Medicine and Health Sciences Commons^™

Critiquing Representations Of Intellectual Disability In Occupation-Based Literature, Rachel Reparon, Pamela Block, Ann Fudge Schormans, Debbie Laliberte Rudman, Gail Teachman

Occupational Therapy Publications

Background: Within and beyond occupation-based scholarship, concerns abound regarding the pervasiveness of discourses that promote a negative, deficit-based view of intellectual disability and associated consequences for disabled people’s lives. Such representations risk reducing the complexities of human doing and being and can limit the occupational possibilities of this group. Yet, there is a lack of critically reflexive research exploring how disability is discursively constructed in occupation-based literature.

Aims/Objectives: This paper critically analyses representations of intellectual disability within occupation-based literature. It considers the influence of such representations on the occupational possibilities of people labelled intellectually disabled.

Methods: This review employed a …

Social Isolation, Third Places, And Precarious Employment Circumstances: A Scoping Review, Debbie Laliberte Rudman, Rebecca M. Aldrich

Occupational Therapy Publications

No abstract provided.

"Making Change By Shared Doing": An Examination Of Occupation In Processes Of Social Transformation In Five Case Studies., Sandra Schiller, Hanneke Van Bruggen, Sarah Kantartzis, Debbie Rudman, Ryan Lavalley, Nick Pollard

Occupational Therapy Publications

BACKGROUND: As social and health inequalities deepen around the world, scholarship in occupational therapy and occupational science has increasingly emphasised the role of occupation as a powerful tool in transformative processes.

OBJECTIVE: To explore how opportunities for everyday doing together may contribute to processes of social transformation by identifying ways occupation is being taken up in socially-transformative practice.

MATERIAL AND METHODS: A generic descriptive qualitative case study design was utilised in order to describe current practice examples and identify ways occupation was being taken up in five initiatives working towards social transformation located in Canada, Germany, South Africa and the …

Situating Occupational Injustices Experienced By Children With Disabilities In Rural India Within Sociocultural, Economic, And Systemic Conditions, Tanya Elizabeth Benjamin-Thomas, Debbie Rudman, Colleen Mcgrath, Debra Cameron, Vinod Joseph Abraham, Jeshuran Gunaseelan, Samuel Prasanna Vinothkumar

Occupational Therapy Publications

This paper contributes to diversifying and situating understandings of occupational injustices through presenting findings from the knowledge generation phase of a participatory action research (PAR) project that utilized participatory filmmaking with children with disabilities in rural South India as co-researchers. Centering on situations of occupational injustices generated through a participatory analysis conducted with the child co-researchers, a critical theoretical analysis, informed by critical occupational science and critical disability perspectives, was carried out. This theoretical analysis of data generated through the filmmaking process, as well as data generated with parents of children with disabilities, community members, and service providers, was used …

Promoting Critically Informed Learning And Knowing About Occupation Through Conference Engagements, Rebecca Aldrich, Roshan Galvaan, Alison Gerlach, Debbie Rudman, Lilian Magalhaes, Nick Pollard, Lisette Farias

Occupational Therapy Publications

As occupation-focused discussions and applications of critical theoretical perspectives increase, attention must also be paid to how different spaces of knowledge dissemination, exchange, and production support critically informed learning and knowing about occupation. This paper presents the reflections of a group of international scholars and lecturers whose shared interest in critical theoretical perspectives prompted the incremental co-development of a series of conference engagements. We describe how our group came together, what kinds of learning experiences we developed to promote and support engagement with critical theoretical perspectives, and what understandings we gained through ongoing critical reflexivity about those learning experiences. Our …

Enacting Contextually Responsive Scholarship: Centring Occupation In Participatory Action Research With Children In India, Tanya Elizabeth Benjamin-Thomas, Debbie Laliberte Rudman, David Mark Thomas

Occupational Therapy Publications

Occupation-based scholars are striving to mobilize socially responsive scholarship to address occupational injustices from local to global scales. Moving forward involves expanding beyond Western, Anglophonic, female, able-bodied, adult perspectives on occupation, with critically informed participatory methodologies providing one key means to incorporate diverse perspectives on occupation and occupational justice. Drawing upon a participatory action research project with children with disabilities from rural South India, this paper puts forward an understanding of participatory action research as an occupational process (i.e., embodying a variety of occupations) and an occupation-based process (i.e., informed by an occupational lens). We forefront how ‘occupation’ was centered …

