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The foundation of inclusive education is that every learner has the potential to contribute positively to society. A sense of belonging to society is vital to this contribution, and to the growth and development of autistic children and young people. New Zealand has made some positive progress towards inclusive education, with some education institutes understanding that all children have the right to be educated and to receive the best possible education they can, regardless of ethnicity, culture or disability. However, research indicates that there are still barriers to inclusive education, and these barriers have drastic lifelong implications for autistic children and young people. This paper outlines inclusive education, identifies barriers from the perspectives of research through literature, educators and families through a small-scale study, and discusses lifelong implications of a non-inclusive education on autistic children and young people.

To examine feasibility and acceptability of providing stepped collaborative care case management targeting posttraumatic stress disorder (PTSD) and pain symptoms after major traumatic injury. Participants were major trauma survivors in Victoria, Australia, at risk of persistent pain or PTSD with high baseline symptoms. Participants were block-randomized, stratified by compensation-status, to the usual care (n = 15) or intervention (n = 17) group (46% of eligible patients). The intervention was adapted from existing stepped collaborative care interventions with input from interdisciplinary experts and people with lived experience in trauma and disability. The proactive case management intervention targeted PTSD and pain management for 6-months using motivational interviewing, cognitive behavioral therapy strategies, and collaborative care. Qualitative interviews explored intervention acceptability. Intervention participants received a median of 7 h case manager contact and reported that they valued the supportive and non-judgmental listening, and timely access to effective strategies, resources, and treatments post-injury from the case manager. Participants reported few disadvantages from participation, and positive impacts on symptoms and recovery outcomes consistent with the reduction in PTSD and pain symptoms measured at 1-, 3- and 6-months. Stepped collaborative care was low-cost, feasible, and acceptable to people at risk of PTSD or pain after major trauma. After hospitalization for injury, people can experience difficulty accessing timely support to manage posttraumatic stress, pain and other concerns. Stepped case management-based interventions that provide individualized support and collaborative care have reduced posttraumatic stress symptom severity for patients admitted to American trauma centers. We showed that this model of care could be adapted to target pain and mental health in the trauma system in Victoria, Australia. The intervention was low cost, acceptable and highly valued by most participants who perceived that it helped them use strategies to better manage post-traumatic symptoms, and to access clinicians and treatments relevant to their needs. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the patterns of objectively measured sedentary behaviour in adults with intellectual disabilities. Methods: Baseline accelerometer data were pooled from two randomized controlled trials of lifestyle behaviour change programmes for adults with intellectual disabilities. Patterns of sedentary behaviours were computed including total volume, number, and duration of bouts and breaks. Results: Participants spent >70% of the day sedentary (8 hr), which was generally accumulated in short sedentary bouts (<10 min). Participants were engaged in significantly more sedentary time during the morning, although differences between time of day were small (mean bout duration range: 19.8-22.3 min). Conclusions: The findings add valuable insight into the patterns of sedentary behaviours among adults with intellectual disabilities. Further research investigating the patterns and context of sedentary behaviour is required to develop targeted interventions to reduce total sedentary time in adults with intellectual disabilities.

Background: In the general population, the transition from adolescence to adulthood has been identified as a "high-risk" period for weight gain. There has been no research examining health behaviours over this transition in adults with intellectual disabilities. Methods/design: The feasibility of recruitment, retention and relevant health behaviours were measured in 31 adolescents with mild-moderate intellectual disabilities. Anthropometric, objective physical activity, dietary and self-determination measures were collected over a 12-month transitional period from school to adulthood. Results: Key results suggest weight and BMI increased significantly from month 6 to month 12 (p = 0.044 and p = 0.043). Waist circumference increased significantly from baseline to month 12 (p = 0.049), and from month 6 to month 12 (p = 0.03). Discussion: Recruiting and retaining young adults with intellectual disabilities over a 12-month health behaviour study is feasible. The data indicate the transition from school to adulthood may be the start of a high-risk period for weight gain.

