Professor Carolyn Unsworth
Professor and Head of Occupational Therapy
Professor Carolyn Unsworth is an internationally respected researcher and educator in occupational therapy, with key research interests in public transport access and driver assessment and rehabilitation for people with disabilities. She is also known for her contributions to the fields of health outcome measurement and clinical reasoning.
Dr Unsworth’s research has informed transport improvements and policy changes for people with disabilities nationally. Her outcome measure AusTOMs-OT and driver assessment OT-DORA are used internationally. In 2017, Carolyn was inducted as an inaugural Fellow of the Occupational Therapy of Australia Research Academy.
Carolyn holds Adjunct Professorial appointments at Monash, Central Queensland and La Trobe University in Australia, and Jönköping University, Sweden. She has authored more than 160 journal articles and book chapters and made 150 conference and keynote presentations. She currently serves on the editorial boards of several journals, including as Associate Editor of the British Journal of Occupational Therapy.
‘A Meaningful Difference, but Not Ultimately the Difference I Would Want’: A Mixed-Methods Approach to Explore and Benchmark Clinically Meaningful Changes in Aphasia Recovery
Applying implementation science theories to support practice change in the assessment of cognition by occupational therapists
A Systematic Review of Effective Interventions and Strategies to Support the Transition of Older Adults From Driving to Driving Retirement/Cessation
Comprehensive quality assessment for aphasia rehabilitation after stroke: protocol for a multicentre, mixed-methods study
Development of a driving clinical decision pathway for non-driver trained occupational therapists
Evaluation of a driving clinical decision pathway for generalist occupational therapists: Pilot test of practice change
Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021
Occupational Encounters: The Interpersonal Impact of Bus Drivers’ Engagement With Disabled Passengers
A Systematic Review of Wheelchair and Mobility Scooter Containment Systems Used Internationally on Public Transit Buses
Education leads to increased adherence to the ‘Australian Competency Standards for Occupational Therapy Driver Assessors’
Initial validation of the powered mobility device autonomy residential screen (PoMoDARS)
Powered mobility device use in residential aged care: a retrospective audit of incidents and injuries
Injury by design: A thematic networks and system dynamics analysis of work-related musculoskeletal disorders in tram drivers
Linking people and activities through community mobility: An international comparison of the mobility patterns of older drivers and non-drivers
Community mobility using private and public transportation is important for maintaining health,...
Menstrual hygiene management strategies used by women who are blind or have low vision
Survey of Occupational Therapy Driver Assessors’ Rehabilitation Interventions With Older Drivers
The rehabilitation strategies used by occupational therapy driver assessors with older drivers...
Use of the AusTOMs-OT to record outcomes in an occupational therapy homeless service
Views of American and Australian mobility device users and ambulant bus users regarding occupant restraint systems on public buses
An early warning system for diabetic automobile drivers with peripheral neuropathy
Purpose: People with Type 2 diabetes exhibit peripheral neuropathy that results in the...
A systematic review of public transport accessibility for people using mobility devices
Purpose: Being able to access public transport is vital for mobility device users as this is an...
Clinical reasoning in occupational therapy practice
Effect of contamination and purity priming on attitudes to vaccination and other health interventions: A randomised controlled experiment
Feasibility of modifying the hospital environment to reduce the length of amnesia after traumatic brain injury: a pilot randomized controlled trial
BACKGROUND: Reorientation programmes have been an important component of neurotrauma...
Fitness to drive practices among non-driver trained occupational therapists in an Australian community-based rehabilitation setting
Introduction: Driving is a valued occupation given the independence and freedom it provides. Safe...
Powered mobility aid access on public transport: A validation study of compliance with disability standards
Introduction: Public transport accessibility is vital for people using powered mobility aids,...
Public perspectives on acquired brain injury rehabilitation and components of care: A Citizens’ Jury
Background: Brain injury rehabilitation is an expensive and long-term endeavour. Very little...
The revision of competency standards for occupational therapy driver assessors in Australia: A mixed methods approach
Introduction: Competency standards outline the knowledge, skills, and attributes that are...
A 3D Measurement and Computerized Meshing Study to Promote Bus Ridership Among People Using Powered Mobility Aids
People who use powered mobility aids such as wheelchairs and scooters need and want to use public...
