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Kate Duggan looks at how the right communication aid can help students as they move beyond school 

Augmentative and alternative communication (AAC) can help individuals, including those with learning difficulties and/or autism spectrum conditions, to communicate more effectively. Aids can range from picture boards, to high-tech computer equipment, depending on the person’s individual needs. As well as helping effective communication, these tools provide users with a voice, something that’s critical to a person’s day-to-day life, but is particularly crucial for young people’s development as they mature and transition from school into adult services.

The use of communication aids

In 2013, a study by Communication Matters found that more than 250,000 individuals in the UK require AAC, with 25,000 of those needing powered aided communication through voice output communication aids (VOCAs). These aids can help to provide a means of expression for many people who would otherwise be unable to communicate effectively with others.

Use of a VOCA can enable individuals to build and maintain relationships with others, such as teachers, staff, friends and family members. It also allows them to make their message understood when they are communicating with less familiar people who may not understand their communication signals, such as vocalisations and facial expressions. With increased communication skills, users are able to experience a higher level of participation in activities both at college and in other environments, helping to build confidence and self-esteem.

Advanced assessment

There is a wide range of communication aids available and assessment for a VOCA must be highly individualised to ensure that each person gets a device tailored for his/her specific needs.

When determining the appropriate aid, a student’s communication skills are assessed in terms of what s/he understands and is able to express. Where there is a discrepancy between the level of understanding and the ability to express oneself, AAC, such as VOCAs, may be appropriate in order to increase the effectiveness of the student’s expressive skills. Following an assessment by a speech and language therapist or other professional to identify the most appropriate software or language programmes, individuals trial a range of devices to find the best solution.

Determining which device is most suitable depends on a number of factors. A student’s range of movement is an important consideration as it will determine how they can access a VOCA. For example, a student may be able to activate the touch screen with his/her hand, while a peer may need a head or elbow activated switch to allow scanning through and selection of parts of the screen. 

Sensory impairments should also be considered when assessing an individual for a communication aid. For students with a visual impairment, the size and type of pictures shown must be factored in, while if they have a hearing impairment, the voice used may need to be adapted.

Easing transition

For those students moving on to further education, being able to demonstrate that they have the necessary communication capabilities enables them to progress quickly. For example, a student with enhanced expression may have the opportunity to move from a specialist school, with key support methods, to a more mainstream institution. Not only is this positive for the individual’s confidence when faced with future unfamiliar situations, but it also helps the student to integrate into a wider community and prepare for adulthood.

Beyond education, students may have the opportunity to access supported employment opportunities; however, this is only possible if they are able to interact with others sufficiently to complete the tasks required for the role. For example, young people who have had access to VOCAs are arguably better equipped to complete work placements, increasing their opportunities after college.

According to the Mental Capacity Act (2005), a key element of assessing whether someone can make a decision in his/her life is whether s/he can communicate that decision. When young people move on from college, they face a transition into adult services, where they frequently encounter unfamiliar places and people. At a time of key decision making, increased participation and the ability to communicate choices means that students are better equipped to actively participate in this process. As well as being able to express their preferences in unfamiliar environments, they will have more confidence among new friends and staff, and have a greater level of control over key life moments.

Sometimes, there is a danger that individuals with learning disabilities have lots of decisions made for them, resulting in them being passive participators. Having the ability to express their preferences and opinions empowers young people to be able to speak for themselves, increasing their autonomy. This can involve simple every day choices, or more significant decisions, such as where to live or how best to budget their money.

Training

To make a successful move from school into adult services, it is essential that those in the students’ environments are able to support them in communicating with their VOCA. Students need support to be able to transfer the skills they have learnt in the classroom into other environments, and ongoing help to programme new words onto their VOCA or troubleshoot if it breaks down.

Training days, via specialist equipment or education providers, can offer support to parents and carers, helping them to gain skills in using technology and encourage interaction for individuals with learning disabilities and autism. 

Increasingly, mainstream technology, such as tablet computers, can be used as communication aids and are accessible for parents and carers to learn how to use. They can be used as a tool to support reflective learning and the development of creative skills, such as film making or music. A wide variety of apps is available to support communication. 

Funding opportunities

Despite the clear benefits of VOCAs, securing funding for the devices can be difficult. While some students are fortunate enough to have devices purchased for them when they are in education, many individuals in adult services are not as fortunate. There are charities that can support with fundraising for devices and operate on a means tested basis. However, funding often falls between health and social care services, meaning that not all individuals get the device required.

Although mainstream devices, such as tablets, are much more affordable than traditional communication aids, they do not necessarily meet everyone’s needs if they have specific access issues. For example, students who need eye gaze to access a screen require much more specialist software and hardware, which can be expensive.

What next?

Although developments in mainstream technology may only benefit some users, these advances have significantly increased the accessibility of VOCAs. In-depth assessment is required to identify the best solution which offers individuals maximum opportunities for communication. Appropriate specialist training for parents and carers can support young people to use their communication aids across a range of environments and become more independent as they enter adult services. With increased funding, these devices have the potential to innovate the learning and development process offering users a greater opportunity to speak for themselves, make choices and achieve their goals as independently as possible.

Further information

Kate Duggan is Clinical Services Manager at Bridge College, a specialist college for students aged 16 to 25 years with disabilities, complex needs and autism:
www.togethertrust.org.uk/education/bridge-college

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