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Background: Organisational culture in group homes for people with intellectual disabilities has been identified as an influence on service delivery and staff behaviour. The aim was to examine patterns of culture across group homes in disability organisations. Method: The Group Home Culture Scale (GHCS) was used to measure staff perceptions of culture. Data were available from 260 staff who worked across 58 group homes managed by eight organisations. Using scatterplots and measures of dispersion, the scores on the seven GHCS subscales were examined for patterns of integrated (i.e., similarities) and differentiated (i.e., variability) culture within the organisations. Results: Patterns of differentiated culture were found in six organisations for one or more GHCS subscales. Patterns of integrated culture were found in three organisations for one subscale. In two organisations, patterns of both integrated and differentiated culture were found. Conclusions: The findings contribute to the conceptualisation of and research into organisational culture in group homes, with implications for changing and maintaining culture.

Purpose: The aim of this study was to gain an understanding of employers' attitudes to, knowledge about, and policies relating to employing someone with a spinal cord injury (SCI). Methods: Semi-structured interviews were conducted with nine employers located in Australia from a range of backgrounds and different sized businesses. The interviews were thematically analysed. Results: Three themes were identified: Organisational policies (sub-themes: Recruitment - inherent requirements of the role vs risk mitigation; Recruitment strategies and targets; Disclosure; Accommodations needed or offered); Barriers & facilitators (sub-themes: Lack of knowledge about SCI; Physical accessibility; Workplace culture); Personal attitudes (sub-themes: Personal attitudes don't align with organisational policy; Personal experiences informed understanding). Conclusions: Organisational policies and practices of the employers' organisations, and workplace culture impact the likelihood of someone with a SCI being employed, particularly in relation to recruitment, employment targets, and available accommodations. Individual staff attitudes and knowledge also influence this process. Multi-faceted approaches are needed to increase the employment of people with SCI. IMPLICATIONS FOR REHABILITATION: Barriers to employing someone with spinal cord injury (SCI) include lack of knowledge about SCI, and lack of knowledge about workplace laws Organisational policies and practices of organisations impact the likelihood of someone with an SCI being employed Individual staff attitudes influence employment of people with SCI Employers' knowledge about and confidence in employing people with SCI, is an important area to target interventions. [ABSTRACT FROM AUTHOR]

Animal‐assisted interventions (AAIs) have the potential to enhance people's well‐being and function and are increasingly being implemented across a range of settings. This scoping review explored how AAIs have been used in adult hospital rehabilitative care. Using JBI and PRISMA‐ScR guidelines, a systematic search of four databases was undertaken. Inclusion criteria involved adults, aged >18 years, who had received AAIs in the hospital rehabilitation setting. Twenty‐two articles met the inclusion criteria. Results identified two intervention types: visitation activities (n = 8 studies) and structured therapeutic interventions (n = 14 studies). Dogs were the most common animal species. Improvements in social and emotional well‐being were reported across both types of interventions, with improvements in ambulation, motor skills, and verbal communication reported by those engaged in structured therapeutic interventions. Implementation challenges included a dependency on volunteer dog‐handlers; the need for better recording of interventions in medical records to enable evaluation; and cost, safety, infection control, and animal welfare considerations. Strengthening the planning of AAIs is fundamental for the realization of potential outcomes from human–animal interactions in hospital rehabilitative care. [ABSTRACT FROM AUTHOR]

