CI4 - ALD 2: Comm Iss.

CI4 - ALD 2: Comm Iss.

1. Informal

   • Quality and pitch of vocalisations

2. MEHRABIAN (1971)

3. Paralinguistics

   • Non-verbal
     • Words

4. COMMUNICATION

   • Receptive skills
     • Parsing words
     • Attention
     • Overloading information
     • Remembering message
     • Understanding code " gesture...
     • E.g. understand where going, before wheeled out door
     • If say "yes" ask CCQ's to make sure understood
   • Expressive skills
     • Not nec. verbal!!
     • Initiation?
     • Functional?
     • Motivation?
     • Opportunities to comm.?
     • What are the repeated behaviors? E.g. volume additions, frustrations if not what want....
   • Other factors:
     • See 'challenging behaviour' doc - sub sec. 'capable envirnoments' RCP (2007)
     • Cognition
     • Pain/discomfort
     • Mood/mental health
     • Fatigue
     • Sensory
     • Memory
     • RCP (2007) 'Challenging behavoiur' - capable environemnts
   • WAIGHT & OLDREIVE (2011) - LEVELS OF PROCESSING
     • 1. Echolalia: Repeat or read - no ling. understanding
     • 2. Grammar: Process key words & simple grammar - not link new to old info. Small chunks best
     • 3. Rigid Reasoning: Predictable responses / thought processes. Rigid. Learning needs scaffolding and repeating
     • 4. Flexible Reasoning: Takes on board new info. Makes ABSTRACT judegments

5. Mental Capacity Act: MCA (2005)

   • 1. Right to make own decisions - assume capacity
   • 2. Support to make decision, e.g. accessible format
   • 3. Allowed to make 'unwise' decision
   • 4. Decisions in cases where ind. lacks capacity must be in 'best interests'
   • 5.Treatment for someone who lacks capacity should be least restrictive of rights and freedoms

6. ASSESSMENT

   • What level of scaffolding is appropriate - at what speed can it be reduced?
   • Capacity screening
   • Language
     • vocab
     • grammar
     • literacy
     • verbal reasoning
     • aud. memory
     • FORMAL
       • PRE-LINGUISTIC
         • Pre-verbal Communication Schedule (PVCS) ***
         • Communication Profile (Kelly, 2000)
         • Personal Communication Program ***
         • Affective Communication Assessment (ACA;O'KANE & GOLDBART, 1998)
       • LINGUISTIC
         • Clinical Evaluation of Language Fundamentals (CELF; ***)
         • Test for Reception of Grammar (TROG; ***)
         • British Picture Vocabulary Scale (BPVS; ***)
         • Derbyshire Language Scheme (DLS;***)
         • Assessment of Comp. & Expression (ACE; ***)
         • N.B. There are no stand. ass. specific to ALD
         • Literacy: Neale Analysis of Reading Ability (NARA, Neale, 1997)
         • VERBAL REASONING: Ass of Ccomp. & Expression (ACE) - Burglar Story ***
           • SEQUENCING: Colour Cards (also social story) - use questioning....
     • INFORMAL
       • E.g. via video
       • Env. obs
       • Signs anticipation?
       • LANGUAGE SAMPLE
       • Interview carers - open questions
         • Esp. GOAL SETTING!
   • Communication
     • intentionality
     • strategies used + consistency
     • engagement / attention
     • What factors affect this for them, e.g. sensory needs
       • Changing rooms? Changing position? Simplifying task? - REDUCE DEMANDS
         • STARKWEATHER (1990) - DEMANDS and CAPACITIES model of STUTTERING

7. AAC

   • LIGHT (1990) COMMUNICATIVE COMPETENCIES
     • LINGUISTIC COMPETENCE: Monitor and exchange linguistic information of appropriate complexity
       • Learn language 'code' of various AAC - systematic instruction
       • Use to represent meaning
       • Combine words & phrases
       • Sometimes across modalities
     • OPERATIONAL COMPETENCE: Instruction how to operate, from simplist AAC to advanced technology
       • Can they see it?
       • Distracting information?
       • Range of movement to use buttons?
       • Do they know where find information?
     • SOCIAL COMPETENCE: Interactional use of AAC / device
       • kowledge and judgement soc situations
       • Interpersonal aspects
     • STRATEGIC COMPETENCE: Learn to use tools strategically within the context, e.g. curricular activites and conversation
       • Training to use flexibly
       • Different AAC for diff purposes / partners

8. RECEPTIVE INTERVENTIONS

   • Easy Read Mears et al. (2004)
     • Symbols aid understanding / pics within text
     • Mass produced
     • Requires literacy
   • Talking matts, (Murphy, J, Cameron, L – 2008)
     • Usually 3 key word level
     • Matt for attention
     • Pics / symbols
     • Express what like, what not like
     • Good for simple ideas
     • Can enable capacity, e.g. used in sessions with GP (Macer & Fox, 2010)
   • Computer Aided Information (Oldreive and waight, 2010)
     • Computer speaks - no reading
     • Individualised easily
     • Navigate between screens
     • Timelines for sequences
     • Gives individuals control
   • ENVIRONMENTAL STRATEGIES: Consistency & understanding
     • Activity schedules
     • Daily timetables
     • Objects of reference
     • Musical, olfactory or touch cues
     • Repeated sequences
     • Physical timers
     • Staff photos - handover
     • E.A. Linguistic
       • Reduce utterance amount and complexity
       • CHUNK into steps
       • Avoid idioms / jargon
       • Repeat
       • Signal for word boundaries
       • Processing time
       • Official driver 'information standard (2012) - previous mind map

9. EXPRESSIVE INTERVENTIONS

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