Burden and preparedness amongst informal caregivers of adults with moderate to severe traumatic brain injury
This study examined the patterns of informal (unpaid) caregiving provided to people after...
Maze test score time adjustments when using nondominant hand in fitness-to-drive assessments
Drivers with medical conditions may need to demonstrate their fitness by participating in...
Occupational therapy and activity pacing with hospital-associated deconditioned older adults: a randomised controlled trial
Purpose: To examine the efficacy of an occupational therapy activity pacing intervention with...
Out on a limb: Applying the Person-Environment-Occupation-Performance model to examine injury-linked factors among light rail drivers
Work-related injuries and musculoskeletal disorders are a workplace problem within and across...
Validity and reliability of the Australian Therapy Outcome Measures - Physiotherapy, for podiatry (AusTOMs-PT for use in podiatry)
Background: Valid and reliable outcome measure enable measurement of health care service impact....
Writing systematic, scoping, and app reviews: summarising and appraising best evidence
[No abstract available]
A randomized controlled trial protocol investigating effectiveness of an activity-pacing program for deconditioned older adults [Un protocole d’essai randomisé pour évaluer l’efficacité d’un programme de planification et de dosage des activités pour des adultes déconditionnés]
Background.: Acute hospitalization of older adults can lead to deconditioning and the need for...
Effect of Navigation Problems, Assessment Location, and a Practice Test on Driving Assessment Performance for People with Alzheimer's Disease
Background: People with Alzheimer's disease may be required to undertake clinical and on-road...
“I’m very visible but seldom seen”: consumer choice and use of mobility aids on public transport
Purpose: The number of mobility aid users continues to rise as the population ages. While...
Predicting fitness-to-drive following stroke using the Occupational Therapy–Driver Off Road Assessment Battery
Introduction: It is difficult to determine if, or when, individuals with stroke are ready to...
The inter-rater reliability of the Powered Mobility Device Assessment Training Tool
Introduction: The prescription of powered mobility devices for clients is an important role for...
The privilege paradox: Geographic areas with highest socio-economic advantage have the lowest rates of vaccination
The present study is the first to examine associations between area-level socio-demographic...
Anti-vaccination and pro-CAM attitudes both reflect magical beliefs about health
We examined the relationship between complementary and alternative medicine (CAM) use and...
A randomised controlled trial to test the effectiveness of decision training on assessors' ability to determine optimal fitness-to-drive recommendations for older or disabled drivers
Background: Driving licensing jurisdictions require detailed assessments of fitness-to-drive from...
Barriers and enablers to aligning rehabilitation goals to patient life roles following acquired brain injury
Background/aim: Life roles are integral to occupational therapy practice. Goal setting is a...
Development of the International Expert Advisory Panel on Community Health and Transport (I-CHaT) to coordinate research on transport mobility
[No abstract available]
Persistent symptoms and activity changes three months after mild traumatic brain injury
Background/aim: Approximately, 80% of traumatic brain injuries are considered mild in severity....
Reliability of the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT)
Background/aim: The delivery of evidence-based health care requires the routine adoption of...
The experience of attempting to return to work following spinal cord injury: a systematic review of the qualitative literature
Purpose: This review sought to answer the question “What are the barriers and facilitators...
The experience of seeking, gaining and maintaining employment after traumatic spinal cord injury and the vocational pathways involved
BACKGROUND: Vocational potential in people with spinal cord injury (SCI) are unrealised with...
Use of 3D scanning technology to determine bus access for people using powered mobility aids
Public transport is designed to move people efficiently and affordably around their communities....
Analysing and interpreting outcomes data to support evidence-based practice using the example of AusTOMs-OT
Statement of context: Occupational therapists working with clients who have neurological...
A systematic review of evidence for fitness-to-drive among people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder
Background: Limited evidence exists regarding fitness-to-drive for people with the mental health...
Hazard perception skills of young drivers with Attention Deficit Hyperactivity Disorder (ADHD) can be improved with computer based driver training: An exploratory randomised controlled trial
Background: Young drivers with Attention Deficit Hyperactivity Disorder (ADHD) are at higher risk...