Affinity with dogs has been defined as the degree to which people value interactions with dogs; it may be influenced by individual preferences, experiences with animals, and characteristics of the dog. To date, however, there has been limited investigation regarding factors that influence dog affinity for people with autism. An anonymous online survey was used in this study; it included demographic questions; exploration of experiences with animals; attitudes, preferences, likes, and dislikes of dogs; and the perceived impact of dogs on the person with autism's social and community participation. The survey was distributed via social media channels, assistance dog organizations, and a disability provider to people living in Australia (n = 131) who were (1) an adult with a diagnosis of autism or (2) a next-of-kin of a person of any age with autism (completing the survey on behalf of their family member). Data were analyzed using descriptive and inferential statistics and content analysis. There were no significant differences in levels of affinity between children and adults with autism. However, findings indicated significant differences in levels of affinity between participants with and without a dog. Text entry responses to questions provided additional insights into participants' attitudes and sensory preferences toward dogs, suggesting that affinity with dogs can be influenced by personal, disability-related, environmental, and animal-related factors. An awareness and consideration of these factors is essential for individuals with autism, their families, and service providers – including animal-assisted therapy or assistance animal organizations – when considering individual participation goals and determining if animal supports are the most appropriate option. Without an awareness and understanding of these factors, this could limit the effectiveness of the human–animal interaction. [ABSTRACT FROM AUTHOR]

Background: Autism is a developmental disorder characterised by changes in social, communication, and behavioural performance. Assistance dogs can support children with autism to engage in everyday occupations. Despite more children being partnered with assistance dogs, there is limited research regarding the impact of assistance dogs on the occupational engagement of children with autism and their families, and further research is needed to fully understand the impact of this type of support within the Australian context. Objectives: To explore caregiver‐reported experiences of an assistance dog on the occupational engagement of children with autism and their families. Method: Using a qualitative approach, semi‐structured interviews were undertaken with six caregivers of seven children with autism, who each had an assistance dog. Interviews ranged from 45 to 60 minutes in duration. Data were transcribed verbatim and thematically analysed. Trustworthiness was maximised through independent recruitment, research team discussions, member checking, and a researcher reflective journal. Findings: Three themes were identified: participation in everyday occupations prior to and after partnering with an assistance dog, increased engagement in everyday occupations, and impact of the assistance dog on the family unit. Assistance dogs were reported to progress children from community 'isolation' to 'freedom'. Participants reported the dog increased children's capacities through positively influencing completion of routines, increasing independence, and improving therapy engagement. Assistance dogs were viewed as supporting the whole family's occupational engagement. Some challenges were identified with the introduction of the assistance dog to the family unit, and with animal maintenance costs and time demands, public access rights, and limited government funding. Conclusion: This research identifies benefits and challenges for children who partner with autism assistance dogs. It provides insights to inform assistance animal referral, assessment, and support of assistance dogs in Australia for children with autism and occupational therapists working with them. [ABSTRACT FROM AUTHOR]

Background and objectives: People with acquired brain injury (ABI) may experience behaviours of concern that require therapy services, including behaviour support. In Australia, the implementation of a National Disability Insurance Scheme (NDIS) and development of the NDIS Quality and Safeguards Commission, has led to significant changes to behaviour support workforce processes, and the way behaviour support is funded, regulated and delivered to people with ABI who are Scheme participants. The aim of this study was to explore the current and future provider market of professionals providing behaviour supports to Scheme participants who experience ABI. Method: An anonymous survey was designed and distributed via social media channels, an email listserv and professional association newsletters to professionals working within the NDIS in Australia. Data were analysed using descriptive statistics and content analysis. Results: One hundred and two surveys responses were analysed. A majority of professionals had an average understanding of the NDIS Quality and Safeguard Commission rules and policies on behaviour support. Responses to current and future registration as an NDIS Practitioner indicated the workforce gap could increase by between 17 and 26%. Respondents also raised concerns about the lack of training and experience of allied health professional students and graduates in addressing behaviours of concern. Responses to the open-ended question highlighted additional issues in the provision of behaviour support within the NDIS. Conclusions: This research highlighted the need for an NDIS behaviour support workforce strategy and supply-side market intervention to ensure a viable and sustainable workforce for people with ABI who need behaviour support. [ABSTRACT FROM AUTHOR]