Indigenous Psychology within Australia reflects the traditional knowledges of Aboriginal and Torres Strait Islander Peoples and their understanding of the cultivation of relational social and emotional wellbeing (SEWB). However, these perspectives are poorly incorporated into dominant "Western" psychological theories and practice, such as Cognitive Behaviour Therapy (CBT). This represents a barrier to the cultural safety of current mental health practice and its decolonisation within Australia. This study brought together CBT Practitioners and Practitioners of an Aboriginal Wellbeing practice ("Wayapa") to engage in a series of yarns (guided focus groups) to share perspectives, insights, and stories on their own and each other's practices. Indigenous qualitative research approaches including Research Topic Yarning were engaged to decolonise the research environment and support dialogue at the cultural interface of the two practices. Through experiencing Wayapa, CBT practitioners reflected on gaps in their own practice, with an enthusiasm for the opportunities that Wayapa provided to decolonise their practice. Wayapa practitioners were able to celebrate the holistic nature of their practice and the possibility for it to inform dominant "Western" psychological theories and practice, such as CBT, and encourage a more connected and culturally safe way of working with First Nations peoples. Creating safe cultural interfaces between "Western" and Indigenous Psychologies, and building awareness of the value of Aboriginal grounded wellbeing models, can help to promote and expand culturally safe practices within Australian psychological practice. What is already known about this topic: The cultural safety and relevance of CBT for Aboriginal and/or Torres Strait Islander Peoples remains uncertain. There is limited knowledge of Aboriginal wellbeing practices and Indigenous Psychologies amongst non-Indigenous Australian mental health practitioners, including psychologists. Broadened understanding of Aboriginal wellbeing practices such as Wayapa Wurrrk, may contribute to decolonising psychology in Australia. What this topic adds: CBT and Wayapa share common and unique tools and concepts that can support the social emotional wellbeing of all Australians. Wayapa Wurrrk concepts such as earth mindfulness and the centring of Country as a foundation for wellness and social emotional wellbeing represent gaps in current CBT practice. Work at the cultural interface of "Western" and Indigenous Psychology offers a pathway to promote appreciation for, and active utilisation of, Indigenous psychologies including the social emotional wellbeing framework (SEWB). In this article, we recognise both Aboriginal and Torres Strait Islander Peoples as the First Nations of Australia. We acknowledge and pay respect to the knowledge that Aboriginal and Torres Strait Islander cultures are unique, all with their own languages, knowledge systems, beliefs, and histories. We recognise the collective terms they prefer also vary. With respectful consideration to these preferences, typically we will specify Aboriginal and/or Torres Strait Islander Peoples when referring to First Nations Peoples in this article. From time to time, we use the term Indigenous. However, we note that for many Aboriginal and Torres Strait Islander Peoples, this is not preferred. As such, we have only used this where we are referencing it's use from another source, or it is the established use of the term, such as its use in "Indigenous knowledges". Where referring to individual Aboriginal and/or Torres Strait Islander people, we have endeavoured to incorporate their preferences, including for example, reference to the Country they are connected to. [ABSTRACT FROM AUTHOR]

Framed by Self-Determination Theory, this investigation explored student experience as they engaged in their physical education (PE), health and well-being (HWB) curriculum in Scotland for the first time. We aimed to uncover the features of various learning environments that appeared to impact upon student motivation in PE over the period one academic year. We carried out focus group interviews with students from one state secondary school (secondary 1 and 2; ages 12-14) and its feeder primary schools (primary 7; age 11 years) immediately after a selection of PE lessons throughout the year. Furthermore, to provide some additional context for our analysis, the students in each year completed a questionnaire (pre-post) to identify and understand their motivation for PE over time. The results from the interviews indicated that students had a number of positive and negative PE experiences. However, the results from the questionnaire demonstrate that the students' experiences during the first year of this 'new' curriculum had little impact on their motivation for PE. The findings highlight the importance of mixed methods research to provide context-specific account of student experience. This detail may be critical for the development of informed and effective pedagogy that supports student learning, health and well-being.

