ACQ Vol 12 No 3 2010

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ACQ Volume 12, Number 3 2010 151
notions of competence (both professionals’ views on
the competence of individuals with aphasia, and the
changing views of people with aphasia with respect to
their own competence). The practical suggestions and
insights provided will challenge clinicians to implement
changes to their own services in order to make them
more accessible.
The second article, “Communication access to
health and social services”, describes a project in which
individuals with aphasia worked together with staff at
Connect to design a training program to enable service
providers, particularly those in health and social services,
to audit and improve communication access to their
services. Individuals with aphasia were involved in all
stages of developing the project, with the project team
including one person with aphasia, as well as the support
of an advisory panel of six people with aphasia.
The simple framework described in the article for
addressing communication access could easily be
adapted for any organisation wanting to improve their
services. The framework describes three phases of
a user involvement with a service: a beginning phase
(e.g. making an appointment), a middle phase (e.g.
the encounter with a service), and an end phase (e.g.
a follow-up from the service, or leaving the service).
At each phase, three components of communication
access can be considered: documents (e.g. appointment
letter, website), interactions (e.g. phone calls, interacting
with a receptionist), and environments (e.g. physical
arrangements in the waiting room). The authors
also suggest that one of the most powerful tools for
educating service providers about the importance of
communication access is the use of real-life stories
(e.g. a video of a person with aphasia describing their
experience in accessing a service). Real-life stories
encourage service providers to put themselves in the role
of service user, and to reflect on the impact of not being
able to access a service because of a communication
disability.
Underlying both of these articles is a strong thread
of user involvement that demonstrates Connect’s
commitment to an inclusive organisational culture and
values. The authors describe how the social model of
disability has influenced their approach to communication
access. A basic tenet of the social model is that “lack of
participation and involvement of people with disabilities
is often more a function of the barriers in society than
it is a result of inabilities on the part of people with
impairments...if people with impairments were given
equal access, they would not be disabled” (Parr, Pound,
& Hewitt, 2006, p. 190). Parallels are drawn between
physical and communicative access, with the authors
arguing that just as a ramp can provide access for
people with motor impairments, communication access
can provide individuals with communication difficulties
the ability to access and engage with organisations
and services. The authors also make the point that
communication access means much more than just
making a few documents accessible. They suggest
that in order to make authentic rather than tokenistic
improvements to communication access, an explicit
focus on organisational values and sustainable whole
systems changes are needed.
While this may make communication access sound
like an impossible hurdle to jump within our already