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The Rights of Persons with Disabilities Bill 2014: Practice Opportunities for Occupational Therapists in India



Legislation and geopolitical context influence health care practice. Legislation to empower persons with physical and mental disabilities has great implications for the occupational therapy profession. This article explores provisions under “The Rights of Persons with Disabilities (RPWD) Bill, 2014”to identify potential practice opportunities for occupational therapists in India. Manyservices listed under the RPWD Bill fall within the scope of occupational therapy practice. Occupational therapists must contribute their expertise to help the governmentfulfill the educational and employment provisions listed under the RPWD Bill. Occupational therapists should advocate and lend their expertise for barrier-free environmentsfor persons with disabilities in India. Occupational therapists can promote the visibility of the profession and extend the reach of their services by aligning their service provision with schemes and services established by the government. Occupational therapists collaboration with organizations that work for the cause of disability is recommended.
IJOT : Vol. 48 : No. 1 January 2016 - April 2016
The Indian Journal of Occupational Therapy : Vol. 48 : No. 1 (January 2016 - April 2016)
An informative article
The Rights of Persons with Disabilities Bill 2014 : Practice
Opportunities for Occupational Therapists in India
Karthik Mani* (MSc, OTD, OTR/L)
Key Words:
Transition Assessment, Vocational
Skills, Adolescents, Low
Functioning Autism
* Asst. Director,
External & Regulatory Affairs
NBCOT Inc., Gaithersburg,
MD 20877 USA.
Correspondence :
Dr. Karthik Mani
339 W Side Dr
Gaithersburg, MD 20878
Tel. : +1 301 250 6864
E- Mail :
Legislation and geopolitical context influence health care practice. Legislation to empower persons with physical and
mental disabilities has great implications for the occupational therapy profession. This article explores provisions under
“The Rights of Persons with Disabilities (RPWD) Bill, 2014”to identify potential practice opportunities for occupational
therapists in India. Manyservices listed under the RPWD Bill fall within the scope of occupational therapy practice.
Occupational therapists must contribute their expertise to help the governmentfulfill the educational and employment
provisions listed under the RPWD Bill. Occupational therapists should advocate and lend their expertise for barrier-free
environmentsfor persons with disabilities in India. Occupational therapists can promote the visibility of the profession and
extend the reach of their services by aligning their service provision with schemes and services established by the
government. Occupational therapists collaboration with organizations that work for the cause of disability is
India enacted its landmark legislation on disability titled Persons with Disabilities (PWD) Act
in 1995.1This legislation is considered the first of its kind to enable the lives of PWD in India.
Despite being criticized for lack of clarity in its provisions and medical oriented definition of
disability, 2the PWD Act has been in effect till date. In 2007, India ratified the United Nations
Convention on Rights of Person with Disabilities (UNCRPD).3In conformity, the Government
of India (GOI) constituted a committee to draft new legislation replacing the PWD Act of 1995
in 2010.4After extensive consultations with various stakeholders, the committee submitted its
report5 along with a draft bill titled “The Rights of Persons with Disabilities” (RPWD).4
The RPWD bill was introduced in the Indian parliament in February 2014 and subsequently
referred to the Standing Committee (SC) in September 2014. The committee submitted its
report in May 2015.8 The bill is yet to be passed as an act in the parliament.
Legislation and geopolitical context influence healthcare practice. As occupational therapy
(OT) practitioners enable PWD to engage in activities of their need or choice, legislation
concerned with disability is imperative to occupational therapy practitioners. It is essential for
occupational therapists (OTs) to familiarize themselves with disability related legislation as it
present both opportunities and challenges to OT practice.The purpose of this article is to
explore the provisions of the RPWD bill and identify practice opportunities for OTs. The latest
draft of the bill available on the PRS legislative website has been used for the purpose of this
RPWD Bill 2014 in respect to OT Practice Opportunities
The bill, as drafted, aims to prevent discrimination against PWD by ensuring their civil rights.
This bill could be considered analogous to the American with Disabilities Act of 1990 enacted
in the United States as both “provides comprehensive civil rights protection in the areas of
employment, public accommodations, transportation, and government services…to enforce
these rights”.10 This bill creates several potential avenues for OT practice.
Rights and Entitlements of Persons with Disabilities
Chapter II of the bill discusses the rights and entitlements of PWD. Clause 3 (2) requires the
government to take steps to utilize the capacity of PWD by providing an appropriate environment.