Background: The prevalence of obesity is higher in those with intellectual disabilities than the general population. The aim of the study was to understand the determinants of physical activity and dietary patterns in this population during their final year of school. Method: Qualitative data were generated from 10 interviews with adolescents with mild-moderate intellectual disabilities. Data were analysed using deductive thematic analysis, employing Self-Determination Theory as a theoretical framework. Results: Adolescents' environment and social interactions play a pivotal role in influencing physical activity and dietary patterns. Three themes emerged from the analysis: situatedness, motivation and wider environmental influences. Conclusions: School structure, high self-efficacy and social connectedness facilitate increased physical activity and healthier diet in adolescents with intellectual disabilities. Home life, low self-efficacy and a lack of social connectedness can serve as a barrier to PA and a healthy diet.

Background: Adults with intellectual disabilities (ID) experience significant inequalities and tend to be more sedentary and less physically active than the wider population. Walking programmes are an effective way to increase physical activity (PA) but have not been used in studies involving adults with intellectual disabilities. Method: Nineteen adults with intellectual disabilities participated in semistructured interviews or focus groups exploring their experiences of taking part in a walking programme (Walk Well). Data were coded using thematic analysis. Results: Four overarching themes emerged: perceived benefits of taking part in the programme, perceived drawbacks/ barriers, walking choices and using the Walk Well resources. While there was not a significant increase in walking for all, the participants reported positive experiences of taking part in the programme. Self-monitoring proved difficult for some, particularly reading the daily step count recorded on the pedometer and writing it in the diary. Carers also played an important role in facilitating and preventing behaviour change in adults with intellectual disabilities. Conclusion: Additional barriers prevent many adults with intellectual disabilities from participating in PA. Capturing participant experiences provides important information for designing effective and equitable health improvement programmes.

Introduction: Responsiveness of health care systems is a global concept defined as the ability of systems to function in a manner that meets the expectations of individuals, and is under‐studied. In Australia, Aboriginal Community Controlled Health Organisations (ACCHOs) are valued by Aboriginal and Torres Strait Islander Peoples for the provision of holistic culturally safe primary health care and are well positioned to be responsive to community needs. Objective: To develop a conceptual framework examining the responsiveness of a rural ACCHO to the health care needs of Aboriginal and Torres Strait Islander Peoples in their service region. Design: A qualitative interview study using abductive reasoning was conducted. Interviews conducted with Aboriginal clients, key informants, and ACCHO health personnel from two evaluations undertaken in partnership with a rural ACCHO located in Victoria, Australia, were analysed through an iterative process of identifying key concepts from the data and evidence. Key concepts were used to develop a conceptual framework. Findings: Across the two evaluations, 22 participants were involved in data collection and 28 interviews were undertaken. A conceptual framework examining the responsiveness of a rural ACCHO to the health care needs of Aboriginal Peoples within their service region was developed and encompassed three concepts: operating within a complex adaptive system, mechanisms of responsiveness used by the ACCHO, and challenges experienced by the ACCHO when being responsive. Discussion: The developed conceptual framework expands on research supporting the value of ACCHOs in providing holistic culturally safe health care to their communities, particularly in rural settings. A key finding is the importance for ACCHOs to meet the health care needs of their community whilst navigating needs in the context of the broader health care system. When dissonance is encountered between external system components and community needs, challenges can be experienced such as adequately resourcing models of service delivery and maintaining the provision of services. Conclusion: Conceptualising the health care system as a complex adaptive system in which an ACCHO operates and is responsive, highlights the competing demands experienced. Findings expand on mechanisms of responsiveness used at the service–user interface. Future research should examine how the broader health care system can support the role and functions of ACCHOs in being responsive to the health care needs of their communities. [ABSTRACT FROM AUTHOR]

