JCPSLP Vol 14 No 2 2012

Complex communication needs

Clinical insights Capacity building and complex communication needs: Challenges and strategies Andrea McQueen

Capacity building is a prevalent contemporary approach in health promotion and community development. In recent years capacity building methodologies have been applied to speech pathology services for people with complex communication needs. However there is minimal published information about this. This paper aims to identify the challenges of using a capacity building approach with people with complex communication needs, and suggests some strategies for maximising the success of this approach. Areas for future research are proposed. Introduction of the terminology Complex communication needs is defined as follows: A person who has communication problems associated with a wide range of physical, sensory, environmental causes, that restrict/limit their ability to participate independently in society. They and their communication partners may benefit from the use of augmentative and alternative communication (AAC) methods, either temporarily or permanently. (Balandin, 2002, p. 2) Capacity building is widely used in health and community development, both in Australia and worldwide (Craig, 2007; Hounslow, 2002). Yet its application to the population with complex communication needs is recent and little studied. A survey of the peer-reviewed literature finds only one article that relates to this topic (McLennan et al., 2006). What is capacity building? Capacity building is a contemporary approach in health promotion and community services (Craig, 2007; Hounslow, 2002; Verity, 2007). Capacity building arose from the field of community development, and remains strongly linked to community development principles and practices (Craig, 2007). Capacity building is a process (Simmons, Reynolds, & Swinburn, 2011) aimed at predefined outcomes, such as health promotion or the empowerment of communities. The World Health Organization (WHO) defines capacity building as: The development of knowledge, skills, commitment, structures, systems and leadership to enable effective health promotion. It involves actions to improve

health at three levels: the advancement of knowledge and skills amongst practitioners, the expansion of support and infrastructure for health promotion in organisations, and the development of cohesiveness and partnerships for health in communities. (Smith, Kwok, & Nutbeam, 2006, p. 341) However, definitions of capacity building are context- dependent (Simmons et al., 2011). For practitioners working in a social model of disability it is useful to have a definition grounded in participation and social inclusion. One such definition was postulated by Britain’s Charity Commission (2000): “Developing the capacity and skills of the members of a community in such a way that they are better able to identify and help meet their needs and to participate more fully in society” (p. 2). Although most definitions of capacity building make mention of key components or characteristics of capacity building (Simmons et al., 2011), the exact components vary from author to author. The NSW Department of Health (2001) proposed a model of capacity building built on five key areas of work: organisational development, workforce development, resource allocation, partnership, and leadership. Capacity building can occur at various levels. VicHealth (n.d.) identifies four levels of capacity building: individual, community, organisational, and systemic. Some researchers combine these levels under the umbrella term “community capacity building”. This paper addresses capacity building at all four levels (individual, community, organisational, and systemic) and across the five areas of work (organisational development, workforce development, resource allocation, partnership, and leadership). Capacity building and speech pathology Capacity building is prevalent in health and disability services (Hounslow, 2002; Verity, 2007). The World Health Organization supports the use of capacity building through its Ottawa (WHO, 1986) and Bangkok Charters for Health Promotion (WHO, 2005). Various Australian states have policies and position papers advocating the use of capacity building approaches within health (Department of Health, 2011; Queensland Health, 2003) and disability (Queensland Government, 2011; Victorian Disability State Plan 2002– 2012). However, there is surprisingly little published information about the use of capacity building in speech pathology. In Victoria, a network of services for people with complex communication needs was established in 2003–04

Keywords COMMUNITY

CAPACITY BUILDING COMPLEX COMMUNICATION NEEDS

Andrea McQueen

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JCPSLP Volume 14, Number 2 2012

www.speechpathologyaustralia.org.au