Impact of Occupational Therapy Education on Students' Disability Attitudes: A Longitudinal Study

Drawing on critical disability and universal design perspectives within occupational therapy

BACKGROUND

Critical perspectives which focus on socio-political influences on occupation have gained increased attention within the occupational therapy profession. Critical disability studies (CDS) question prevailing assumptions about disability and how disabling ideologies and practices are perpetuated in society. Universal Design (UD) is a design approach that aims to operationalise issues of inclusion and justice.

AIM

To identify and discuss how the tenets of CDS and UD can contribute to occupational therapy practice and research.

METHODS AND RESULTS

Drawing on the writings of leading scholars within CDS, UD and occupational therapy, we demonstrate the intertwined barriers faced by disabled children, youth, and adults who have participated in our studies and provide ideas on how practice can be guided by the tenets of CDS and UD to promote social equity.

CONCLUSIONS

Incorporating CDS and UD perspectives in occupational therapy practice and research requires a change in mindset and ways of working. Occupational therapy knowledge needs to be expanded to scrutinise disabling hindrances hidden within social and structural spaces, and implemented in services. We recommend working with disability communities to raise awareness and combat disabling barriers at various level of society, as mandated by policy.

Finding Our Strengths: Recognizing Professional Bias and Interrogating Systems

No one builds their lives on remediated weaknesses. No one. Who does a deficits-based approach benefit? Those we serve, or the professional community? Do our current models of practice support flourishing? Our professional biases make it hard for us to see not only how our practice may be getting it wrong today but is also perpetuating systems that prevent us from getting it right tomorrow. A paradigm shift to a strengths-based model that interrogates the educational, research, and practice systems we work in is proposed. It is a shift that we must see, speak, and act on. Our vulnerability and willingness to rethink is our strength, which will meet the changing needs of society. This lecture will draw on literature from positive psychology, disability justice, well-being, and research that centers the voice of self-advocates.

A call to resist occupational therapy's promotion of ableism

BACKGROUND

Critical occupational therapists have exhorted their profession to engage with disability studies' scholarship, curtail occupational therapy's promotion of ableism and amend its disabling practices. These appeals have largely been ignored despite their importance for a profession that researches, theorizes, assesses, and intervenes in the lives of disabled people.

AIMS AND OBJECTIVES

To interrogate occupational therapy's collusion with an ableist neoliberal agenda; and call for occupational therapists to resist their profession's disabling practices.

MATERIAL AND METHODS

This paper draws from critical disability scholarship to expose, critique and contest the ableist ideology underpinning occupational therapy.

RESULTS

Interlinked with racism, heteronormativity and gender binarism, ableism upholds certain bodies as normal and appropriate. Ableist values shape occupational therapy, with clients classified according to their proximity to 'normality', and exhorted to minimize their occupational performance deviations from dominant norms.

CONCLUSIONS

Collusion with colonialism's binary classificatory systems and neoliberal ableist norms, and avowed aspirations to improve bodies, 'normalize' performances, promote individualism, self-reliance, independence, self-care, and productivity contribute to the perception that ours is a disabling profession.

SIGNIFICANCE

This paper calls for occupational therapists to resist their profession's promotion of ableism, and refuse to collude with colonial practices that contribute to the oppression of disabled people.

Float to grow: nurturing the roots of socially inclusive and just practice in occupational therapy students

Abstract Models of practice and theoretical frameworks that seek to deemphasize impairment and focus on the implications of societal attitudes, norms, and culture are significant and relevant to the practice of occupational therapy. As an underpinning of client-centered practice, there is a need to highlight and embrace the intersection of impairment-deemphasizing theories and move from conceptual understanding to true application of those theoretical models in practice. This article describes the inclusion of the Salamander Workshop; an experiential learning activity designed to facilitate the development of students’ therapeutic self-awareness and initiate a starting point for incorporating social frameworks into authentic practice. Student reflections conceptualize the discussion about professional growth and development against the backdrop of disability experiences, social change, and empowerment. The article begins with an introduction to how the profession of occupational therapy and disability studies interconnect. This is followed by a description of both the occupational therapy education program where the experiential learning activity took place, and details of the workshop itself. The final two sections of the article articulate and discuss student reflections of the experiential learning exercise and conclude by framing the discussion within the larger context of occupational therapy pedagogy. The Salamander Workshop facilitated an opportunity for students to immerse themselves in the lived experience of others, while enhancing their own self-awareness, which in turn may translate to their growth and development as inclusive practitioners.

Explicit and implicit disability attitudes of occupational and physical therapy assistants

BACKGROUND

Reduction of explicit and implicit bias in healthcare providers is a critical issue faced by our society in moving toward more equitable and culturally appropriate health and rehabilitation care. Because resources for OT and PT services are limited and shortages in these professions exist, direct care provision by occupational and physical therapist assistants (OTA/PTA) is on the rise and valued in comprehensive rehabilitation practice. It is important to consider attitudes and biases of OTA/PTA, as they are directly involved in provision of rehabilitation services for people with disabilities.

OBJECTIVE

This study examined the explicit and implicit disability attitudes of a large cross-section of OTA/PTA.

METHODS

Secondary data analysis was completed using data from 6113 OTA/PTA from the Project Implicit Disability Attitudes Implicit Association Test. Implicit attitudes were calculated and OTA/PTA explicit and implicit disability attitudes were compared. Results were further categorized using an adapted version of Son Hing et al.'s two-dimensional model of prejudice.

RESULTS

Findings revealed the majority of OTA/PTA reported having no explicit preference for people with disabilities or nondisabled people. However, the majority of OTA/PTA were aversive ableists, indicating low explicit and high implicit bias.

CONCLUSIONS

Though explicit bias is lower in OTA/PTA, implicit bias is strong, indicating that people with disabilities face bias that may influence clinical interactions, and may be reproduced in professional education, practice, and policy. Concrete action must be taken to recognize and address disability bias to reduce health disparities in people with disabilities.

Disability Studies and Occupational Therapy: Renewing the Call for Change

Disability studies (DS) is an interdisciplinary field grounded in a minority studies philosophy that approaches disability as a socially constructed phenomenon. The first special issue of the American Journal of Occupational Therapy on DS was published in 2005. The present issue serves as a follow-up to highlight opportunities for and examples of DS integration into occupational therapy education, research, and practice. Studies in this special issue reflect a DS approach to research that prioritizes lived experiences, critical approaches, and participatory methodologies. Reported interventions focus on changing societal barriers rather than remediating individual impairments and acknowledge instrumental activities of daily living often neglected by traditional research. Studies on educational practices in occupational therapy have found persistent issues around negative attitudes toward disability and many opportunities to better infuse disabilities studies into curricula. Revisiting DS as it applies to occupational therapy has shown that many of the issues and considerations raised in 2005 remain in the field today. Recommendations across articles in this special issue highlight that advocacy and working for broader social change are essential for occupational therapy practitioners, given ongoing occupational injustices for people with disabilities. Infusing DS ideas into occupational therapy can promote greater alignment with priorities of disability communities and spur professional change to dismantle oppressive structures and ideologies.