Mentoring speech pathologists in AAC

CAN’s work is all about inclusion and participation of people with communication disabilities in their communities.

People with communication disabilities benefit if their speech pathologist is competent in AAC and related areas. If a person has effective AAC, opportunities for social relationships, choice, and community participation open up.

Regional Communication Services provide specialised peer support to local speech pathologists to develop their skills.

With the roll out of NDIS in Loddon, new speech pathologists have arrived.

Southern Loddon Mallee Regional Communication Service has been mentoring them on request.

This time, when another speech pathologist asked for particular support, we decided to make it a two hour session and invite anyone from local speech pathology services who wanted to come.

There was an immediate response from five different service managers. Ultimately new speech pathologists from three services attended our session on positive behaviour support and strategies for communication.

The session included:

-orientation and reminders about elements of positive behaviour support

-real life stories about working with staff and services delivering positive behaviour support

-exploring options and resources for communication support

In evaluation feedback all these were identified as key learning areas.

The speech pathologists also enjoyed meeting each other and learning together.

We all agreed this was a two hours well spent.

Personal Information Cards – For Emergencies and More

Gippsland Regional Communication Service and Wellington Shire Council have been working with local Emergency Relief Centres.

One of the things they did was develop a template and information so all members of the community could create a Personal information Card.

The card is wallet sized so a person can have it with them all the time.

On the front is the person’s name, date of birth, address, and two emergency contacts with phone numbers. On the back is the person’s communication/language, required supports and alerts.

The cards were developed for use in emergencies, particularly for people with disabilities. But the cards can be useful for everyone and at other times.

The template is on the BoardMaker program, which is used to produce visual communication aids.

 

Through previous partnerships with the Regional Communication Service, BoardMaker is available for public use at the Sale Library. An information sheet now sits with the Library’s BoardMaker discs: “How to make your own card”.

The Regional Communication Service also ran an information session for community members.

It was well attended. Everyone went home with their own personalised card.

 

The session was advertised on the local radio and in the newspaper Council notes. From the advertisements for the community session, there was further interest – this time from local police.

This simple idea may have a big future!

 

 

3 Days without speech for a Speech Pathologist

North West Regional Communication Services’s Steph Bryce decided to take a three day challenge of communicating without speech.

It was a way to raise awareness among her colleagues at IPC Health. It also gave her a chance to partially “walk in the shoes” of people with communication disabilities.

Steph reflected on some things she noticed…

It helped to have an introduction card.

It explained how she was communicating and why. It  provided the context for communication partners. Then they made more time to communicate.

It was natural to use many methods to communicate. 

Steph found that she  pointed to objects, typed out words, used facial expression and gesture –  often all in the same sentence!

At home, communication methods were different – and it was easier.

Steph used a ‘text to speech’ app on her iPad to type out messages. She found she used the iPad much less at home. There, she relied on gesture, facial expression and yes/no questions. It was quicker and required less effort.

There were a number of things to consider with communication technology.

Steph tried a few different text to speech apps and found apps with better predictive text easier to use.

She was speaking with an English accent (which did not suit her!) because the easiest app had no  alternative voice options.

She used an external speaker. The volume on the iPad was not sufficient for noisy environments or large groups.

She had to make sure that the iPad was charged at every opportunity. And she had to remember to take it everywhere.

Steph’s colleagues learnt a bit about communication and alternatives to speech. They are looking forward to working with the Regional Communication Service to improve communication access at IPC Health. 

Sustainable Collaboration for Communication Access – Aqua Energy Leisure Centre, Wellington Shire: 2007-2018

Back in 2007, Gippsland Regional Communication Service began working with Aqua Energy as part of the Inclusive Leisure Initiative.

(Inclusive Leisure was a state-wide project lead by Leadership Plus (previously Inclusive Leisure Victoria) and Aquatics & Recreation Victoria. It was funded by a “Participation in Community Sport and Active Recreation” grants from VicHealth.)

A successful partnership was established between Aqua Energy, Wellington Shire Council, GippSport, Gippsland Regional Communication Service and community members, which continues today.

Aqua Energy partners for Inclusion in 2018: Geordie Cutler (Aqua Energy Customer Service/Administration Leader), Mark Thorpe & Shane Young (Auditors), Jocelyn Collins (Regional Communication Service), Leanne Wishart (Rural Access)

What did we do?

