Real life; real low techJulie Atkinson(Access to Communication & Technology)Helen Paterson(COMPASS)

SummarySymbol & Text resourcesPractical ideasInterspersed with case studies / videosChildrenAdults with acquired conditions

Access to Communication & TechnologyRegional NHS Tertiary Assistive Technology ServiceAAC, EC, computer accessChildren and adultsMission statement:To empower people with disabilities, using techniques and technologies which optimize potential for communication and control Staff: OT, SLT, Clinical Scientists, Workshop team, Administrators about 20 peopleWebsite: http://nww.bhamcommunity.nhs.uk/departments-and-services/rehabilitation-services/services/act Email: julie.atkinson@bhamcommunity.nhs.uk Phone number: 0121 466 3050Referral helpline 0121 472 0754

Royal Hospital for Neuro-disabilityCOMPASSBased in London, serving all of UK.Rehabilitation & longer term care230 Patients & Residents with Head Injury, Stroke, MS, HD & a range of other neurological conditions.

Compass 6 team members working with High Tech AAC, Computer Access, Environmental Control and Powered MobilityComputerAccessEnvironmentalControlCommunicationAidsPoweredMobilitySwitches& Mounting

COMPASS http://www.rhn.org.uk/our-work/our-services/electronic-assistive-technology/hpaterson@rhn.org.uk

Symbol Resources

PictoSelector http://www.pictoselector.eu/

SparkleBox http://www.sparklebox.co.uk/

Widgit

http://www.widgit.com/resources/health/a_and_e/index.htm

http://www.widgit.com/resources/classroom/index.htm

Foreign Language ChartsBedside messages, hospital flashcards, A and E passport - 28 languages: http://www.widgit-health.com/downloads/languages.htm

Foreign Language ChartsEastern Health cue cardshttp://www.easternhealth.org.au/gp/service,serviceid,35836.aspx

Straight-street (Mulberry symbols)www.straight-street.org

Matrix Maker

Symbol ResourcesEye EncodingPartner Assisted ScanningACT symbol resourcesTalking MatsBooks

Eye pointing / colour encoding to decorate cakes

Perspex boards for eye pointing

ACT symbol resourcesDoll play Aided Language DisplayBath with symbols Wheres Daddy book symbols to tell story Practicalities: Consider displaying on classroom whiteboardUse a tabard / old woolly pully free hands Tupperware for wet environments

Low Tech IdeasAided Language Displays / Stimulation

Daniel using Partner Assisted Scanning on an Aided Language DisplayUsed to demonstrate to Mum the flexibility of vocabulary within a non-Noun-based Aided Language Display (and Partner Assisted Scanning) when reading the My Presents book

In the real World!

i-SETACT Goal setting tool based on Talking Mats and the Means, Reasons, Opportunities model(Bulpitt1989)

Talking Mats to review AAC

Talking mats to review AAC

Talking mats to review AAC

Sally Conner books

Other Book-based resourcesBirmingham Childrens Hospital bookLife Book / Communication PassportsLook 2 TalkPODD-typeCommunication placemat

Angelo videoSpinal Muscular AtrophyIn hospitalUsing his symbol book to talk about what he wants for Christmas

A book for BillyReceptive use of symbol communication book for adult post-brain injury with acquired central hearing impairmentFor behavioural management 2 way communication

Chart based on Talking Mats

Chart based on Talking Mats

Text-based resourcesDirect accessIndirect accessEyesPartner Assisted Scanning

Direct access: Video-Brenda using direct access

Help with direct access: prodders

Charts with guards & FAB

E-tran frame

SpeakBookhttp://www.speakbook.org

SpeakBook

SpeakBook

Eye Linking-videohttp://www.youtube.com/watch?v=zdTeVwTXjxI

PAS chartSPACEMISTAKE

Partner Assisted ScanningHow to use the alphabet chart

Need to establish a reliable yes/no response Have a pen and paper handy so you can keep track of all the letters the person is giving youHold the chart where the person report they can see itPoint down to the beginning of each row (row A, row E, etc), until they indicate the row containing the letter they wantOnce the row is selected, move along it, starting with the first letter, until they indicate that you have got to the letter they want

Practicalities 1The alphabet board was wonderful, except that nobody else knew how to use it. The rules were too long and complicated. First of all, there were not any set rules written down and when somebody did write down rules there were too many. Alec in Fried-Oken et al 1991

Practicalities 2 One of the problems was that people wouldnt know how to hold the board high enough up for me. Im laying on my back and theyre standing upThey need to hold it at their head level so I can see whats going on people wouldnt be aware of holding it at a proper height for me and not for them Vic in Fried-Oken et al 1999

Practicalities- clear Communication Guidelines Richard can understand everything you are saying to him.Richard looks up for yes:and down for no:You can use this method to ask closed questions e.g. are you in pain? Do you want to go back to bed?