Longitudinal employment outcomes of an early intervention vocational rehabilitation service for people admitted to rehabilitation with a traumatic spinal cord injury
Study design:Longitudinal cohort design.Objectives:First, to explore the longitudinal outcomes...
Review papers: Getting the best occupational therapy evidence into practice
[No abstract available]
Revision of the Competency Standards for Occupational Therapy Driver Assessors: An overview of the evidence for the inclusion of cognitive and perceptual assessments within fitness-to-drive evaluations
Background/aim: Determination of fitness-to-drive after illness or injury is a complex process...
A systematic review of professional reasoning literature in occupational therapy
Introduction: Over the past 33 years, theoretical and empirical articles have been published on...
Determining client cognitive status following mild traumatic brain injury
Background People with mild traumatic brain injury (mTBI) commonly experience cognitive...
Determining Fitness to drive among drivers with Alzheimer's disease or cognitive decline
Introduction: Fitness to drive skills progressively deteriorate following a diagnosis of...
Engaging patients with moderate to severe acquired brain injury in goal setting
Background/Aims: An exploratory study of a novel approach to using the Goal Engagement Scale to...
Determination of the minimal clinically important difference on the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT)
Purpose: Outcome measures must be responsive to change (able to show statistically significant...
Determining fitness to drive: A systematic review of the methods and assessments used after mild traumatic brain injury
Introduction: Limited evidence is available to support knowledge of the time-frame and capacity...
Determining fitness-to-drive following stroke using the OT-DORA Battery
No Abstract
Development and validation of the Occupational Therapy Risk Propensity Test (OT-RiPT) for drivers with disability
Background: Male drivers in the 16- to 19-year age group have a nine-fold increase in their crash...
Fitness-to-drive after mild traumatic brain injury: Mapping the time trajectory of recovery in the acute stages post injury
Introduction Little is known about the trajectory of recovery in fitness-to-drive after mild...
How do driver assessors make fitness-to-drive decisions for older or disabled drivers?
No Abstract
How therapists think: Exploring therapists’ reasoning when working with patients who have cognitive and perceptual problems following stroke
[No abstract available]
How to use the Australian Therapy Outcome Measures for Occupational Therapy
No abstract
Occupational therapy inpatient rehabilitation interventions with deconditioned older adults following an acute hospital admission: A Delphi study
Background/aim: Older adults admitted to an acute hospital setting with an illness often...
Special Issue: Driving and community mobility (I) - Clinical assessment of fitness to drive
[No abstract available]
Special issue: Driving and community mobility (II) - Interventions to enable driving
[No abstract available]
The role of occupational therapists in the rehabilitation team
The purpose of this chapter is to define the scope and role of the occu-pational therapist...
Using social judgment theory method to examine how experienced occupational therapy driver assessors use information to make fitness-to-drive recommendations
Introduction: As people with a range of disabilities strive to increase their community mobility,...
What information is provided in Australian emergency departments about fitness-to-drive after mild traumatic brain injury: A national survey
Background/aim: Occupational therapists work together with their medical and nursing colleagues...
A systematic review of hospital experiences of people with intellectual disability
Background: People with intellectual disability are at risk of poor hospital experiences and...
A systematic review of the effectiveness of behavioural interventions for improving driving outcomes in novice drivers with attention deficit hyperactivity disorder (ADHD)
Introduction: The efficacy of non-pharmacological interventions for improving driving outcomes in...
Driver rehabilitation: A systematic review of the types and effectiveness of interventions used by occupational therapists to improve on-road fitness-to-drive
Objective Driver rehabilitation has the potential to improve on-road safety and is commonly...
Rehabilitation interventions with deconditioned older adults following an acute hospital admission: A systematic review
Objective: To determine effectiveness of inpatient rehabilitation interventions with older...
Using the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT) to measure client participation outcomes
Introduction: Measuring change in clients' 'participation', and being able to attribute this...
Clinical assessment of fitness-to-drive: Positioning occupational therapy for workforce development
[No abstract available]
Exploring the mobility preferences and perceived difficulties in using transport and driving with a sample of healthy and outpatient older adults in Singapore
While activity engagement is important to older adults, limitations in ability can affect...
The inter-rater and test-retest reliability of the Self-care and Transfer scales, and intra-rater reliability of all scales of the Swedish Translation of the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT-S)
Objective: The Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT) are used...
