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Purpose: The rollout of individualised disability funding in Australia resulted in an increased demand for services for people with a disability, particularly support for the high percentage of Australians with autism spectrum disorder. Continuing professional development is one way to grow and maintain a skilled workforce; however, face-to-face opportunities can be limited in remote areas of Australia. Technology may provide a low-cost and widely accessible platform for providing education and support for staff in these areas. Design/methodology/approach: The current study evaluated a novel webinar training and individual online support program for 36 allied health, education and community support staff. Data were collected via a survey on changes in perceived "knowledge and skills" and "confidence" in supporting children with autism, as well as mode of participation, and accessibility of the program. Findings: Participants reported a significant increase in their "knowledge and skills" and "confidence", in working with children with autism. This increase was positively related to the number of webinars the participants accessed. The mode of webinar access was predominantly via watching recordings of webinars (asynchronous learning). Synchronous learning via individual online sessions was accessed by a small number of participants, mostly allied health professionals. Workload and scheduling were identified as barriers to engaging in the program. The technology platform was found to be accessible and acceptable. Originality/value: A predominantly asynchronous mode of delivery was successful, thereby increasing program access and flexibility for remote staff. Technology was not a barrier to accessing the program regardless of remoteness or job role.

Introduction: This study compares the experiences of high school students with visual impairments (that is, those who are blind or have low vision) in and out of school. Methods: Twelve visually impaired high school students completed the same in-the-moment survey seven times daily for seven consecutive days. The frequencies of their activities, interactions, and ratings of internal variables (fitting in, acceptance, loneliness, and enjoyment) were compared across three contexts: home, school, and other (neither home nor school) contexts. Results: Participants spent much of their time out of school alone at home. They rated leisure and structured recreation in "other" locations as their most enjoyable activities. Doing nothing at school was the least positively rated activity. Participants fitted in significantly less and felt significantly less accepted at school than elsewhere. A large proportion of school interactions involved receiving help; few involved giving help. Participants with additional disabilities reported more school social challenges than their peers who were only visually impaired. Discussion and implications for practitioners: This study highlights the subjective dimensions of choice in everyday life. The social impact of doing nothing at school provides an imperative for staff members to ensure that adolescents with visual impairments can participate in lessons. Staff may also need to facilitate opportunities for these students to reciprocate with peers. Adolescents with visual impairments highly value activities with friends out of home and, as with most adolescents, may need to lean on their families for assistance in this area until they can participate in such activities independently.

Introduction: This study explores the social experiences in high school of students with visual impairments. Methods: Experience sampling methodology was used to examine (a) how socially included students with visual impairments feel, (b) the internal qualities of their activities, and (c) the factors that influence a sense of inclusion. Twelve students, including three with additional disabilities, completed the Psychological Sense of School Membership (PSSM) questionnaire as a measure of inclusion. They were subsequently asked to complete an in-the-moment survey seven times daily for one week using an iOS device. This survey asked about activities and ratings of internal variables: fitting in, acceptance, loneliness, awareness, and enjoyment. Each student was also interviewed. Z-scores were created for internal variables and correlations calculated to examine relationships between experiences, PSSM, and demographic variables. Results: This group felt included as measured by the PSSM (m = 4.24, SD = 0.67). Students' most frequent activity was classwork. Doing nothing rated most negatively and was described as time wasting. Out-of-class activities were rated most positively. In the three participants with additional disabilities, it appeared that the presence of this additional disability negatively influenced a sense of inclusion (rb = -0.67, p < 0.05), fitting in (rb = -0.86, p < 0.05), enjoyment (rb = -0.65, p < 0.05), and loneliness (rb = 0.88, p < 0.05). Interviews revealed a lack of common ground between adolescents with both visual impairments and additional disabilities and their peers. Discussion and implications for practitioners: These students worked hard to maintain parity with peers and found school more enjoyable if they fit in. It is important to provide discreet and timely access to the curriculum. Friendships require time, common interests, and reciprocity. There may be potential to further explore out-of-class clubs as a means of supporting friendship development. In addition, findings suggest that students with additional disabilities are not likely to feel included. Because this population comprises the majority of visually impaired students, this result has serious implications for practitioners and should be examined in future research.