Background and objectives: In Australia, people with disability continue to experience low employment rates (48%), compared to the national average (79%), and employment is even lower (30%) for people with acquired brain injury (ABI). This paper evaluates a pilot study of a new mainstream employment pathway following ABI, called Employment CoLab. Method: Employment CoLab was piloted across multiple industries using a mix of reasonable employer adjustments, insurance-funded supports and/or access to capacity-building supports. Semi-structured interviews were undertaken with four stakeholders; (1) Employees with ABI (n = 5, age 31–49 years, time since injury M(R) = 11(4–26) years); (2) Employers/co-workers (n = 3); (3) Allied health professionals/vocational providers (n = 4); and (4) Injury insurance funders who hold portfolio responsibility for disability employment (n = 5). An explorative economic evaluation was also conducted to compare the cost to the funder for Employment CoLab compared to traditional employment pathways. Results: Employment CoLab offered a new approach for people with ABI to gain and sustain open employment. Four major themes were identified from participant interviews: valuing employment and diversity; barriers to mainstream employment; reflections on being employed; and being supported over time. The economic evaluation was unable to detect if the pathway was, or was not, less costly when compared to traditional employment pathways. Conclusions: Employment CoLab is a person-centred collaborative approach which, together with effective social disability insurance approaches, has built new opportunities for inclusive mainstream economic participation following ABI. [ABSTRACT FROM AUTHOR]

This study aimed to investigate: (1) the characteristics of people using, or had previously used, assistance animals within community living in Australia; (2) positive and/or negative experiences of these users; and (3) educational resources that may aid public awareness. An online survey was distributed through Australian assistance animal organisations and social media channels. Past/current assistance animal users (n = 112) responded to questions on demographic and types of animal supports used, experience of assistance animal use, community attitudes experienced, and perspectives about the need for public education. Data were analysed with descriptive and inferential statistics. Content analysis provided additional insights of the positive and/or negative experiences assistance animal users had faced. Nearly all participants used an assistance dog (n = 111), and 37 (33%) used the animal for more than one type of support. Seventy percent reported experiencing both positive and negative community attitudes/reactions. Length of time of having an assistance animal was associated with significantly higher prevalence of positive attitudes/reactions, whilst users who received medical support from the animal tended to experience more negative community attitudes/reactions than other users. The majority (90%) agreed that more public education is needed regarding assistance animal public access rights. This study is the first in Australia to undertake a large-scale survey of assistance animal users with a range of disability types. It highlights the benefits and challenges of assistance animals, which could be useful to consider when determining the most appropriate support for an individual. There are a range of possible benefits, but also challenges, in the use of assistance animals that should be considered when a person with disability or health conditions, or people advising them, are determining if an animal is the most appropriate support. Assistance animals can provide multiple types of support to one user, so could offer a potential cost-benefit beyond traditional assistive devices or other types of support. To ensure better inclusion of assistance animal users, public education is needed to promote community awareness of the types of animals that meet the definition of an 'assistance animal', and thus have public access rights. In Australia, a nationally consistent government approach to the regulation, accreditation and funding of assistance animals should be established with the aim to address the current fragmented or unfair investment approach and/or discrimination experienced by some individuals. [ABSTRACT FROM AUTHOR]

To evaluate a dog-walking program (called "Dog Buddies") designed to address the need for evidence-based programs that create opportunities for people with cognitive disabilities to be more socially included in mainstream society. The research question was: Does community dog walking foster social interaction for people with cognitive disabilities? Single-case experimental design was used with four individuals (three with intellectual disability; one with Acquired Brain Injury (ABI)) recruited via two disability service providers in Victoria. Target behaviours included frequency and nature of encounters between the person with disability and community members. Change was measured from baseline (five community meetings with a handler but no dog) to intervention period (five meetings minimum, with a handler and a dog). Semi-structured interviews, audio-recorded and transcribed verbatim, provided three participants' subjective experiences of the program. Dog Buddies increased the frequency of encounters for all participants. The presence of the dog helped to foster convivial encounters, community members were found to be more welcoming, and some participants were recognised or acknowledged by name over time in the intervention phase. The dog-walking program offered a simple means of influencing the frequency and depth of community-based social interactions for people with cognitive disabilities. The co-presence of people with disabilities in the community with the general population does not ensure social interaction occurs. Both disability policy, and the programs or support that is provided to people with disabilities, needs to have a strong commitment to the inclusion of people with disabilities in mainstream communities. Dog Buddies is a promising example of a program where the presence of a pet dog has been demonstrated to support convivial, bi-directional encounters of people with cognitive disabilities and other community members. Dog-walking offers a simple means of influencing the frequency and depth of community-based social interactions for people with cognitive disabilities. [ABSTRACT FROM AUTHOR]