Producing Precarity: The Individualization Of Later Life Unemployment Within Employment Support Provision, Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

There have been marked policy shifts within many nations towards ‘extended work lives’, with such shifts often underpinned by an assumption that individual aging citizens can make the responsible choice to prolong work and thereby avoid dependency on the state. However, possibilities for extended work lives are inequitably distributed, and older workers who become unemployed often face prolonged unemployment and barriers to obtaining sustainable employment. Drawing on findings from an ethnographic study addressing the negotiation of long-term unemployment in two North American cities, this article attends to how jobseekers aged 50 and older, employment support service providers, and organizational stakeholders …

Mobilizing Occupation For Social Transformation: Radical Resistance, Disruption, And Re-Configuration, Debbie Rudman

Occupational Therapy Publications

Background. Given the sociopolitical roots of widening occupational, social and health inequities, it is imperative that occupational therapy move forward in mobilizing occupation for social transformation. Purpose. Three key aims are addressed: articulating the imperative to mobilize occupation for social transformation; highlighting the political nature of occupation and occupational therapy; and providing guideposts for embracing a radical sensibility to inform moving forward in mobilizing occupation for social transformation. Key issues. Conditions of possibility within occupational therapy leave the profession ill equipped to enact social transformation. Enacting calls to mobilize occupation for social transformation requires radically reconfiguring these conditions of …

A Systematic Review Of Occupational Therapy Interventions In The Transition From Homelessness, Roxanne Isard Ms., Carrie Anne Marshall, Leonie Boland, Lee Ann Westover, Sharon A. Gutman

Occupational Therapy Publications

Background: Although systematic and scoping reviews have identified a range of interventions for persons experiencing homelessness, no known reviews have captured the range and quality of intervention studies aimed at supporting a transition from homelessness. Objectives: To capture the range and quality of occupational therapy intervention studies aimed at supporting a transition to housing following homelessness. Method: Using Joanna Briggs Institute (JBI) guidelines, we conducted a systematic review including a critical appraisal and narrative synthesis of experimental studies. Results: Eleven studies were included. Critical appraisal scores ranged from 33.3 to 88.9 of a possible score of 100 (Mdn = 62.5; …

The Occupational Therapy Examination And Practice Preparation (Otepp) Program: Development, Implementation And Evaluation Of An Educational Program For Internationally-Educated Occupational Therapists, Colleen E. Mcgrath

Occupational Therapy Publications

This paper provides a chronological overview of the development, implementation, and evaluation of an educational initiative aimed at ensuring internationally-educated occupational therapists are prepared to enter practice in their new country, Canada. The three major phases of the program’s 12-year evolution are described, to distill the key lessons learned at each phase. Data related to the demographics of participants, program content, results of the national examination, registration, and employment outcomes are included. An enhanced understanding of the transition experience of internationally educated occupational therapists provides a strong foundation from which to support internationally-educated colleagues and strengthen the occupational therapy profession.

Centering The Complexity Of Long-Term Unemployment: Lessons Learned From A Critical Occupational Science Inquiry, Rebecca Aldrich, Debbie Rudman, Na Eon(Esther) Park, Suzanne Huot

Occupational Therapy Publications

Inquiries that rely on temporal framings to demarcate long-term unemployment risk generating partial understandings and grounding unrealistic policy solutions. In contrast, this four-phase two-context study aimed to generate complex understandings of post-recession long-term unemployment in North America. Grounded in a critical occupational perspective, this collaborative ethnographic study also drew on street-level bureaucracy and governmentality perspectives to understand how social policies and discursive constructions shaped people’s everyday ‘doing’ within the arena of long-term unemployment. Across three phases, study methods included interviews with 15 organizational stakeholders who oversaw employment support services; interviews, participant observations, and focus groups with 18 people who provided …

Occupational Therapists As Street-Level Bureaucrats: Leveraging The Political Nature Of Everyday Practice., Rebecca M Aldrich, Debbie Rudman

Occupational Therapy Publications

BACKGROUND.: As front-line service providers who often work in systems regulated by governmental bodies, occupational therapists can be conceptualized as "street-level bureaucrats" ( Lipsky, 1980/2010 ) who effect and are affected by policy.