This paper draws on work undertaken to inform the alternative Children's Right Impact Assessment (CRIA) undertaken by the Observatory for Children's Human Rights Scotland (the observatory) in the early months of the impact of COVID-19 in the UK. With reference to children who are at risk of neglect and abuse, potentially subject to statutory intervention in family life, or living in care, the paper focuses on the purpose, process and value of children's rights impact assessments (CRIAs). It argues that wider understanding of the limitations of policy-making processes and close attention to existing limitations of CRIAs can help to enhance their effectiveness in achieving the realisation of children's rights in practice. [ABSTRACT FROM AUTHOR]

Background: There is a significant amount of research which shows a proportion of girls are not engaging with physical education (PE) in school, resulting in a number of relatively inactive girls within the PE class. These girls are often identified in the literature as "low active", "hard to reach" or "disengaged". Reasons for this "disengagement" are often due to a combination of psychological, social and environmental barriers. Purpose: This research aimed to qualitatively explore the reasons for girls' disengagement in PE classes. By longitudinally tracking a sample of 'disengaged girls' from one case study school in Scotland, the study investigated if and how girls' experiences and engagement are affected by a physical activity (PA) intervention programme, "Fit for Girls". Research design: A questionnaire was used to identify five disengaged girls for three phases of semi-structured individual interviews. These were to track changes in girls' engagement and experiences in the PE environment. Interviews were carried out with the selected girls over an 18-month period, resulting in 15 interviews for this case study school. Data analysis: In order to understand why some girls have more positive PE experiences of a PA intervention than others, self-determination theory (SDT) was used as the theoretical framework for this paper. SDT is a useful theoretical framework for the present study because it explains task engagement in relation to the characteristics and needs of the individual, as well as the environmental conditions in which the individual acts. The theory proposes that the quality of a learner's engagement and motivation in an activity is related to the way in which the environment satisfies three main psychological needs: feelings of relatedness, competence and autonomy. Conclusions: Pre-intervention the PE environment did not fulfil the girl's basic psychological needs of autonomy, competence and relatedness. However, the PA intervention, which included consultation and a choice of activity, resulted in increased participation and more positive perceptions of the subject, for most of the selected girls. These factors resulted in a more supportive PE environment overall and so were critical for the girls transition from disengagement to engagement.

Introduction: Globally, primary care organisations responded rapidly to COVID-19 physical distancing requirements through the adoption of telehealth to maintain the delivery of health care to communities. In Australia, temporary Medicare Benefits Schedule (MBS) telehealth items were introduced in March 2020 to enable the provision of telehealth services in the primary care setting. These changes included funding for two modes of telehealth delivery: videoconferencing and telephone consultations. As primary care organisations, Aboriginal Community Controlled Health Organisations (ACCHOs) rapidly adopted telehealth consultations to maintain the delivery of primary care services to Aboriginal and Torres Strait Islander clients. The aim of the present study was to evaluate the implementation (specifically the uptake, acceptability and requirements for delivery) of telehealth primary healthcare services for Aboriginal and/or Torres Strait Islander peoples by a rural ACCHO during COVID-19. Methods: A single-site convergent--parallel mixed--methods study was undertaken in the context of an ongoing research partnership established between a rural ACCHO and a university department of rural health. De-identified health service data from March 2020 to March 2021 was extracted, including MBS telehealth consultations and client demographics (eg age, gender and postcode). Variables were analysed using descriptive statistics to examine the uptake of telehealth by Aboriginal and Torres Strait Islander clients. A geographical analysis of postcode data was also undertaken. Semi-structured interviews were undertaken concurrently with a purposive sample of health service personnel (including health professionals) involved in the implementation or delivery of telehealth, and Aboriginal and/or Torres Strait Islander clients who had accessed telehealth, to explore the acceptability of telehealth and requirements for delivery. Thematic analysis using an inductive approach was undertaken. The analyses of quantitative and qualitative findings were merged to identify key concepts pertaining to the uptake, acceptability and requirements for telehealth delivery. Results: During the first year of implementation, 435 telehealth primary healthcare consultations were delivered to Aboriginal and/or Torres Strait Islander clients. Seven health personnel and six Aboriginal and/or Torres Strait Islander clients participated in interviews. Merged findings from an analysis of quantitative and qualitative data were grouped under three concepts: uptake of telehealth consultations by Aboriginal and Torres Strait Islander clients, maintaining the delivery of ACCHO services during COVID-19, and implications for sustaining telehealth in an ACCHO. Findings identified that telehealth maintained the delivery of ACCHO services to Aboriginal and/or Torres Strait Islander clients across the lifespan during COVID-19, despite a preference for face-toface consultations. A greater uptake of telephone consultations compared to videoconferencing was identified. Barriers to the utilisation of videoconferencing were largely technology related, highlighting the need for additional support for clients. Conclusion: Telehealth was a useful addition to face-to-face consultations when used in the appropriate context such as the administration of long-term medication prescriptions by a GP. Engaging the ACCHO sector in the policy discourse around telehealth is imperative for identifying requirements for ongoing implementation. [ABSTRACT FROM AUTHOR]

