JCPSLP Vol 14 No 2 2012

Complex communication needs

The Communication Access Network Karen Bloomberg and Denise West

I n 2002, the Department of Human Services in Victoria funded what was known as the “Speech Therapy Initiative”. This initiative involved the creation of a “hub and spoke” model of service delivery consisting of the Communication Resource Centre as the “hub” (in metropolitan Melbourne) and 13 statewide Regional Communication Services as the “spokes”. The regional communication services are located in 18 sites across Victoria. This initiative recognised that Victorians who have complex communication needs have had limited access to specialist speech therapy services and support in their local communities. This situation arose in part because of the small number of therapists available with expertise in supporting people with complex communication needs. In addition, funding constraints and targets have historically focused on delivering individual services rather than promoting general community inclusion of people with a disability. The priority was to develop and provide a statewide model of service that was accessible and equitable for people with complex communication needs. The term “Speech Therapy Initiative” was a misnomer as the focus of the initiative was not solely on providing direct speech therapy services. This innovative model of service delivery placed a greater emphasis on the role of speech pathologists to engage in projects and activities that support community capacity building. Indeed, the aim of the initiative is to make the community more accessible for people with little or no speech. With this aim in mind, the Communication Resource Centre and the Regional Communication Services developed under the “hub and spoke” model became known as the Communication Access Network (CAN). This network supported the Victorian government’s commitment to building more inclusive communities and the Victorian State Disability Plan 2002–2012 (Disability Services Division 2002) affirming the rights of people with a disability to live and take part in community life as citizens of Victoria. This has since been further endorsed by the National Disability Strategy 2012–2020 which calls for the removal of all barriers to the inclusion of people with disability in their communities (http://www.fahcsia.gov.au/ sa/disability/progserv/govtint/Pages/nds.aspx). The objectives of the CAN (Communication Access Network, 2010) include to: • facilitate the participation and inclusion of people with complex communication needs in community life • increase access to generic services for people with complex communication needs • engage in capacity building for individuals and the general community

• raise awareness of communication as a human right • provide opportunities for active participation and leadership by people with complex communication needs To this end, the speech pathologists in the Communication Resource Centre and the Regional Communication Services have a two-fold focus. A minor proportion of their time is allocated to individual case- work. Where possible, this is done in collaboration with other speech pathologists seeking support in the area of alternative and augmentative communication (AAC). The majority of their time is spent in activities and projects that facilitate access and inclusion for people with complex communication needs. Working in the CAN has been a rewarding experience but has not been without its challenges. Early work focused on community mapping. We needed to know where there were gaps and what resources and services were available across the state. In our search for that information we also began the process of developing new networks and working in partnerships so we could share expertise and value-add to work already being done in the community. Much of our work has involved addressing the opportunity barriers identified in the participation model described by Beukelman and Mirenda (2005). These include policy, practice, attitude, skills, and knowledge barriers. In the last few years there have been two major objectives driving the CAN. One has been providing tertiary speech pathology services to people with lifelong disabilities. This has led to a train-the-trainer model of service delivery for support workers and communication partners living and working with people with complex communication needs. Staff participate in a comprehensive training package covering assessment of intentional and unintentional communicators, behaviours of concern, sensory-based activities, Key Word Sign, Boardmaker training, and developing functional communication strategies. The training has been supported with access to resources such as Getting Started with Key Word Sign (Caithness, Brownlie, & Bloomberg, 2012), The Triple C (Bloomberg, West, Johnson & Iacono, 2009), InterAACtion – strategies for intentional and unintentional communicators (Bloomberg, West, & Johnson, 2004), NECAS (Non-electronic Communication Aid Scheme); http://www.scopevic.org.au/index.php/site/whatweoffer/ communicationresourcecentre /necas), and other information and material on the Scope website (www. scopevic.org.au). The second statewide objective has focused on projects and activities that support communication access and the

Karen Bloomberg (top) and Denise West

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JCPSLP Volume 14, Number 2 2012

Journal of Clinical Practice in Speech-Language Pathology