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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);

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

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

The Communication

Access Network

Karen Bloomberg and Denise West