Communication Aids

Gippsland Regional Communication Service developed a Communication Kit with Aqua Energy. It included communication boards, and information sheets in Easy English.

There were different communication boards for different areas including the Reception/front counter, Café, Gym, Group fitness rooms and Pool. The range of communication boards ensured everyone has the vocabulary they need to communicate in all areas of the Centre.

Audits

Every month, an audit ensured all communication boards, information sheets, and equipment were maintained in the Centre. This audit was done by a person with a communication disability and an Aqua Energy staff member.

Outcomes

The Communication Access strategies seemed to be working. People said:

“All staff now chat and interact with my daughters. They always assist with our needs.” (Mother of a person with communication disability)

“All the staff at Aqua Energy are very friendly and helpful. I look forward to doing the auditing each month because I now have some great friends who work at Aqua Energy. The communication boards have made it more accessible for the public who have limited or no speech.” (Auditors)

“Through the making of the communication boards, the Aqua Energy staff and people with a disability developed relationships and understanding. It has developed confidence and broken down barriers.” (Support Worker)

Three years later

Three years after the partnership was initiated, the Regional Communication Service provided training and information sessions for management and staff at the Aqua Energy pool and gym. Communication boards were modified for new needs and some more boards and Easy English documents were produced.

The new Aqua Energy Communication Kit was launched in Sale on International Day of People with a Disability in December 2010.

But…

Three months after, things had changed at Aqua Energy! Many staff did not know what the communication aids were for, or where to find them. Customers with communication disabilities were frustrated!

Aqua Energy is a busy leisure centre, open 7 days a week for long hours. It has many part time, casual and sessional staff.

There had to be a new strategy to ensure all staff knew about communication access. The Regional Communication Service and Auditors had to find a way to  maintain a working relationship with staff and with management and to minimise the time required of them.

Sustainable Communication Access at Aqua Energy

The solution was to engage three customers with communication disabilities as independent Communication Auditors.

The Regional Communication Service trained the new Auditors. The Regional Communication Service and the Auditors worked together to develop and test an Easy English Communication Audit tool. Each Auditor, wearing a uniform, visited the Centre once a month. They reported their results to the Centre’s Manager. 

Soon, Management and staff warmly welcomed and supported these Auditors. There was again strong staff awareness and commitment to communication access and Easy English documents.  Communication aids were again available. Every month staff have opportunities to interact and learn from the communication Auditors. 

Into the community

The Auditors were invited to join the Access and Wellington Shire Inclusion Advisory Group, and now advise Councillors and Council Officers about disability policy.

Auditors had several new work experience opportunities.

The Auditors were involved in community awareness training, talking to to staff and community groups about their roles.

The Auditors received awards and were recognised by Wellington Shire at a community celebration during Volunteers Week.

What’s happened so far in 2018?

Aqua Energy was awarded the Communication Access symbol several years ago and maintains its commitment.

Two Aqua Energy Auditors ceased auditing. A new Auditor was engaged.

The Regional Communication Service ran an education session for the new Auditor and his carer. Then the two Auditors completed an audit together. The remaining Auditor assumed a mentor and training role for the new Auditor.

Each Auditor visits on alternate months. Results are reported to Aqua Energy Management and at the Wellington Shire Access and Inclusion Advisory Group (as a standard agenda item). Auditors report the number of crosses (ie unsatisfactory) and the reason for them.

The Aqua Energy Manager is very committed. She takes “crosses” seriously and fixes the issues quickly. Sometimes Auditors can include what has been done to rectify the issue in their regular reports.

When the new Auditor started, the Regional Communication Service provided a communication access refresher (in power point), which was emailed to all staff. The Regional Communication Service also provides face to face training on staff request.

Aqua Energy management recognises the value of the Auditors’ work to its business. It now remunerates the Auditors through free membership, worth about $800 per year.

Into the Future

Aqua Energy has sets a high standard for communication access in Sale. Its commitment to community partnerships and to receiving and addressing feedback, means that it remains a business where everyone can communicate.

Communicating Choice in NDIS: Building NDIS Staff Skills – East Hume Regional Communication Service

East Hume Regional Communication Service facilitated a very successful Talking Mats training day in Wodonga this week.  Karyn Muscat from Zyteq presented to an enthusiastic fourteen participants from across the Wodonga and Wangaratta regions.