Background: Assistance dogs, considered a form of assistive technology within Australia's National Disability Insurance Scheme (NDIS), can support scheme participants to achieve greater independence. To receive funding, an allied health assessment report (most often from occupational therapists) is required to justify the animal as a reasonable and necessary support. Objectives: Examine Australian occupational therapists' knowledge and perceptions of assistance dogs; NDIS funding of animal supports; and resources considered useful to guide occupational therapy assessment and report writing. Method: An online anonymous survey was developed and distributed via social media channels, an email listserv, and professional association newsletters to Australian occupational therapists. Data were analysed using descriptive and inferential statistics. Inductive content analysis of open‐ended question responses provided additional insights regarding occupational therapists' knowledge, experiences, and information needs in relation to animal supports. Results: One hundred forty‐five completed surveys were received. A majority of participants had limited knowledge regarding the purpose, scope, and funding of assistance dogs. Only 14 participants had made a referral for an assistance dog for an NDIS participant. For the 36 participants who self‐identified as having good or excellent knowledge of one or more types of assistance dogs, benefits included increasing users' independence, confidence, and quality of life. Although participants agreed they had suitable skills to prescribe assistance dogs, greater clarification regarding their role in the NDIS assessment, advisory, and application process was seen as necessary. Conclusion: This research highlighted the need for increased information for occupational therapists regarding the various types of assistance dogs and NDIS funding rules. The provision of NDIS reporting templates, practice guidance, and professional development resources—as well as occupational therapy curriculum for near‐graduate therapists—could enhance knowledge, clinical reasoning, and practice when considering the most appropriate support and whether an assistance dog is both reasonable and necessary based on the person's goals and needs. [ABSTRACT FROM AUTHOR]

Background and objectives: People with acquired brain injury (ABI) have traditionally experienced low employment rates, compared with the national average and others with disability in Australia. To positively impact mainstream economic participation following ABI, a co-design approach was used to investigate open employment pathways available and consider necessary pathway features to enable employment for people with ABI. Method: A qualitative focus group methodology was used with four groups: people with ABI; health professionals working with this group; employers providing work for people with ABI and social and injury insurers funding employment services. The project was delivered in two phases: (1) review existing work pathways in Australia and gather knowledge about enablers and barriers to employment following ABI and (2) use ABI lived experience, employers' experience and allied health and social insurer expertise to develop a new pathway to mainstream employment. Results: Co-design helped to identify enablers and barriers to employment of people with ABI, as well as practical strategies to facilitate workplace diversity and inclusion. Enablers included replacing interviews with an onsite assessment to meet key staff and trial work tasks, employer education on ABI, the use of compensatory cognitive aides and graded on-the-job support. This guided the development of a new employment pathway, tailored for people with ABI, called 'Employment CoLab'. Conclusions: The Employment CoLab pathway, when coupled with person-centred collaborative and effective social disability insurance approaches, offers opportunities to build inclusive, sustainable and scalable economic participation and mainstream wages for people with ABI. [ABSTRACT FROM AUTHOR]

The introduction of Australia's National Disability Insurance Scheme (NDIS) has changed the way housing and support are delivered to Scheme participants. NDIS policy reform focuses on coordinated housing and support responses. These responses are guided by the Specialist Disability Accommodation (SDA) Rule, Framework and pricing and Supported Independent Living payments. To date, the National Disability Insurance Agency (NDIA) has only released limited data to understand SDA demand or inform market development. To understand changing housing and support approaches and the impact of NDIS housing policy on market responses, this research had three aims: (1) to examine the locations and characteristics of housing and support vacancies advertised for people with disability; (2) to investigate funding sources for, and providers of, these supported housing options; and (3) to examine the proportion and source of government, nonprofit and private sector funding for housing and support developments advertised. An audit was undertaken of all advertisements on the two main non‐government organisation Websites that list Australian supported housing vacancies. A total of 562 property adverts were reviewed in March 2019. Audit findings are considered in relation to the current NDIS policy context. Possible housing futures and market gaps for people with significant and permanent disability in Australia are discussed. [ABSTRACT FROM AUTHOR]