As per 2011 census, more than 26 million peoplehave some form of disability.11To assist the
government in transitioning this massive manpower into economic productivity, OTs can identify
suitable jobs for PWD. Occupational therapists role in vocational rehabilitation (VR) has been
IJOT : Vol. 48 : No. 1 January 2016 - April 2016
affirmed in the literature.12In this arena, some potential OT
services include job and job-site analysis, functional capacity
evaluations (FCE), andmodifications to job tasks or environmentto
promote employee-job fit.
Reporting Abuse, Exploitation, and Violence
Clause 6 (2) requires any person or organization to report an act
of abuse, exploitation, or violence committed against PWD to
the local Executive Magistrate. Chapter XVI of the bill discusses
the penalties for offences related to fraudulently availing or
misusing the benefits under this bill.As OTs work closely with
PWD in their practice, the probability of witnessing such acts
are high. When an abuse or offense is witnessed or suspected,
OTs should report such incidents to the appropriate authorityin
a timely manner and hence must familiarize themselves with
the administrative structure of the Indian judiciary system.
Voting Rights of Persons with Disabilities
Clause 10 demands the national and state election commissions
(EC) to ensure that all polling stations and materials related to
the election process are accessible to PWD to execute their
voting rights. Kothari stated that the majority of voting sites in
Bengaluru were not accessible to voters with physical and
locomotor disability in 2014 Lok Sabha elections.13Through their
state associations, OTs can volunteer to help state EC design
accessiblepolling stations.
Accessibility to Technology
Clause 11 (4A) requires the government to ensure that all public
documents are in accessible formats. Clause 41 recommends
the government ensure all audio, print, and electronic media
content is accessible to PWD and electronic gadgets are available
in universal design. In this technology era, often, public
documents are made accessible through websites. Hence, the
issue of accessible website gains attention. The Ministry of Social
Justice and Empowerment awarded National Institute for
Empowerment of Persons with Multiple Disabilities, Chennai
the best website award for the year2011, 14 which shows that
the emphasis on developing more accessible websites is growing
in India. Occupational therapists knowledge on the impact of
virtual environment on human occupation combined with their
experience in low vision rehabilitation15enables them to act as
consultants to government and private entities to help design
more accessible websites.
Accessibility to Environment
Clause 15 (ii) mandates all government funded educational
institutions (GFEI) to make their buildings, campuses, and other
facilities accessible to PWD. Clause 24 (1b) mandates that the
government create an accessible environment in all government
funded healthcare institutions. Occupational therapists can
perform environmental assessment on the GFEI and healthcare
campusesto recommend suitable modifications.Further, OTs
shall advocate for barrier free environments16 in all private health
institutions that serve PWD.
Clause 39 mandates that the National Commission (NC)
formulate accessibility standards for physical environment
enabling personal and community mob ility of PWD.
Occupational therapists shall participate in this commission as
a volunteer or submit their views to the commission to help
create accessibility standards.Clause 40 (1) requires that the
government ensure access to public places and transportation
for PWD. Clause 44 (1) mandates the government to ensure
that all existing public buildings are made accessible to PWD
adhering to the standards to be set by the NC within five years
from the date of publication of regulations. Occupational
therapists can act as consultants to help authorities ensure that
public buildings adhere to the regulations of the NC.
Educational Provisions for Persons with Disabilities
Chapter III of the bill discusses the educational provisions
underPWD. Clause 15 (i) demands the GFEI to provide
educational, sports, and recreational opportunities for PWD.
With their extensive knowledge on pediatric rehabilitation, OTs
caneducate school teachers modify educational strategies and
environments to successfully integrate children with disabilities
in classroom environments.17
Provisions for Children with Learning and Communication
Clause 15 (vi) of the draft requires GFEI to identify children
with specific learning disabilities (SLD) and to take relevant
measures to overcome them. Clause 16 (d) suggests that the
government train professionals and staff to support inclusive
education. School based practice is one of the common areas of
practice for OTs in India.18As OTs encounter children with SLD
in their day to day practice, using their knowledge and
experience, they can help school teachersand administrators
identify the symptoms and behaviors suggestive of SLD and
modify classrooms and educational methods to suit the needs
of children with SLD.19 Clause 16 (f) recommends that the
government promote the use of appropriate augmentative and
alternative modes of communication to enable persons with
communication or language disabilities to participate in the
community. Occupational therapists can assist in the process
of choosing an appropriate assistive and augmentative
communication device and its placement20in collaboration with
other related service providers such as speech language
pathologists and special educators.
