Faculty publications - Department of Occupational Science and Occupational Therapy

Permanent URI for this collectionhttps://hdl.handle.net/1807/72263

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Accessible independent housing for people with disabilities: A scoping review of promising practices, policies and interventions
(2023) Lindsay, Sally; Fuentes, Kristina; Ragunathan, Sharmigaa; Li, Yiyan; Ross, Timothy
The aim of this study was to understand promising practices, policies and interventions regarding accessible independent housing for people with disabilities.
Unravelling the Complexities of Workplace Disclosure Among Persons with Non-Visible Disabilities and Illnesses: A Qualitative Meta-Ethnography
(2022-01-17) Tomas, Vanessa; Ahmed, Hiba; Lindsay, Sally
Background: Deciding whether and how to disclose a disability at work for persons with non-visible disabilities and illnesses involve complex processes. Research has focused on antecedents and outcomes of disclosure. More research is needed to understand the lived experiences related to disclosure decision-making and actual navigation of disclosure and concealment at work. Purpose: To understand the experiences of persons with non-visible disabilities and illnesses regarding workplace disclosure decision-making, navigating disclosure and/or concealment, and experiential differences across disability and illness types, ages, geographic locations, and genders. Methods: We conducted a qualitative meta-synthesis using Noblit and Hare’s seven steps of meta-ethnography. Searches were conducted via six databases. Studies were analyzed to develop conceptual categories, third-order constructs (themes), and a line-of-argument with comparisons drawn from the disclosure decision making model, disclosure process model, and consideration of disability and illness types, genders, ages, and geographic locations. Results: Twenty-four studies were included involving 489 participants, aged 16 to 81, from nine countries, focusing on one non-visible disability or illness, or multiple. We developed four themes for the disclosure decision-making process (self- and other-focused, experiential, and environmental/workplace factors) and two themes for the disclosure/concealment event (disclosure/concealment logistics and timing) and noted emerging trends across ages, genders, disability and illness types, and geographic locations. Conclusions: Knowledge obtained could be used among professionals who support persons with non-visible disabilities and illnesses to help them navigate disclosure at work, and to consider the role of age, genders, disability and illness types, and geographic locations on disclosure.
A Scoping Review of the Benefits and Challenges of Using Service Dogs for Finding and Maintaining Employment
(2022-03) Lindsay, Sally; Thiyagarajah, Kavitha
Purpose Having a service dog can help increase the independence of people with disabilities and they are considered a reasonable accommodation within employment settings. The objective of this scoping review was to understand the benefits and challenges of using a service dog in gaining and maintaining employment. Methods Systematic searches of seven international databases led to 19 studies meeting our inclusion criteria. Using a narrative review approach, we analyzed these studies regarding their sample characteristics, methods, results and quality of evidence. Results Nineteen studies were included in the review, which spanned across 6 countries over a 24-year period. Our findings showed that the benefits of having a service dog included improvements in employment status, employers' recognition of service dogs as a workplace accommodation, lower absenteeism, ability to travel to work, and other career-related benefits. Challenges with having a service dog included discrimination and exclusion, and lack of employers' awareness of service dogs and people with disabilities. Conclusions Our findings highlight several benefits and challenges of having a service dog in the workplace. More research is needed to explore the impact of service dogs on employment, health and productivity in the workplace and how this may vary by type of disability and service dog.
A systematic review of self-determination interventions for children and youth with disabilities
(Taylor and Francis, 2021-05-30) Lindsay, Sally; Varahra, Azar
Purpose Developing self-determination skills is an important component of youth’s maturation. However, many youths with disabilities lack opportunities to engage in activities that can promote these skills. The purpose of this study was to conduct a systematic review of self-determination interventions for children and youth with disabilities. Methods A systematic review was performed on seven international databases that identified 28 studies meeting our inclusion criteria. Results Among the 28 studies, 5184 youth with disabilities (aged 9–29, mean age 16.8 years) were represented across three countries. The interventions varied in duration, length, number of sessions, and delivery format, which included curriculum-based, workshops, experiential or residential learning, peer coaching and mentoring, self-directed individual learning, computer games, and multi-component designs. 19/28 studies reported a significant improvement in self-determination. Of these 13/18 studies showed improvements as measured by Arc’s self-determination scale, while 8/13 studies reported a significant improvement as measured by AIR self-determination scale. Other significant differences were reported in vocational skills self-efficacy and self-determination inventory. Conclusions Our findings highlight that there are several types of interventions that have the potential to improve self-determination for youth with disabilities. Further research is needed to understand what program components could help youth to obtain optimal outcomes.
