Assistance-animal decisions can involve substantial professional and personal input.

A person considering an assistance animal may receive input from:

• Occupational Therapists;
• family members;
• support workers;
• veterinarians;
• animal trainers and behaviour professionals;
• psychologists;
• medical practitioners;
• educators;
• employers;
• funding bodies;
• advocates; and
• assistance-animal organisations.

With so many people contributing opinions, there is a risk that the person whose life is most affected by the decision becomes the least powerful voice in the room.

Supported decision-making is therefore an important foundation for AAOT practice.

The purpose is not simply to ask:

Can this person make this decision?

A more useful starting point is often:

What support does this person need to understand, consider and communicate their own decision?

This distinction is particularly important for people who may have:

• intellectual disability;
• acquired brain injury;
• cognitive disability;
• communication differences;
• neurodivergence;
• psychosocial disability;
• limited literacy;
• sensory impairment;
• language barriers; or
• other circumstances affecting how information is received, processed or communicated.

Needing support to make or communicate a decision is not the same thing as being unable to make one.

Why WAFA Has Chosen the La Trobe Support for Decision Making Practice Framework

There are a number of approaches to supported and shared decision-making. WAFA has deliberately selected the La Trobe Support for Decision Making Practice Framework as the principal foundation framework for AAOT.

This was not an arbitrary choice.

The framework was developed by researchers from La Trobe University’s Living with Disability Research Centre specifically to guide people supporting individuals with cognitive disability, particularly people with intellectual disability and acquired brain injury, to participate in and make decisions about their own lives.

Importantly for an advanced professional credential, it is evidence-based rather than simply a statement of good intentions.

Its development drew upon:

• a systematic review of the peer-reviewed literature;
• qualitative research examining the experiences of people with cognitive disability and their supporters;
• seven grounded-theory studies;
• feasibility and pilot work involving disability support workers and health professionals; and
• subsequent evaluation and implementation work.

The resulting framework identifies an iterative decision-support process comprising seven components or steps, informed by principles and implemented through individually tailored support strategies.

WAFA considers the framework particularly suitable for AAOT because it is:

• Australian-developed, making it highly relevant to the professional and disability context in which most AAOT participants initially practise;
• developed specifically in relation to cognitive disability, where people are particularly vulnerable to having others take over decisions;
• based upon published research rather than professional opinion alone;
• informed by the experiences of people with cognitive disability and people providing decision support;
• practical enough to apply to real professional situations;
• relevant to health professionals as well as family members and disability supporters;
• focused upon understanding the person’s will and preferences;
• compatible with human-rights and autonomy principles introduced earlier in AAOT;
• useful across different types of life decisions rather than being restricted to a single clinical choice; and
• supported by freely available learning resources, practical activities, a workbook, checklist and decision-recording tools.

The Australian Government’s Disability Gateway also identifies the La Trobe Framework and its learning resources among supported decision-making training resources for supporters.

This does not mean that WAFA considers the La Trobe Framework the only legitimate approach to decision support.

Rather, it provides AAOT participants with a strong, evidence-based common framework from which to begin.

As advanced practitioners, you are encouraged to explore other evidence-based models and consider what they contribute, where their purposes differ and whether aspects may complement one another.

Other Evidence-Based Decision-Making Frameworks Worth Exploring

The following are examples of peer-reviewed frameworks or models that participants may wish to explore.

They have different purposes and should not automatically be treated as substitutes for the La Trobe Framework. Some focus upon supported decision-making for people with cognitive disability, while others originate from shared clinical decision-making or healthcare decision-support research.