Reasonable Accommodations for Education
Clause 15 (iii) of the bill mandates the GFEI to provide reasonable
accommodations according to individual requirements. Clause
16 (g) recommends that the government provide learning
materials and assistive devices, free of charge, to students with
benchmark disabilities. As fabricating, fitting and training on
appropriate use of assistive/adaptive devices fall within the realm
of OT, 21OTs canidentify cost-effective adaptive devices to assist
the government fulfill this provision. Clause 16 (i) suggests that
the government make suitable modifications to the curriculum
and examination system to meet the needs of students with
disabilities. Occupational therapists utilizing their knowledge
on functional strengths and weaknesses of children with
disabilities19can volunteer on committees that decide suitable
IJOT : Vol. 48 : No. 1 January 2016 - April 2016
modifications. For instance, OTs may recommend that the
government/ school administr ation mini mize writing
assignments, allow the use of calculators during testing, and
provide extra time during examinations for children with
Educational Provisions for Persons with Benchmark Disabilities
The RPWD bill defines “persons with not less than 40 percent
of a specified disability” as persons with benchmark disabilities
(PWBD).9Clause 30 (1) entitles children with benchmark
disabilities between the age of six and 18 years to free education
in a neighborhood school or special school. Clause 31 (1)
requires the government and GFEI to reserve a minimum of five
percent of all seats for PWBD. Occupational therapists can
disseminate these benefits to PWBD and support them by
providing a letter of recommendation with appropriate
accommodations, when necessary.
Employment Provisions for Persons with Disabilities
Clause 18 mandates that the government formulate schemes
and programs to facilitate and support employment of PWD.
This clause also recommends that the government offer loans to
PWD at concessional rates. Occupational therapists can educate
PWD about their eligibility to obtain these loans for vocational
training and self-employment purposes. Komblau suggested
OTs work with employers’ human resource professionals to help
them recruit PWD by enabling them to use functional job
descriptions during the interview process.10Occupational
therapists may also organize and conduct vocational training
workshops along with a vocational trainer22 to train PWD on a
specific job such as operating a photocopy or printing machine.
Employment Reservations for Persons with Benchmark
Clauses 32 (i) and 33 (1) suggests that the government identify
reserved posts and fill five percent of vacancies in its
establishments withPWBD. Occupational therapists can educate
stakeholders about these provisions and assist in the process
through FCE and job-analysis. Further, OTs can review and
recommend listed job postings to help PWD and PWBD identify
an employment opportunity.
Clause 34 suggests the government incentivize employers in
the private sector to ensure five percent of their workforce is
composed of PWBD. Occupational therapists can advocate for
employment reservations for PWBD in the private sector.
Further, OTs can work with private employers to help them
identify suitable positions while emphasizing how this will
benefit their business and goodwill.23
Provisions for Persons with Benchmark Disabilities with High
Support Needs
Clause 37 (1) under chapter VII provides PWBD with rights to
request high support if there is a need. When a request is
received, clause 37 (2) mandates that the government forward it
to an assessment board to determine the need for high support
and take necessary measures. As OTs are skillful in using
rehabilitative and adaptive approaches to minimize functional
dependence and empowering caregivers, 24they can take part in
the assessment board to determine the functional needs of the
applicants and required support.
Prevention of Disabilities
Clause 24 sub-sections 2a, 2c, and 2e recommends the
government to conduct survey and research, perform annual
health screening, and disseminate health information
respectively, with the aim of preventing disabilities. Health
an d wellness i s an em e rging a re a of pra c tice f o r
OTs.25Occupational therapists possess research and evidence
based practice skills.Occupational therapists have a deeper
understanding of teaching learning process as they use patient
education as an intervention.21Further, in addition to healers,
OTs also function as health advocates.26Hence, OTs are in a
best position to engage in abovementioned prevention activities.
Occupational therapists can disseminate health information
through awareness campaigns and educational materials on
health, hygiene, and disability prevention. During these
campaigns, OTs canhighlight the role of occupation in ensuring
health and wellness.27
Clause 24 (2f) recommends the government take suitable
measures during prenatal, perinatal, and postnatal care of a
mother and child to prevent the incidence of disabilities.