They included Local Area Coordinators, support coordinators from disability and mental health agencies, as well as speech pathologists and disability support workers.  A number of those attending also had family members with communication disabilities and were interested in gaining new skills to support their communication.

The session also provided networking opportunities. There were some very interesting conversations about the current disability services landscape.  The session also highlighted the role of the Regional Communication Service in advocating for people with communication disabilities and their support networks and the practical services we can provide.

Here’s some of the feedback on the day:

“I came to the training with a specific resident in mind, but I got so much more.  I can see this being beneficial for all of our guys”

“This will help me better support the vulnerable people who use our service with their decision making”

We were thrilled to be able to provide such a useful resource to a wide range of services and feel that it is a positive addition to the skills of disability services in our region.

 

Meredith and Kelsey

 

 

Working Together to Build Communication Access – Southern Mallee Regional Communication Service

Everyone was ready around the table when Meg arrived just before 10.30. We waited for the others to leave and shut the door. We moved so we could see each other.
We talked about Communication.
We looked at a picture of two women talking – Communication is about understanding and getting your message across.
We talked about the different ways of communicating – We found 5 ways:
• Talking
• Signing (“Sign of the week” was “boat” so we used that.)
• Drawing
• Writing
• Choosing and pressing a button on the Tech Talk (a speech generating device)
We all had a go doing each one.

 

We know that not everyone speaks, but everyone communicates – and everyone has the right to communicate.
Meg left pictures and a folder for each of us. She left more information and the Tech Talker so Kharlie can practise with us until Meg comes again.

So ends a typical meeting of the Communication Access Group at Distinctive Options with the Southern Loddon Mallee Regional Communication Service.

What is the Communication Access Group?

The Communication Access Group is a group of four young women in Bendigo.
The group started meeting in January, 2018. They are supported by Kharlie, a Communication Coordinator, trained by the Southern Loddon Mallee Regional Communication Service [see the 21.6.18 blog]. Kharlie works at Community Connect, Distinctive Options. Meg is the Southern Loddon Mallee Regional Communication Service speech pathologist who comes to the group each month.

How did the Communication Access Group happen?

Last year Distinctive Options partnered with the Regional Communication Service to join the local Communication Coordinators Network.
A Distinctive Options disability support worker was trained by Southern Loddon Mallee Regional Communication Service to be a Communication Coordinator. Communication Coordinators have advanced communication support skills.
The partnership between the Regional Communication Service and Distinctive Options enabled more collaboration to start a communication access group.
The Regional Communication Service developed accessible consent forms for participants and parents to sign.

 

The manager at Bendigo Distinctive Options sent forms to 7 people and their families.
Four people agreed to participate. Two of them also consented to being photographed.
At the end of 2017, Distinctive Options asked the Regional Communication Service to train all staff. The training was in January. It focussed on effective communication support so everyone can participate.
Then the Communication Coordinator went on maternity leave! Luckily, there was time for a new Communication Coordinator to train. The Regional Communication Service held another Communication Coordinator course at the start of 2018.
Staff rosters at both the Regional Communication Service and Distinctive Options meant that meetings had to be monthly. (Fortnightly would have been better.) The Communication Coordinator is there every week. She supports the group to review everything when the Regional Communication Service does not come.

What has happened so far?

January: We all met each other. The Regional Communication Service speech pathologist saw how well some people watched and listened, that some could read words, that one could sign very well, that most could understand speech most of the time, that some already knew about their right to do what everyone else can do. Everyone was keen to interact. Speech was not everyone’s most effective way to communicate, but that did not stop everyone communicating!

February: We talked about communication. (The February meeting was described at the start.)

March: We tried AAC (Augmentative and Alternative Communication) – low and high tech. We looked at the wheelchair access symbol and found out what it meant.
Later, everyone looked out for the symbol.

April: We found out what “access” means and looked at the Communication Access symbol.

 

May: We found that the Communication Access symbol and the wheelchair access symbol look different and show different kinds of access.
We looked at personal communication cards

 

June – Something extra:

The Regional Communication Service speech pathologist saw the Group was ready to use a communication board so they could prepare to have impact in the community. She looked at the research and consulted other speech pathologists at the Communication and Inclusion Resource Centre and chose the best items for the board. She made the boards using the [email protected]+ on the iPad.

