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OTHY201 Contextual Determinants of Health, Illness and Disability

Teaching organisation

150 hours of focused learning.

Unit rationale, description and aim

Understanding the factors that influence quality of life and health outcomes for people with disabilities is important for occupational therapists because of the profession's focus on participation in everyday occupations and roles. In this unit, students examine the social context of disability including community attitudes, policies, legislation, health service delivery and barriers to participation. Students will examine and reflect on the role that occupational therapists and other allied health professionals play in enabling occupational participation.

This unit builds on the experience and personal development gained by students in the previous semester in the unit OTHY201, and in previous year in the University Core Curriculum unit UNCC100 by undertaking 25 hours of Community Engagement spread over the semester. In OTHY204 students work with individuals within community groups and consider the historical, societal, cultural, environmental and personal factors that might limit that person's participation in their local community.

The overreaching aim of this unit is for students to develop and understanding of the social context of disability and the role Occupational Therapists, other allied health professionals, families and communities play in enabling occupational participation.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Reflect on the role of the occupational therapist, other allied health professionals, families and members of the community in supporting participation for people with a disability (ACU Graduate Attributes: 1, 2, 7, 9)

LO2 - Analyse the impact of culture, attitudes, values, and beliefs on the assessment, intervention and outcome measurement of occupational participation for people with a disability; (ACU Graduate Attributes: 1, 9)

LO3 - Examine current social theories that impact on policy and service delivery for people with a disability; (ACUGraduate Attribute: 2, 9)

LO4 - Critique the impact of services, systems, and policies and frameworks on health, participation and disability; (ACU  Graduate Attributes: 6)

LO5 - Analyse the impact of the environment on health, participation and disability; (ACU Graduate Attributes: 2)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA2 - recognise their responsibility to the common good, the environment and society 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA7 - work both autonomously and collaboratively 

GA9 - demonstrate effective communication in oral and written English language and visual media 

GA10 - utilise information and communication and other relevant technologies effectively.

Australian occupational therapy competency standards (AOTCS) 2018

Australian occupational therapy competency standards (AOTCS) 2018 developed within this unit are:

Standard/Attributes/CriteriaLearning Outcomes

Standard 1 Professionalism

An occupational therapist practices in an ethical, safe, lawful and accountable manner, supporting client health and wellbeing through occupation and consideration of the person and their environment.

An occupational therapist:

1. complies with the Occupational Therapy Board of Australia’s standards, guidelines and Code of conduct

2. adheres to legislation relevant to practice

3. maintains professional boundaries in all client and professional relationships

4. recognises and manages conflicts of interest in all client and professional relationships

5. practises in a culturally responsive and culturally safe manner, with particular respect to culturally diverse client groups

7. collaborates and consults ethically and responsibly for effective client-centred and interprofessional practice

8. adheres to all work health and safety, and quality requirements for practice

9. identifies and manages the influence of her/his values and culture on practice

10. practises within limits of her/his own level of competence and expertise

11. maintains professional competence and adapts to change in practice contexts

12. identifies and uses relevant professional and operational support and supervision

13. manages resources, time and workload accountably and effectively

14. recognises and manages her/his own physical and mental health for safe, professional practice

15. addresses issues of occupational justice in practice

17. recognises and manages any inherent power imbalance in relationships with clients.


Standard 2 Knowledge and learning

An occupational therapist’s knowledge, skills and behaviours in practice are informed by relevant and contemporary theory, practice knowledge and evidence, and are maintained and developed by ongoing professional development and learning.

An occupational therapist:

1. applies current and evidence-informed knowledge of occupational therapy and other appropriate and relevant theory in practice

2. applies theory and frameworks of occupation to professional practice and decisionmaking

3. identifies and applies best available evidence in professional practice and decisionmaking

5. maintains current knowledge for cultural responsiveness to all groups in the practice setting

8. reflects on practice to inform current and future reasoning and decision-making and the integration of theory and evidence into practice

9. maintains knowledge of relevant resources and technologies, and

10. maintains digital literacy for practice.

1, 2, 3, 4, 5

Standard 3 Occupational therapy process and practice

An occupational therapist’s practice acknowledges the relationship between health, wellbeing and human occupation, and their practice is client-centred for individuals, groups, communities and populations.

An occupational therapist:

1. addresses occupational performance and participation of clients, identifying the enablers and barriers to engagement

2. performs appropriate information gathering and assessment when identifying a client’s status and functioning, strengths, occupational performance and goals

3. collaborates with the client and relevant others to determine the priorities and occupational therapy goals

4. develops a plan with the client and relevant others to meet identified occupational therapy goals

5. selects and implements culturally responsive and safe practice strategies to suit the occupational therapy goals and environment of the client

7. reflects on practice to inform and communicate professional reasoning and decisionmaking

8. identifies and uses practice guidelines and protocols suitable to the practice setting or work environment

10. reviews, evaluates and modifies plans, goals and interventions with the client and relevant others to enhance or achieve client outcomes

11. evaluates client and service outcomes to inform future practice

12. uses effective collaborative, multidisciplinary and interprofessional approaches for decision-making and planning

13. uses appropriate assistive technology, devices and/or environmental modifications to achieve client occupational performance outcomes

1, 2, 4, 5

Standard 4 Communication

Occupational therapists practise with open, responsive and appropriate communication to maximise the occupational performance and engagement of clients and relevant others.

