Including people with intellectual disabilities in the development of their own positive behaviour support plans

Purpose People with intellectual disabilities are not routinely involved in the assessment of their behaviours that challenge, as this is often completed by a proxy respondent and the health-care professional. This is contrary to guidance stating that everyone should be involved in the planning of their care. This paper aims to show how health-care professionals can support people with intellectual disabilities to engage in the assessment of their behaviours that challenge and the subsequent development of their own positive behaviour support (PBS) plans. Design/methodology/approach A non-systematic review of the existing literature on improving the engagement of people with learning disabilities in health-care planning, and specifically PBS planning, was undertaken. Appropriate papers were included in this paper. Findings There are several evidence-based methods to improve people’s engagement in the assessment of their own behaviours that challenge and then the development of their PBS plans. These methods are discussed in terms of their application to supporting people to communicate and involving them in the process of developing a valid and meaningful PBS plan. This is a relatively new focus within the literature, and further research should focus on increasing engagement in the process, as well as monitoring how co-production affects PBS outcomes. Originality/value This paper summarises some of the approaches used to support people with intellectual disabilities to engage in the assessment of their behaviours that challenge and the development of their own PBS plans. This should encourage health-care professionals to consider how to use alternative and augmentative communication strategies to facilitate co-production in their own clinical practice.

Communicating with Mechanically Ventilated Patients Who Are Awake. A Qualitative Study on the Experience of Critical Care Nurses in Cyprus during the COVID-19 Pandemic.

Background: Modern protocols for light sedation in combination with the increased turnover of COVID-19 infected patients hospitalized in Intensive Care Units (ICUs) have increased the number of patients who are mechanically ventilated and awake. Nurses require specific skills to care for this vulnerable group of patients. At the same time, nurses report feeling inadequate and frustrated when they attempt to establish communication with mechanically ventilated, conscious patients. Methods: The purpose of this study was to explore nurses’ experiences taking care of conscious, intubated patients in the intensive care unit. The research questions aimed to identify i. the strategies that nurses use for communicating with patients, and ii. the barriers in communication between nurses and patients. This study employed a qualitative design. Data were collected using semi-structured interviews with 14 intensive care nurses working at ICUs in four different hospitals of Cyprus. The data were analyzed by applying thematic analysis.Results: We identified several strategies of unaided (movements -lips, hands, legs- facial expressions, gestures, touching) and aided forms of communication (pen and paper, boards, tablets, mobiles) used by nurses to communicate with patients. Additionally, barriers in communication were reported by participating nurses mainly pertaining to patients’, nurses’ characteristics and the ICU environment. The health protocols imposed by the pandemic added more barriers in the communication between nurses and patients mostly related to the use of protective health equipment.Conclusions: The results of this study, combined with those of others in different countries, point to the difficulties nurses face when trying to communicate with conscious patients during mechanical ventilation. It appears that the complex communication needs of this group of patients are not being met mainly due to the lack of nurses’ training and of appropriate equipment to facilitate alternative and augmentative communication. Our study is amongst the first to add that the protective health protocols due to the pandemic imposed further communication barriers. Undoubtedly, the recognition of such an important issue creates an urgent need to educate nurses in alternative ways of communication with mechanically ventilated, conscious patients during their ICU stay.

Iranian Speech-language Pathologists’ Awareness of Alternative and Augmentative Communication Methods

Objectives: Alternative and Augmentative Communication (AAC) provides a means of effective communication to individuals with severe impairments in speech comprehension and production. The present study aimed to examine the awareness of Iranian Speech-Language Pathologists (SLPs) of AAC services. Methods: In total, 111 SLPs who were selected by convenience sampling method participated in this cross-sectional study. Using a researcher-made questionnaire, information on SLPs’ familiarity with the term AAC and its methods; patients who can benefit from AAC methods; the kind of AAC method that could be used per patient, and the effectiveness of each method were obtained. This research was conducted at rehabilitation clinics in Tehran City, Iran. Results: The obtained results revealed that only 8.1% of the respondents were familiar with the concept of AAC; however, 92.8% of SLPs had contact with Patients With Communication Problems (PWCP). Only 0.9% of SLPs were familiar with high-tech devices. Additionally, 88.3% of the respondents were willing to further educational opportunities concerning AAC. Discussion: Iranian SLPs had little familiarity with AAC and the target population of these services. Overall, there appeared to be a lack of AAC expertise within the profession in Iran. Therefore, training these professionals, both theoretically and clinically, is essential.

An Overview of the Technological Options for Promoting Communication Skills of Children With Cerebral Palsy

This chapter provides the reader with a selective overview of the empirical contributions available in literature on the use of assistive technology-based interventions for promoting communication skills of children with cerebral palsy. Four categories were selected regarding (1) microswitches and computers, (2) aided-alternative and augmentative communication devices, (3) eye tracking, and (4) robots. Overall, 18 studies were retained, and 47 participants were included. Results were largely positive although a few failures occurred. Clinical, psychological, and rehabilitative implications for research and practice were critically discussed.