A systematic review of workplace disclosure and accommodation requests among youth and young adults with disabilities
(2018) Lindsay, Sally; Cagliostro, Elaine; Carafa, Gabriella
Purpose: The objective of this systematic review is to critically appraise the literature on disability disclosure and workplace accommodations for youth and young adults with disabilities. Methods: Systematic searches of nine international databases identified 27 studies meeting our inclusion criteria. These studies were analyzed with respect to the characteristics of the participants, methodology, results of the studies and the quality of the evidence. Results: Among the 27 studies, 18,419 participants (aged 14–33, mean 23.9 years) were represented across seven countries. Barriers to disability disclosure and requests for workplace accommodations were found at the individual (i.e., disability type, severity, poor self-concept, and advocacy skills), employment (i.e., type of industry, and working conditions, lack of supports), and societal levels (i.e., stigma/discrimination). Facilitators of disability disclosure included individual factors (i.e., knowledge of supports and workplace rights, self-advocacy skills), employment (i.e., training/supports, effective communication with employers, realizing the benefits of accommodations), and societal factors (i.e., positive attitudes toward people with disabilities). There was little consensus on the processes and timing of how disability should be discussed in the workplace among youth with disabilities. Conclusions: Our findings highlight the complexities of disability disclosure for youth with disabilities. More studies are needed to explore issues of workplace disclosure and accommodations for young people to improve disclosure strategies and the process of providing appropriate accommodations.
An ecological approach to understanding barriers to employment for youth with disabilities compared to their typically developing peers: views of youth, employers, and job counselors
(2015) Lindsay, Sally; McDougall, Carolyn; Menna-Dack, Dolly; Sanford, Robyn; Adams, Tracey
Purpose: The purpose of this study is to explore the extent to which youth with physical disabilities encounter different barriers to finding employment compared to their typically developing peers. Methods: This study draws on 50 qualitative in-depth interviews with a purposive sample of 31 youth (16 typically developing and 15 with a disability), and youth employers and job counselors knowledgeable about employment readiness among adolescents (n = 19). We utilize Bronfrebrenner’s ecological framework to reveal the complex web of factors shaping youth’s labor market outcomes. Results: Only half of youth with a disability were working or looking for work compared to their peers. The findings show this was a result of different expectations of, and attitudes toward, youth with disabilities. For many youth with a disability, their peers, family and social networks often acted as a barrier to getting a job. Many youth also lacked independence and life skills that are needed to get a job (i.e. self-care and navigating public transportation) compared to their peers. Job counselors focused on linking youth to employers and mediating parental concerns. Employers appeared to have weaker links to youth with disabilities. System level barriers included lack of funding and policies to enhance disability awareness among employers. Conclusions: Youth with physical disabilities encounter some similar barriers to finding employment compared to their typically developing peers but in a stronger way. Barriers to employment exist at several levels including individual, sociostructural and environmental. The results highlight that although there are several barriers to employment for young people at the microsystem level, they are linked with larger social and environmental barriers.
Understanding clinicians' strategies for providing gender-sensitive care: an exploration among pediatric rehabilitation health care providers
(2020-10-23) Lindsay, Sally; Kolne, Kendall
Purpose Although there is an increasing awareness of the critical role of gender within pediatric rehabilitation, little is known about the strategies that clinicians use to provide such care. The purpose of this study was to explore clinicians’ strategies for providing gender-sensitive care within a pediatric rehabilitation hospital. Methods We used a qualitative needs assessment design and a convenience sampling strategy to recruit clinicians from a pediatric rehabilitation hospital. We conducted interviews with 23 pediatric rehabilitation health care providers from various disciplines. We applied a thematic analysis to the interview transcripts. Results Our analysis revealed the following themes regarding clinicians’ strategies in providing gender-sensitive care: (1) awareness of gender biases and not making assumptions; (2) recognizing gender-based vulnerabilities; (3) respecting patient values, preferences and needs; and (4) advocacy. Conclusion Health care providers working within pediatric rehabilitation have several strategies for providing a gender-sensitive care approach to clients.
