JCPSLP vol 19 no 3 2017 low res. pdf

5 / 64

JCPSLP Volume 19, Number 3 2017 119
and acceptable terminology to provide a common lexicon.
We propose that such terminology avoids stigmatising
or promoting an underlying medical condition, and rather
recognises and promotes the need for environmental
adaptations. The following questions may help guide the
ensuing discussion and assist with refining the conceptual
frameworks that inform practices.
1. What collective term is appropriate for the people who
benefit from environmental adaptations that facilitate
communication?
2. What term should be used to refer to an environment
that enables this level of inclusion?
3. What do we call the process of creating responsive,
inclusive communication environments?
Discussion
A total of 12 terms have been identified from three sources:
(a) discussions and relevant documents from national and
international SLP colleagues involved in communication
access activities; (b) discussion with communication access
assessors (employees with complex communication needs);
and (c) feedback from members of the Victorian
Communication Access Advisory Groups (Solarsh, Johnson,
& West, 2012). Of the 12 terms, six refer to communication
characteristics of the individual (communication disability,
communication disorder/impairment , communication difficulty,
complex communication needs , communication support
needs, and complex communication support needs ), and six
refer to environmental adaptations that include communication
( aphasia friendly, autism friendly, communication friendly,
communication access , dementia friendly, and inclusive
communication ) (see Table 1). Each term has been analysed
in relation to three features that the authors consider
desirable for socially inclusive contexts: (a) the model that is
reflected by the term, (b) the inclusivity of group/s that
would benefit from having communication supports, and (c)
whether the term is transparent to the broader community.
communities more inclusive for people with communication
disabilities through environmental adaptations. In 2014, a
consortium of speech pathology professional bodies from
six countries established the International Communication
Project (ICP). The aims of the ICP support and further
extend Article 21 by encouraging “people around the
world to join together and make a difference in the lives
of people living with a communication disability” (www.
).
Exploring the current lexicon for
communication access
At Scope’s Communication and Inclusion Resource Centre,
staff members (including SLPs) are creating communication
access in the community by offering education, training, and
capacity building support to businesses and services. Once
the communication access standards have been met, and
verified by an audit process, the Communication Access
Symbol (Figure 1) is awarded. The definition of communication
access states that “Communication access occurs when
people are respectful and responsive to individuals with
communication difficulties, and when strategies and
resources are used to support successful communication”
(Johnson, West, Solarsh, Wyllie, & Morey, 2013, p. 7).
However, SLPs at Scope are wrestling with the
application of current communication disability terminology
in the context of social inclusion. Adoption of the social
model has led to a shift in emphasis from the disability
itself to environmental support needs (attitude, knowledge,
skills and practical resources) that arise from the disability.
This shift reflects a move from clinical supports exclusively
offered by a SLP to improve an individual’s communication
skills, towards community supports that may be offered
by community members in order to facilitate successful
communication in mainstream social settings. What is
being described are adaptations to the environment in
which the people, the setting and available communication
resources, facilitate communication for anyone in that
place. Yet, medical terminology and a focus on impairment
still pervades discussions.
In light of this tension, the use of clinical terms such as
communication disorder, impairment or difficulty that focus
on an individual’s impairment need to be reconsidered in
relation to the role of environment as discussed by the
World Health Organization (WHO, 2007). An example of
reinterpretation is the increased use of alternative terms to
communication disability such as complex communication
needs (Balandin, 2002), communication support needs
(Law et al., 2007) and complex communication support
needs (K. Anderson, personal communication, 29 May
2017). In addition, terms emphasising the importance of
the environment have appeared. Terms such as aphasia
or autism friendly focus on environmental adaptations
to enhance participation of specific diagnostic groups,
in addition to more general communication adaptations
(Howe, Worral & Hickson, 2004). Other overarching
terms such as communication friendly environments,
communication access, and inclusive communication have
also come into use in the last decade (Money, 2016; Pound
et al., 2007; Scottish Government, 2011; Shepherd &
McDougall, 2008; Solarsh, Johnson, & West, 2012).
This discussion paper aims to present a description of
the terms commonly used in discourse around creating
communicatively accessible environments and identify the
dilemmas in selecting the most appropriate terminology.
Further, the authors hope to open a dialogue on appropriate
®
Figure 1. Communication Access Symbol
Terms referring to the individual
The terms that have been identified as relating to an
individual include a person with (a) communication disability,
(b) communication disorder/communication impairment, (c)
communication difficulty, (d) complex communication needs
(e) communication support needs and (f) complex
communication support needs.