Introduction: Disability, accessibility, and inclusion are well established concepts within the literature as tenets of how allied health and speech pathology clinicians work with clients. However, little is known about the diversity of the speech pathology workforce with respect to those living with disability, nor about the accessibility and inclusivity of speech pathology training program. Anecdotal experiences highlight how a range of positive and negative factors influence the experiences of students with disabilities, with clinical education programs an area requiring particular exploration. The aim of the presentation is to propose a model that will support inclusive practice in clinical education and ultimately lead to increased workforce diversity.
Method: A narrative review of models of disability inclusion was conducted. General models of disability (e.g. Social Model of Disability and the International Classification of Functioning, Disability, and Health), and discipline specific models (e.g. Participation Model in speech-language pathology) were reviewed. Common themes across the literature were identified for translation into a model with application to a case exemplar.
Results: The Model of Inclusive Clinical Education (MICE) is proposed to support the successful inclusion of disabled into speech-language pathology and allied health practice education with four key elements. Elements include: (i) shared goals, (ii) individual student characteristics, (iii) environment/placement factors, and (iv) bridging pillars.
Conclusion: MICE provides a strong base for discussions that support equitable access and inclusion of students with disability into clinical education programs. Further discussion between academics and clinicians with and without disability is required to explore its practical application.

Keywords: diversity, disability, clinical education

Submission statement: Recent times have seen our profession reflect on its workforce diversity. The focus of this presentation developed in response to the lived experience of students with disability. A collaboration seeking to increase workforce diversity emerged addressing barriers and enablers to equitable inclusion of students with disabilities in clinical programs.

Introduction.
The National Disability Research Partnership recently funded the National Disability Research Agenda project in Australia and published (i) an update of Australian disability research; (ii) results of a sector-wide consultation on disability research prioritise; and (iii) an online survey outlining research priorities. It was important that the sector-wide consultation included adults with communication disability to consider their views on research priorities in Australia.
Aim. To determine the views of people with communication disability and their supporters on priorities for research to guide and influence the research agenda in Australia.
Method. Three online focus groups and five in-depth interviews were conducted with adults with communication disability (n=12) and their family members or support workers (n=8). Data was transcribed, de-identified and analysed using content thematic analysis.
Results. Research themes identified included accessibility, assistive technology, attitudes, discrimination, stigma, and choice. Specifically, research on communication needs, access to services, rights and advocacy were prioritised. Increased focus on supports for education, employment, participation and engagement, housing, health services and systems, and government policy is needed. The findings aligned with the larger consultation and were integrated into the report on its findings.
Conclusion. Supportive communication in research can enable the inclusion of people with communication disability in agenda-setting discussions. Foregrounding the views of people with communication disability, this paper will outline implications for speech pathologists seeking to further inclusive and enabling disability research in Australia.

Keywords
Communication disability, access, focus groups, interviews, priorities, research

Statement
This paper respects and prioritises the voices of people with communication disability participating in a research-agenda-building national project. Reflecting upon and responding to their call for action in research to improve their participation, inclusion, and access is vital in the field of speech pathology.

Introduction/or rationale:
It is estimated that 5% of the Australian population has a communication disorder. Research consistently shows that people with a communication disability report that their access to community and health services has been impacted. Communication failures (verbal or written) can result in errors, misdiagnosis, inappropriate treatment and poor care outcomes.

Aim(s)
Communication for Safe Care is aiming to improve communication exchanges between consumers and health care services. We will be looking at this holistically from environmental design to day-to-day interactions between healthcare workers and consumers.

Methods:
Funded through a National Disability Insurance Agency Mainstream Capacity Building Grant, Communication for Safe Care is a collaboration between:
• South Western Sydney Local Health District (SWSLHD)
• Western NSW Local Health District (WNSWLHD)
• University of Sydney
The project will be imbedded in 4 public health services over a period of 18 months. Using an iterative process of collaboration and co-design, we will work with consumers and clinicians to develop culturally safe and locally appropriate communication access solutions.

Results:
Early results confirm that communication access receives little consideration from healthcare services.

Conclusions
Our project seeks to develop a transferrable model of practice that any health care services across Australia can use to assess their communication accessibility and partner with consumers to co-design solutions.

Keywords - Communication access; healthcare; co-design; action research; consumers; communication failures.

Submission Statement: After reflecting on the growing body of evidence that communication access is inadequate within health care settings, the Communication for Safe Care project was created. Instead of jumping to solutionism, the project is working with consumers and health care workers to co-design access solutions that are respectful and responsive to local contexts.

Abstract: Close to 100 students access the playground every day at Giant Steps Sydney. All students have a diagnosis of autism and intellectual disability, with most having visual learning preferences. Consistent barriers to the availability of communication supports in the playground include laminated visual supports being damaged, transition of individual communication supports including communication books and high-tech assistive devices from the classroom to the playground, or devices being seen as play items by other students. The aim of this Quality Improvement Project was to design and implement a range of more-permanent visual communication supports for students in the playground. To achieve this, teachers and therapists supplied input into the vocabulary, layout of icons, and the location of the boards; visual lanyards with playground-specific vocabulary including swings and flying fox; and a storage tub labelled ‘Talker Tub’ where students could safely store their communication supports while playing. These supports were implemented in Term 2, 2022. To evaluate the effectiveness of the strategies, staff provided observations and completed a survey. Communication boards have been used by many students, speaking and non-speaking, to support interactions and clearly convey messages. We have seen students’ use methods of communication to make requests for equipment that they have never otherwise accessed. Ensuring consistent access to communication supports across our school is an ongoing process. Due to the success of the communication boards, the project will continue in other areas around our school in collaboration with teachers, therapists, and students.