Exploring the relationships between race, ethnicity, and school and work outcomes among youth and young adults with disabilities: a scoping review
(2021-11-16) Lindsay, Sally; Varahra, Azar; Ahmed, Hiba; Abrahamson, Sara; Pulver, Sierra; Primucci, Mara; Wong, Karen
Purpose Youth with disabilities often encounter barriers in finding meaningful employment and completing post-secondary education. Such challenges are often even more profound for youth who identify as an ethnic minority. The purpose of this study was to understand the relationships between race, ethnicity and school and work outcomes for youth with disabilities. Methods We conducted a scoping review while searching eight international databases that identified 49 studies meeting our inclusion criteria. Results Of the 49 studies that were included in the review, they involved youth and young adults with disabilities (aged 6–29) over a 21-year period. The majority of the studies focusing on school showed that ethnic minority youth with disabilities had poorer school outcomes compared to white youth with disabilities. Meanwhile, most studies focusing on work reported that ethnic minority youth with a disability had worse employment outcomes compared to white disabled youth. Factors influencing school and work included cultural differences in expectations, inequitable access to services and resources, and discrimination. Conclusions Our findings highlight the disparities that exist for young people with disabilities from ethnic minority backgrounds. There is an urgent need for further research to understand their lived experiences to help address gaps in school and work outcomes.
Outcomes of gender-sensitivity educational interventions for healthcare providers: A systematic review
(2019) Lindsay, Sally; Rezai, Mana; Kolne, Kendall; Osten, Victoria
Background: Although gender plays an important role in health, most healthcare providers lack knowledge in providing gender-sensitive care. Offering gender-sensitivity training for healthcare providers can help to address gender-based health inequalities. Method: A mixed-methods systematic review of gender-sensitivity training programmes or interventions for healthcare providers was undertaken to assess their outcomes and to document areas for future research. Comprehensive searches of seven international databases were conducted for peer-reviewed literature published between 1998 and 2018. Eligible studies included at least one outcome related to gender-sensitivity training for healthcare providers. Results: Twenty-nine studies met the inclusion criteria. Fourteen studies focused on gender-sensitivity in reducing gender bias towards men and women, and 15 studies focused on addressing the needs of lesbian, gay, bisexual and transgender (LGBT) patients. Thirty-seven percent of studies showed a significant improvement in gender-related knowledge, attitudes or practice after the training. Multiple training methods were used to teach gender-sensitive care. Common content of the training included learning sex/gender terminology, understanding gender issues and inequalities in health, stigma and discrimination and communication skills. The duration and frequency of interventions ranged considerably. Sex differences in training outcomes also occurred among the learners. Conclusion: Review findings highlight that although gender-sensitivity training for healthcare providers is increasing, there is insufficient evidence to determine its effectiveness. Additional, more rigorously designed studies are needed to assess the long-term implications on learner behaviours and practices, especially across a wide variety of healthcare providers.
Employers’ and employment counselors’ perceptions of desirable skills for entry-level positions for adolescents: how does it differ for youth with disabilities?
(2014) Lindsay, Sally; Adams, Tracey; Sanford, Robyn; McDougall, Carolyn; Kingsnorth, Shauna; Menna-Dack, Dolly
Today’s youth face high unemployment and other labor-market challenges; these challenges are often worse for youth with disabilities. This paper explores what employers and employment counselors look for when hiring youth into entry-level jobs and whether they believe youth with disabilities have fewer skills than those without. This study used a qualitative design with a purposive sample of 19 youth employers and employment counselors. Our findings show that youth employers and employment counselors identify the following traits as enhancing young workers’ employability: a well-prepared job applicant; job fit and a good attitude; and soft skills. We find youth with disabilities are perceived to be at a disadvantage. Consistent with a rising body of research, the emphasis on soft skills, and pliability, opens the door for employment discrimination.
