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Natasha Layton's Sylvia Docker Lecture

Presented at the 25th National Occupational Therapy Conference Adelaide July 26
by

Natasha Layton

on 28 May 2015

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Transcript of Natasha Layton's Sylvia Docker Lecture

Milena Flament
the nexus of practice and policy
practice issues not
addressed by
most research
practice, research, and policy
Nexus
by Natasha Layton
23rd SylviaDocker lecture
Inclusive Research
the
Interpretive
paradigm
Research
Framing of
Occupational Therapy Australia National Conference: Adelaide July 2013
Political theory:
reframing conditions
into problems
Research
NEXUS
Practice
Policy
people with disability
Ownership
participatory
Co-presenting
Materials that are
A range of types
Research that
Re-defining
'The right people
asking the right questions
and getting the right answers'
Consent
with
Health Conditions
Body Structures
& Functions
Participation
Personal
Factors
Activities
Environmental
Factors
Contextual Factors
Human Variation
Peter Willcocks
Ricky Buchanan
Gottliebsen, D., Layton, N. & Wilson, E. (2010) Comparative Effectiveness Report - online surveys. Disability & Rehabilitation: Assistive Technology, 5 401–410.
Inclusive Research: The Equipping Inclusion Studies Layton,
Foreman
,
Buchanan
&
Willcocks
(2012) Independent Living Journal
Adapting to Disability-Home Modifications and Equipment
Foreman
(2012) Independent Living Journal
'nothing about us without us'
Expert Users involved in AT Design: the example of the Bed Spa™
Buchanan
& Layton (2010) Independent Living Journal
I want to save my funding scheme money but they won't let me
Buchanan
& Layton (2010) Independent Living Journal
'No Time to Wait
' A summary of the AEAA Wait Times Project. Layton &
Willcocks
(2013) Independent Living Journal.
by Natasha Layton
Heather Lawson
Dijkers
When the best is the enemy of the good: The nature of research evidence used in systematic reviews and guidelines
. Task Force on Systematic Review and Guidelines (2009)
Johnston et al
The Challenge of Evidence in Disability and Rehabilitation Research and Practice
National Centre for Dissemination of Disability Research (2009)
Brotkorb et al (2008)
Cost-effectiveness

of C-Leg compared with Non-Micro-Processor-Controlled Knees: A modeling approach.
The role of
smart home technology
in enhancing supported living for people with complex needs and challenging behaviour. Linskell & Hill (2010)
use remediation techniques at the level of
body structures & functions
address
health conditions
through education, advice, compensatory strategies
Task analyse, adapt
and modify
activities
as the building blocks to occupation
Facilitate
participation
through collaborative
practice and goalsetting & matching person, environment and task
Address the impact of
personal factors
, using
therapeutic strategies to
mediate and strengthen
a persons responses
Adapt & transform
environment
al
barriers into
facilitators
OTs...
OTs...
OTs...
OTs...
OTs...
OTs...
occupational therapy roles
constrain our scope of practice
Policy-focussed
research
Too Little, Too Late Report
Wilson, Wong & Goodridge (2006) Scope
Pate, A. & Horn, M. (2006) Aids and equipment for Victorians with disabilities - entitlement or hand-out? Melbourne Citymission.
Bolshydivas@weebly.com

evidence-based?
evidence-informed?
based on ill-informed
anecdote and media?
Research
Evidence for best practice
Practice
Policy
Scientific or positivist paradigm
Health Economics
Mixed Methods
Inclusive
&
accessible
of activities
to real life
what research is
Occupational Therapy is
the
profession which operates across the
whole
ICF
Research
NEXUS
Practice
Policy
Chapparo & Ranka (2004)
Clinical reasoning in Occupational Therapy
Boyt Schell & Schell (2008) Clinical and professional reasoning in occupational therapy
Pragmatic constraints limit our practice...
Policy limitations
Service limitations
clear evidence of
consumer dissatisfaction
Preservation of upper limb function
following spinal cord injury:
a clinical practice guideline
for health-care professionals (2005)
Prevention and treatment
of pressure ulcers:
clinical practice guideline (2009)
NEXUS
Inclusion
based
practice
Policy-focussed
research
Objects of Meaning
: assistive devices as symbols of professionalism, identity and disability. Hocking (2008)