Community mobility promotes participation for people of all ages and abilities
[No abstract available]
Development of a standardised Occupational Therapy - Driver Off-Road Assessment Battery to assess older and/or functionally impaired drivers
Introduction: Research has been conducted over several years to develop a new off-road assessment...
Relationship between intuition and emotional intelligence in occupational therapists in mental health practice
OBJECTIVE: Clinical reasoning studies have acknowledged tacit aspects of practice, and recent...
Validity of the Occupational Therapy-Drive Home Maze Test for right and left handed test takers
The Occupational Therapy-Drive Home Maze Test (OT-DHMT) is part of the OT-DORA Battery used in...
Developing skills in everyday activities and self-determination in adolescents with intellectual and developmental disabilities
Autonomous functioning, an essential characteristic of self-determined people, has been...
Evidence-based practice depends on the routine use of outcome measures
[No abstract available]
Gaining insights to the clinical reasoning that supports an on-road driver assessment
Background: Researchers have yet to examine the clinical reasoning of occupational therapists...
Interrater reliability of the Road Law and Road Craft Test as part of the OT-DORA Battery for off-road driver assessment
Background: The Occupational Therapy Driver Off Road Assessment (OT-DORA) Battery is in...
Normative data, preliminary inter-rater reliability and predictive validity of the Drive Home Maze Test
Objective: The Drive Home Maze Test has been developed as part of a clinic-based driver...
The patterns of activity, and transport to activities among older adults in singapore
Background: Engagement in occupations is important, and appropriate transportation modes are...
A grounded theory of intuition among occupational therapists in mental health practice
Objectives: This study aimed to explore occupational therapists' understanding and use of...
Validation of a test of road law and road craft knowledge with older or functionally impaired drivers
OBJECTIVE. The number of functionally impaired drivers being assessed is increasing the urgency...
An evaluation of the construct validity of the developmental test of visual-motor integration using the rasch measurement model
Background: One method of evaluating the construct validity of instruments is the Rasch...
Benchmark comparison of outcomes for clients with upper-limb dysfunction after stroke using the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT)
OBJECTIVES. The objective was to benchmark upper-limb outcomes for clients after stroke by...
Construct validity of the test of visual-motor integration: An evaluation using Rasch analysis
Background: Rasch analysis can be used as a method of evaluating construct validity during test...
Construct validity of the Test of Visual-Motor Skills-Revised (TVMSR): An evaluation using the Rasch Measurement Model
Construct validity of instruments, tests, and scales can be examined using the Rasch Measurement...
Evaluating construct validity of the slosson visual-motor performance test using the rasch measurement model
The aim of this study was to evaluate the construct validity of the Slosson Visual-Motor...
Factor structure of four visual-motor instruments commonly used to evaluate school-age children
OBJECTIVE. Having access to high-quality, rigorously developed, valid visual-motor integration...
Internal consistency and concurrent validity of four instruments used to evaluate the visual-motor integration skills of school-aged children
Objective. The study aim was to examine the internal consistency and concurrent validity of four...
Validation of the modified assessment of living skills and resources, an IADL measure for older people
Purpose. The aim of this study was to examine the validity of the assessment of living skills and...
To continue, modify or relinquish driving: Findings from a longitudinal study of healthy ageing
Background: The number and proportion of drivers among people entering later life continues to...
Using the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT) to measure outcomes for clients following stroke
Purpose: To examine a range of measures used to document client outcomes following stroke,...
Development and current status of occupational therapy driver assessment and rehabilitation in Victoria, Australia
[No abstract available]
Using social judgment theory to study occupational therapists' use of information when making driver licensing recommendations for older and functionally impaired adults
Objective. This study sought to identify the informational cues that driver-assessor-trained...
Factors that lead to successful community integration following severe traumatic brain injury
OBJECTIVE: To assess and identify predictive factors of community integration of people 3 to 15...
Reliability of the Australian therapy outcome measures for occupational therapy self-care scale
Background and Aims: With the shift of health care towards evidence-based practice, demonstrating...
A comparison of client outcomes from two acute care neurological services using self-care data from the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs - OT)
The 12 scales in the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs - OT)...