Occupational therapists can provide stress management
interventions to reduce labor anxiety to minimize the effect of
stress on pregnant women.28Occupational therapists can also
educate pregnant women on body mechanics and edema
management to manage back pain and edema associated with
Provisions for Persons with Disabiliti es throughNon-
Governmental Organizations
Clause 26 (2) advocates the government to offer financial
assist ance to non-governmental organizations (NGOs)
functioning for the cause of PWD. Occupational therapists can
establish NGOs to provide holistic rehabilitation and extend
their services to PWD who belong to middle and lower
socioeconomic classes, as the primary means of reimbursement
for health ca r e s e rv i c e s in I n d i a is out o f pocket
payment.29Occupational therapists can also engage in advocacy
activities through their NGOs as clause 26 (3) requires the
government to consult with NGOs when for mulating
rehabilitation policies.
Clause 27 advises the government initiate research through
individuals and institutions on issues including habilitation and
rehabilitation to empower PWD. Occupational therapists can
utilize this provision to engage in research on issues like the
impact of architectural barriers on community mobility; suitable
job opportunities for PWD; effective disability prevention
strategies; influence of cultural practices on life of PWD; and
reasonable accommodations in educational and employment
settings for PWD.
Clauses 28 and 29 recommends the government take measures
to enrich cultural and recreational life of PWD. Occupational
therapists, on behalf of their organizations, shall organize sports
IJOT : Vol. 48 : No. 1 January 2016 - April 2016
and cultural events to cultivate interest and talent among
PWD.Clause 36 (c) recommends that the government allot five
percent land on concessional rate if that land is used to
accommodate/create employment opportunities for PWBD.
Occupational therapists may use this provision to acquire land
to establish VR settings.
Advisory Board on Disability
Clauses 59 and 65 mandates the respective governments toform
an Advisory Board on Disability with five members who are
experts in the field of disability and rehabilitation. Occupational
therapists, by nature of profession, are certainly experts on
disability and rehabilitation. Occupational therapists shall take
necessary measures to get nominated for these boards.
Opportunities abound for OTs under the provisions of the RPWD
bill. Occupational therapists in India should engage in collective
efforts to highlight the role of OT in rehabilitating PWD and
transforming themas economically productive citizens.
Collaborating with organizations (government and non-
government) working for the cause of PWD is the key toward
this goal.
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... In addition, they may explore practice opportunities for OTs in government programs and schemes. [16] Alheresh and Nikopoulos, in their study on the awareness of OT among health-care professionals in Jordan, highlighted OTs' lack of role clarity as a factor that could contribute to poor awareness. [10] This could be applicable to the Indian scenario as well. ...
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Background: Occupational therapists (OTs) practice on both a first contact and a referral basis. Medical practitioners are often the primary referral source for OTs. To make timely and appropriate referrals to occupational therapy (OT), it is imperative that the referral sources demonstrate a broader level of understanding of the OT profession. Objectives: To determine the level of awareness of OT among medical practitioners in South India. Study Design: Survey research design was used to conduct this study. Methods: An electronic survey was developed for this study and sent via email and social media to medical practitioners in South India who were identified through convenience and snowball sampling. Data were collected from 15 June to 31 July 2019. Results: The number of responses received was 116. Eighty two percent of respondents reported either being familiar with or having heard about OT. Respondents who are specialists, work in the private sector, and practice their profession in a foreign country were more familiar with the OT profession and referred patients to OT. Gender and years of medical practice did not influence the familiarity level. Conclusions: Though many respondents have heard about OT and recognize it as a profession aligned with the rehabilitation of individuals with disabilities, their responses indicate that they have a limited understanding of the profession’s scope of practice, OTs role in some practice areas, and practice settings in which OT services are delivered. The consequence of this could be missed referrals. Key Words: India, Occupational Therapists, Private Sector, Physicians, Surveys & Questionnaires.
Full-text available
Background: Compensation data provides critical information on the issues faced by a profession. Objectives: This study aimed to determine the average compensation of occupational therapy practitioners in India and factors influencing it. Study Design & Methods: A ten-item survey was sent to a random sample of 1,252 occupational therapy practitioners drawn from the members of occupational therapy India Facebook group. Data were collected from 26th May, 2015 to 30th June, 2015. All communications were made through Facebook private messaging facility. Results: The response rate was 17.45%. The use of Facebook to administer this survey prevented participants who are quinquagenarians. The average annual compensation range of occupational therapists in India was 2,40,000 to 3,60,000 INR. Several factors including private sector employment and level of education influence the compensation. Conclusions: India experiences a significant shortage of occupational therapists, especially in rural areas. Strategic initiatives to strengthen the occupational therapy workforce and service delivery are warranted. Further research with an in-depth analysis of variables recommended.