Everyone needed to learn how to use the communication board, through modelling and practice.

The communication access meetings continued. But more meetings started (at a different time) so everyone could to learn to use the board. This time, the Regional Communication Service allied health assistant will come. For the first meeting, the Regional Communication Service speech pathologist and another Distinctive Options disability support worker came as well.

Eventually the communication board will have 40 pictures. Everyone got their own copy with 8 pictures to start with. The Regional Communication Service also gave the two Distinctive Options workers other resources, including a chart of the Key Word Signs (for words that will be on the communication board) and a training package about how to model AAC.

 

 

What next?

Group members are learning about communication access and rights together. The  Communication Coordinator supports everyone to communicate in effective ways and in different places in the community. Everyone’s confidence and communication skills have grown. The group will work together for communication access in the community in the second half of 2018.

Southern Loddon Mallee Regional Communication Service Communication Coordinator Network

The Communication Coordinator Network – New growth and deep roots in the Loddon Region

Grey Box tree of the Loddon region

Grey Box tree of the Loddon region © Meg Irwin

Southern Loddon Mallee Regional Communication Service started the first Communication Coordinator Network. It has trained and supported Communication Coordinators for more than 10 years.

Communication Coordinators are disability support workers from day and accommodation services. They are skilled to give great communication support to people with communication disabilities and to improve environments, so that everyone can communicate.

The Communication Coordinator Network uses a capacity building approach. It has impacted on thousands of staff in disability-funded services. It has improved communication support and opportunities for hundreds of people with communication disabilities in the Loddon region.

How do Disability Support Workers become Communication Coordinators?

Southern Loddon Mallee Regional Communication Service forms partnerships with local disability-funded service providers.

Managers of services give their Communication Coordinator time to carry out Communication Coordinator tasks, and provide resources (such as a colour printer and communication apps). They agree to support communication access for all the people using their service – within and beyond their walls.

Each year, Southern Loddon Mallee Regional Communication Service offers training for 24 new Communication Coordinators. They may be from 24 different residential and day services across the region. Trainees attend a 6 day training course over two months. Twelve workers are accepted into each group.

They learn about communication basics, Augmentative and Alternative Communication (AAC), and how to observe communication and plan effective communication support.

They learn how to support people with sensory processing disorders or behaviours of concern.

They learn about the Regional Communication Coordinator Network and its powerful person-centred approach.

They practice communication skills, identify appropriate communication aids for people they support, produce aids, explore staff support strategies, and start improving communication access and support in their services.

At the conclusion of the course, new Communication Coordinators receive badges and certificates listing their new knowledge and skills.

Alice works in a respite accommodation facility. Three months after finishing her training, she reflected on her role as a Communication Coordinator and the difference it makes:

  • Staff support participation regardless of speech ability

“Now everyone is involved in activities, even when they’re not verbal  –  e.g. playing Uno, staff play with them and explain how the game works and what’s going on – they also give them choices in what card they want to put down.”

  • She has confidence and skills to try out communication supports

“I went through one communication app in our iPod, I created a YES and NO option and I tried it with one of our people who is not verbal.  I asked her “do you want more dinner?” and she touched NO. I gave her a follow up question; “Are you full?” and she touched YES. It’s still a grey area for me until I see her communication plan and we need to spend more time with her using that app, so we know if that app really works with her.”

  • She supports staff to implement communication strategies

“The last couple of weeks we have a new person staying at the house. I spent more time with her to get to know her and I think it went really well. And she has a personal communication dictionary in her support plan, so I printed it out with bright colour paper and laminated and showed it to the staff in the meeting.”

  • She takes the initiative to seek person-centred collaboration with other services

“Now I’m contacting communication coordinators in day programs, so they can share with us our peoples’ communication plans.”

After training, what else?

 The Regional Communication Service supports all Communication Coordinators (new or experienced), including:

  • Quarterly full day training and collaboration meetings
  • Phone and email support
  • Site visits
  • Whole service or other training or consultations

Staff at quarterly meeting

Christine Lambie has worked in a Castlemaine day service for many years. She trained in the early years of the Network and is still a Communication Coordinator.

