Considering inclusion in digital technology: An occupational therapy role and responsibility.

These days it is hard to identify occupations or daily activities that have not been shaped by the use or non-use of digital technology. Identified as part of the digital revolution or the Industrial Revolution 4.0, digital technology has moved from expensive and specialised, to ubiquitous and widely accepted. This has important implications for occupational therapists (Liu, 2018). Keeping up with the contributions of, and needs related to, digital technology has seen new roles and responsibilities for occupational therapists. An emerging role, for example, is in the design and evaluation of mainstream technologies (Proffitt et al., 2019). Occupational therapists and users with disabilities work in companies creating gaming, rehabilitation and health-related digital technologies (Proffitt et al., 2019). There are calls for engaging occupational therapists in the creation of accessible options to promote working remotely, inclusive health and social networks, transportation systems and communities (e.g. Anzai et al., 2023; Field et al., 2021; Slegers et al., 2020). The role for ensuring we support people in adjusting to requirements to use technologies and as technologies change has also been noted (Liddle, Worthy, Frost, Taylor, Taylor, et al., 2022). The lack of consideration of all potential users in the development of current mainstream technologies and in datasets that fuel automated systems and artificial intelligence has led to concerns about technology-related exclusion (Langston, 2020; Proffitt et al., 2019). The human rights implications of accessibility and potential exclusion in emerging technologies are of international concern (Australian Human Rights Commission, 2021). Vitally, occupational therapists need to be aware of and consider the digital divide in their practice. The digital divide, captured locally by the Australian Digital Inclusion Index (Thomas et al., 2021), describes how technology availability, accessibility, support, cost and confidence are leading to the increasing exclusion of some groups within Australia. Against a trend of increasing digital inclusion, a substantial number of Australians remain highly excluded, with over one in four Australians experiencing digital exclusion. Those at risk of digital exclusion include people with lower incomes, those living in regional and remote areas, those with lower levels of education, older people and those living with a disability. While the pandemic has shifted many activities into digital spaces, its impact on digital inclusion was not experienced consistently across the population. Those people not successfully engaging with technology were further excluded from participation. People working to reduce the digital divide identify the need to particularly address digital skill building, digital health literacy and technology during disasters and crises, and community led ways of building skill and capacity (Good Things Foundation., 2022). In moving towards an inclusive future, it is essential that occupational therapists support the creation, adaptation and use of meaningful and accessible technologies. One important avenue towards this is through the codesign of technologies and associated services and supports. Partnering with technology users (or potential users) to create more accessible and acceptable options, and recognising the expertise of assistive technology users as a vital resource will support more inclusion (Layton et al., 2021; Liddle, Worthy, Frost, Taylor, & Taylor, 2022; Ong et al., 2023). Occupational therapists can develop and support participatory and inclusive ways of working with people and technologies. It is important that occupational therapists directly address the potential for technology to impact on occupational justice and health (Larsson-Lund & Nyman, 2020). This needs to include advocating for more inclusive technologies, ways of working, infrastructure, technology funding and supports.