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ӣ����Ƶ of California has been awarded a three-year, $600,000 federal grant to support research on the role of occupational therapy consultation to improve cultural arts access and inclusion for people with disabilities.

The timely grant comes as a growing number of cultural arts organizations – including museums, concert halls, theaters, and festival organizers – work to increase accessibility for an increasingly diverse public, including people with a range of disabilities and those who identify as neurodivergent. The grant will create unique research and program development opportunities for Doctor of Occupational Therapy (OTD) and Master’s of Science in Occupational Therapy (MSOT) students in the Dominican’s Occupational Therapy degree programs. 

Dominican is one of four awardees nationwide to receive this National Institute on Disability, Independent Living, and Rehabilitation Research (NIDLRR) funding specifically for institutions with Minority Serving Institution/Hispanic Serving Institution designation. Dr. Caroline Umeda, Associate Professor and Director of Curriculum and Assessment in Dominican’s Department of Occupational Therapy, is the project’s principal investigator. 

People with a range of neurodevelopmental disabilities and those who identify as neurodivergent (e.g., ADHD, autism), can face significant barriers participating in various cultural and community activities, including attending performances and visiting museums and galleries. These barriers can include large crowds, substantial background noise, behavioral expectations, negative public attitudes, and other environmental factors that can make cultural settings feel unwelcoming or inaccessible to adults, children, and their families. 

Though occupational therapists can contribute valuable knowledge and skills to partner with the disability community and promote accessibility in community spaces, little research exists to support their role or guide future occupational therapy practitioners interested in this innovative and emerging realm of practice. 

An earlier study by Dr. Umeda, published in The American Journal of Occupational Therapy noted that while the Americans with Disabilities Act has improved accessibility of public and private spaces for people with physical, vision, and hearing challenges, ADA implementation has yet to fully address community access barriers faced by people with intellectual and developmental disabilities (IDD). This population, Dr. Umeda says, experiences access challenges  as a result of barriers in the sensory and social environment. 

“Participation in the community, including access to the arts, is a right of everyone in our diverse population. Disability is a normal part of human diversity. Breaking down known environmental access barriers and promoting meaningful inclusion of people with neurodevelopmental disabilities is a social responsibility and key to improved implementation of the ADA. This is the work to which occupational therapists are committed.”

Occupational therapists are uniquely positioned to work alongside the disability community, disability advocates, and other professionals to develop inclusive strategies for adults and children with diverse needs and abilities. OTs contribute valuable input on ways a community cultural arts organization can modify the environment to create more accessible experiences for neurodivergent visitors or anyone who could benefit from a more relaxed experience, whether or not they identify as having a disability.

Occupational therapists, Dr. Umeda explains, view accessibility through a broad lens, as they frequently work with clients who face a wide range of engagement and participation challenges. OT practitioners possess skills in activity analysis, environmental modification, and expertise in sensory processing. 

“Occupational therapists do not represent any specific diagnostic group, and our consultative approach is often more focused on how to make a cultural arts space or event as accessible as possible to a group of people with diverse needs, recognizing that every person, whether or not they identify as having disability, is unique.” she says.

“There’s a small but growing body of research documenting that people with disabilities and their families are positively impacted by sensory-friendly and other access programs developed with occupational therapy consultation.”

Dr. Umeda’s research interests include community and cultural arts accessibility for children with disabilities and their families and the role of OT consultation in developing access programs. Much of Dr. Umeda’s work has occurred within the theater context with professional and community theaters, including Seattle Children’s Theatre, to develop and implement sensory-friendly theater performances and programs.

Dominican will serve as the lead institution on the NIDILRR grant. Co-investigators are Dr. Roger Ideishi, Professor and Program Director of the Occupational Therapy Program at the George Washington University, and Dr. Elizabeth Schmidt, Assistant Professor of Occupational Therapy and Director of Research at Lincoln Memorial University. This project team also includes autistic research associates, and the research process will be informed by a diverse advisory board comprised of individuals with disabilities, disability advocates, OT researchers, and arts organization representatives.

The grant-funded research has three goals: 

1. Build a foundation for “best practices” for OTs working in arts access by analyzing OT consultation processes used with cultural arts institutions.  The three researchers will each work with three cultural institutions (museums, performing arts centers, etc.) to collect data on consultation methods and their impact.
2. Evaluate the impact of OT consultation on the capacity of cultural institutions to support access and inclusion. The researchers will use an organizational capacity-building framework to measure growth in areas such as service expansion, program development, staff knowledge, etc. The researchers will assess changes in organizational practices and resources that best fit each institution. For example, a theater may be interested in developing sensory friendly performance programs while a museum might want to focus on training its docents. “It will be important that our work meets institutions where they are but moves them forward in their access journey,” Dr. Umeda says.
3. Improve inclusion for people with disabilities in cultural settings. The researchers will assess how programs and practices developed with OT collaboration directly impact the sense of belonging for people with disabilities. Using a standard belongingness scale, the research team will collect data from individuals with disabilities to assess inclusion within arts settings.

This semester, Dr. Umeda is wrapping up a multi-year faculty-mentored capstone project with OT students to develop a series of resources and protocols now being used at San Francisco’s California Academy of Sciences to support community access and inclusion for diverse populations, including people with sensory, social, and learning disabilities. 

The students worked with two departments within the museum: the Planetarium and Volunteer Services. The work started with a needs assessment – including consulting with staff and families from the disability community – and then program implementation, training, and evaluation. This assessment helped students determine the need for visual guides that visitors could use before and during the show. 

The visual guides feature photographs to help visitors anticipate and follow the sequence of events in the show. The photos represent the key content presented in the show – including images of the sun and asteroids – but in more of a ‘scavenger hunt’ type of format.

“When someone with an intellectual disability or a sensory processing challenge attends a show, it may be difficult to engage just by listening to the words coming at them,” Dr. Umeda explains. “Research shows that visual guides can support engagement and understanding of some people with disabilities who engage better with written words and pictures versus listening to spoken words. Many people without disabilities also have visual learning preferences, and these guides benefit them as well.”

The students presented their work at the American Occupational Therapy Association national conference in Florida earlier this year.

In Marin, Dr. Umeda and her OT students worked with Mill Valley’s Throckmorton Theater to develop a sensory friendly performance of Willy Wonka and the Chocolate Factory. This included creating a “chill space” in the lobby and “movement” and “tech friendly” zones in the audience. Prior to the show, there was an onstage announcement outlining the zones and their uses and explicitly communicating that movement, vocalization, and moving around as needed were acceptable and embraced. 

Dr. Umeda also worked with San Anselmo’s 23 Elephants Theatre Company on a youth performance of Mamma Mia! In addition to creating inclusive opportunities for the audience, the work allowed the youth cast to experience performing within a sensory-friendly environment.

This project is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $594,069 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.