Can disability studies contribute to client-centred occupational therapy practice?

Occupational therapists frequently cite a ‘client-centred’ approach as a fundamental aspect of their practice. However, there are many examples in the narratives of disabled people that suggest that the health and social care services they experience do not quite meet this aspiration. The authors propose that an understanding of disability from disabled people’s perspectives is elemental to client-centred practice and that knowledge of the academic discipline of disability studies can contribute to authentic client-centred occupational therapy

Universal design for learning: what occupational therapy can contribute

As an occupational therapist supporting disabled students1 in higher education, I frequently came across barriers that impacted on students’ ability to succeed in university. I recognised that many issues were due to an inaccessible educational environment rather than impairment, that modifications for diverse learners supported all students and how my occupational therapy perspective could contribute to affecting institutional change through promoting and explaining universal design for learning. This article presents a perspective on how occupational therapy could contribute to universal design for learning (UDL), a specific educational application of universal design. It first explains the basic principles of UDL and then explores the contribution that occupational therapy could make to this area and how we could all benefit from it

The meaning of the experience of sea kayaking for persons with spinal cord injury

Engagement in meaningful activity is at the core of occupational therapy; when a person sustains a spinal cord injury (SCI), access to leisure activities that once had meaning may become limited. This study aims to gain an insider’s perspective on the meaning of engaging in kayaking as a leisure pursuit for six adults with a SCI. It compares the findings to an original study by Taylor & McGruder (1995). A qualitative approach using Spradley’s (1979) interviewing technique was employed. A number of meaningful themes matched the original study by Taylor & McGruder (1995) and were consistent with current literature: atmosphere, achievement, adjusting, safety and physical benefits. The two unique findings of this study were the themes of sense of freedom and equality. Overall, kayaking was found to offer the participants with a SCI a unique experience to participate on equal terms with an able-bodied person, and facilitates freedom of mobility on the water

Blurry Lines: Reflections on “Insider” Research

Insider research poses a range of benefits and challenges for researchers and the communities being researched. It is commonly advocated for disability research but there is limited work exploring disabled researchers’ experiences. Influenced by autoethnography and through a process of asynchronous structured conversations, we reflected on our experiences as two blind researchers. Through our collective reflective process and analysis, we created three main themes: insider research is complex and subjective, there is judgment about the “right” thing to do, and insider research requires “different” work. We argue that insiderness is more than sharing characteristics: it is a situated, fluctuating, and “felt” experience. The complexities, judgments, and emotional labor associated with insider research can challenge researchers in potentially very personal and unexpected ways. We propose that further investigation is required about how researchers can best prepare for, engage ethically throughout, and be supported through the insider research process

Care coordination for children with a disability or developmental difficulty: Empowers families and reduces the burden on staff supporting them

Background: Almost half of all children and young people with a disability or developmental difficulty (DDD) have complex disability and are likely to require multidisciplinary care. Care coordination (CC) aims to provide a single point of contact and a coordinated service, thereby improving care experiences, meeting unmet needs and empowering families. The impact of CC for children with DDD was evaluated. Method: Between May and August 2020, an in‐depth evaluation of CC in Gwent, South Wales was conducted. Of 284 families who accessed CC, 38 were approached, as well as 177 health and social care professionals based at Serennu, Nevill Hall and Caerphilly Children's Centres. Nine families and 14 professionals completed semi‐structured interviews. Interview transcripts were analysed using thematic analysis. Results: This evaluation found perceived improvements in families' abilities to navigate, organize and understand care and increased parental engagement. Professionals observed fewer missed appointments, and both professionals and families described CC as a source of holistic support, including practical advice regarding housing, finances and emotional support. Professionals commented on CC easing pressure on their service. Potential limitations included restricted staff capacity and the role not being defined clearly for families and professionals. Conclusions: At a time of increased stress for families of children with DDD, and scarce resources to support them, care coordinators play a vital role in assisting families to engage with health services, while feeling supported and empowered. CC reduces the burden on professionals, while enhancing relationships with families

Disabled people’s voices on sexual well-being

Disabled people have equal rights to positive sexual wellbeing including sexual citizenship; however, this may not always be experienced and support for sexual well-being is less likely to form part of services offered by professionals in health and social care services. Inspired by disabled people, phenomenological research into the experience of sexual well-being for a group of physically disabled adults was undertaken. The results show that sexual well-being is understood in several ways. The notion of sexual well-being raises issues of the physical body, connection to notions of normality and what support disabled people want from health and social care professionals. There is a clear link between sexual well-being and other aspects of physical and emotional well-being, making it an issue which needs to be proactively addressed by health and social care professionals in ways which are directed by disabled people

Educational outcomes of children with cerebral palsy

Introduction Children with special educational needs (SEN) are more likely to have disadvantaged backgrounds than their peers, attend school less and do not achieve as well academically. Many children with a cerebral palsy (CP) have SEN but little is known about their educational outcomes. Objectives and Approach To investigate the background of children in Wales with CP and describe their educational experience including: type of SEN and SEN provision; school attendance; achievement—teacher assessments at the end of the Foundation Phase and Key Stages 2 and 3 of the National Curriculum (NC)— and in General Certificate of Secondary Education (GCSE) examinations. Data from the Pupil Level Annual School Census (PLASC), NC and GCSE results were linked with routine e-health records of primary and secondary health care data held in SAIL. Using health care records for everyone aged between 0-25 in 2004–14, cases of CP were flagged. Results The linked data set included some 1500–2000 children per school census classified as having a CP, representing a prevalence of some 0.3%. Provisionally, results show: prevalence of CP is higher amongst children living in relatively deprived areas; around 60% of CP children have a statement of SEN; the SEN type most commonly recorded for CP children with SEN is ‘Physical and medical difficulties’ and relatively high proportions have profound, multiple or severe learning difficulties; around 30% of CP children are educated in special schools; CP children in main stream (primary, middle and secondary) schools tended to miss more school sessions (~50% more) than other children and lower percentages achieved the expected levels at key stages 2 and 3 and the Level 2 GCSE threshold. Conclusion/Implications This work demonstrates the utility of record-linkage for providing information to parents, carers and policymakers about education outcomes for this group of children to inform planning and service provision

First- and second- generation design and engineering students: Experience, attainment and factors influencing them to attend university.

Challenges for students who are ‘first in family’ to attend university have been discussed within widening participation discourse. However, in the UK, ‘first in family’ or first-generation students have frequently been conflated with those experiencing poverty or from lower socio-economic groups. This research integrated survey data with assessment data from final-year design and engineering students in a UK university to examine students’ attainment, the influences on why students decide to attend university, and students’ experiences during their degree programmes. Analysis of the data showed variations in the reasons for first- and second-generation students wanting to go to university, particularly a significant difference in the influence of parents. First-generation students described significantly less parental influence on the decision to attend university than second- or subsequent-generation students. Smaller differences in students’ experiences and attainment in university were also noted. While first-generation students reported differences in study habits, their attainment was, on average, marginally higher than that of their peers. Building on others’ theoretical work, which suggests the importance of social capital within higher education, this research highlights the difference in social influences both on university application and expectations of university for those with and without a family history of tertiary education. Further research is needed to explore, in larger samples, whether the social influences on an individual’s perception of higher education are in turn shaped by whether or not their parents attended university, and further, what impact this may have, not only on degree outcomes but on the broader benefits typically associated with graduate experience