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

Troubling ideas for widening participation: how higher education institutions in England engage with research in their access agreements.

This article explores how higher education institutions in England engage with research in their access agreements. Through an analysis of access agreements from 2014-15 to 2016-17, a picture of how research is understood, undertaken and documented emerges. A lexical analysis of the texts was used to establish the different ways research is being referred to or funded as part of the access agreement process. The analysis shows a productive relationship between national policy and institutional activity. But there appears to be a lack of infrastructure at an institutional and sector level to join up sustained and rigorous research with widening participation activity and policy. This means that, even after ten years of access agreements, widening participation is not fully embedded into the academic practice of higher education. We argue that research undertaken as part of the access agreement process can provide much needed evidence of impact and situate activity within an institution-wide context. However, we also suggest that widening participation research has the potential to offer productive troubling ideas to dominant rhetoric and, in so doing, shape new ways of thinking about, and doing, widening participation within institutions and across the sector

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