An occupational therapist:

1. communicates openly, respectfully and effectively

2. adapts written, verbal and non-verbal communication appropriate to the client and practice context

4. uses culturally responsive, safe and relevant communication tools and strategies

7. obtains informed consent for practice and information-sharing from the client or legal guardian

8. maintains collaborative professional relationships with clients, health professionals and relevant others

9. uses effective communication skills to initiate and end relationships with clients and relevant others

10. seeks and responds to feedback, modifying communication and/or practice accordingly, and

11. identifies and articulates the rationale for practice to clients and relevant others.

1, 2, 5


The construction of disability and its relationship to Occupational Therapy

Occupational therapy models and processes

Social determinants


Definition and description of disability

International Classification of Functioning Disability and Health (ICF)

Occupational participation and inclusion

The social construction of health, illness and disability

Theories informing societal attitudes and values

Historical perspectives

Human services and disability

Social reform

The social model of disability

Empowerment and self-determination

Service systems, policies and supports

Describing and evaluating environments for people in service systems

Issues for carers and families

Natural supports, networks and relationships

The inter-relationship between environment, health, participation and disability



Community living


National Disability Insurance Scheme & National Injury Insurance Scheme 

Inter-professional collaboration and the multidisciplinary team 

Products and technology

Natural and man-made environment


Practical use of technological equipment

The impact of the built environment on participation

Learning and teaching strategy and rationale

Teaching and learning strategies for this unit will include lectures, practical sessions, case studies and self-directed learning including -25 hrs Community Engagement experience. These strategies will enable students to develop an understanding of the social context of disability and the scope of their own and other professional’s roles in the context of complex client management (people with disability). The 25 Community Engagement hours in this unit are counted towards student’s 1000hrs of Professional Practice Education as required by the World Federation of Occupational Therapists and Occupational Therapy Australia. Community Engagement is a crucial element of Professional Practice Education at ACU and this unit helps to prepare students to work with people with disabilities.  

Students will be expected to take responsibility for their learning and to participate actively within group activities, demonstrating respect for the individual as an independent learner. 

Assessment strategy and rationale

A range of assessment procedures will be used to meet the unit learning outcomes and develop graduate attributes consistent with University assessment requirements.  The assessment strategy for this unit includes a case-based group oral presentation, a written assignment, and a written reflective piece. This strategy will enable students to demonstrate their understanding of the social context of disability and the role Occupational Therapists and other allied health professionals play in enabling occupation. The assessments in this unit are scaffolded to enable students to adopt a person centred approach, starting with a focus on individual goal setting and intervention planning though a case-based group oral presentation and community engagement activities; extending out to consider the influence of broader social factors, including service systems, policies and supports on opportunities for individual participation through a written essay; and finishing with a reflection on individual and social factors impacting on participation for individuals encountered during community engagement.

Overview of assessments

Brief Description of Kind and Purpose of Assessment TasksWeightingLearning OutcomesGraduate Attributes

Assessment 1. Case-based group presentation: students will, in groups of 3, deliver a 15 minute oral presentation to demonstrate skills in gathering and presenting material related to evaluating the impact of the physical, social and technological environment on occupational participation and communication for a client with a disability 


1, 2, 5,

1, 2, 7, 9, 10

Assessment 2. Written assignment (2000 word essay) students will write on the National Disability Insurance Scheme to develop skills to synthesise and analyse societal, political, environmental and other factors impacting the community participation and inclusion of individuals with disabilities


2, 3, 4

1, 2, 6, 9

Assessment 3. Post Community Engagement Critical Reflection: students will write a 1500 word reflection on their preparation for community engagement and the community engagement experience 


3, 4, 5

1, 2, 9

Completion of 25 hours Community Engagement Experience

  1. Completion of Disability Dynamic Online Learning Module “Working with Clients” (3 hrs) and further Disability Dynamic modules (other than those used for assessment in the unit) to a total of 20 hrs
  2. Completion of NDIS Worker Orientation Module ‘Quality, Safety and You’ (90 mins)

Hurdle Requirements



Assessment 1: Agreement of Contribution Form

Hurdle Requirements



Assessment 1: Record of Contribution Form

Hurdle Requirements



Representative texts and references

Barbara, A., & Curtin, M. (2008). Gatekeepers or advocates? Occupational therapists and equipment funding schemes. AustralianOccupational Therapy Journal, 55, 57-60.

Bigby, C., Fyffe, C. & Ozanne, E. (Eds.) (2007). Planning and support for people with intellectual disabilities: Issues for casemanagers and other professionals. Sydney: UNSW Press Ltd.

Cerebral Palsy Alliance (Producer). (2012).Disability Dynamic [DQ Online Learning Portal]. Sydney, Australia: Cerebral PalsyAlliance.  

Dempsey, I., & Nankervis, K. (Eds) (2006). Community disability services. Sydney: UNSW Press.

Etmanski, A. (2000). A good life for you and your relative with a disability. Burnaby, BC: Planned Lifetime Advocacy Network.

Imms, C. (2006). The International Classification of Functioning, Disability and Health: They’re talking our language. AustralianOccupational Therapy Journal, 53, 65-66.

French, S., & Swain, J. (2008). There but for fortune. In J. Swain & S. French (Eds.), Disability on Equal Terms (pp. 7 - 20). LosAngeles: Sage Publishing.

Goggin, G., & Newell, C. (2005). Disability in Australia: Exposing a social apartheid. Sydney:

Law, M., Baptiste, S., Carswell, A., McColl, M., Polatajko, H., & Pollock, N. (1998). Canadian Occupational Performance Measure.Toronto, Canada: CAOT Publication.

O’Brien, J., & Mount, B. (2005). Make a difference: A guide book for person-centred direct support. Inclusion Press.

Townsend, E.A., & Polatajko, H.J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being,& justice through occupation. Ottawa: Canadian Association of Occupational Therapists.

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