She says:

“The Communication Coordinator Network has made a significant difference to the way we support participants at Windarring.”

Here’s why:

  • All the staff at the Service get to learn about communication support

“With Regional Communication Service-trained Communication Coordinators at three of our sites, all support staff have been made aware of the benefits of communication (including sensory) support for people with complex needs. “

  • Many communication aids and strategies are provided

“Communication support we provide includes documents presented in Easy English format, Key Word Sign training, development of Choice & Request cards, sensory support plans, personal communication dictionaries, behaviour support strategies, communication evaluation using the Checklist of Communication Competencies,  ‘Book About Me’, ‘Talking Mat’ and  ‘Chat Book’ tools, introduction and instruction on electronic aids, and specialized training sessions.” *

  • People with disabilities benefit

“Countless participants have grown in confidence, independence and social and emotional wellbeing as a result of this support.”

  • Communication Coordinators learn and get support through the Communication Coordinator Network

“Networking with Communication Coordinators from other services provides unexpected ideas, solutions and support.”

Deep roots: New growth

Over the years, Southern Loddon Mallee Regional Communication Service has trained and supported approximately 250 communication coordinators.

At any one time, there are about 60 Communication Coordinators in the Network.

Not everyone who trained is still in the role. Many have moved into management, NDIS-related roles, or other positions in the disability field. Some have left the area. About 100 people trained as communication coordinators are active in the region in various roles.

This means trained Communication Coordinators (past and present) influence and build capacity in thousands of people in the region every year – people with disabilities and workers.

The Regional Communication Service has provided the necessary long term commitment to the Communication Coordinator Network. It has also provided expertise in communication and capacity building partnerships.

The Communication Coordinator Network provides an integrated and powerful collaboration so that everyone in Loddon region can communicate.

NDIS is bringing many new services into the region and is changing the context and nature of disability support work. There is lots more to do!

*Want to know more about some of the communication strategies Chris mentions? Enter them into the “search” box here: www.scopeaust.org.au

 

 

Communication Training for Local Area Coordinators – East Hume Regional Communication Service

Latrobe Community Health is working with local communities to ensure it is welcoming and inclusive for people with disabilities.

It partnered with the East Hume Regional Communication Service to improve its communication access.

Latrobe Community Health is the Region’s NDIS Local Area Coordinator organisation.

Local Area Coordinators are responsible for linking individuals to the National Disability Insurance Scheme and providing information and support in the community.

East Hume Regional Communication Service delivered training in two sessions at Wodonga and Wangaratta. Twenty seven Local Area Coordinators from across three sites (Benalla, Wangaratta and Wodonga) attended.Group of people attending onsite training

The training sessions increased awareness of the impact of a communication disability on an individual’s ability to be involved in decision making about their life, and how communication partners can provide meaningful support.

Wodonga team attending via video link up

Attendees participated enthusiastically in the communication training activities and enjoyed the sessions. Comments included:  “Extremely relevant to what we do.”; “Great information, engaging presentation.”; “I have done this type of training a number of times but never tire of the content and always learn something”; “Very positive and caring …presenter”

As a result of the success of this training, EHRCS has also been able to provide training for Murray Primary Health Network, and Partners in Recovery (who provide support for people with severe mental health issues).

East Hume Regional Communication Service is continuing to build the partnerships with providers of NDIS services in the North East region.

More choice and control at dinner time

How do people make a choice when they can only accept or reject what’s offered? That’s the problem some people living in residential facilities with little or no speech can face.

It may help if staff ask questions, such as “Would you like sausages? or “Would you like chicken?” But that’s only two choices. And the person has to know what the words mean and have a way to indicate yes or no. That’s hard for some people.

It can be easier if there are pictures to choose from.

It can be even easier – and more empowering – if the pictures are used with Talking Mats ®

Many options can be explored and a person can have a record of all the preferences they’ve identified. (That’s why Talking Mats is also a great planning tool!)

Dietitians at Bendigo Health wanted a way for people with communication disabilities living in the community to have more food choices, including the healthy ones! They wanted people with communication disabilities to have their choices heard by the people supporting them at home.

In partnership with the Southern Loddon Mallee Regional Communication Service, the dietitians developed a set of Talking Mats with photos of many different food options.

