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Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity. To date, provision has mainly focused on just delivering the wheelchair instead of following an evidence-based wheelchair service delivery process. In addition, many governments have not committed to a national wheelchair provision policy. Approach: To prepare this position paper, a systemic development model, founded on the sustainable human security paradigm, was employed to explore the global challenges to accessing appropriate wheelchairs. Positions: I: Consideration of key perspectives of wheelchair provision across the life course is essential to meet the needs to children, adults, older people and their families; II: Comprehensive wheelchair service delivery processes and a competent workforce are essential to ensure appropriate wheelchair service provision; III: Evaluations on wheelchair product quality development, performance and procurement standards are key as wheelchair product quality is generally poor; IV: Understanding the economic landscape when providing wheelchairs is critical. Wheelchair funding systems vary across jurisdictions; V: Establishing wheelchair provision policy is a key priority, as specific policy is limited globally. Conclusion: The vision is to take positive action to develop appropriate and sustainable wheelchair service provision systems globally, for me, for you, for us.

Increased awareness, interest and use of assistive technology (AT) presents substantial opportunities for many citizens to become, or continue being, meaningful participants in society. However, there is a significant shortfall between the need for and provision of AT, and this is patterned by a range of social, demographic and structural factors. To seize the opportunity that assistive technology offers, regional, national and sub-national assistive technology policies are urgently required. This paper was developed for and through discussion at the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit; organized under the auspices of the World Health Organization’s Global Collaboration on Assistive Technology (GATE) program. It outlines some of the key principles that AT polices should address and recognizes that AT policy should be tailored to the realities of the contexts and resources available. AT policy should be developed as a part of the evolution of related policy across a number of different sectors and should have clear and direct links to AT as mediators and moderators for achieving the Sustainable Development Goals. The consultation process, development and implementation of policy should be fully inclusive of AT users, and their representative organizations, be across the lifespan, and imbued with a strong systems-thinking ethos. Six barriers are identified which funnel and diminish access to AT and are addressed systematically within this paper. We illustrate an example of good practice through a case study of AT services in Norway, and we note the challenges experienced in less well-resourced settings. A number of economic factors relating to AT and economic arguments for promoting AT use are also discussed. To address policy-development the importance of active citizenship and advocacy, the need to find mechanisms to scale up good community practices to a higher level, and the importance of political engagement for the po

Assistive technology (AT) is a powerful enabler of participation. The World Health Organization’s Global Collaboration on Assistive Technology (GATE) programme is actively working towards access to assistive technology for all. Developed through collaborative work as a part of the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit, this position paper provides a “state of the science” view of AT users, conceptualized as “People” within the set of GATE strategic “P” s. People are at the core of policy, products, personnel and provision. AT is an interface between the person and the life they would like to lead. People’s preferences, perspectives and goals are fundamental to defining and determining the success of AT. Maximizing the impact of AT in enabling participation requires an individualized and holistic understanding of the value and meaning of AT for the individual, taking a universal model perspective, focusing on the person, in context, and then considering the condition and/or the technology. This paper aims to situate and emphasize people at the centre of AT systems: we highlight personal meanings and perspectives on AT use and consider the role of advocacy, empowerment and co-design in developing and driving AT processes.

peer-reviewed, Governments are obligated to safeguard social inclusion for disabled people through user-led personal assistance (PA) under Article 19 of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). This scoping review was carried out to map and explore current knowledge on how governments internationally have managed PA schemes in response to the UNCRPD. The review examined 99 documents, and categorised the literature into the following themes; legislation, funding, model of service provision, governance and regulation, and the COVID-19 pandemic response. We include recommendations to co-design legislation and quality improvement policies to ensure that PA schemes are underpinned by a social model of disability mindset. Further research needs to be undertaken to guarantee that policymakers include the voice of PA users in the management of PA schemes

