Total Communication

1
Total Communication

• Are we paying it lip-service?
• Yasmin James
• Head of Speech and Language Therapy - Learning
  Disabilities
• NHS Grampian

Report on the Grampian Speech and Language
Therapy Training Strategy for Adults with
Learning Disabilities
2
Background to the Strategy

• Noble (1990) reported that 89 of people with
  learning disabilities will have some form of
  communication impairment
• It is well documented that communication
  difficulties lead to the development of
  behaviours that challenge services
• A study in Grampian in 2001 revealed that for a
  major private sector provider only 12.5 of staff
  had attended a communication training programme
• An ongoing commitment to a rolling training
  programme for all staff working with this client
  group was essential

3
How was the training developed?

• Joint working with Speech and Language Therapy,
  Aberdeen City Social Work Training Department and
  Cornerstone Community Care
• Agreement regarding the content of the programme
  and consideration of the potential impact on
  service users, staffing and resources
• Pilot site agreed for Aberdeen City

4
Contents of the Training Programme

• Focus on extrinsic rather than intrinsic factors
  and on the skills of the communication partner
  rather than the individual
• Non-verbal skills and levels of comprehension
  explored through practical activities
• Wide range of learning styles utilised
• Links explicitly to SVQ
• Signing and symbol training included
• Use of monitored pledges and follow-up by speech
  and language therapists

5
Learning Objectives

• Course participants will acquire a basic
  understanding of the processes involved in
  delivering a total communication environment in
  their setting
• Course participants will demonstrate a basic
  knowledge of the core vocabulary of signs and
  symbols
• Staff to demonstrate an understanding of the
  impact of the communication environment on
  individual service users
• Staff to identify a key area to focus on from the
  Partners in Communication training and make an
  achievable pledge

6
What has happened so far?

• All Aberdeenshire and Moray Social Work Day
  Services have closed for 3 days to participate in
  training
• Aberdeen City is in progress but there are
  barriers to closure of the day centres
• Implementation programme for residential and
  private sector providers is in progress
• Approximately 500 people have been through the
  3-day course

7
Initial Results Feedback from the Course

• 99 of course participants reported that the
  course was good or very good
• 92 of the course participants felt that the
  timing for each part of the programme was just
  right
• 91 of the course participants felt that the
  content detail for each part of the programme was
  just right

8
Initial Results Levels of Confidence Pre and
Post Course Random Sample

• 42 of participants felt confident in their level
  of understanding of communication skills
  pre-course and this increased to 85 post-course
• 19 of participants felt confident in their use
  of signs and/or gestures pre-course and this
  increased to 73 post-course

9
Initial Results Levels of Confidence Pre and
Post Course Random Sample

• 23 of participants felt confident in their
  knowledge and use of symbols pre-course and this
  increased to 81 post-course
• 68 of participants felt confident in their
  ability to impact the communication environment
  pre-course and this increased to 100 post-course

10
Where to from here?

• Maintaining the high level of commitment to
  training
• Ensuring adequate follow-up
• Involving other sectors in training initiative,
  e.g. ASDA, Leisure Centre
• Ongoing evaluation and development of the
  training materials