Individuals with an autism spectrum disorder commonly have limited social participation. This study aimed to examine the similarities and differences of everyday participation among males and females with autism spectrum disorder in Australia and Taiwan, using an experience sampling methodology. A total of 14 Australians (4 males, aged 16-43 years) and 16 Taiwanese (12 males, aged 19-45 years) with autism spectrum disorder who are cognitively able were asked to carry a device which prompted them seven times per day for 7 days, to record everyday participation: where they were, what they were doing, and who they were with. Multilevel analyses were used to identify the relationships between everyday participation and associated factors including gender, country of residence, clinical severity of autism spectrum disorder, and social anxiety. The results showed that Taiwanese participants were more likely to stay at home than Australian participants. However, female participants were more likely to engage in social situations than males. Furthermore, participants with fewer autism spectrum disorder symptoms and those with higher levels of social anxiety were less likely to engage in social interactions. This study sheds light on ways that culture and gender affect social participation and highlights the relationship of social anxiety to social participation. The findings have implications for interventions for social participation.

Because leisure activities are often viewed as optional, their value to people with disabilities may not be recognized. This study explored the benefits of leisure activities for eight young people who are blind. These activities provided them with supportive relationships, a desirable identity, experiences of power and control, and experiences of social justice. They enabled the young people we studied to thrive despite adversity. (Contains 1 table.)

School playgrounds offer everyday opportunities for physically active and social play that combats obesity, develops skills, and promotes well-being. However, teachers' fear of the legal consequences of injury can elicit over-zealous risk reduction with the result that playgrounds lack challenge, and the potential benefits of play become limited. In this research, we trialled a simple, cost-effective strategy to encourage children to be more active and social on a school playground. Over 11 weeks, we made available materials with no fixed purpose (e.g. car tires, boxes) to a playground of children aged five to seven. Accelerometers showed children became significantly more active. Interviews with teachers suggested children also became more social, creative, and resilient. However, despite no incidence of injuries, teachers perceived an increased risk and encountered dilemmas regarding duty of care. We conclude that future interventions should address issues of 'surplus safety' at individual, school, system, and policy levels.

This study explored the social inclusion in high school of Australian students with vision impairment (VI). We sought to understand how students described school social inclusion, whether they felt included and what influenced these perceptions. As part of a larger mixed methods study, 12 students with VI, who had previously answered the Psychological Sense of School Membership (PSSM) questionnaire, were interviewed about the social aspects of school. These interviews were analysed thematically. Participants described social inclusion as about being noticed and not overlooked by others. While two-thirds of participants reported satisfactory social relationships in high school, one-third, including all those with additional disabilities, reported being teased or rejected by their school peers. Five themes encompassed the varying influences on school social inclusion. These were: (a) putting myself forward; (b) knowing me; (c) having control; (d) having a place to shine; and finally a negative influence (e) peer exclusion and rejection. These themes largely parallel those of competence, autonomy, and relatedness found in self-determination theory. This suggests that staff can enhance the social inclusion of students with VI by facilitating these students’ self-determination. In practice, this would require school staff to focus on enabling students with VI to explore and build on strengths, fully access the curriculum alongside their peers, and have time and opportunity to develop friendships with these peers. [ABSTRACT FROM AUTHOR]

Background: Providing 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/design: We 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.Discussion: New 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 Registration: Australian and New Zealand Clinical Trials Registration Number ACTRN12614000549628 (registered 22/5/2014). [ABSTRACT FROM AUTHOR]