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Non communicable diseases (NCDs) are now the major cause of death and disability worldwide. It increasingly affects people from developing as well as developed countries. Over the coming decades the burden from NCDs is projected to rise particularly fast in the developing world. There is a lack of optimal data collection about the burden of risk factors related to NCDs especially in the developing countries. To assess the burden of healthcare utilization and out-of-pocket costs associated with NCDs in an Indian setting. A cross sectional study was performed to enroll a convenient sample of 166 participants aged 18 years and above from a tertiary hospital in Punjab, a Northern state of India. The data was gathered during the period of Feb 2010-April 2010. A mixed methods approach was used to assess the burden of diabetes, hypertension, high cholesterol, and their associated risk factors. Further we evaluated the burden of healthcare utilization and out-of-pocket costs associated with these conditions using self-reported assessments. Results showed the average age of the participants was 50 years, 63 % (n = 104) were females, 32 % (n = 53) had education less than high school and 20 % (n = 33) had no formal education. About 96 % of the study participants were living with a partner. Majority of the study participants were non-smokers and 17 % (n = 27) of them reported to have history of alcohol consumption. The majority of the participants had access to cell phones (94 %; n = 156) and about 40 % (n = 66) had computers at home. About 33 % (n = 55) of the study participants had some form of previous knowledge of computers. Majority of the study participants went to the private hospital (47.5 %) for seeking healthcare. About 32 % (n = 53) also sought healthcare from some kind of healthcare professional including a primary care doctor or a nurse or even a pharmacist in a village setting. Doctor visits related to diabetes were higher as compared to the individuals either with hypertension or high cholesterol. However; the out-of-pocket costs of the visit to the healthcare professional were much higher for hypertension than for diabetes or high cholesterol. A strengthened surveillance system, effective inter-sectoral action, and improved access to basic healthcare are pivotal to prevent NCDs. A multifaceted NCDs surveillance system could help us measure the burden of risk factors, its associated health care utilization and out of pocket costs, and further facilitate interventions that can guide evidence based decision making.
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A single-subject design was used to assess the effectiveness of therapy ball chairs on classroom participation in 6 boys with autism spectrum disorder (ASD). The sensory processing pattern of each participant was assessed using the Sensory Processing Measure. Data on in-seat behavior and engagement were collected using digital video recordings during Circle Time. During baseline, participants sat on chairs. During intervention, participants sat on therapy ball chairs. Social validity was assessed by means of a questionnaire completed by the teacher. Each child demonstrated a unique response. The ball chair appeared to have a positive effect on in-seat behavior for the child who had the most extreme vestibular-proprioceptive-seeking behaviors. Children with poor postural stability were less engaged when sitting on the therapy ball chair. The results illuminate the complex nature of children with ASD and the importance of using sound clinical reasoning skills when recommending sensory strategies for the classroom.
Assistive technology is recognized in occupational therapy as an accepted means of using compensation and adaptation as intervention approaches. The profession advocates using assistive technology to promote, maintain, and improve function in activities of daily living, work, education, leisure, play, social interaction, and sleep occupations (American Occupational Therapy Association [AOTA], 2010). Although assistive technology is often thought of as products or devices, it can also include modifying existing technology to make it more accessible. This article describes how occupational therapy practitioners can take an active role in identifying and addressing client issues related to using computers and portable devices. Specifically, the accessibility features built into these devices are described in relation to the problems they address and how they are implemented. © 2015, American Occupational Therapy Association, Inc. All rights reserved.
Health care reform presents opportunities for occupational therapy professionals to play a key role in improving the health of a population through prevention and wellness.
Comprehensive and accurate evaluation is a critical step in the return-to-work process for individuals with head injury. Research findings have been reported on the barriers for a successful return to work. Assessment frameworks have been published, but they do not include a protocol that contains each component for the assessment. This paper describes an occupational therapy assessment protocol developed and used in the evaluation of the work skills of individuals with head injury. This protocol focuses on assessment of physical, cognitive and behavioural abilities in relation to the demands of the workplace and measures these within the framework of productivity, interpersonal skills and safety. The functional approach inherent in this protocol provides information to complement the findings of other interdisciplinary team members. This paper also explores the strengths and limitations of this protocol.