Clinical reasoning during community health home visits: Expert and novice differences
Very little is known about the differences between novice and expert clinical reasoning in...
Measuring outcomes using Australian Therapy Outcome Measures for occupational therapy (AusTOMs-OT): Data description and tool sensitivity
Although there is increasing demand for greater accountability from occupational therapists for...
Occupational therapy in acute hospitals: The effectiveness of a pilot program to maintain occupational performance in older clients
Background: Research evidence suggests that during acute hospitalisation, older people may...
Reliability of the Australian therapy outcome measures for quantifying disability and health
The Australian Therapy Outcome Measures (AusTOMs) quantify client outcomes for physiotherapy,...
Review of tests contributing to the occupational therapy off-road driver assessment
Driving is viewed as a skill fundamental to our lifestyle. Driving affords independence, mobility...
Time use following a severe traumatic brain injury
Recent outcome studies have found that a significant number of people have limited opportunity...
Using a head-mounted video camera to explore current conceptualizations of clinical reasoning in occupational therapy
OBJECTIVE. The purpose of this study was to explore current conceptualizations of clinical...
A HOME‐BASED OCCUPATIONAL THERAPY ENVIRONMENTAL MODIFICATION PROGRAM FOR CAREGIVERS HAD A MODEST EFFECT ON THE PERFORMANCE OF IADL IN PEOPLE WITH DEMENTIA, WHILE FOR SOME CAREGIVER SUBGROUPS, THERE WAS IMPROVED EFFICACY AND REDUCED UPSET
Research Objective: To determine if: (i) occupational therapy home visits targeting...
Clinical reasoning: How do pragmatic reasoning, worldview and client-centredness fit?
Using both clinical reasoning data and literature from the past 20 years, this paper sought to...
Role perceptions and clinical reasoning of community health occupational therapists undertaking home visits
This paper presents the findings of a survey that aimed to: (i) describe the work of metropolitan...
Therapy outcome measures for allied health practitioners in Australia: The AusTOMs
Objective. The aim of this study was to develop a valid and reliable measure of therapy outcome...
The test-retest reliability of the child-initiated pretend play assessment
OBJECTIVE. The purpose of this study is to establish the test-retest reliability of the...
Validity of the AusTOM scales: A comparison of the AusTOMs and EuroQol-5D
Background: Clinicians require brief outcome measures in their busy daily practice to document...
External validation of a housing recommendation model for clients following stroke rehabilitation
Purpose: Using a Social Judgment Theory approach, mathematical models of clinical decisions can...
Examining the evidence base for occupational therapy with clients following stroke
Purpose: Using a Social Judgment Theory approach, mathematical models of clinical decisions can...
Let us use randomised controlled trials (multiple letters)
[No abstract available]
Reporting p values (multiple letters)
[No abstract available]
A comparison of self-report versus observation of performance using the assessment of living skills and resources (ALSAR) with an older population
This study assessed the capacity of 15 older people to report their instrumental activities of...
Selection for rehabilitation: Acute care discharge patterns for stroke and orthopaedic patients
This study aimed to develop predictive models to assist clinicians working in acute care to...
Studying clinical reasoning (multiple letters)
[No abstract available]
The clinical reasoning of novice and expert occupational therapists
Over the past 15 years, research in health sciences has consistently shown that differences in...
Time use and importance of instrumental activities of daily living
This study investigated time use and the importance of instrumental activities of daily living...
Using a head-mounted video camera to study clinical reasoning
Studies of clinical reasoning are essential if we are to extend our knowledge of occupational...
Development of an assessment to identify play behaviours that discriminate between the play of typical preschoolers and preschoolers with pre-academic problems
Occupational therapists regard play as the primary occupation of childhood. However, many authors...
Measuring the outcome of occupational therapy: Tools and resources
Current pressures to document outcomes and demonstrate the efficacy of occupational therapy...
The importance of pretend play in child development: An occupational therapy perspective
Play is a complex behaviour and is defined as being more internally than externally motivated,...
Commentary: Occupational Therapy — Reflections on the State of the Art
Tlte purpose of this cOnLmentary is to sltare Ollr reflections on the current state of...
Living with epilepsy: Safety during home, leisure and work activities
Although there is a large literature concerning epilepsy and issues such as quality of life,...