JCPSLP Vol 14 No 2 2012

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Complex communication needs
JCPSLP Volume 14, Number 2 2012 83
Andrea
McQueen
Keywords
COMMUNITY
CAPACITY
BUILDING
COMPLEX
COMMUNICATION
NEEDS
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
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
Clinical insights
Capacity building and complex communication needs:
Challenges and strategies
Andrea McQueen