Wednesday, 25 February 2009

Widening the support for AAC

I had a great time at the AAC SIG yesterday. Being the only OT there it was interesting to reflect on what OTs can bring to the AAC table, especially as I plan for the roundtable I am co-chairing at the BAOT conference.

Much of the discussion was about how difficult it is for people who use AAC when they transition from education and the disparity between support in education and "black hole" of services and funding when they leave.

We also talked about the use of the Internet for people who use AAC including the importance of social networking and web based video conferencing media such as Skype.

My recent background is in social care and this led me to think more about how AAC and social care could fit together. It seems to me that AAC has traditionally been though of as sitting in health and education but in actual fact communication is pretty fundamental to securing and maintaining a productive place in society. I know some other AAC services are part funded by local authorities but this isn't common practice. There are some parts of the Chronically Sick and Disabled Persons Act (1970)

(b) the provision for that person of, or assistance to that person in obtaining, wireless, television, library or similar recreational facilities;

(c) the provision for that person of lectures, games, outings or other recreational facilities outside his home or assistance to that person in taking advantage of educational facilities available to him;

which might provide a good avenue to start discussions with local authorities. In the same way that health would provide a wheelchair and then social care would facilitate its use in the home and community so you could argue for support with communication?

Direct payments and individual budgets are aimed to empower people with disabilities to make their own choices about what and how to fund the things they need to support them. This could also open up interesting opportunities to source support for people who use AAC.

I might have good patient to see if we can develop a case for communication support through social care so I will keep you posted.

Taking AAC beyond words and phrases to truly functional communicative interaction is something that really fascinates me!

Tuesday, 17 February 2009

Talking to people with complex communication needs

Last Friday was a great day for me. I was exhausted, fed up and not looking forward to a long drive to see a patient for what looked like a really complex assessment.

When I got to the appointment I met a young woman with Cerebral Palsy who has very complex communication needs. She used a low tech coded eye pointing AAC system with her personal assistant to communicate with me during the appointment. I wont bore you with the details but we chatted away and, in collaboration with the equipment rep, came to a decision about how to move forwards.

At the end of the assessment the pateint thanked me for holding the conversation directly with her and not with the PA. She explained how degraded and angry she felt when interacting (or not) with other people and in particular health professionals.

I later had a converstaion with another patient, her communication aid had broken down. As you would expect, her communication difficulties meant conveying this problem to the people who needed to know to fix it was a real challenge. The really sad part was that her sister had recently died and throughout the last days of her sisters life she had experienced a constant battle with health care staff trying to contact her to update her on her sisters condition but being thrown completey by her significantly dysarthric speech. The callers had had differing responses ranging from shouting on the phone, asking if they could call her carer and even hanging up.

She asked me how our service educated other health professionals about how to talk with people with communication difficulties. The challenge is that as a regional service we dont have that day to day contact with local teams to be able to convey this information as we might like. This continues to be source of frustartion for me so I urge anyoen reading this to take the time to take a look at the excellent leaflet from Communication Matters to get more information. The feel good factor was that, despite her speech disorder we were able to chat, to get to the bottom of the problem she called about and I was motivated to publish this post.

Sunday, 8 February 2009

An Occupational Therapy Carnival - call for submissions

So rather than just post about it I've decided we should do it! So I'm announcing the inaugural edition of the Occupational Therapy Carnival which will be published on the 9th March.

For those of you who don't know:
A blog carnival is a type of blog event. It is similar to a magazine, in that it is dedicated to a particular topic, and is published on a regular schedule, often weekly or monthly.[1] Each edition of a blog carnival is in the form of a blog article that contains permalinks to other blog articles on the particular topic.
But why have one? As more and more OT bloggers appear using a carnival offers an opportunity to harness our collective enthusiam and knowledge in one place. For people who dont use the internet so much it can be a great digest of recent OT blog activity and gives a way to connect. Blog Carnival explains:
There is so much stuff in the blog-o-sphere, just finding interesting stuff is hard. If there is a carnival for a topic you are interested in, following that carnival is a great way to learn what bloggers are saying about that topic. If you are blogging on that topic, the carnival is the place to share your work with like-minded bloggers.
For this first edition I welcome any submissions on any topic to get us going. I would also like people to nominate themselves to host subsequent editions, and suggest topics to focus on.

Please help make this a success by contributing and publicizing the carnival. I really look forward to your thoughts.

Use the blog carnival widget on the right hand pane to submit an article and refer to the blog carnival FAQs for more information. If you need any help or information just leave me a comment or get in touch via Twitter.

Friday, 6 February 2009

Is there anybody out there? Talking into the wind

Blogging is great but I sometimes wonder - is anyone actually reading this stuff or finding it interesting? I know trying to get people to comment on your blog is a common affliction for bloggers, and that the web is smothered with lurkers.

Having a blog about OT means that my blog might not get as much traffic as others on say celebrity gossip but hopefully the posts get read by people who have a real interest the the things I blog about.

It almost feels like talking into the wind.................. That said talking into the wind can be quite cathartic and useful in itself. Worst care scenario it's a great tool for reflection and getting some thoughts down.

So I'm going to try a different tactic and propose this as a delurking post. Maybe thats a bit mad because if no-one comments I'm going to feel a bit silly but oh well sometimes you've just to put yourself out there. So go on lurkers (lets hope there are some) dip your toe in the blogging water and say hi!

Thursday, 5 February 2009


Following discussions at RAatE this year I have attempted to contact services who assess for and provide electronic assistive technologies to create an online networking space to further improve communication between similar services. I’m sure we are all discussing similar issues of service inclusion/exclusion criteria, keeping pace with technological advances and adapting to funding challenges. As the services we work for are spread across such a broad geographical area creating a viable SIG for face to face meetings can be a challenge. So I set up a webSIG using Ning and a we already have a few members from different services which is exciting. I quite Ning as its easy to use, add features and rearrange. That said......

I must temper my enthusiasm with the knowledge that it may not be so well embraced by the people I am trying to reach. For numerous reasons people may not feel they have the time, inclination, skills or desire to share information to want to join in. However I am by nature blindly optimistic so I'm sure it will be a resounding sucess :-)

If you work for a EAT service please get in touch for details of how to join.

High expectations of EAT

I was having an interesting chat with a visiting SPR today about the high expectation of EAT he had found when visiting patients in our service. We discussed the impact of the constant media stream of technological advances which he termed "Bill Gates Syndrome" so that when we visit a person they often expect us to be able to provide star trek level controls of their home and beyond.

The reality of course is that EAT is often well behind mainstream technology. Costs incurred for necessary hoops like MHRA regs and a comparably small market make for often lower tech solutions that service users envisage.

A common misconception is always that throwing lots of technology in to the mix will in some way enhance a patients underlying skills and abilities. I always try to explain that we can use the tech factor to support and enhance but if a person doesn't have the often critical cognitive abilities and motivation we are often limited. Starting an assessment by talking about expectations cab be an effective way to get an idea of a starting point to negotiate.

As an Occupational Therapist I feel I have special skills to be able to breakdown the skills needed to use EAT and I hope I can then convey these in a sensitive and meaningful way to my patients. It might seem contradictory to underplay the role of technology when working in an EAT service but it serves to remind us that the focus should be on skills of the individual and the technology as a means to harness those abilities.