Introduction of play materials- materials without a defined purpose and facilitative of social cooperation will be introduced to the school playground for children to use at all break times. A control period will be undertaken first for two school terms, followed by two terms of the intervention period. Outcome measures will include playground observations, The Coping Inventory, qualitative field notes, and The Tolerance of Risk in Play Scale.DiscussionNew national programs, such as Australia’s National Disability Insurance Scheme, will place increasing demands on young people with disabilities to assume responsibility for difficult decisions regarding procuring services. Innovative approaches, commencing early in life, are required to prepare young people and their carers for this level of responsibility. This research offers innovative intervention strategies for promoting autonomy in children with disabilities and their carers.Trial RegistrationAustralian and New Zealand Clinical Trials Registration Number ACTRN12614000549628 (registered 22/5/2014).

Understanding Parent Advocacy during the Transition to School of Children with Developmental Disabilities: Three Canadian Cases.

Research has shown the benefits of parent involvement for student participation in education. Parent advocacy is a critical form of involvement by parents for children who are young, have disabilities, and are making transitions. Studies have classified forms of parent advocacy but have not illuminated the components necessary for effective parent advocacy. In this study of three families of children with developmental disabilities making the transition to kindergarten, we examined the applicability of Test’s conceptual framework of self-advocacy (CFSA) for guiding research and interventions for parent advocacy. The four components of CFSA were all reported in the parents’ experiences of advocacy. These cases highlight how parent advocacy is similar to, and more complex than, self-advocacy and suggest that parent advocacy is also influenced by the parent’s perceptions of the child’s needs and is context specific. In these cases, advocacy during transition reflects the parent’s priorities for the child’s inclusion.

Planning for outdoor play: Government and family decision-making

Abstract Background: Despite indisputable developmental benefits of outdoor play, children with disabilities can experience play inequity. Play decisions are multifactorial; influenced by children’s skills and their familial and community environments. Government agencies have responsibilities for equity and inclusion of people with disabilities; including in play. Aim: This multiple-perspective case study aimed to understand outdoor play decision-making for children with disabilities from the perspectives and interactions of: local government and families of primary school-aged children with disabilities. Material and method: Five mothers, four local government employees, and two not-for-profit organization representatives participated in semi-structured interviews. Inductive and iterative analyzes involved first understanding perspectives of individuals, then stakeholders (local government and families), and finally similarities and differences through cross-case analysis. Findings: Local government focused more on physical access, than social inclusion. Local government met only minimal requirements and had little engagement with families. This resulted in poor understanding and action around family needs and preferences when designing public outdoor play spaces. Conclusion and significance: To increase meaningful choice and participation in outdoor play, government understanding of family values and agency around engagement with local government needs to improve. Supporting familial collective capabilities requires understanding interactions between individuals, play, disability, and outdoor play environments.

Is play a choice? Application of the capabilities approach to children with disabilities on the school playground

ABSTRACT Outdoor play is important for children’s development and an area in which many children with disabilities struggle at school. The aim of this multiple-perspective case study was to understand educator play decision-making for children with disabilities within one low socioeconomic status and culturally and linguistically diverse community. Data collection included playground observations of children with disabilities and educators and interviews with teaching assistants, teachers, and a vice principal. Data were analysed inductively and thematically, with findings aligned to the capabilities approach. School staff and typically developing children appeared to not value the children with disabilities as players or learners, and had a limited understanding of the children’s home and community play environments. School staff had low expectations of children with disabilities’ play and learning capacities. Participants perceived children’s playground presence and not breaking rules as sufficient. Despite educators stating that children with disabilities had choice on the playground, the children experienced few meaningful choices due to relative skills delays and an unsupportive environment. Applying the capabilities approach may lead to greater choice through valuing all children as learners, players, and community members; raising play and learning expectations; and creating play spaces that support the play of all children.