Framework/model	Primary focus	Potential relevance to AAOT
La Trobe Support for Decision Making Practice Framework Douglas, J., & Bigby, C. (2018). Development of an evidence-based practice framework to guide decision making support for people with cognitive impairment due to acquired brain injury or intellectual disability. Disability and Rehabilitation. https://doi.org/10.1080/09638288.2018.1498546	Supporting people with cognitive disability, including intellectual disability and acquired brain injury, to participate in and make decisions	WAFA’s principal framework; particularly useful for autonomy, will and preferences, communication support and avoiding unnecessary substitute decision-making
Ottawa Decision Support Framework (ODSF) Stacey, D., Légaré, F., Boland, L., Lewis, K. B., Loiselle, M.-C., Hoefel, L., Garvelink, M., & O’Connor, A. (2020). 20th anniversary Ottawa Decision Support Framework: Part 3—Overview of systematic reviews and updated framework. Medical Decision Making, 40(3), 379–398. https://doi.org/10.1177/0272989X20911870 AND Hoefel, L., O’Connor, A. M., Lewis, K. B., Boland, L., Sikora, L., Hu, J., & Stacey, D. (2020). 20th anniversary update of the Ottawa Decision Support Framework Part 1: A systematic review of the decisional needs of people making health or social decisions. Medical Decision Making, 40(5), 555–581. https://doi.org/10.1177/0272989X20936209	Understanding and addressing people’s decisional needs when making difficult health or social decisions	Useful for considering knowledge gaps, values, uncertainty, available support, options and decision quality
Three-Talk Model of Shared Decision Making Elwyn, G., Durand, M.-A., Song, J., Aarts, J., Barr, P. J., Berger, Z., Cochran, N., Frosch, D., Galasiński, D., Gulbrandsen, P., Han, P. K. J., Härter, M., Kinnersley, P., Lloyd, A., Mishra, M., Perestelo-Perez, L., Scholl, I., Tomori, K., Trevena, L., Witteman, H. O., & Van der Weijden, T. (2017). A three-talk model for shared decision making: Multistage consultation process. BMJ, 359, j4891. https://doi.org/10.1136/bmj.j4891	Structured clinician–patient shared decision-making through Team Talk, Option Talk and Decision Talk	Useful for explaining options, eliciting goals and preferences, considering trade-offs and conducting collaborative professional conversations
Interprofessional Shared Decision-Making Model (IP-SDM) Légaré, F., Stacey, D., Pouliot, S., Gauvin, F.-P., Desroches, S., Kryworuchko, J., Dunn, S., Elwyn, G., Frosch, D., Gagnon, M.-P., Harrison, M. B., Pluye, P., & Graham, I. D. (2011). Interprofessionalism and shared decision-making in primary care: A stepwise approach towards a new model. Journal of Interprofessional Care, 25(1), 18–25. https://doi.org/10.3109/13561820.2010.490502 AND Légaré, F., Stacey, D., Gagnon, S., Dunn, S., Pluye, P., Frosch, D., Kryworuchko, J., Elwyn, G., Gagnon, M.-P., & Graham, I. D. (2011). Validating a conceptual model for an inter-professional approach to shared decision making: A mixed methods study. Journal of Evaluation in Clinical Practice, 17(4), 554–564. https://doi.org/10.1111/j.1365-2753.2010.01515.x	Decision-making involving the person and an interdisciplinary healthcare team	Particularly relevant to AAOT because assistance-animal decisions commonly involve OTs, veterinarians, trainers, medical professionals, psychologists and other disciplines

Participants interested in this area are encouraged to compare these approaches rather than assuming that all terminology involving “supported” or “shared” decision-making means exactly the same thing.

Supported Decision-Making and Shared Decision-Making Are Related but Not Identical

You may encounter both terms throughout the literature.

Supported decision-making is strongly associated with enabling a person—particularly a person who may require cognitive, communication or other assistance—to exercise their own decision-making ability, will and preferences.

Shared decision-making is frequently used in healthcare literature to describe a collaborative process through which a practitioner and patient consider available options, evidence, risks, benefits, goals and preferences.

There is substantial overlap.

However, the concepts arise from somewhat different traditions and should not automatically be used interchangeably.

For AAOT practice, both can be useful.

A person may require supported decision-making in order to meaningfully participate in a shared decision-making process with an interdisciplinary team.

Decision-Making Is a Human Right

The La Trobe Framework is grounded in the recognition that people with cognitive disability should be enabled to participate in decisions affecting their lives.

The framework encourages supporters to assist the person to:

• understand the decision;
• access relevant information;
• consider options;
• identify preferences;
• understand possible consequences;
• communicate their views;
• experience options where appropriate;
• weigh risks and benefits; and
• exercise as much choice and control as possible.

This has direct relevance to assistance-animal practice.

Decisions may include:

• whether to explore an assistance animal at all;
• whether an existing animal should be assessed;
• whether to acquire another animal;
• which training pathway to pursue;
• whether a program-trained or handler-trained pathway is preferred;
• what tasks may be useful;
• whether the animal should work in particular environments;
• how care responsibilities will be managed;
• what additional human supports are needed;
• whether another intervention should be considered;
• whether duties need to change; and
• when an assistance animal should retire.