The Bendigo Health Food Preferences Talking Mats kit:

Food preferences Talking mats pack

In Talking Mats, each card shows a picture of a different item.  A person places their preferred items on the left and non-preferred items on the right. Items without a strong preference go in between.

There are 9 sets of cards in the Bendigo Health kit. They are: snacks, vegetables, cereals, takeaway, drinks, meat & alternative, fruit, dairy and exercise.

Here’s how one person completed her Talking Mat about her meat/alternatives preferences:

Example of a talking mat showing meat and meat alternatives

Some of these may be foods she had not thought of – or ones she had not been able to ask for.

Having her own photos of her mats mean she can communicate her food choices and have more variety in what she eats.

[We used the header cards (which were user tested) with permission from Talking Mats https://www.talkingmats.com/ It is well worth a visit for resources and more information about Talking Mats.

 

 

Communication Champions: Changing the Culture of Day Services

Steph Bryce from North West Regional Communication Service interviews Hannah Chalker, Communication Coordinator at Distinctive Options

Photograph of Hannah Chalker, Communication Coordinator at Distinctive Options

Hannah Chalker

How did you get started as a disability support worker?
I’ve known since I was a young child that I wanted to support people with disabilities. As a teenager, I did lots of volunteering, including with Riding Develops Abilities. When I was 18, I completed a Cert IV in Disability. I’d planned to work with kids, but my parents encouraged me to submit my resume to Distinctive Options, and here I am six and a half years later!

How did you end up in the Communication Coordinator role?
The opportunity came up for me to become the Communication Coordinator and it sounded like something I would enjoy. I had studied Auslan, so I have a keen interest in using sign. I have been the role for almost a year. 

What is a Communication Coordinator?
A communication coordinator is a designated person within a disability service provider who is given specific time away from the clients to develop communication aids and strategies for the service (and individuals), to give staff guidance on using AAC and to keep up to date with the latest technology and strategies.

Sometimes I go into programs and model using communication aids with our participants, with both low tech and high tech aids, such as Proloquo2go. I also send out emails with useful resources and information.

I hear that you have an exciting project at the moment!
At the start of the last term, we came up with the idea of having a team of dedicated people who we call ‘Communication Champions’. They are staff members who want to develop their communication skills, really make an effort to use AAC within their programs and model to other staff. We thought it would be good to have different people spread out around the service who feel confident in their AAC skills. There are eleven people in the Champions team.Communication Champions Flyer

What inspired you to do this?
One of my managers felt that we could make communication a higher priority within our service and really wanted to push staff to use AAC more often. That’s where the seed was planted.

What was the aim?
We want communication to become something that we do every day as part of our routine, not something extra. Obviously, it will still take effort to use alternative methods of communication but that’s what our participants need and what we should be providing.

How does the ‘Communication Champions’ project work?
At the moment we have a meeting once a term. Sometimes I’ll send out emails that have more detailed information than I would send to other staff. I try to provide support, asking the champions how they are going with AAC or what they feel like they need more support in. We are just in the beginning stages, so we are still building on the skills of the Communication Champions.

Have you had any good outcomes so far?
One of the Champions came to me the other day telling me about how she used a photo for successful communication. She was trying to get one of our participants to come inside and was using different signs such as ‘stand up’, ‘go’ and ‘bus’ and this wasn’t working. Then she brought out a photo of him at the place they were going to. He responded straight away, stood up and went inside.

The Champions are thinking more about different strategies that can be used and trying other methods of communicating. It’s great to see the different interests within the team emerging. One Champion is passionate about Key Word Sign– she’ll come to me and show me what sign she learnt today. Another Champion who has been there for over 20 years commented that just being a part of this team has inspired her to think differently about communication.

What are your aspirations for this?
I hope in the future that the culture of Distinctive Options will have a bigger focus on communication and that this will be built into everyday routines. I’m going with the flow for now. It would be great if the Champions had more admin time for training and more regular meetings but that is not always possible and this is one of the challenges. But I’m looking forward to seeing this area of our service flourish!

Any final thoughts?
I’m so grateful to be part of the Communication Coordinator Network trained and convened by the North West Regional communication Service. It is great to have that support and to know that Libby and Steph (the two Regional Communication Service speech pathologists) are just a phone call away. Every time I come to a Network meeting, I pick up new pieces of information and ideas and that’s something I really appreciate!