Exploring employment readiness through mock job interview and workplace role-play exercises: comparing youth with physical disabilities to their typically developing peers
(2015) Lindsay, Sally; McDougall, Carolyn; Sanford, Robyn; Menna-Dack, Dolly; Kingsnorth, Shauna; Adams, Tracey
Purpose: To assess performance differences in a mock job interview and workplace role-play exercise for youth with disabilities compared to their typically developing peers. Methods: We evaluated a purposive sample of 31 youth (15 with a physical disability and 16 typically developing) on their performance (content and delivery) in employment readiness role-play exercises. Results: Our findings show significant differences between youth with disabilities compared to typically developing peers in several areas of the mock interview content (i.e. responses to the questions: “tell me about yourself”, “how would you provide feedback to someone not doing their share” and a problem-solving scenario question) and delivery (i.e. voice clarity and mean latency). We found no significant differences in the workplace role-play performances of youth with and without disabilities. Conclusions: Youth with physical disabilities performed poorer in some areas of a job interview compared to their typically developing peers. They could benefit from further targeted employment readiness training.
Challenges with providing gender-sensitive care: exploring experiences within pediatric rehabilitation hospital
(2022-03) Lindsay, Sally; Kolne, Kendall; Rezai, Mana
Purpose The purpose of this study was to explore the perceived challenges with providing a gender-sensitive care approach among pediatric rehabilitation care providers. Methods Using a qualitative needs assessment design and a purposive sampling strategy, we recruited clinicians from a Canadian pediatric rehabilitation hospital. We conducted interviews with 23 pediatric rehabilitation healthcare providers (19 women, 3 men, 1 transgender man) from a range of disciplines. Three coders performed a thematic analysis of the transcripts. Results Our analysis revealed the following themes regarding the perceived challenges in providing a gender-sensitive care approach: (1) a lack of training and experience; (2) gender differences and stereotypes; (3) binary documentation and potential for misgendering; (4) the complexity of gender identity; and (5) the gender of the clinician. Conclusions Pediatric rehabilitation care providers face many challenges in offering a gender-sensitive care approach and need further training and systemic support.
A disability disclosure simulation as an educational tool
(2020) Lindsay, Sally; Rezai, Mana; Shen, Winny; Lyons, Brent
Purpose Many employers struggle with how to have a disability disclosure discussion with their employees and job candidates. The primary purpose of this study was to identify issues relevant to disability disclosure discussions. In addition, we explored how simulations, as an educational tool, may help employers and managers. Design/methodology/approach Seven participants (four employers and three human resource professionals) took part in this study. We used a qualitative design that involved two focus group discussions to understand participants' experiences of building a simulation training scenario that focused on how to have a disability disclosure discussion. The simulation sessions were audio-recorded and analyzed using an open-coding thematic approach. Findings Four main themes emerged from our analysis. Three themes focused on issues that participants identified as relevant to the disability disclosure process, including: (1) creating a comfortable and safe space for employees to disclose, (2) how to ask employees or job candidates about disability and (3) how to respond to employees disability disclosure. A fourth theme focused on how simulations could be relevant as an educational tool. Originality/value Developing a simulation on disability disclosure discussions is a novel approach to educating employers and managers that has the potential to help enhance diversity and inclusion in the workplace. Further, the process that we followed can be used as a model for other researchers seeking to develop educational training scenarios on sensitive diversity and inclusion topics.
Career aspirations and workplace expectations among youth with physical disabilities
(2021) Lindsay, Sally; Cagliostro, Elaine; Leck, Joanne; Stinson, Jennifer
Youths with disabilities have lower employment rates than youths without disabilities, which are often a result of inaccessible environments, employer's lack of knowledge about people with disabilities and discriminatory attitudes. Exploring youths' career aspirations is important because it can prompt or hinder career planning, and contribute to youths' preparation for adult life. The purpose of our study was to explore the career aspirations and workplace expectations of youths with physical disabilities.
