Tag Archives: key word sign

Working together to Build Communication Access – There’s a communication aid for that!

The Communication Access Group in Bendigo was initiated by Southern Loddon Mallee Regional Communication Service (see our July, September & October blogs) in partnership with Distinctive Options, a day and lifestyle service. But the Group couldn’t have happened without Kharlie, Communication Coordinator and Disability Support Worker!

Kharlie worked closely with the young women in the Group, getting to know them well and supporting them to use communication aids and strategies and to learn about communication access in the community. Kharlie stayed in touch with the Southern Loddon Mallee Regional Communication Service and went to Communication Coordinator Network meetings. Distinctive Options provided time every fortnight for Kharlie to develop communication  aids and resources. The Communication Access Group, and others supported by Distinctive Options, got the benefits.

Here are just some of the things Kharlie developed:

  • Picture based (individual) choice boards
  • Picture and object based shopping lists
  • Picture based what to bring lists to prepare for outings
  • Picture based instructions such as safety in the kitchen
  • Picture based routines such as arrival or washing the dishes
  • Community request cards (shared and individual)
  • Who here photos of everyone (both participants and staff)
  • Picture based activity planner so everyone can plan the details of what will happen and have an accessible way to remember it
  • Picture based story guides for individuals such as a road safety book for one participant

And she’s inspired others:

Now staff include pictures in notices to go home. That means participants have more access to information that concerns them.

Now one member of the Communication Access Group gets resources organised to ensure that staff and participants keep developing more communication strategies.

Over the year, Kharlie’s understanding of communication strategies and contribution to communication access has grown. She will be able to support Distinctive Options to be an even more inclusive and innovative service for participants with little or no speech into the future.

Key Word Sign in Wangaratta

East Hume was treated to an outstanding basic Key Word Sign workshop at the Wangaratta Library in October. Marlene Eksteen, a qualified Key Word Sign Presenter, facilitated the workshop, and 16 people with a broad range of backgrounds, including support workers, day care teachers and parents, attended to further their knowledge of Key Word Sign.

The day incorporated lots of fun and practical activities where everyone was encouraged to practice and refine their signing skills!

‘Would you like a chocolate or a lolly?’ Participants received a yummy reward when they made their request with Key Word Sign!

During the morning we learnt about AAC (Alternative and Augmentative Communication) and its importance for people who have difficulty communicating. Participants were excited to learn how they could use Key Word Sign as a form of AAC.

We learnt about the different stages of communication and how Key Word Sign  can help at every level.

After lunch we attempted to bring on some Christmas cheer in October by learning how to sign ‘We Wish You A Merry Christmas’, which ended in lots of laughs!

We learnt how to finger spell the alphabet, and of course to introduce ourselves by spelling our names.

Participants were also given the opportunity to make their own scripts, which they could take home and practice with their loved ones/clients or other people they support. We also shared these with the group and learnt lots of new signs as we went.

Feedback from the day was resoundingly positive; with everyone saying that they loved the day and found it very relevant, practical and informative.

And we heard some comments that showed just how valuable Marlene’s session was:

“I feel much more confident to use Key Word Sign now – I always thought we could only use it with people who are deaf”

“I work in a disability home, and the staff who use Key Word Sign with the clients often seem to have a better rapport than staff who don’t”

We are looking forward to holding further Key Word Sign workshops in the East Hume region in the near future.

Kelsey and Meredith, East Hume Regional Communication Service

 

 

 

 

 

 

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.

Supporting the Supporters: Helping Martin enjoy the pool

Martin pictured with his social story book he uses when he goes swimming

A simple picture-based story has made Martin’s trips to the leisure centre a more pleasurable experience for him and those around him

The Regional Communication Service (RCS) supports people who live with communication difficulties and the people who support them.

To provide this support, the RCS uses an innovative capacity building model of service provision. This is different from traditional service provision, such as the medical model. In the medical model, the speech pathologist is the expert who assesses, provides therapy and resources. In the Regional Communication Service, the Speech Pathologist builds the capacity of staff and/or other significant people with a person’s life to ensure sustainable change.

A recent example of working in this way was a request I received from a staff member at Noweyung, an adult training and support service in Bairnsdale. We share an on-going professional relationship where we collaborate to provide communication strategies for people with disabilities who attend Noweyung. As a speech pathologist, I provide advice and feedback on communication strategies that staff suggest, thus building the capacity of the staff in the process.

The staff member described the scenario of Martin, an enthusiastic and outgoing man with a disability. He communicates using key word sign, some words (although often difficult for those who don’t know him to understand) and pictures. Martin loves swimming at his local leisure centre. He attends a swimming program with staff there to support him.