The Role and Capacity of Disabled People’s Organisations (DPOs) as Policy Advocates for Disability Inclusive DRR in Indonesia

This chapter describes Disaster Risk Reduction (DRR) capacity building activities with disabled people’s organizations (DPOs) in four hazard risk provinces in Indonesia. Established as part of an Australian Aid supported development research initiative, the project was implemented in the last years of the Hyogo Framework for Action by the Centre for Disability Research and Policy, University of Sydney and Arbeiter-Samariter-Bund Deutschland e.V, Indonesia and Philippines Office. As in other regions, participation in DRR by Indonesian DPOs was highly limited under the HFA. With the Sendai Framework for DRR (SFDRR) now recognizing persons with disabilities as key stakeholders, there is a need to broaden knowledge on the role of DPOs in DRR. While the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) refers to situations of risk, the related article has received little attention from DPOs due to multiple competing priorities. Similarly, DRR actors have rarely engaged with the disability sector. The SFDRR calls for greater collaboration between these two groups. This chapter outlines core features of the capacity building initiative and the impact of the programme on equipping Indonesian DPOs to engage within DRR. We describe how capacity building initiatives contributed to increased collaboration between disability and DRR actors, providing a practical model for supporting DPOs as policy advocates in other regions and countries. Disability-inclusive DRR recognizes the importance of collaboration to reduce and prevent risk. As the chapter illustrates, the resources to achieve this are far closer at hand than the DRR community previously thought.

Uncertainty in the school playground: shifting rationalities and teachers’ sense-making in the management of risks for children with disabilities

Recent theoretical debates highlight the competing risk logics and varying rationalities mobilised in response to dangers and approaches to risk management. Yet the concept of uncertainty, and how it informs perceived risks, is relatively less well understood. Debates of this kind are illuminated in contexts where risks are managed as part of everyday practice. The school setting provides an example of a context in which risks are continuously negotiated amidst dominant protectionist concerns about children’s well-being and safety. Such protectionist concerns are particularly pronounced for children with disabilities, as assumptions about limited capabilities complicate and structure the everyday play experiences for children. Drawing on findings from the Sydney Playground Project, in this article we aim to unpack the felt discomfort experienced by school staff in their responses to uncertain moments in children’s play. We report qualitative data collected from two schools between October 2014 and September 2015 using video observations of children’s play and teachers’ responses to an online Tolerance of Risk in Play Scale. Our findings point to the competing logics and forms of sense-making operationalised by teachers to manage the unknown. Our analysis explored the ways in which risk strategies were (re)framed by school staff and such reframing explained their action (or inaction) in the playground and how these were underpinned by concerns about professional accountabilities. Their responses located risks within the child with disabilities, rather than the play activity itself. Another approach to uncertainty can be achieved by mobilising a discourse of trust in which ‘letting-go’ offers children opportunities to reflexively engage in risk-taking.

Incorporating Therapy into the Regular Curriculum: Working Together with Occupational Therapists

Abstract Over the past three decades, there has been considerable change in the education of children with disabilities in Canada. Children with developmental disabilities attend inclusive classrooms and are educated alongside their non-disabled peers, receiving services and supports to optimize their participation (Hutchinson, 2014; Slee, R. (2001). Social justice and the changing directions in educational research: The case of inclusive education. International Journal of Inclusive Education, 5(2), 167–177). In Canada, occupational therapists have provided services in schools for over three decades with the aim of supporting participation of children with disabilities (Graham, D. R., Kennedy, D., Phibbs, C., & Stewart, D. (1990). Position paper on occupational therapy in schools. Canadian Journal of Occupational Therapy, 57(4), 1–6; Reid, Chiu, Sinclair, Wehrmann, & Naseerl, 2006). This chapter presents examples from case study research conducted in Ontario, Canada, on the delivery of school-based occupational therapy (SBOT) for two young children (focal participants) with developmental disabilities. Case study research was used to describe the nature of SBOT service delivery from multiple stakeholder perspectives. Data were gathered over the duration of one school year using a combination of observation, document analysis, and interviews involving participants directly involved in the delivery of SBOT with each focal participant. Common characteristics in these two cases enabled cross-case analysis to identify features of collaborative working that facilitated educational programming and outcomes for students with developmental disability.