Background This scoping review aimed to identify literature describing allied health interventions used to address challenging behaviour for adults with an acquired brain injury (ABI) living in community settings and identify the impact of these interventions on outcomes across the domains of behaviour, activity, and participation. Methods The Polyglot Search Translator for scoping reviews guided the search of six databases: (1) Ovid Medline®, (2) EmCARE (Ovid), (3) CINAHL Complete, (4) Embase (Ovid), (5) Scopus, and (6) Cochrane Library to identify literature published between 1990 and 2023. Results Of the 1748 records screened, 16 articles met the inclusion criteria. Studies commonly described therapeutic, least restrictive approaches to challenging behaviour founded on a positive behaviour support framework. Interventions were individualised, combining multiple elements to effect change in the environment, behaviour of the people providing support, and/or skills and behaviour of the person with ABI. Although most studies reported clinical gains from intervention, study designs used a range of methods and either single cases or mixed populations. Conclusions The findings of this review suggest that allied health interventions have the potential to reduce challenging behaviour experienced by people with ABI. However, further research addressing the impact of interventions on activity and participation is required to inform clinical practice and improve long-term outcomes.

Animal-assisted interventions (AAIs) have the potential to enhance people's well-being and function and are increasingly being implemented across a range of settings. This scoping review explored how AAIs have been used in adult hospital rehabilitative care. Using JBI and PRISMA-ScR guidelines, a systematic search of four databases was undertaken. Inclusion criteria involved adults, aged >18 years, who had received AAIs in the hospital rehabilitation setting. Twenty-two articles met the inclusion criteria. Results identified two intervention types: visitation activities (n = 8 studies) and structured therapeutic interventions (n = 14 studies). Dogs were the most common animal species. Improvements in social and emotional well-being were reported across both types of interventions, with improvements in ambulation, motor skills, and verbal communication reported by those engaged in structured therapeutic interventions. Implementation challenges included a dependency on volunteer dog-handlers; the need for better recording of interventions in medical records to enable evaluation; and cost, safety, infection control, and animal welfare considerations. Strengthening the planning of AAIs is fundamental for the realization of potential outcomes from human-animal interactions in hospital rehabilitative care., (© 2024 The Author(s). Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)

Background and Objectives: People with acquired brain injury (ABI) may experience behaviours of concern that require therapy services, including behaviour support. In Australia, the implementation of a National Disability Insurance Scheme (NDIS) and development of the NDIS Quality and Safeguards Commission, has led to significant changes to behaviour support workforce processes, and the way behaviour support is funded, regulated and delivered to people with ABI who are Scheme participants. The aim of this study was to explore the current and future provider market of professionals providing behaviour supports to Scheme participants who experience ABI., Method: An anonymous survey was designed and distributed via social media channels, an email listserv and professional association newsletters to professionals working within the NDIS in Australia. Data were analysed using descriptive statistics and content analysis., Results: One hundred and two surveys responses were analysed. A majority of professionals had an average understanding of the NDIS Quality and Safeguard Commission rules and policies on behaviour support. Responses to current and future registration as an NDIS Practitioner indicated the workforce gap could increase by between 17 and 26%. Respondents also raised concerns about the lack of training and experience of allied health professional students and graduates in addressing behaviours of concern. Responses to the open-ended question highlighted additional issues in the provision of behaviour support within the NDIS., Conclusions: This research highlighted the need for an NDIS behaviour support workforce strategy and supply-side market intervention to ensure a viable and sustainable workforce for people with ABI who need behaviour support.