peer-reviewed, Purpose: Appropriate wheelchair provision is necessary for addressing participation barriers experienced by individuals with mobility impairments. Health care professionals involved in the wheelchair service provision process require a specific set of skills and knowledge to enable wheelchair use that meets individual posture, mobility and daily living requirements. However, inconsistencies exist in academic programmes globally about providing comprehensive education and training programmes. The planned scoping review aims to review and synthesize the global literature on wheelchair service provision education for healthcare professional students, healthcare personnel and educators offered by universities, organizations and industries. Methods: This scoping review will be guided by the Joanna Briggs Institute (JBI) methodological framework. Comprehensive literature searches will be conducted on various global electronic databases on health to seek out how wheelchair service provision education is organized, integrated, implemented and evaluated. Two independent reviewers will perform eligibility decisions and key data extractions. Data from selected studies will be extracted and analysed using conventional content analysis. Information related to wheelchair service provision education including curriculum development, content, teaching methods, evaluation and models of integration will be synthesized. Implications and dissemination: The planned scoping review will be the first to examine all aspects of wheelchair service provision education across professionals, settings and countries. We anticipate that results will inform the content of a Wheelchair Educators’ Package, and if appropriate, a follow-up systematic review. An article reporting the results of the scoping review will be submitted for publication to a scientific journal. Implications for Rehabilitation A comprehensive examination of wheelchair service provision education could help develop strategies to

non-peer-reviewed, Background: Literature suggests that every aspect of wheelchair provision from referral to follow up and management has an impact on overall outcomes for wheelchair service users. The use of outcome measures (OMs) is called for to ensure best practice in this complex area. Objectives: To identify available outcome measures suitable for the evaluation of a wheelchair intervention and critically appraise measures deemed most suitable in terms of achievement of activity & participation and impact of the service on quality of life. Methods: OMs were be identified using databases: Medline, CINHAL, PsychInfo, and Google Scholar. An evaluation was conducted to establish those particularly useful and a critical appraisal was completed on these. Results: The five OMs identified as most relevant were the Wheelchair Outcome Measure (WhOM); Functioning Everyday in a Wheelchair (FEW); Goal Attainment Scale (GAS); Psychosocial Impact of Assistive Devices Scales (PIADS); and the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST). A critical appraisal was competed on these identifying the strengths and limitations of each. Conclusion: No one outcome measure captures all necessary information and trade-offs are inevitable. When choosing an outcome measure for a service, the specific goals of the service evaluation and resources available need to be considered. This research presents a critical appraisal of five outcome measures deemed appropriate for the evaluation of a wheelchair intervention and highlights some areas for consideration so an informed decision can be made.

non-peer-reviewed, The purpose of this study is to describe the lived experience of children who have specialised wheelchair and seating needs from a family perspective with a view to facilitating family-centred practice in wheelchair and seating services. Concepts of acceptance and adjustment for the family, integration into the home and community environments, experiences with service providers, perceptions of family-centred practice, and general views and opinions regarding wheelchair and seating services were of interest in this study. Participants were recruited under the Enable Ireland remit. An interpretative phenomenological approach was used and data was gathered through semi structured interviews with three families. The research provided an insight into how family members viewed the impact of the phenomenon and adjusted to life with a child who has specialised wheelchair and seating needs. Four main themes emerged from the data: Acceptance and adjustment, learning new ways of doing, being independent and interactions with service providers. Findings from the study suggest that caring for a child with specialised wheelchair and seating needs is a family affair and affects the entire family unit. Using a holistic approach to wheelchair and seating service provision which encompasses the philosophy of family centred care is optimal to support family health and wellbeing.

non-peer-reviewed, As many of the skills that early childhood educators focus upon are also a focus in occupational therapy1, the area of school readiness is paramount to the profession (Cronin and Mandich 2005). On-going debates surround the meaning of school readiness but emerging consensus recognises it is a multi-dimensional concept, which must reflect the child’s personal readiness and consider contextual influences (Kiernan et al 2008). This pilot qualitative study explored perceptions that occupational therapists2 and pre-school teachers have of school readiness, and consequently implications for the professional practice of OT’s. The aims were to ascertain the skills and abilities participants perceived as most important in preparation for school, explore collaboration between OT’s and pre-school teachers and investigate the importance of social and emotional development for school readiness. Four individual, semi-structured interviews were completed; two OT’s and two pre-school teachers. Thematic analysis revealed three themes: starting school as a period of transition; importance of social and emotional development for school readiness and the experience of mainstreaming children. Findings suggest that both professions place emphasis on social and emotional development rather than academic knowledge. Play emerged as a context for child development. An ecological understanding of child development emerged as a consideration for practice.