ACQ Vol 12 No 3 2010

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

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ACQ Volume 12, Number 3 2010

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