PURPOSE.: Drawing on understandings from a study of long-term unemployment, this article proposes that occupational therapists, as street-level bureaucrats, respond to inter-related policies and systems in ways that can perpetuate, resist, or transform opportunities for doing and being.

KEY ISSUES.: By highlighting practitioners' everyday negotiation of governmental, organizational, and professional power relations, the notion of street-level bureaucracy illuminates the political nature of practice as well as the …

A Participatory Filmmaking Process With Children With Disabilities In Rural India: Working Towards Inclusive Research, Colleen E. Mcgrath

Occupational Therapy Publications

Children with disabilities often experience exclusion within their communities, and this exclusion can extend into research processes. The United Nations Convention on the Rights of the Child, however, emphasizes that children of all abilities need to be involved as decision makers in matters affecting them. This article provides an in-depth description of the process of a participatory action research project carried out with children with disabilities from a rural village in India. It argues for the utility of participatory filmmaking as a research methodology that supports inclusion of children with disabilities as co-researchers in research and action processes. The …

Using Participant Observation To Enable Critical Understandings Of Disability In Later Life: An Illustration Conducted With Older Adults With Low Vision, Colleen E. Mcgrath

Occupational Therapy Publications

Research with older adults aging with vision loss has typically been informed by a biomedical theoretical framework. With a growing focus, however, on critical disability perspectives, which locates disability within the environment, new methods of data collection, such as participant observation, are needed. This article, which reports on the findings from a critical ethnographic study conducted with older adults with age-related vision loss (ARVL), aims to share those insights gained through participant observation and to demonstrate the utility of this method. Three insights were gained including the adaptive strategies tacitly employed to navigate the physical environment, a grounded understanding of …

A Protocol Paper On The Preservation Of Identity: Understanding The Technology Adoption Patterns Of Older Adults With Age-Related Vision Loss (Arvl), Colleen E. Mcgrath

Occupational Therapy Publications

There are a growing number of older adults with age-related vision loss (ARVL) for whom technology holds promise in supporting their engagement in daily activities. Despite the growing presence of technologies intended to support older adults with ARVL, there remains high rates of abandonment. This phenomenon of technology abandonment may be partly explained by the concept of self-image, meaning that older adults with ARVL avoid the use of particular technologies due to an underlying fear that use of such technologies may mark them as objects of pity, ridicule, and/or stigmatization. In response to this, the proposed study aims to understand …

‘That's For Old So And So's!’: Does Identity Influence Older Adults’ Technology Adoption Decisions?, Colleen E. Mcgrath

Occupational Therapy Publications

The role of identity in older adults’ decision-making about assistive technology adoption has been suggested but not fully explored. This scoping review was conducted to understand better how older adults’ self-image and their desire to maintain this influence their decision-making processes regarding assistive technology adoption. Using the five-stage scoping review framework by Arksey and O'Malley, a total of 416 search combinations were run across nine databases, resulting in a final yield of 49 articles. From these 49 articles, five themes emerged: (a) resisting the negative reality of an ageing and/or disabled identity; (b) independence and control are key; (c) the …

Initiating Participatory Action Research With Older Adults: Lessons Learned Through Reflexivity*, Colleen E. Mcgrath

Occupational Therapy Publications

Participatory action research (PAR) is well suited to research that aims to address social exclusion and inclusion in older age. Illustrations of and reflections on PAR with older adults are scarce, particularly the initiation stage, which sets the stage for the cyclical participatory action that follows. In this article, we describe the initiation of a PAR project with older adults and reflect on the alignment of this process with key participatory principles and fit within typical research structures. Findings point to the tensions between developing relationships over time and time-sensitive calls for funding, how traditional conceptions of research can influence …

Engaging The Occupational Imagination: Meeting In Diversity, Debbie Rudman

Occupational Therapy Publications

This article provides a reflection on the 2017 Occupational Science Europe conference through a critical occupational science lens. I first provide a key synopsis of lines of arguments forwarded in a keynote talk I delivered at this conference, titled ‘Embracing a critical turn in occupational science: Contributions and future possibilities’. I then draw upon one of the key directions forwarded in this talk as a means to further enact a transformative agenda through critical occupational science to reflect on how ‘meeting in diversity’ fostered critical alertness. In particular, the strategy of ‘meeting in diversity’ with occupation as a common ground …