These decisions can substantially affect both the person and the animal.

Supporting a Decision Is Not Making the Decision

Supported decision-making is different from substitute decision-making.

Substitute decision-making involves another person making a decision on someone’s behalf.

Formal substitute decision-making arrangements may lawfully exist in particular circumstances.

However, practitioners should not casually move into substitute decision-making merely because:

• a person has a disability;
• a person communicates differently;
• a person requires additional processing time;
• a person has an intellectual disability;
• a person makes a choice the practitioner would not make;
• family members say the person cannot decide;
• a decision involves some risk; or
• the person requires assistance to understand complex information.

The first question should generally be:

What support might enable this person to participate more fully in the decision?

Communication Difference Is Not Incapacity

Communication strongly affects how other people perceive decision-making ability.

A person may:

• take longer to answer;
• communicate through AAC;
• use sign language;
• communicate through gestures;
• prefer writing;
• require visual information;
• benefit from plain language;
• need information repeated;
• communicate less when overwhelmed;
• need questions broken into smaller components; or
• communicate differently depending upon the environment.

A fast-paced verbal interview may therefore tell us as much about the accessibility of the assessment as it does about the person’s decision-making ability.

Before concluding that someone does not understand, an AAOT should consider:

Have we provided this person with a fair opportunity to understand and communicate?

Accessible Information Supports Meaningful Decisions

A person cannot make an informed decision if the information required to make it is inaccessible.

In assistance-animal practice, relevant information can be extensive.

It might include:

• what an assistance animal can realistically do;
• what it cannot do;
• daily care requirements;
• animal welfare needs;
• training commitments;
• public-access expectations;
• costs;
• veterinary care;
• exercise;
• grooming;
• housing implications;
• transport;
• time commitments;
• likely waiting periods;
• public attention;
• potential challenges;
• retirement;
• contingency arrangements;
• funding limitations;
• alternative interventions; and
• responsibilities of the handler.

Information may need to be communicated using:

• plain language;
• Easy Read;
• diagrams;
• photographs;
• videos;
• demonstration;
• trial experiences;
• written information;
• translated information;
• interpreters;
• AAC;
• repetition; or
• several smaller discussions.

Accessible information is not simply a courtesy.

It may be what makes meaningful decision-making possible.

Experience Can Support Understanding

Some decisions are difficult to understand purely in the abstract.

A person may benefit from appropriate opportunities to experience components of an assistance-animal pathway.

This might include:

• meeting an assistance-animal team;
• observing training;
• visiting an appropriate training environment;
• practising a care routine;
• learning about grooming;
• considering a realistic weekly schedule;
• discussing actual costs;
• seeing equipment;
• meeting a trainer;
• speaking with an experienced handler; or
• trialling non-animal alternatives.

The purpose is not to place someone or an animal into an unsafe trial.

It is to recognise that experience can itself be an important form of accessible information.

Break Large Decisions Into Smaller Decisions

“Do you want an assistance dog?” is a very large question.

It may actually contain dozens of smaller decisions:

• Do I want to live with a dog?
• Do I want the daily responsibility?
• What functional needs am I trying to address?
• Would another intervention work?
• How would a dog affect my household?
• How will I meet veterinary and financial costs?
• Who helps if I become unwell?
• How will I manage exercise?
• How do I feel about increased public attention?
• What training pathway would suit me?
• What happens when the animal cannot work?
• What happens when the animal retires?

Supported decision-making may involve breaking a complex decision into manageable components rather than expecting the person to answer one enormous yes/no question.

Will and Preferences

A core feature of supported decision-making is understanding the person’s will and preferences.

Compare:

How do I convince this person that an assistance animal is not appropriate?

with:

How do I help this person understand the relevant information and participate meaningfully in deciding what they want to do?

The professional may still ultimately conclude that they cannot recommend the requested intervention.

However, the assessment process should not simply be designed to lead the person toward a predetermined answer.

What if the Person Wants Something You Do Not Recommend?

Respecting autonomy does not require abandoning professional judgement.

Suppose a person wants an assistance animal but the OT identifies serious concerns involving:

• animal welfare;
• unrealistic proposed tasks;
• an unsuitable animal;
• inability to sustainably meet the animal’s needs;
• environmental risk;
• major unresolved behaviour concerns;
• insufficient functional benefit;
• inadequate information; or
• significant safety risks.

