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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.

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.

Purpose: 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., Materials and Methods: 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., Results: 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., Conclusions: 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.Implications for RehabilitationThere 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.

Purpose: 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?, Materials and Methods: 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., Results: 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., Conclusions: The dog-walking program offered a simple means of influencing the frequency and depth of community-based social interactions for people with cognitive disabilities.IMPLICATIONS FOR REHABILITATIONThe 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.

Purpose: The often-invisible access barriers to public transport encountered by people with communication disabilities, who have sensory, language or cognitive impairments have gained little attention. This study investigated the experiences of people with communication disabilities on a rail network in Victoria, Australia to identify the barriers they encountered., Methods: Twenty-one passengers with communication disabilities participated in either an individual interview or a focus group. They talked about their experiences of train travel, factors that made travelling difficult and suggestions for making travelling easier. A six-phase approach to thematic analysis was conducted to identify themes., Results: The difficulties identified in travelling fell into three themes: (a) variable accessibility of information, (b) negative impact of a large and complex service system, and (c) an uncertain culture of help seeking and giving. Only two passengers had ever complained but all identified ways to improve the service. They suggested, better staff training, more use of communication tools, mechanisms to enable passengers to seek help, and attention to making information easier to understand., Conclusions: For transport to be accessible to people with communication disabilities many different types of adjustment are required. Using multiple modes of communication with attention to understandability and consistent responses from public contact staff skilled to interact in multiple ways, may be the most flexible and effective means of responding to difficulties posed by the complex and unpredictable nature of train services. Implications for Rehabilitation People with communication disabilities are a diverse group which includes people with physical, sensory, speech, language, and cognitive impairments. Public transport services need to provide a range of communication adjustments to enable people with communication disabilities to travel successfully. Transport services must retain and refine accessible alternatives to online information and booking systems for people with cognitive impairments to avoid widening the digital divide. Frequent and unavoidable changes to train services mean that skilled public contact staff, access to information and a culture of help seeking and giving are particularly important in facilitating access for people with communication disabilities.