Keywords: consistent, communication, AAC, autism, playground, access

Submission Statement: Communication Station addresses the previously inconsistent communication supports within the playground space at Giant Steps Sydney. The project reflects the input of staff and students, responds to communication supports currently available in public playgrounds, and advocates for the students’ voice by respecting their learning preferences, communication styles and motivators.

Introduction/or rationale
Patient-centred services are essential to minimise the negative impacts associated with dysphagia and to optimise outcomes. Consulting patients and caregivers as a part of service review and enhancement will ensure that proposed changes meet their needs.

Aim(s)
Identify and prioritise issues that patients and caregivers felt were required for dysphagia service enhancement in Singapore.

Methods
Using a concept mapping process, five patients and 11 caregivers from diverse backgrounds reflected on their experiences of receiving dysphagia services, and provided suggestions for service improvement. They sorted the collated suggestions into groups based on similarity, and rated the importance and changeability of each suggestion on a 5-point scale. Using multidimensional scaling and bivariate analysis, clusters of similar suggestions were grouped into clusters, and highly important and changeable suggestions for service enhancement were identified.

Results
The participants proposed 59 unique suggestions, which were grouped into 12 clusters. Almost all clusters were rated as more important than changeable. The clusters rated as most important were (a) operational workflow and processes and (b) assessments and dietary management, while the clusters rated as most changeable were (a) audio-visual mealtime resources for caregivers, (b) dietary preparation and therapy support, and (c) technology-enhanced care. Participants rated 23 suggestions as being both highly important and changeable, with the most common theme being the need for information on dietary preparation and therapy support.

Conclusions
Patients and caregivers identified and prioritised changes that they perceived would make meaningful improvements to dysphagia services within Singapore. Findings have provided direction for service enhancement to better meet consumers’ needs.

Introduction.
Restaurants, cafés and other hospitality venues represent an important environment embodying a ‘consumption space’ attached to the symbolic meanings associated with several rituals. Eating out can be problematic for people with swallowing and communication disability.

Aim.
To systematically review literature relating to disability and eating out in cafes, restaurants, and other hospitality venues, focusing on the views and experiences of people with disability, their supporters, staff in eating establishments, managers and owners and the extent to which populations with disability have been included in the research.

Method
A protocol for the systematic review was published and ultimately identified 36 original research studies in English meeting the inclusion criteria of relating to ‘eating out’ and disability.

Results
Most studies related to people with mobility impairments (n=15), visual impairments (n=9), intellectual disability (n=6), communication disability after stroke (n=6), hearing impairment, or disability in general. Key themes encapsulating both barriers and facilitators to inclusion in eating out culture related to: (a) the individual with disability to manage the hospitality environment and expectations of interactions; (b) hospitality staff and their communication, attitudes, and approaches to access; and (c) restaurant and café environments including technology or equipment, physical access, and community empathy.

Conclusions
This review identifies what constrains or limits people with disability in eating out cultures, and what facilitates or enables inclusion. Findings will be discussed in relation to implications for people with swallowing or communication disability and roles of speech pathologists in supporting access and inclusion.

Keywords
Disability, inclusion, eating out, dysphagia, systematic review, accessibility

Submission statement:
It is important to reflect upon knowledge in prior research to build evidence-based interventions and identify priorities for inclusive action. Speech pathologists can support communities to (a) respect the needs of people with swallowing disability, and (b) reduce barriers and enhance facilitators to their community and cultural inclusion.

Introduction/rationale: Dysphagia and its interventions can have negative impacts on a person’s quality of life, but the impacts of food design on those who require texture-modified foods are not well understood. This paper presents the results of three integrated studies exploring the views and experiences of people with dysphagia, their supporters, and allied health professionals on dysphagia-related quality of life and food design.

Aim(s): To create an evidence-based model to guide practice on dysphagia, quality of life, and food design.

Methods: A qualitative meta-synthesis of findings from a systematic review, a narrative review on food design and dysphagia, and three original research studies by the authors informed development of a model on dysphagia, quality of life, and food design. In total, 80 participants took part in interviews, focus groups, and survey studies forming the evidence on which the model is based.

Results: Three main components of the model are (i) the true cost of dysphagia on quality of life, (ii) barriers and facilitators to quality of life related to dysphagia management; and (iii) the implementation of food design strategies to improve the mealtime experience.

Conclusions: This meta-synthesis provides an evidence-based framework for quality of life to be considered in dysphagia management. According to the model, a comprehensive assessment of dysphagia should include exploration of both quality of life and food design options; placing the views and preferences of people with dysphagia at the centre of practice; and supporting the person’s mealtime routines that impact on quality of life.

Keywords: dysphagia, quality of life, food design, meta-synthesis, evidence-based framework.

Submission Statement: Speech pathologists should respect the decisions made by people with dysphagia regarding dysphagia management to maintain quality of life. The evidence-based framework will allow clinicians to respond to and meet the needs of people with dysphagia regarding quality of life particularly through food design strategies.