In attending the local leisure centre, there are many social rules that people observe – this includes an understanding of change room etiquette, when it is OK to get in and out of the water and where it is OK to swim, exercise or just play around. Staff supporting Martin understood that using speech alone could not communicate the many rules and expectations at the pool. So, it was decided to develop a picture-based story that looked at important information for Martin be able to understand the rules of pool behaviour. The picture-based story, also known as a social story, incorporated photos of Martin and simple written information about what to do and what not to do at the leisure centre.

The staff member took photos and drafted the story with the help of the speech pathologist from the Regional Communication Service. The book was then read to Martin who was able to recognise the photos and understand what it meant. He particularly enjoyed the section on when it was okay to jump in and to splash.

This book changed Martin’s swimming program completely. It increased his understanding of the behaviour that was expected. Staff noticed that Martin seemed more confident swimming at the pool and it also reduced many of the tensions that arose from misunderstandings that had previously occurred.

With the support and supervision of a RCS speech pathologist, the staff member was able to produce a simple picture-based story that made Martin’s trips to the leisure centre a more pleasurable experience for him and those around him. The added bonus now, being a staff member who has learned how to develop and implement a useful communication strategy.

By Mel Newcomen
Speech Pathologist
Gippsland Regional Communication Service

 

 

Value our volunteers: equipping them with the tools to engage people in local communities

As a student Speech Pathologist one of the many aspects of my placement with the eastern regional communication access network was to present at training workshops for community volunteers. The first training session was for community volunteers in the south-eastern region and the second training session was for community visitors who visit people with disabilities in residential housing and advocate for their needs if they can’t speak up for themselves.

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Key Word Sign training

The first training session involved volunteers from varying cultures and backgrounds. Some volunteers were working with people with disabilities on a regular basis and wanting to learn more strategies to improve effective communication. The others in the training worked with a range of people from those with mental health issues to people who were socially isolated. The content of the training included practical strategies for improved communication with people with communication difficulties, an explanation and discussion of Augmentative and Alternative Communication (AAC) and an introduction to the communication access symbol and what it represents.

Many people were also very interested in key word sign and what it is and learnt some helpful signs too! The volunteers were shown different AAC devices including low tech, paper based devices as well as some electronic AAC devices. There was a lot of interest surrounding the different devices and what were the possibilities with someone using these devices.

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Listening to Those Rarely Heard is a training package designed to guide supporters of people with severe to profound disability through the supported decision-making process.

The second training was for community advocates who were eager and enthusiastic to be given the training opportunity and therefore keen to learn new information. All of the advocates visit people with disabilities in their homes regularly. Many are individuals with severe intellectual disabilities where determining their preferences and concerns is very difficult. The presentation included an overview of communication, an introduction to supported decision making (Watson, 2013) and introduction to the concept of “Talking Mats” (Joan Murphy) as a potential tool for people who would benefit from structured conversation.

This group had indicated they would like to use a tool to gauge an individual’s situation and concerns so they could be better at advocating for the person. They were interested in how structured conversation may be a way of discussing meaningful topics that may require advocacy (e.g. living  arrangements, diet, activities).

These volunteers had an impressive understanding of how their client’s communicate and explained how they were able to differentiate between subtle differences in vocalisations, facial expressions or body language. The training was very well received and they were keen on doing further training particularly in applying Talking Mats to specific clients who may be able to use it and benefit from more detailed discussion around how they wanted their life to be.

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Talking Mats in action

All the volunteers responded with positive feedback and were very happy to have upskilled their abilities. It was very encouraging to know that there are very competent people willing to volunteer their time and who are eager and willing to be a part of change for individuals and their communities.

By Bethany Simons                               Supervised by Bron Jones
Student Speech Pathologist                Eastern Regional Communication Access Network

Watson, J. (2013). Listening to those rarely heard: Supported decision making in this brave new world of individualised services. Paper presented at the 11th Biennial AGOSCI conference, Sydney, Australia.

Training for Communication Coordinators and Facilitators in Southern Loddon Mallee

Support workers from Disability Services in Kyneton, Castlemaine, Echuca, Woodend, Gisborne, Rochester, Bendigo and Maryborough attended six days’ training with the Southern Loddon Mallee Regional Communication Service in February-April 2016.

The training helps build the capacity of disability services across Southern Loddon Mallee to provide sustainable and effective communication support for adults with communication difficulties.

Participants learnt how to develop and champion communication support within their services, between services and in the community for active inclusion of people without speech.

Topics included:

  • Communication support needs – the individual and the environment
  • Communication aids and strategies
  • Key Word Sign
  • Sensory processing disorders
  • Communication for life participation (including for positive behaviour support)

The Sensory Processing Disorders day was at a local conference centre and the entire regional communication coordinators and facilitator network was invited. Mandy Williams from CIRC was our very knowledgeable presenter. We were also grateful to Bendigo Health, the Regional Communication Service’s auspice body, for funding the venue and lunch.