Disclosure and workplace accommodations for people with autism: a systematic review
(2021) Lindsay, Sally; Osten, Victoria; Rezai, Mana; Bui, Sunny
Purpose: The objective of this systematic review was to describe the prevalence and processes of disability disclosure for persons with autism spectrum disorder. Methods: Systematic searches of seven international databases revealed 26 studies meeting our inclusion criteria. We analyzed these studies with respect to participant demographics, methodology, results and quality of the evidence. Results: Among the 26 studies, 7006 participants (aged 13-75, mean 28.1 years) were represented across seven countries. Our findings showed that rates of disclosure and receiving workplace accommodations varied considerably. Benefits of disclosing in the workplace included greater acceptance and inclusion, receiving accommodations, and increasing awareness about autism. Limitations of disclosing to employers involved experiencing stigma and discrimination. Factors affecting decisions to disclose included age at diagnosis, social demands of the job, and workplace policies. Types of accommodations that were received or desired included adjustments to the job interview process, schedules (i.e., flexibility, working from home), job content or working conditions, environment (i.e., lighting, quiet space); support with communication and social skills; and disability awareness training for their workplace colleagues. Conclusions: Our findings highlight that disclosing a condition of autism in the workplace and requesting accommodations is complex. More research is needed to explore processes of disclosing and accommodation and how these processes vary by autism sub-type, gender, and industry type. Implications for rehabilitation Clinicians and vocational Counselors should support people with autism to advocate for their needs in the workplace, including the potential benefits of disclosing their conditions so they can access accommodations that allow them to keep healthy and productive in workplace.Clinicians should recognize that people with autism spectrum disorder may have different workplace accommodation needs than those with other types of disabilities, in particular support with social and communication skills.Clinicians should aid people with autism to access resources and supports that are available to them to access workplace accommodations.
A Systematic Review of the Benefits of Hiring People with Disabilities
(2018-02-01) Lindsay, Sally; Cagliostro, Elaine; Albarico, Mikhaela; Mortaji, Neda; Karon, Leora
Purpose We reviewed literature on the benefits of hiring people with disabilities. Increasing attention is being paid to the role of people with disabilities in the workplace. Although most research focuses on employers' concerns, many companies are now beginning to share their successes. However, there is no synthesis of the peer-reviewed literature on the benefits of hiring people with disabilities. Methods Our team conducted a systematic review, completing comprehensive searches of seven databases from 1997 to May 2017. We selected articles for inclusion that were peer-reviewed publications, had a sample involving people with disabilities, conducted an empirical study with at least one outcome focusing on the benefits of hiring people with disabilities, and focused on competitive employment. Two reviewers independently applied the inclusion criteria, extracted the data, and rated the study quality. Results Of the 6176 studies identified in our search, 39 articles met our inclusion criteria. Findings show that benefits of hiring people with disabilities included improvements in profitability (e.g., profits and cost-effectiveness, turnover and retention, reliability and punctuality, employee loyalty, company image), competitive advantage (e.g., diverse customers, customer loyalty and satisfaction, innovation, productivity, work ethic, safety), inclusive work culture, and ability awareness. Secondary benefits for people with disabilities included improved quality of life and income, enhanced self-confidence, expanded social network, and a sense of community. Conclusions There are several benefits to hiring people with disabilities. Further research is needed to explore how benefits may vary by type of disability, industry, and job type.
Gender matters in the transition to employment for young adults with physical disabilities
(Taylor and Francis, 2017-10-17) Lindsay, Sally; Cagliostro, Elaine; Albarico, Mikhaela; Mortaji, Neda; Srikanthan, Dilakshan
Purpose: The purpose of this study was to explore the role of gender in the transition to employment for young adults with physical disabilities. Methods: This study drew on in-depth interviews with a purposive sample of 33 participants (23 youth and 10 clinicians). The youth in our sample included 13 females (mean age 22.9) and 10 males (mean age 21.3) who had various types of physical disabilities. The person–environment–occupation (PEO) model informed our analysis. Results: Our research showed several similarities and some differences between young males and females with physical disabilities as they transition to employment and adulthood at the person, environment, and occupational level. At the person level, issues included managing their condition, self-advocacy, and willingness to ask for help. At the environment level, themes focused on parental and social support, accommodations, stigma and discrimination, and transportation challenges. Finally, in the occupation component of the PEO model, we found that males and females with disabilities had different levels of engagement in employment. Although most clinicians commented on gender differences, many reported that they did not tailor their clinical practice accordingly. Conclusions: Gender sensitive vocational approaches are needed for youth with disabilities as they transition to employment.
