JCPSLP Vol 14 No 2 2012

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Complex communication needs
98 JCPSLP Volume 14, Number 2 2012 Journal of Clinical Practice in Speech-Language Pathology
Karen
Bloomberg (top)
and Denise West
• 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);
communicationresourcecentre /necas), and other
information and material on the Scope website (www.
).
The second statewide objective has focused on projects
and activities that support communication access and the
In 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
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
The Communication
Access Network
Karen Bloomberg and Denise West