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Competencies defined in practice standards and frameworks promote safe and effective healthcare by underpinning training curricula and service standards. The provision of mobility assistive products involves a range of professionals, each guided by various standards and frameworks that define various competencies. This environmental scan aimed to identify global resources containing professional competencies applicable to mobility assistive product provision and to compare them against a gold standard. Competencies for mobility assistive products were found in 14 resources of diverse types. While there were similarities between competency standards, such as service steps, there were also significant differences, such as minimum education levels and competency domains. This environmental scan highlights an opportunity for professionals providing mobility assistive products to collaborate and establish unified competencies. Standardizing these competencies could harmonize training, regulation, and service standards, thereby improving coordination and service quality. Additionally, this approach could serve as a model for developing standardized competencies for other assistive products, such as hearing and vision aids, enhancing outcomes across various assistive technology types. [ABSTRACT FROM AUTHOR]

Australians with disability have inequitable access to assistive technology (AT) and home modifications (HMs). This is inconsistent with human rights obligations and fails to capitalise on internationally recognised potential return on investment. Co‐designed with a consortium of AT stakeholders, this study quantifies the public provision of AT and HM in Australia by identifying all publicly funded national and state‐/territory‐based schemes and reporting and comparing available data on the spend per person. An environmental scan and data survey identified 88 government funders administering 109 schemes. Data were available for 1/3 of schemes. Economic evaluation of available cost and participant data estimated the annual AT/HM and wrap‐around support spend per person per scheme and organisational costs. Data demonstrated significant AT/HM spend variability across schemes, for example a 50‐fold difference between Aged Care ($51) and National Disability Insurance Scheme (NDIS, $2500). Modelled costs are presented for a $16 billion national scheme where all Australians with disability are funded NDIS‐equivalent. These foundation data demonstrate substantial service provision gaps and an urgent need for change in disability policy. A cost model and policy principles have been proposed to achieve economies of scale and equity in the provision of AT and HM. [ABSTRACT FROM AUTHOR]

After an initial pilot in 2021, work is now underway to establish a new aged care Support at Home programme, which includes development of an effective goods, equipment and assistive technology programme, and funding for assistive products (Australian Government Department of Health & Aged Care, [2], [3]). Pilli et al use survey methodology to examine assistive technology personnel, exploring clinician use and experiences of assistive technology in brain injury rehabilitation across the Australian State of New South Wales. The World Health Organization defines assistive technology as an umbrella term covering the systems and services related to the delivery of assistive products and services (World Health Organization, [19]). How is assistive technology meeting the needs and goals of people with brain impairment?. [Extracted from the article]

Background: Communication changes following acquired brain injury (ABI) may necessitate use of augmentative and alternative communication (AAC). Speech pathologists regularly assist people with ABI and their families with AAC assessment and recommendations, as well as education and training on AAC use. To date, there has been no Australian research investigating the perspectives of speech pathologists working in the field of ABI and AAC. This research aimed to 1) Explore speech pathologists' insights regarding enablers and barriers to considerations and uptake, and ongoing use, of AAC by people with ABI and 2) Understand their perspectives on AAC acceptance, abandonment and rejection. Method: A qualitative research design, with semi-structured interviews, was used with seven speech pathologists working across three Australian states. Interviews were transcribed verbatim, and thematically analysed. To triangulate results, the lived experience reflections of one co-author, who has an ABI and uses AAC, were drawn on. Results: Seven themes were identified, relating to four of the five domains of the World Health Organization's assistive technology model. These included that AAC should be person-centred, with consideration of both products and personnel required, and with effective policy aiding AAC trial, uptake and use. Conclusion: This research has highlighted considerations for AAC use by people with ABI, from the perspective of speech pathologists and aided by lived experience reflections. Speech pathologists need to understand the breadth of products, and good practice service steps, to ensure successful AAC use and skill development. Listening to the perspectives of people with ABI is central to that understanding. [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]

Rehabilitation technologies are rapidly evolving, presenting promising interventions for people with neurological impairments. Access to technology, however, is greater in metropolitan than rural areas. Applying a capabilities approach to this access issue foregrounds healthcare recipients' rights and personhood within the discourse on resource allocation. Within this context, this study aimed to investigate the economic viability of robotics-based therapy (RBT) in rural Victoria, Australia. A regional health network developed a model of care to provide equitable access to RBT following stroke. This explorative economic evaluation examined both the clinical and economic impact of RBT program implementation across six program iterations compared to 1:1 out-patient rehabilitation. While clinical outcomes were equivalent, the per patient RBT cost ranged from AUD 2681 (Program 1) to AUD 1957 (Program 6), while the per patient cost of usual care 1:1 out-patient rehabilitation, was AUD 2584. Excluding Program 1, the health service cost of usual care 1:1 out-patient rehabilitation was consistently higher, indicating that an established RBT program may be cost-effective, specifically providing less cost for the same effect. This research demonstrates the economic feasibility of delivering RBT in a regional public health stroke service. More broadly, it provided a reduction in the capability gap between rural and metropolitan stroke survivors by tackling an access disadvantage. [ABSTRACT FROM AUTHOR]

The principle of 'working with, not on' people with disabilities is widely espoused within inclusive research, yet historically such opportunities have not been fully realized. This paper speaks from the perspective of users of health, rehabilitation, assistive technology services, and the academics with whom they collaborate. We draw on Australia's Disability Inclusive Research Principles to reflect on the practice of inclusive research across the areas of assistive technology policy, digital information, and health access, as well as the co-design of allied health resources. We consider and provide examples of how power and knowledge play out in health and rehabilitation, the developing discourse around consumer co-design and co-production, and the challenges of enacting inclusive research. This paper is about shared power in the mechanisms of research production and our journeys towards it. Engaging in inclusive research has enabled us to assume roles beyond the binary of the 'researcher' and the 'researched'. We conclude by proposing an adaptation of the ladder of participation for inclusive research. [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]