Video-Andrew using PAS

You Tube clipshttp://www.youtube.com/watch?v=pLb6-Oi3uR0 (memorised Partner Assisted scanning of AEIOU)

http://www.youtube.com/watch?v=3jynuu7smBM (low tech temporary vocab, laser pointer)

Mirror for sideways Partner Assisted Scanning

My first communication boardafter I had learned to spell

The transparent communication board. The carer watches my eyes through the board.

Low tech to reflect high tech: StarTalker

Photocopy your High Tech display!

Research-comparing low tech methodsExperimental Study by Roman, Quach, Coggiola and MooreCompared EyeLink, Etran and Partner Assisted ScanningSurvey of 343 SLPs and AT Specialists found that they were most likely to have heard of, demonstrate and use PAS and were least likely to have heard of, demonstrate and use the EyeLink

Research continued15 individuals with MND and their partnersTaught all three methods

ResultsEyeLink- the least known and least popular method in the survey of SLTs, was the fastest and preferred method by our MND clients and partners.Why is PAS most popular with SLTs?=Availability/Easily improvised=Can function even when eye movement is impaired (targeting not required)

Research - comparing techniqueshttp://www.alsmndalliance.org/wp-content/uploads/2010/12/008-Study-of-3-Low-Tech-Communication-Methods-for-People-with-Only-Eye-Movement-A-Roman.pdf

ReferencesBulpitt D (1989) Means, reasons and opportunities model: Training material. Leicester Health Authority & Central Nottinghamshire Health Authority

Fried-Oken M, Howard JM & Roach Stewart S (1991) Feedback on AAC Intervention from Adults who are Temporarily Unable to Speak Augmentative & Alternative Communication Vol 7 43-50

Fried-Oken M (2001) Been There, Done That: A Very Personal Introduction to the Special Issue on Augmentative and Alternative Communication and Acquired Disorders Augmentative and Alternative Communication 17 138-140

Personalised placemats: angela.crocker@nwb.n-i.nhs.uk

*JA**JAHP*HP*HP**JAFree, downloadable Pictograms which you can create grids with*JACommunication fans / keyrings*JAFree downloadable classroom resources e.g. Spring, Xmas packs

This Communication Passport uses Widgit symbols and is for use with Accident and Emergency. It contains three sections: Things you must know about me (Red) Things important to me (Amber) My likes and dislikes (Green

*HP*HP*HP*HP*JALook to Talk structured starter pack for making and using a communication book for eye pointing communicatorsLook at the block, then the colourSkills for communication partners as well as the communicator*HP*JAAAC Summer Camp Chatterbox (Joan Bruno) art session different displays for children at different levelReasoning talk to children in their language i.e. symbols - modelling vocab and expanding their utterances

*ACT video*JAIt can be tough deciding if low or high tech is most appropriate to the situation!*7 point Visual Analogue ScaleReasons Language Functions e.g. convey info, ask Q, learn, repair breakdownsOpportunities People and Settings

*HP*HP*HP*JA*JA**JA**JAJA*HP*HP*HP*HP**HPToby Churchill Communication chartsHP*HP*HP*HP*HP*HP*HP*HP*HP*HP*HP*HP*HP**JA*JAAlso 20 Questions - formalisedAxelWhen I was younger I could communicate with my eyes. I could only communicate with my mother, that was hard for my mother and myself. I looked at things I wanted to talk about. My mother then asked questions and I could indicate yes or no by nodding or shaking my head. Sometimes it took lots and lots of questions! For instance how could you tell at home that a child was naughty at school and pushed the fire alarm button and the big red fire engine came, or that a bee had stung a child, when you can only say yes or no. Formalised system of 20 questions would not work for unpredictable messages such as these.Things got better when I had learned to spell, at age 6, and I started to use a communication board, a board with all the letters and numbers in three rows and I look up, when I want to have that letter. I like to attend meetings with other people who use communication devices to get an idea how others cope without being able to speak. *Recently I attended the communication matters conference in Leicester and saw somebody using a transparent communication board. This is a piece of transparent plastic with the letters of the alphabet stuck on it at large intervals. I liked it instantly and we copied it. My carer holds it fairly close to my face and as I look at a letter the carer can see where I am looking. It is very fast, much better than the board I described earlier. **JA Photocopy LightwritersHP*HP*HP*HP*HP**