Working Towards The Promise Of Participatory Action Research: Learning From Ageing Research Exemplars, Colleen E. Mcgrath

Occupational Therapy Publications

Within research addressing issues of social justice, there is a growing uptake of participatory action research (PAR) approaches that are ideally committed to equitable participation of community members in all phases of the research process in order to collaboratively enact social transformation. However, the utilization of such approaches has not always matched the ideal, with inconsistencies in how participation and action are incorporated. “Participation” within various research processes is displayed differently, with the involvement of community members varying from full participation to their involvement as simply participants for data collection. Similarly, “action” is varyingly enacted from researchers proposing research implications …

Expanding Beyond Individualism: Engaging Critical Perspectives On Occupation., Alison J Gerlach, Gail Teachman, Debbie Rudman, Rebecca M Aldrich, Suzanne Huot

Occupational Therapy Publications

BACKGROUND: Perspectives that individualize occupation are poorly aligned with socially responsive and transformative occupation-focused research, education, and practice. Their predominant use in occupational therapy risks the perpetuation, rather than resolution, of occupational inequities.

AIM: In this paper, we problematize taken-for-granted individualistic analyses of occupation and illustrate how critical theoretical perspectives can reveal the ways in which structural factors beyond an individual's immediate control and environment shape occupational possibilities and occupational engagement.

METHOD: Using a critically reflexive approach, we draw on three distinct qualitative research studies to examine the potential of critical theorizing for expanding beyond a reliance on individualistic analyses …

Understanding Parkinson’S Through Visual Narratives: “I’M Not Mrs. Parkinson’S”, S. G. Lutz, Jeffrey D. Holmes, D. Rudman, A. M. Johnson, K. Ladonna, M. E. Jenkins

Occupational Therapy Publications

Although it is accepted that individuals with Parkinson’s disease (PD) must navigate challenges such as receiving their diagnosis, and changing daily occupations, little is known about how they navigate. The purpose of this study is to deepen the current understanding of the experience of living with PD and its implications for occupation through a narrative visual methodology (photo-elicitation). Methods: Six individuals with PD were asked to take photographs and share verbal narrative accounts to illustrate their experience of living with PD. Findings: Results highlight the interrelationship between occupation and identity, as many of the participants stories were interpreted as foregrounding …

Investigating The Enabling Factors Influencing Occupational Therapists’ Adoption Of Assisted Living Technology, Colleen E. Mcgrath

Occupational Therapy Publications

Method

This qualitative study utilized semi-structured interviews and focus groups with 20 occupational therapists in England and Scotland. The goal was to identify those enabling factors necessary for occupational therapists to adopt assisted living technology.

Results

Five themes emerged regarding the enablers needed to support the adoption of assisted living technology by occupational therapists, including: (1) a positive client–therapist relationship; (2) affordability; (3) time; (4) increased awareness, education, and training; and (5) usability features of the assisted living technology.

Conclusion

With an aging population and the increasing role that technology is playing globally in older adults’ lives, it has never …

Discerning The Social In Individual Stories Of Occupation Through Critical Narrative Inquiry., Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

Calls to ‘transcend the individual’ in occupational science have emerged in recognition of the boundaries of individualistic perspectives and the drive to develop a socially responsive science. In this article, we contend that transcending the individual does not equate to neglecting how individuals make sense of and experience occupation; rather, it requires looking at individual constructions of experiences and occupations in critically informed ways that highlight the socio-political influences on those constructions. This discussion article considers how critical narrative inquiry can be taken up as a methodological approach to interpretively link individual ‘stories’ with social ‘stories’ or discourses, enabling further …

Precarity In The Nonprofit Employment Services Sector, Carlo Fanelli, Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

Drawing on interview and focus group data, this article explores research undertaken as part of a larger research project exploring precarity in the nonprofit employment services sector in a mid-sized Canadian city. We critically survey major legislative changes to Canadian employment and income security policies and programs, including the restructuring of work and labor relations, growth of performance-based contracting-out, erosion of intergovernmental transfers, worker stress, and emotional tolls. Our study’s results demonstrate how employment precarity in the nonprofit employment services sector is amplified by top-down and centralized relationships with funding partners and policymaking divorced from the employment experiences of frontline …