A Systematic Review of the Role of Gender in Securing and Maintaining Employment Among Youth and Young Adults with Disabilities
(Springer Verlag, 2017-08-23) Lindsay, Sally; Cagliostro, Elaine; Albarico, Mikhaela; Srikanthan, Dilakshan; Mortaji, Neda
Purpose There is a critical need for gender-specific vocational supports for young adults with disabilities as they transition to employment. We conducted a systematic review to explore the role of gender in securing and maintaining employment. Methods Systematic searches of seven databases identified 48 studies meeting our inclusion criteria. Using a narrative synthesis approach, these studies were analyzed in terms of the characteristics of the participants, methodology, results, and quality of the evidence. Results Among the 48 studies, 112,473 participants (56% male), mean age (of the total sample) was 21, represented across ten countries. Twenty-one studies reported that young men with disabilities had better employment outcomes than women with disabilities. Eight studies showed that females with disabilities had better employment outcomes than males. Five studies reported that there were no gender differences in employment outcomes for youth with various disabilities. With regards to maintaining employment, men with disabilities often work more hours and have better wages compared to women with disabilities. There are several gender-related barriers and facilitators to maintaining employment including social supports and gender role expectations. Conclusions Our findings highlight that there is a critical need for gender-specific vocational supports for young adults with disabilities.
A framework for developing employer’s disability confidence
(Emerald, 2018-09-26) Lindsay, Sally; Leck, Joanne; Shen, Winny; Cagliostro, Elaine; Stinson, Jennifer
Purpose: Many employers lack disability confidence regarding how to include people with disabilities in the workforce, which can lead to stigma and discrimination. The purpose of this study was to explore the concept of disability confidence from two perspectives, employers who hire people with a disability and employees with a disability. Design: A qualitative thematic analysis was conducted using 35 semi-structured interviews (18 employers who hire people with disabilities; 17 employees with a disability). Findings: Themes included the following categories: disability discomfort (i.e., lack of experience, stigma and discrimination); reaching beyond comfort zone (i.e., disability awareness training, business case, shared lived experiences); broadened perspectives (i.e., challenging stigma and stereotypes, minimizing bias and focusing on abilities); and disability confidence (i.e., supportive and inclusive culture and leading and modelling social change). Our results highlight that disability confidence among employers is critical for enhancing the social inclusion of people with disabilities. Originality/Value: Our study addresses an important gap in the literature by developing a better understanding of the concept of disability from the perspectives of employers who hire people with disabilities and also employees with a disability.
Employers’ perspectives of including young people with disabilities in the workforce, disability disclosure and providing accommodations
(IOS Press, 2019-01-24) Lindsay, Sally; Cagliostro, Elaine; Leck, Joanne; Shen, Winny; Stinson, Jennifer
Background: Enhancing the employment of people with disabilities can help support healthy and productive work. Objective: Our objective was to understand employer accommodation practices with youth with disabilities (i.e., as they currently exist and what employers need help with) and how they create an inclusive environment. Methods: A descriptive qualitative study was conducted involving in-depth interviews with a purposive sample of 18 employers who hire young people with disabilities. Thematic analysis explored issues related to disclosure, accommodations, and inclusion. Results: Most employers encouraged youth with disabilities to disclose their condition and emphasized the importance of building trust and rapport. Employers described how and when to provide accommodations, types of accommodations (i.e., formal, informal, physical, and social), and how they addressed unmet needs. Employers’ strategies for creating an inclusive workplace culture included: diversity training, addressing stigma and discrimination, open communication, mentoring and advocacy. Conclusions: Our findings highlight that most employers hiring youth with disabilities have strategies for encouraging them to disclose their condition and request accommodations, which can help to inform employers who do not hire people with disabilities or have effective strategies in place to support them.

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