The practitioner should not simply provide the requested recommendation because:

“Choice and control means it is their choice.”

Instead, the AAOT should:

• explain concerns accessibly;
• provide relevant evidence;
• listen to the person’s perspective;
• identify what information is still missing;
• consider whether circumstances could change;
• explore supports that may reduce risk;
• involve relevant professionals;
• discuss alternatives;
• document professional reasoning; and
• preserve the person’s dignity and participation throughout the process.

Supported decision-making concerns the quality of the person’s participation in the decision, not a guarantee that every requested professional recommendation will be provided.

Family Members and Other Supporters

Family members, carers, advocates and support workers can provide valuable information and assistance.

They may contribute knowledge about:

• communication;
• routines;
• preferences;
• history;
• functional performance;
• care requirements;
• previous experiences; and
• available support.

However, supporters should not automatically become the person’s voice.

An AAOT may encounter appointments where another person answers every question before the client has time to respond.

The practitioner may need to:

• direct questions to the person;
• deliberately allow processing time;
• provide communication supports;
• ask the person how they want supporters involved;
• distinguish the supporter’s opinion from the person’s preference;
• meet separately where appropriate; or
• find another accessible way for the person to communicate.

Support should expand the person’s participation rather than replace it.

What if the Family Disagrees?

Disagreement is common.

A family might believe:

They could never manage a dog.

while the person believes they can.

The reverse may also happen.

A family may strongly want an assistance animal while the intended handler has little interest in one.

Rather than deciding immediately who is correct, explore:

• what each person is concerned about;
• what responsibilities are involved;
• who will actually provide care;
• what the intended handler wants;
• whether they understand the implications;
• what supports are available;
• what the animal requires;
• whether further information would assist; and
• whether the proposed arrangement is sustainable.

Supported Decision-Making With Children

When an assistance animal is being considered for a child, professional discussion can easily become:

parent → therapist → trainer → school → funding body

with the child’s perspective becoming secondary.

Children should be involved according to their age, communication, maturity, development and circumstances.

Consider:

• Does the child want the animal?
• What do they think the animal will do?
• How do they feel about living with the animal?
• What are their goals?
• What concerns do they have?
• How do they currently interact with animals?
• What information needs to be made accessible?
• Who will actually carry responsibility for care?
• How will the arrangement change as the child develops?

Parents and guardians have important responsibilities.

That does not make the child’s perspective irrelevant.

Neurodivergence and Decision Support

Neurodivergent people may process and communicate information differently.

An autistic person, for example, may:

• require more time to respond;
• prefer written communication;
• become overwhelmed in an unfamiliar environment;
• need predictable appointment structures;
• interpret questions literally;
• require detailed information;
• communicate less when stressed; or
• find hypothetical questions difficult.

An assessment can be made more accessible through strategies such as:

• sending information beforehand;
• providing written questions;
• reducing sensory demands;
• allowing breaks;
• explaining what will happen;
• giving processing time;
• permitting alternative communication; and
• conducting more than one shorter appointment.

These strategies should not be confused with lowering professional standards.

They improve access to the assessment itself.

Positive Risk-Taking and Dignity of Risk

Supported decision-making may include choices involving risk.

People without disability routinely make decisions involving uncertainty.

People with disability should not automatically be expected to live risk-free lives because professionals are involved.

An AAOT might initially respond to a concern by asking:

What if this goes wrong?

A supported decision-making approach additionally asks:

What could make this choice safer and more achievable?

For example:

• reminders;
• visual routines;
• support-worker prompts;
• automated feeders;
• shared-care planning;
• veterinary reminders;
• environmental prompts; or
• additional training

might enable a person to take greater responsibility for animal care.

However, dignity of risk does not justify foreseeable serious neglect or harm to an animal.

The AAOT must consider both autonomy and welfare.

The Assistance Animal Has Needs Too

Supported decision-making within AAOT has an additional dimension:

the person’s decision affects another living being.

A person’s preferences matter.

But so do the animal’s:

• physical health;
• temperament;
• developmental stage;
• behaviour;
• stress;
• emotional wellbeing;
• environmental tolerance;
• workload; and
• quality of life.

For example, someone may strongly prefer to use their existing pet as an assistance animal.

That preference should be taken seriously.

