Participation – Inclusion – Independence – such powerful words, and the theme for this year’s National OT Week. As OTs working with NDIS participants, we often achieve big outcomes, through home modifications and complex assistive technology, which are wonderful achievements. Whilst a stair lifter, scripted wheelchair, and accessible bathrooms are fantastic, I also love hearing stories about the small wins that make a huge difference and change people’s lives.

As Paul Kelly and Kev Carmody famously wrote in 1991, “from little things big things grow”.  Occupational Therapists specialise in understanding the power small changes make to the quality and independence to enable participants to engage in daily living.

Psychologists estimate that the average person makes 35,000 choices every day – which equates to roughly 2,000 choices for every waking hour. When we consider the concept of the “butterfly effect”, which suggests that even tiny actions can result in huge events, it would stand to reason that each of those little choices impacts our lives long after the thought crosses our mind.

What if that choice wasn’t even an option for you to begin with? If you never had the opportunity for big things to grow from little things. For people living with a disability, frequently the choices we take for granted aren’t even an option. Their participation and inclusion is decided by others and independence is limited for the sake of time or convenience.

A small task such as teaching a person to use a mobile phone which, though simple, can open them up to a world of opportunities when accessing the community, online shopping, and connecting with friends or family. Or a medication alarm that could enable someone to live alone, when they were previously reliant on others to ensure their consistency with medications – there are so many possibilities!

Think about the impact of independence on a wider scale, through its effect on every task you do or choice you make throughout the day. Consider the importance of seemingly inconsequential activities, such as brushing your teeth, cooking your breakfast, or catching the bus, and the resultant satisfaction and positive sense of self through participation, inclusion and independence. From little things, big things grow…. and from small, independent choices, participation is enabled.

Nathan, a 3 year old with an early diagnosis of autism, experienced significant tactile defensiveness with feeding, to the point that he could not participate in any aspect of feeding himself or tolerate cutlery, with his family needing to hand feed him. Our Paediatric OT implemented sensory desensitisation and introduced him to varying food textures in a graded sensory program. Nathan can now feed himself using cutlery. This simple skill has not only helped his parents, who are also caring for a new baby, but Nathan has also been able to attend a mainstream kindergarten due to this newfound independence, and he can now participate in mealtimes with his peers. Our next step……toileting!

At ORS, we recognise, celebrate, and encourage the power of assisting to provide participants with autonomy and unlocking their potential as a basis for participation, inclusion, and independence.  The feeling of seeing a participant successfully engage in an activity they haven’t been able to before is extremely powerful indeed. Seeing the boost they are given through the services we provide enabling independence, whilst also understanding the positive impact this will have on their lives….is the favourite part of my job!


George Tyler

Regional Manager – Occupational Therapy Services

George has been working as an Occupational Therapist for approximately six years. He has extensive experience within the workplace rehabilitation sector, including Workers’ Compensation, Compulsory Third Party insurance, self-insurance and life insurance. Clinically George has experience in paediatrics, orthopaedic conditions, equipment prescription and home modification. He has specific interest and specialised experience in trauma and psychological injuries, secondary to catastrophic motor vehicle accidents. George has extensive experience leading small and large allied health teams to success, working with both experienced and new graduate therapists.