This pilot study examined whether two different types of non-powered mobile arm supports (MAS) enhanced upper limb function and independence with activities of daily living (ADLs) in people with Duchenne muscular dystrophy (DMD). A mixed methods cross-sectional design was used. Participants were four males with DMD, aged 16 to 20 years (M = 18.25 years). Two participants were current MAS users, and two had previously used MAS. To explore experiences of MAS use, semi-structured interviews were undertaken, then transcribed verbatim and analysed thematically. To measure the impact of MAS on arm function and ADLs, participants using MAS completed the Performance of the Upper Limb (PUL) and the DMD Upper Limb Patient Reported Outcome Measure with and without MAS. Participants no longer using MAS only completed the PUL without MAS. MAS enhanced upper limb function and independence with ADLs in three of four participants. Eating and drinking was most often positively impacted by MAS. Access to informal support for MAS set-up, and ongoing input from a clinician or assistive technology (AT) supplier with MAS expertise, were important enablers to successful MAS use. Barriers to use included inadequate upper limb strength, interference of MAS with wheelchair controls, and AT funding delays. MAS should be considered by individuals with DMD and clinicians working with them as the disease progresses and strength declines. Potential barriers to MAS use need to be addressed to ensure maximum utility. AT funding delays must also be minimized to avoid impact on outcomes of people with DMD. Individuals with DMD, and clinicians working with them, may consider MAS to aid achievement of functional goals as the disease progresses and upper limb function declines. Both objective and subjective outcome measures should be used when evaluating the effectiveness of MAS. Consideration should be given to the potential interference of MAS with wheelchair controls and the availability of informal or paid supports (e.g., family, support workers, teachers) to aid MAS use. Efficient and timely funding of MAS is required, as delays may negatively impact outcomes for people with progressive neurological conditions, such as DMD. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine use of electronic assistive technology for social networking by people with disability living in shared supported accommodation (SSA), and compare participants' Electronic Social Networking (ESN) integration with Australian ESN normative data. Method: Telephone surveys and the ESN subscale of the Community Integration Questionnaire-Revised (CIQ-R) were administered with SSA managers. Surveys gathered demographic data, and data on Internet access, technology use and ESN integration, of 91 people with disability who were identified technology users and living in SSA. Participant ESN data were then matched with existing CIQ-R ESN normative data (N = 359). Relative risk of reduced ESN integration was calculated. Results: This study identified that, despite access to mainstream technologies, people with disability living in SSA experience low ESN integration, and use ESN for social contact less than other Australians. This group were 210% more likely to report reduced ESN integration than the matched normative sample when key demographic variables were held constant. Conclusions: Factors related to disability, including high care and support needs and greater time spent completing essential activities of daily living (such as personal care), may explain the low electronic social networking integration for people with disability living in SSA identified in this study. Further research that examines factors that influence ESN access and use following disability is necessary to inform practice to bridge the digital divide that exists between this group and other Australians. [ABSTRACT FROM AUTHOR]

Electronic assistive technologies (EATs) are fast becoming considered an essential component of everyday life. To date, there has been little research on the use of EAT by people living in shared supported accommodation (SSA), one of the major community-based housing options for people with disability (PwD) in Australia. This study aimed to (1) audit current EAT use by PwD living in SSA, (2) describe the impact of Internet access on EAT use, and (3) examine potential relationships between individual characteristics and EAT use. A customized survey administered with 32 house managers, representing 52 SSAs, gathered data on the EAT use of 254 people. Only 45.7% of residents used EAT, and devices available to the mainstream market were most frequently used. Access to home-based Internet was not a predictor of the number of devices in use. Disability type (congenital or acquired) was found to be significantly correlated with the number of devices in use, however, associations across a number of variables suggest complex mediational interactions. These findings provide an insight into the EAT use trends of PwD living in SSA, indicating that further work needs to be done to support the uptake and continued use of EAT by PwD Implications for Rehabilitation: Further work needs to be done to promote the uptake and use of electronic assistive technology (EAT) by people with disability (PwD). Personal characteristics and experiences need to be considered in the prescription of EAT to PwD, as these may explain variations in use between individuals. [ABSTRACT FROM AUTHOR]

Introduction: People with severe acquired brain injury often require lifetime support, sometimes received from paid workers if living in shared supported accommodation. Electronic assistive technology may offer a less intrusive method of support that can enable autonomous participation and deliver cost savings. However, research on rates, barriers, and facilitators of electronic assistive technology uptake is lacking. This study aimed to identify electronic assistive technology types used by people with acquired brain injury living in shared supported accommodation, assess user satisfaction and psychosocial impact of electronic assistive technology, detail the impact of technology use on respondents' participation and support needs, and describe barriers and/or facilitators to electronic assistive technology uptake and ongoing use. Method: Participants were identified electronic assistive technology users with acquired brain injury living in shared supported accommodation in Australia (N=22). Mixed methods data were collected using semi-structured interviews and published measures of support need, electronic assistive technology satisfaction, and psychosocial impact. Results: Participants reported satisfaction with the devices they used, and positive psychosocial outcomes. Areas impacted by electronic assistive technology, key facilitators and barriers to electronic assistive technology use, and implications for occupational therapists working to deliver electronic assistive technology solutions were identified. Conclusion: Electronic assistive technology use by this group can positively influence both everyday functioning and participation. Skilled prescription and ongoing support services are necessary to maximise uptake and use. [ABSTRACT FROM AUTHOR]