Introduction: Engagement in meaningful occupations is of central importance in mental health recovery. The purpose of this study was to gain a richer understanding of the relationships between occupations, sources of meaning and recovery for people living with mental illness. Method: People living with mental illness (n = 78) attending an Australian Clubhouse completed the recovery assessment scale and socially valued role classification scale. Qualitative and quantitative data were analysed using mixed methods. Findings: The most meaningful occupations were those most likely to provide opportunities for social connection and being valued by others. The frequency with which these socially derived sources of meaning were identified far outweighed other sources: positive sense of self; skills/personal development; time use/routine; financial gain and fun/pleasure. Neither the occupations identified as most meaningful nor the source of meaning differed depending on level of recovery. Conclusion: Irrespective of stage of recovery, socially derived aspects of meaning are most frequently prioritized by people living with mental illness. In facilitating engagement in personally meaningful occupations, occupational therapists need to understand that, for many, meaningfulness centres around inter-dependence: being with others, belonging, giving or contributing and being valued by others. [ABSTRACT FROM AUTHOR]

Background/aim Previously developed cut-off scores for off-road assessments, DriveSafe and DriveAware, were applied to data from a new sample. Our aim was to determine whether results from previous research are replicable in a different population, to further investigate the psychometric properties of the tools. Methods Using a retrospective cohort design, we analysed data from DriveSafe and DriveAware gathered in three driving centres in Sydney ( N = 90). We calculated sensitivity and specificity of DriveSafe and DriveAware data for predicting results of on-road testing. Results Sensitivity and specificity for this study were very similar to those documented previously. The lower cut-off produced specificity of 96%, identical to previous calculations. The upper cut-off score yielded sensitivity of 91% compared with 93% previously. When scores from DriveSafe and DriveAware were trichotomised (i.e. 'pass,' 'fail,' and 'requires on-road testing'), they predicted on-road performance of about half of drivers with ≥ 90% accuracy. Conclusion Findings will add to the body of evidence suggesting that not all drivers referred to occupational therapy driving assessors require expensive, time-consuming and potentially high risk on-road assessments. [ABSTRACT FROM AUTHOR]

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.

Aim: To investigate parent-reported health status of boys with Duchenne muscular dystrophy (DMD) compared with a large Australian normative population and a cohort of children with Charcot-Marie-Tooth disease type 1A (CMT1A)., Methods: The Child Health Questionnaire parent form (CHQ-PF50) was completed by parents of 34 boys with confirmed DMD. Seventeen parents were followed up at 6 months. CHQ-PF50 data were compared with 2620 age-matched norms and 90 children with CMT1A., Results: All domains of the CHQ-PF50 for the DMD cohort were significantly lower than the general paediatric population, particularly for physical functioning (t = -17.2, P < 0.001) and the child's ability to fulfil school and social roles because of physical limitations (t = -9.4, P < 0.001). Parents experienced greatest emotional impact of their child's DMD around the time of loss of ambulation. Children with DMD had lower health status compared with children with CMT1A with the exception of the behaviour and pain domains. Physical functioning worsened during 6 months (P = 0.04); no other changes in health status were observed at follow-up., Conclusions: Parents report the impact of DMD on health status to be considerably worse when compared with CMT1A. Interventions should target minimising the impact of physical limitations on role functioning., (© 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)

Background: Sensory processing disorders have been linked to stereotypical behaviours in children with intellectual disability (ID) and autism spectrum disorders (ASD) and to anxiety in children with ASD. In earlier phases of this study with the same participants, we found that those with both ASD and ID were more motivated than those with ID alone to engage in stereotypical behaviour to alleviate anxiety. In this phase, we confirmed that children with both ASD and ID and those with ID alone process sensation differently than typically developing children. We asked: Do the sensory processing difficulties of children with ASD and ID differ significantly from those of children with ID alone in a way that would help explain the increased anxiety of the former group?, Method: Parents of children with ASD and ID (n = 29; mean age 9.7 years) and with ID alone (n = 23; mean age 9.5 years) completed a Sensory Profile (SP) to provide information about their children's sensory processing abilities. SP quadrant scores for each group were compared with each other and with the published norms of typically developing children., Results:   Children with ASD and ID and with ID alone processed sensory information differently than typically developing children (P=0.0001;d= >2.00). Children with both ASD and ID were significantly more sensitive (P=0.007;d=0.70) and avoidant (P < 0.05;d=0.47) than the children with ID alone., Conclusion: We conclude that increased sensitivity and the tendency to avoid sensation may help explain anxiety in children with autism., (© 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.)