It does not require a professional to disregard evidence that the animal is fearful, medically unsuitable or unable to safely undertake the role.

A useful distinction is:

The person has a right to meaningfully participate in decisions affecting their life.

That does not mean:

The person has an unrestricted right to require a particular animal to undertake work regardless of its suitability or welfare.

Choosing Not to Proceed Can Be a Successful Outcome

A genuine supported decision-making process must allow no to be a valid outcome.

A person may begin an assessment convinced they want an assistance animal.

After learning about:

• care;
• costs;
• training;
• exercise;
• public attention;
• veterinary requirements;
• long-term responsibilities;
• welfare;
• retirement; and
• alternative interventions,

they may decide:

I don’t want this after all.

That is not necessarily an unsuccessful assessment.

It may demonstrate that the person received sufficient information and support to make a decision that reflects their own priorities.

The purpose of an AAOT assessment is not to produce an assistance animal.

It is to support an appropriate, informed and professionally defensible decision.

Supported Decision-Making During Retirement

Decision support remains relevant throughout the working life of an assistance animal.

Retirement may involve:

• grief;
• fear of losing independence;
• identity changes;
• anxiety about replacement;
• financial concerns;
• attachment to the animal; and
• disagreement with professionals.

The handler should be meaningfully involved in discussions about:

• veterinary findings;
• animal welfare;
• changing duties;
• workload reduction;
• temporary supports;
• gradual retirement;
• replacement planning;
• alternative supports; and
• the animal’s future after retirement.

Some welfare or legal requirements may ultimately place limits on available options.

But the process should still be respectful, transparent and participatory.

Supported Decision-Making Does Not Mean Professional Neutrality

An Occupational Therapist remains professionally accountable.

If available information indicates that a proposal is unsafe, unethical or inconsistent with animal welfare, the practitioner should say so.

For example:

I understand why this option matters to you. Based on the information and evidence currently available, I cannot professionally recommend it because…

This can be followed by:

Let’s consider what would need to change, whether further assessment is required and what other options are available.

Respect for autonomy and professional integrity can coexist.

Avoiding Coercion

Coercion may be direct or subtle.

A person may experience pressure from:

• family;
• practitioners;
• trainers;
• funding systems;
• service providers;
• employers;
• schools; or
• organisations.

Language itself can create pressure.

For example:

“If you cared about being independent, you’d get a dog.”

“Your family knows what’s best for you.”

“If you really cared about your dog, you’d do what I’m telling you.”

“If you disagree with us, we can’t help you.”

Professionals can be clear about genuine requirements without using shame, fear or manipulation.

Decision-Making May Take Time

Some assistance-animal decisions should not be rushed.

Good decision support may involve:

Information → Time → Experience → Discussion → Reflection → More information → Decision

External pressures such as funding deadlines, school transitions, employment changes or an ageing animal may complicate this process.

However, administrative urgency should not unnecessarily remove meaningful participation.

Documenting Supported Decision-Making

Professional documentation should record more than the final yes/no outcome.

Where relevant, documentation might identify:

• the decision under consideration;
• the person’s goals;
• stated preferences;
• communication supports;
• accessible information provided;
• supporters involved;
• options considered;
• benefits and risks discussed;
• animal-welfare considerations;
• alternatives;
• professional recommendations;
• areas of disagreement;
• the person’s decision; and
• agreed next steps.

Language should remain objective and respectful.

For example, there can be an important difference between:

Client refused professional advice.

and:

The client indicated that they understood the concerns discussed and wished to explore an alternative option. Relevant risks, evidence and next steps were reviewed.

Documentation should accurately represent what occurred rather than framing disagreement as misconduct or non-compliance.

Formal Decision-Making Arrangements

Some people may be subject to guardianship or other formal decision-making arrangements.

The existence, scope and legal effect of these arrangements vary according to jurisdiction and the particular order or appointment.

Do not assume:

They have a guardian, so the guardian makes every decision.

Where formal arrangements exist:

• determine what they actually cover;
• support the person to participate as much as possible;
• respect accessible communication needs;
• recognise the person’s will and preferences; and
• seek legal or specialist advice if the scope of authority is unclear.

Interdisciplinary Decision Support

Decision-making support is often interdisciplinary.