Mandy Training for CC

Mandy Williams from Scope’s Communication and Inclusion resource centre presenting at the Sensory Processing Disorder day

Evaluations at the end of each training day were extremely positive. Participants also completed a survey several months after the course concluded. They reported that the course gave them more knowledge and confidence to use communication tools and to promote a positive communication environment in their services.

One new Communication Coordinator said:

“Staff engagement has been an issue at my service for a number of years, one reason for this I feel has been that we have not had “one” person heading this area. Since completing the training, and also having the Regional Communication Service Speech Pathologist hold a training session with all our staff, this area has improved somewhat. There are now staff members who are wanting to try different ideas and who are willing to listen to advice.”…

Due to the large number of clients we have and the limited time available for communication. I have been working on things that may benefit a number of clients. So far we created a daily timetable for clients which shows pictures of which staff they have in their program and the program picture matches the picture on their timetables at home. … We have also created a couple of choice boards, we are using these so clients can pick what it is they would like at the i.e. café before leaving then we are using the same picture in smaller size as a request card.”

The six day course is offered twice annually by SLMRCS.

By Meg Irwin

Speech Pathologist – Southern Loddon Mallee Regional Communication Service

 

She understands everything I say…

How many times have we heard this said about people with severe disabilities? As a speech pathologist I often think about how I know if someone understands what I am saying to them and what I need to do if I think they do not.

Why does it matter?

Everyone deserves to be understood and their wishes respected regardless of their ability level. But, how do we really respect someone’s wishes if we do not understand their communication skills and limitations. It is important to remember that not everyone understands speech. I know this can be hard to accept – particularly when the person you are talking to is an adult. But, the reality is, some people with severe disabilities find that understanding speech alone is just too hard. That does not mean we stop talking to people but it does mean being aware of how many other cues we might be using that allows someone to get the gist of what we are saying to them.

car keys

Holding up car keys as a signal to go home is an example of how messages can be understood without the need for speech.

Apparently only 35% of our speech is understood through words alone. Gestures, facial expression, body language, use of pictures and objects actually make up the rest. We know this from our own life experience. How many of us have been to a noisy bar and a friend has motioned a drink gesture and we have nodded in agreement. Or, held up the keys to the car and got the attention of our partner across a crowded room as a signal to go home. The message has been understood without the need for speech.

I have often been in situations where I have questioned whether the person with a severe communication disability has actually understood what has been said to them. A recent example was when I watched an interaction at the end of a meal. The support worker asked the person to take their plate to the sink. They pointed to the plate and then to the sink. Then they beckoned to the person and touched the back of the chair and asked the person if they would like tea, coffee or milo. This time, they got out the teabags, the jar of coffee and the tin of milo. Then, they signed the word spoon and got a spoon out of the drawer and pointed to the fridge and said “Can you get the milk?” Afterwards, the support worker said “See, she understands everything I say.”
I did not think the person understood everything that was said. But, what I saw was a successful interaction based on the use of speech and other cues.


There were a number of cues that helped that situation:

1)         Routine – at the end of a meal we generally take our dirty dishes to the sink

2)         “Do what you usually do in a situation” e.g. sit on the chair that is indicated

3)         Use objects that relate to the activity

4)        Use natural gesture or sign (where the sign visually relates to the concept or object talked about)

5)         Accompany use of objects and gesture with speech. People respond to tone of voice even if they do not understand speech alone

6)         (Do what others do in the same situation – even if you are not sure, following the crowd works more often than not).

I did not see the last cue but I was told that this person will often get their bag and go to the door when they see their peers head off in that direction.

A number of informal and one formal strategy i.e. the use of the Auslan sign “spoon” were used in that brief exchange. And more could have been done in that situation but it would have meant more planning and effort by the more able communication partner.

The options available to help understanding involve either unaided e.g. use of sign and gesture or aided e.g. use of pictures or photos strategies.

Using Key Word Sign (unaided communication) – Using simple sign and gesture with people who have difficulty understanding helps them understand the spoken word by relying on the visual cue of the sign. Teaching and learning simple signs has now been made much easier with the release of the Key Word Sign Australia App. This has access to over 600 line drawings and can be used to create individualised communication resources. It is also possible to attend Key Word Sign workshops to learn basic signing skills. Visit the Key Word Sign Victoria website for details. http://keywordsignvictoria.org/

Using objects and communication aids (aided communication) – If remembering manual signs is difficult, you could use pictures or objects. Scope’s Non-electronic Communication Aid Service develops communication aids, completely individualised to your needs.  (NECAS -http://www.scopevic.org.au/service/necas/) or get the Tools2Talk+ App (http://www.scopevic.org.au/shop/tools2talk-app/ ) and do it yourself.

The person may not understand everything you say but there are many things you can do to make comprehension easier.

By Karen Bloomberg & Hilary Johnson