The Universal Design for Learning (UDL) framework has the potential to enhance the inclusive practices of teachers with autistic learners in their classes. This study examines the extent to which the UDL framework is currently being used as a model for the inclusion of autistic learners in New Zealand primary schools. This study gathered data from a survey conducted online by primary teachers of autistic learners, and used the Universal Design for Learning guidelines to ask teachers how they felt they were using them within their classroom programmes. The study concludes that while some teachers are aware of and use the UDL framework, there is still work that needs to be done to ensure that it is consistently and consciously used to benefit autistic learners. There needs to be robust professional development programmes accessible to all teachers to see the UDL framework fully utilised within New Zealand primary schools. [ABSTRACT FROM AUTHOR]

Background: The health and wellbeing impacts of commercial activity on Indigenous populations is an emerging field of research. The alcohol industry is a key driver of health and social harms within Australia. In 2016 Woolworths, the largest food and beverage retailer in Australia, proposed to build a Dan Murphy's alcohol megastore in Darwin, near three 'dry' Aboriginal communities. This study examines the tactics used by Woolworths to advance the Dan Murphy's proposal and understand how civil society action can overcome powerful commercial interests to protect Aboriginal and Torres Strait Islander health and wellbeing. Methods: Data from 11 interviews with Aboriginal and non-Aboriginal informants were combined with data extracted from media articles and government, non-government and industry documents. Thematic analysis was informed by an adapted corporate health impact assessment framework. Results: Woolworths employed several strategies including lobbying, political pressure, litigation, and divisive public rhetoric, while ignoring the evidence suggesting the store would increase alcohol-related harm. The advocacy campaign against the proposal highlighted the importance of Aboriginal and non-Aboriginal groups working together to counter commercial interests and the need to champion Aboriginal leadership. Advocacy strategies included elevating the voices of community Elders in the media and corporate activism via Woolworths' investors. Conclusions: The strategies used by the coalition of Aboriginal and non-Aboriginal groups may be useful in future advocacy campaigns to safeguard Aboriginal and Torres Strait Islander health and wellbeing from commercial interests. [ABSTRACT FROM AUTHOR]

While there is unequivocal agreement on the need to support families and to avoid all unnecessary separation, there are ongoing debates across policy and practitioner communities nationally and internationally, around the place of residential care within the range of alternative care services which should be available to children who need them. This paper presents the findings of a review of evidence looking at the function, quality and outcomes of residential care based on 111 papers identified for inclusion using systematic searches. The review identifies definitional ambiguity in the use of the terms 'residential' and 'institutional' care in the literature, which, alongside the different cultural, social and economic contexts, makes generalizing challenging. However, we found insufficient evidence to substantiate claims that residential care is inherently unsuitable. We identify research gaps in the literature, including in relation to quality, children's perspectives and factors that impact upon the suitability of residential care for different children, before discussing implications of the findings for research, policy and practice. [ABSTRACT FROM AUTHOR]