Depending upon the person’s needs, contributors may include:

• Occupational Therapists;
• speech pathologists;
• psychologists or neuropsychologists;
• social workers;
• advocates;
• disability support professionals;
• support coordinators;
• legal professionals;
• behaviour support practitioners;
• veterinarians;
• animal trainers;
• family members or trusted supporters; and
• other relevant professionals.

This is one reason the Interprofessional Shared Decision-Making Model may be useful supplementary reading for AAOT participants: assistance-animal decisions rarely occur within a simple one-practitioner/one-client dyad.

The goal is not to have the largest possible professional team.

It is to involve the right expertise for the decision being made.

What This Means for an AAOT

When supporting an assistance-animal decision, develop the habit of asking:

Whose decision is this?

Has the person actually had an opportunity to communicate their view?

Is the information accessible?

Have I allowed sufficient time?

What communication supports are required?

Am I confusing disagreement with incapacity?

Am I assuming disability means somebody else should decide?

Are supporters helping the person decide—or deciding for them?

What options have genuinely been explored?

Would experience or demonstration improve understanding?

Have risks been explained without using fear to control the outcome?

What does the person value?

What are the animal-welfare implications?

What professional recommendation can I genuinely support?

Where does my professional scope end?

Who else should be involved?

These questions should become part of your AAOT professional reasoning.

Why We Want You to Explore More Than One Framework

WAFA has selected the La Trobe Support for Decision Making Practice Framework to provide AAOT participants with a shared evidence-based foundation.

However, advanced professional practice should not become:

WAFA gave me one framework, therefore I never need to look elsewhere.

Different frameworks highlight different parts of decision-making.

The La Trobe Framework is particularly valuable for supporting people with cognitive disability to exercise will, preferences and participation.

The Ottawa Framework can broaden your thinking about decisional needs and decision quality.

The Three-Talk Model provides a useful approach to professional conversations about options, preferences and trade-offs.

The Interprofessional Shared Decision-Making Model can help you consider how multiple professional disciplines participate without displacing the person at the centre of the decision.

You are encouraged to explore these and other credible peer-reviewed literature throughout AAOT.

Ask:

What problem was this framework designed to address?

For whom was it developed?

What evidence supports it?

What does it add to my reasoning?

What are its limitations?

Is it appropriate to this particular person and decision?

This is the type of critical comparison expected at an advanced professional level.

Connecting This Topic to What Comes Next

Supported decision-making connects directly with later AAOT learning concerning:

• NDIS participant choice and control;
• neurodivergent-affirming practice;
• trauma-informed care;
• children and safeguarding;
• cultural safety;
• communication;
• risk;
• dignity of risk;
• ethics;
• professional boundaries;
• animal welfare; and
• interdisciplinary practice.

Two principles should remain with you:

Supporting autonomy does not mean abandoning professional responsibility.

and:

Professional responsibility does not give us ownership of another person’s decisions.

Effective AAOT practice requires both.

Continue This Topic in Your Reflective Workbook

You have now completed the learning material for:

Topic 4 — Supported Decision-Making Practice Framework

Please now refer to the corresponding section of your AAOT Foundation Learning Reflective Workbook.

The workbook will ask you to apply supported decision-making principles to assistance-animal scenarios involving:

• communication differences;
• intellectual and cognitive disability;
• family disagreement;
• children;
• accessible information;
• dignity of risk;
• animal welfare;
• professional disagreement;
• training-pathway choices;
• decisions not to proceed;
• retirement;
• substitute decision-making; and
• interdisciplinary professional involvement.

You will also be encouraged to compare the La Trobe Framework with at least one other evidence-based decision-making framework, considering its purpose, evidence base, strengths, limitations and potential relevance to assistance-animal practice.

One of the most important ideas to consider is that a person beginning an assessment wanting an assistance animal and ultimately choosing not to obtain one may represent an excellent supported decision-making outcome.

The purpose is not to achieve a predetermined assistance-animal outcome.

The purpose is to support a process in which the person’s will, preferences and participation are respected while professional responsibilities, evidence, risk and animal welfare are appropriately considered.

As with previous topics, return to your workbook responses later in AAOT and note how your reasoning develops.

The questions raised here may also provide valuable material for your Capstone Portfolio or Capstone projects, particularly around accessible decision-making, professional power, autonomy, family involvement, interdisciplinary practice and animal welfare.

Once you have completed or commenced the corresponding workbook activities, continue to Topic 5 — NDIS Worker Orientation and Participant Rights.