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-andservices/rehabilitation-services/services/act
• Email:
julie.atkinson@bhamcommunity.nhs.uk
• 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
Environmental
Control
Communication
Aids
Powered
Mobility
Switches
& Mounting
Computer
Access
COMPASS
• http://www.rhn.org.uk/our-work/ourservices/electronic-assistive-technology/
• hpaterson@rhn.org.uk
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.widgithealth.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
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•
•
•
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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
SPACE
B C
F G
J K
P Q
V W
D
H
L M N
R S T
X Y Z
1 2 3 4 5 6 7 8 9 10
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.”
Alec 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=pLb6Oi3uR0 (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/wpcontent/uploads/2010/12/008-Study-of3-Low-Tech-Communication-Methodsfor-People-with-Only-Eye-Movement-ARoman.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) “Been There, Done That: A Very Personal Introduction to
the Special Issue on Augmentative and Alternative Communication and
Acquired Disorders” Augmentative and Alternative Communication 17 138-140
•
Personalised placemats: angela.crocker@nwb.n-i.nhs.uk