Resource Seeking As Occupation: A Critical And Empirical Exploration., Rebecca M Aldrich, Debbie Rudman, Virginia A Dickie

Occupational Therapy Publications

Occupational therapists and occupational scientists are committed to generating and using knowledge about occupation, but Western middle-class social norms regarding particular ways of doing have limited explorations of survival occupations. This article provides empirical evidence of the ways in which resource seeking constitutes an occupational response to situations of uncertain survival. Resource seeking includes a range of activities outside formal employment that aim to meet basic needs. On the basis of findings from 2 ethnographic studies, we critique the presumption of survival in guiding occupational therapy documents and the accompanying failure to recognize occupations that seem at odds with self-sufficiency. …

“You Got To Make The Numbers Work”: Negotiating Managerial Reforms In The Provision Of Employment Support Service., Debbie Rudman, Rebecca Aldrich, John Grundy, Melanie Stone, Suzanne Huot, Awish Aslam

Occupational Therapy Publications

No abstract provided.

Three-Year Trajectories Of Global Perceived Quality Of Life For Youth With Chronic Health Conditions, Janette Mcdougall, David J. Dewit, Megan Nichols, Linda Miller, F. Virginia Wright

Occupational Therapy Publications

Purpose Objectives of this longitudinal study were to examine 3-year trajectories of global perceived quality of life (QOL) for youth with chronic health conditions, as obtained from youth and parent reports, and to identify personal and environmental factors associated with the trajectory groups for each perspective.

Methods Youth with various chronic conditions aged 11–17 years and one of their parents were recruited from eight children’s treatment centers. Latent class growth analysis was used to investigate perceived QOL trajectories (separately for youth and parent perspectives) over a 3-year period (four data collection time points spaced 12 months apart). Multinomial logistic regression …

“Activated, But Stuck”: Applying A Critical Occupational Lens To Examine The Negotiation Of Long-Term Unemployment In Contemporary Socio-Political Contexts, Debbie Rudman, Rebecca Aldrich

Occupational Therapy Publications

Solutions for the problem of long-term unemployment are increasingly shaped by neoliberally-informed logics of activation and austerity. Because the implications of these governing frameworks for everyday life are not well understood, this pilot study applied a critical occupational science perspective to understand how long-term unemployment is negotiated within contemporary North American socio-political contexts. This perspective highlights the implications of policy and employment service re-configurations for the range of activities that constitute everyday life. Methods: Using a collaborative ethnographic community-engaged research approach, we recruited eight people in Canada and the United States who self-identified as experiencing long-term unemployment. We analyzed interviews …

“Why Would I Want To Go Out?”: Age-Related Vision Loss And Social Participation, Debbie Rudman, Deborah Gold, Colleen Mcgrath, Biljana Zuvela, Marlee Spafford, Rebecca Renwick

Occupational Therapy Publications

Social participation, a key determinant of healthy aging, is often negatively impacted by age-related vision loss (ARVL). This grounded theory study aimed to understand social participation as a process negotiated in everyday life by older adults with ARVL. Interviews, audio diaries, and life-space maps were used to collect data with 21 older adults in two Ontario cities. Inductive data analysis resulted in a transactional model of the process of negotiating social participation in context. This model depicts how environmental features and resources, skills and abilities, and risks and vulnerabilities transacted with values and priorities to affect if and how social …

The Child And Adolescent Scale Of Environment (Case): Further Validation With Youth Who Have Chronic Conditions, Gary Bedell, Janette Mcdougal

Occupational Therapy Publications

Objective: To further validate the Child and Adolescent Scale of Environment (CASE).

Methods: Baseline data (n = 430) were analyzed from a longitudinal study on quality of life for youth with chronic conditions ages 11–17 in Ontario, Canada. Internal consistency and structure, and convergent and discriminant validity were examined via Cronbach’s alpha (α), exploratory factor analyses, correlation analyses and ANOVA.

Results: The CASE had high internal consistency (α = 0.89). A three-factor solution was produced with 55% variance explained: (1) Community/Home Resources, (2) School Resources and (3) Physical Design/Access). CASE total and factor …