The Northwest Communication Coordinator Network has been running for nearly 8 years, and we currently have 8 day services involved. We meet each month to provide training, mentoring and peer support to the Communication Coordinators.
We have a time at the beginning of each meeting where the Communication Coordinators (CCs) share a little of what has happened in the last month. Often these discussions end up focusing on the challenges or obstacles faced by all, because there is so much that can and needs to be done, and never enough time and funding to do it. This time we asked the CCs to talk about the benefits they are seeing now from work that has been done in the past.
Use of Visual Schedules is a common strategy that has yielded some excellent outcomes. In one centre this is done by having a folder with all the components necessary to communicate information about who is here and what is going to happen. A large carpet square sits on the wall and participants now know to take it down at the beginning of the session, put it on the desk and add/change elements for each day. This strategy has provided clear structure for the day’s activities, participants are calmer and less stressed because they understand the schedule and can anticipate what will happen next. It is also a focus for conversation, commenting and interaction. Initially the more “dominant” personalities took over the process, but they have been encouraged to “help” those clients who were more withdrawn. Over time participants have learned to support each other in this process and the clients who were withdrawn have become more involved and interactive, initiating communication far more than they used to.
A “first – then” strategy has been added to the use of the visual schedule, to help people understand the order in which activities will happen. This strategy can also be done electronically with an app on the ipad (Book Creator is a favourite, but there are a number of others). This means that a participant can take this home and share it with people he lives with. One man is now much more aware of what will happen each day, and will show people the thing that he is most looking forward to. He is also learning that sometimes one or two things need to happen before it’s time for the activity he most enjoys.
These strategies help people know what the next activity will be, but they often would like to know when the next thing will begin. One Communication Coordinator put this together for a person who can tell the time but doesn’t comprehend the meaning. This person frequently asks the time because he is waiting for morning tea or lunch. The yellow dots are added as time passes, and he can now see how much longer he has to wait.
Another strategy along similar lines is an alarm clock with a visual cue for a deaf participant. He would get quite anxious and ask often when morning tea would be. The alarm clock is now always set to ring a little before morning tea time, and has little flag on the part that moves back and forth, so that he can see when the alarm is going off. Now he is much calmer and happier.
One centre has been exploring how to add more choice and control to daily activities. The basic premise of the Sandwich Making Program is the freedom to choose. For some people this can be a daunting process and with this in mind, the program is broken down into parts. The individuals in the group are picking their fillings using a photo board and then constructing either rolls or sandwiches however they want!
Over time, everyone is finding their favourite part of the process. One person is picking lettuce from the herb garden and she looks forward to this every week. Another really enjoys using the photo board and creating a masterpiece of fun to eat. Others enjoy slicing the range of ingredients and one takes the construction very seriously. Group members are expanding their range of foods they like to include in their sandwich, as well as growing in confidence and learning everyday living skills. This has proven to be a great strategy for increasing engagement, interaction, choice and control.
A Weather Chart is used in some services. In one centre this has helped people understand the best clothes to wear for different weather. It has also provided a regular topic of conversation (as the weather is often talked about in Melbourne!) and people attending the service now pay attention to what others are wearing and make comments about the different articles of clothing.
It can sometimes take a while of working on a particular strategy, teaching other staff how to use it and then using it with participants of the service, before we see the benefits emerge. While the pressure is often on for us to move on to the next strategy, to make the next aid, these stories show how important it is to give each new strategy and approach enough time to “take root”. Other staff and participants need to understand what the strategy is for, how to use it and how it is helpful. They may need ongoing support, and enough time for that to happen. Giving enough time and support is essential to our work of building capacity, and this discussion showed us just how much it pays off in the end.
BY Libby Brownlie and Julie Kenny
North-West Regional Communication Service