Evaluation of alternative and augmentative communication in patients with amyotrophic lateral sclerosis, based on ICF

Introdução: A comunicação alternativa e aumentativa (CAA) é uma ferramenta que busca de proporcionar uma comunicação funcional eficiente em pacientes com dificuldade de habilidade comunicativa. Objetivo: avaliar o uso da CAA em pacientes com Esclerose Lateral Amiotrófica (ELA) de acordo com a Classificação Internacional de Funcionalidade (CIF). Métodos: pacientes com diagnóstico de ELA que tinham indicação de CAA ou que já utilizavam algum recurso, mas apresentavam queixas em relação ao uso, passaram por um processo de avaliação por meio de um questionário baseado na CIF, posteriormente receberam um novo recurso CAA junto a adequações posturais necessárias para a utilização do recurso; receberam treinamento e suporte para utilização; utilizaram o novo recurso por cerca de dois meses e retornaram para a reavaliação. Resultados: Foram avaliados cinco pacientes com idades entre 43 e 76 anos, de ambos os sexos. Os achados apontam impacto positivo da CAA na dificuldade de comunicação ao transmitir uma mensagem utilizando o novo recurso de CAA disponibilizado. Conclusão: mesmo com a progressão da ELA, todos os pacientes apresentaram redução da dificuldade comunicativa, confirmando os benefícios comunicativos em relação ao seu uso.

Utilization of alternative and augmentative communication resources by patients with amyotrophic lateral sclerosis

Introdução: Esclerose Lateral Amiotrófica (ELA) é uma doença de comprometimento multissistêmico, dentre eles, a perda total das habilidades comunicativas. A Comunicação Aumentativa e Alternativa (CAA) busca proporcionar uma comunicação eficaz por meio de recursos específicos. Objetivo: verificar a influência da ELA nos aspectos de vida pessoal, social e ambiental em pacientes que utilizem a CAA. Métodos: Os pacientes foram observados e convidados a participarem de uma avaliação com questionário sociodemográfico e semiestruturado. Cada participante obteve um recurso de CAA disponibilizados pela presente pesquisa e retornaram para uma reavaliação. Resultados: A análise foi realizada a partir dos relatos que emergiram dos comentários espontâneos e gerou cinco categorias (socialização, atitudes sociais, comunicação e direitos, serviços, sistemas e políticas, e interação familiar). Conclusão: Mesmo com a utilização da CAA, a ELA gera impactos negativos na socialização e participação social devido fatores sociais e ambientais.

Utilization of alternative and augmentative communication resources by patients with amyotrophic lateral sclerosis.

Introduction: Amyotrophic Lateral Sclerosis (ALS) is a multisystemic impairment disease, among them, the total loss of communicative abilities. Augmentative and Alternative Communication (CAA) seeks to provide effective communication through specific resources. Objective: To verify the influence of ALS on aspects of personal, social and environmental life in patients who use the CAA. Methods: This is a qualitative, exploratory, longitudinal research of a series of cases. The patients with ALS were invited to participate of an evaluation with a sociodemographic and semi-structured questionnaire. Each participant obtained a CAA resource offered by the present research and returned for a reevaluation. Results: The analysis based on the reports that emerged from the spontaneous comments and generated five categories (socialization, social attitudes, communication and rights, services, systems and policies, and family interaction). Conclusion: Even with the use of CAA, ELA generates negative impacts on socialization and social participation due to social and environmental factors.

Kommunikative Kompetenz bei Mehrsprachigkeit und komplexer Kommunikationsbeeinträchtigung ermöglichen

Alternative and Augmentative Communication (AAC) is demanding a stronger inclusion of multilingualism. The implementation therefor is aggravated by the lack of multilingual communication aids and difficult collaboration with parental home. The German-Arabic communication aids demonstrate ways in which aspects of language acquisition theory and features of communicative competence can be conveyed. These can be used to encourage multilingualism. Additionally, collaborative opportunities with parents are outlined.

Integrating Alternative and Augmentative Communication into Music Therapy Clinical Practice: A Clinician’s Perspective

This article provides an overview of Alternative and Augmentative Communication (AAC) and discusses ways in which AAC may be integrated into music therapy clinical practice with neurodivergent children and young adults. The article begins with an overview of commonly used AAC modalities and subsequently explores their use in clinical practice through a series of vignettes. This article may be of value to students who wish to understand the myriad ways in which AAC may be integrated into their clinical work and to clinicians interested in developing their clinical practice knowledge in this area.