Real life; real low tech

Julie Atkinson (Access to Communication & Technology) Helen Paterson (COMPASS)

Summary • Symbol & Text resources • Practical ideas • Interspersed with case studies / videos – Children – Adults with acquired conditions

Access to Communication & Technology • Regional NHS Tertiary Assistive Technology Service – AAC, EC, computer access – Children and adults • Mission 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 people • Website: http://nww.bhamcommunity.nhs.uk/departments-and services/rehabilitation-services/services/act • Email: [email protected]

• Phone number: 0121 466 3050 • Referral helpline 0121 472 0754

Royal Hospital for Neuro-disability COMPASS • Based in London, serving all of UK.

• Rehabilitation & longer term care • 230 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 Mobility Communication Aids Environmental Control Powered Mobility Switches & Mounting Computer Access

COMPASS • http://www.rhn.org.uk/our-work/our services/electronic-assistive-technology/ • [email protected]

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/inde x.htm

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

Foreign Language Charts Eastern Health cue cards http://www.easternhealth.org.au/gp/service,serviceid,35836.aspx

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

Matrix Maker

Symbol Resources • Eye Encoding • Partner Assisted Scanning • ACT symbol resources • Talking Mats • Books

Eye pointing / colour encoding to decorate cakes

Perspex boards for eye pointing

ACT symbol resources • Doll play – Aided Language Display • Bath – with symbols • “Where’s Daddy” book – symbols to tell story Practicalities: • Consider displaying on classroom whiteboard • Use a tabard / old woolly pully – free hands • Tupperware for wet environments

Low Tech Ideas • Aided Language Displays / Stimulation

Daniel using Partner Assisted Scanning on an Aided Language Display • Used 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-SET • ACT 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 resources • Birmingham Children’s Hospital book • Life Book / Communication Passports • Look 2 Talk • PODD-type • Communication placemat

Angelo video • Spinal Muscular Atrophy • In hospital • Using his symbol book to talk about what he wants for Christmas

A book for Billy • Receptive use of symbol communication book for adult post-brain injury with acquired central hearing impairment – For behavioural management – 2 way communication

Chart based on Talking Mats

Chart based on Talking Mats

Text-based resources • Direct access • Indirect access – Eyes – Partner Assisted Scanning

Direct access: Video-Brenda using direct access

Help with direct access: prodders

Charts with guards & FAB

E-tran frame

SpeakBook http://www.speakbook.org

SpeakBook

SpeakBook

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

PAS chart

Row A Row E Row I Row O Row U Row No.s

A E I O U

0

B C D F G H J K L M N P Q R S T V W X Y Z

1 2 3 4 5 6 7 8 9 10

SPACE MISTAKE

Partner Assisted Scanning

How 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 you • • Hold the chart where the person report they can see it • • Point

down

to the beginning of each row

(row A, row E, etc)

, until they indicate the row containing the letter they want • • Once 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 1 “The 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.” A lec in Fried-Oken et al 1991

Practicalities 2 “ One of the problems… was that people wouldn’t know how to hold the board high enough up for me. I’m laying on my back and they’re standing up…They need to hold it at their head level so I can see what’s going on… people wouldn’t 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 clips • http://www.youtube.com/watch?v=pLb6 Oi3uR0 (memorised Partner Assisted scanning of AEIOU) • http://www.youtube.com/watch?v=3jynuu7sm BM (low tech temporary vocab, laser pointer)

Mirror for sideways Partner Assisted Scanning

My first communication board after 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 methods • Experimental Study by Roman, Quach, Coggiola and Moore • Compared EyeLink, Etran and Partner Assisted Scanning • Survey 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 continued • 15 individuals with MND and their partners • Taught all three methods

Results • EyeLink- 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 techniques • http://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

References •

Bulpitt 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)

the Special Issue on Augmentative and Alternative Communication and Acquired Disorders” “Been There, Done That: A Very Personal Introduction to

Augmentative and Alternative Communication

17 138-140 • Personalised placemats: [email protected]