On an equal footing:
adults’ accounts
of the
experience
of using assistive devices for standing. Nordström et al (2013)
Canning (2005) Funding, ethics, and assistive technology: Should
medical necessity
be the criterion by which wheeled mobility equipment is justified?
How personalised technology can be used to benefit
quality of life
for people with learning disabilities who have multiple and complex needs. Fry (2012)
Power Wheelchair Prescription, Utilization, Satisfaction, and Cost for Patients With
Amyotrophic Lateral Sclerosis
. Ward et al (2010)
Inclusive Research Principles
Emancipatory Research
1975
2011
Sally French (1992) Researching disability:
the way forward. Disability & Rehabilitation
2011 Quality Statement:
Disability Inclusive Research Collaboration (Australia)
1992
Participatory Research
Barnes & Mercer (2004) Implementing the
Social Model of Disability: Theory and Research
Colin Barnes (2001) 'Emancipatory' Disability Research: project or process?
Rioux & Bach (1994) Disability is not Measles - new research paradigms in disability
Danieli & Woodhams (2005) Emancipatory Research Methodology and Disability: A Critique. International Journal of Social Research Methodology
THE UNION OF THE PHYSICALLY IMPAIRED AGAINST SEGREGATION (1975) Fundamental Principles
Co-production
'a partnership between citizens
and public services to achieve
a valued outcome.'
within an
Inclusive Research Paradigm

'where the rubber..hits the road'
An effective profession addresses nexus issues
Lynne (& Alex) Foreman

gatekeeper
role
how are these nexus issues addressed by research?
what is possible....
...what is practical
consumer priorities
Peter introduces the AEAA
WHO International Classification of
Functioning, Disability and Health (ICF)
Do current research paradigms address nexus issues?
'the best is the enemy of the good'
Queer
Theory
Feminist
Research
Kronenberg
Pollard
Whiteford
OCCUPATIONAL
INJUSTICE
'DOING WHAT MATTERS'
Address the nexus
POWER AND RESISTANCE
COMMUNITY ACTIVISM
AEAA Steering Group
Shaw
Walls
Foucault
transfers
through
Research that is informed
and/or
led by
http://www.thinklocalactpersonal.org.uk/
Aimee Mullins: non-human design
From the perspective of occupational therapy's consumers:
The Disability Academy
Campbell 2007; Banks 2009
(Kingdon 2003)
Address nexus issues
Research
Practice
Policy
Victoria's Aids and Equipment Action Alliance challenge Treasury about inadequate equipment funding www.aeaa.org.au
Inclusive research principles
Reeve (2002) Negotiating Psycho-emotional Dimensions of Disability and their Influence on Identity Constructions. Disability & Society


Swain, French, Barnes, & Thomas (2004)
Disabling Barriers – Enabling Environments

Goggin & Newell (2005)
Disability in Australia: exposing a social apartheid

Client-centered?

Client-centered practice is defined without
evident reference to clients' perspectives.

Few occupational therapy researchers have sought
clients' perceptions of their client-centeredness

Occupational therapy research is (not) consistently
undertaken in a collaborative manner
Client-centred practice in occupational therapy:
critical reflections. Scandinavian Journal
of Occupational Therapy
Karen Whalley-Hammel (2013)
We need to develop 'inclusion-based practice' to address nexus issues
'EBP' principles do not address nexus issues well
notdoneliving.com
fourwallsnolimits.net
Heather and colleagues
addressing Treasury
Lynne addresses PM
Heather advises
PM via tactile
communication
with Inclusion-Based Practice
Health Conditions
Personal
Factors
Activities
Environmental
Factors
Body Structures
& Functions
WHO International Classification of
Functioning, Disability and Health (ICF)
Human Variation
Participation
Contextual Factors
Tom Shakespeare (2006)
Disability Rights and Wrongs
address the
through
natasha@natashalayton.com.au
Ref: Prof Stephen Hawking preface World Report on Disability 2011
'disturbing the idea of disability'
'challenging the existence of normal'

USBs available at www.aeaa.org.au containing:
- Equipping Inclusion Studies
- Invitation to potential research partners
- Multimedia footage of AT users demonstrating AT
outcomes over WHO ICF activity and participation chapters
Action on 'problems'
DIRCC 2012:Lynne Foreman, Barwon Disability Access Committee, Geelong, Australia, meets Vo Thi Hoang Yen, Director, Disability Resource and Development, Ho Chi Minh City, Vietnam and Ipul Powaseu, Papua New Guinea Assembly of Disabled People.
Lady Gaga commissions worlds first gold-plated wheelchair
Ethics Committees conflate impairment with vulnerability
http://www.cds.med.usyd.edu.au/
disability-inclusive-research-principles

Full transcript