“Tweet Reach” a Twitter communication project #TweetReach #DECRA ARC 2014-17

This project is approved as funded 2014-17 by the Australian Research Council and is under application for Ethical Approval at the University of Newcastle, NSW, Australia, Human Research Ethics Committee.

Its method is also published in the journal Developmental Neurorehabilitation and pre-print copies of this can be requested from the first author bronwyn.hemsley@newcastle.edu.au

Hemsley, B., Palmer, S., & Balandin, S. (2013). Tweet reach: A research protocol for using Twitter to increase information exchange in people with communication disabilities. Developmental Neurorehabilitation. Posted online on December 31, 2013. (doi:10.3109/17518423.2013.861529) 

Read More: http://informahealthcare.com/doi/abs/10.3109/17518423.2013.861529

Other researchers are also instrumental in this project: Prof. Susan Balandin (Victoria University, Wellington) and Dr. Stuart Palmer (Deakin University) were consulted in its design and will be involved in the analysis. Two PhD students will be engaged in investigating particular aspects of the use of Twitter for additional populations, including adults with Acquired Brain Injury, with co-supervision from Dr. Stephen Dann of the Australian National University and Prof. Leanne Togher of The University of Sydney.

The information below is taken directly from the DECRA application “Tweet Reach”

SUMMARY OF PROPOSAL

With as many as 7% of Australians having a physical and/or communication disability and being disenfranchised from information, Twitter offers a valuable form of social media allowing short segments of text communication that bypasses impaired speech. This program of research will evaluate the impact of training designed to increase use of Twitter for information exchange in people who have little or no speech and need information for better inclusion, empowerment, and to make evidence-informed decisions. Outcomes will inform policies and practices in training vulnerable populations to use social media for increased information exchange and will promote inclusion of all people with disabilities in social media campaigns.

Media Description 

Twitter is useful for communicating and exchanging information, particularly for people who struggle to speak or have poor motor control. This project will examine the impact of training adults with communication disabilities to use Twitter, and barriers and facilitators to successful use to increase information exchange in this vulnerable group.

PROJECT TITLE: Tweet Reach: Using Twitter to Increase Information Exchange in People with Communication Disabilities

The aims of this research are to:

(a) Determine the efficacy of an online training module for people with severe physical and communication disabilities to access and use social media micro-blogging (Twitter) to exchange information.

(b) Evaluate the use of social media Twitter by people with severe physical and communication disabilities.

There are three studies in this project. 2014 will see the start of Study 1.

STUDY 1. Expert consensus panel and survey of adults with physical and communication disabilities.

Rationale : Using a recent survey adapted from a survey on social media conducted with children with physical and communication disabilities, the proposed study will determine the frequency of use of Twitter in the target population and the nature and extent of any problems experienced in learning to use Twitter. Results will inform development of the training module for adults in Study 2. A face-to-face survey has been selected to avoid barriers to participation and rule out any unknown influence of carers in completing online surveys20, and to verify the primary communication method of each participant.

Method: Face-to-face interview survey of Australian adults with physical and communication disabilities.

Expert Consensus Panel for survey design : An expert consensus panel comprising 1 adult with cerebral palsy, 1 adult with aphasia following stroke, 1 adult with motor neurone disease, 1 occupational therapist (computer access issues), 1 psychologist (cognitive issues), and Dr Bronwyn Hemsley will discuss and agree upon adaptations of the survey of children with physical and communication disabilities for use with adults in this study.

Survey participants : After piloting the survey with 10 adults and making any further revisions indicated, a survey of 400 adults with lifelong, acquired, and progressive physical and communication disabilities will be recruited through Disability Organisations in Australia, based in NSW (n = 100), Victoria (n = 100), QLD (n = 100), and Western Australia (n = 100). Each sub-group (lifelong, acquired, progressive) will make up at least 25% of the sample for each data site.

Survey administration and analysis: Survey items will include categorical responses (Yes/No), Likert scale responses, with comments explaining responses. The final question will be open-ended and invite ‘any other comments’. Questions will seek information on the participants’ level of familiarity with and knowledge of Twitter, needs and preferences, expected barriers and facilitators to use of social media; and current rates of using social media for information or engagement. The survey will be administered once for each participant in a face-to-face setting at a venue to suit the participant. The researcher administering the survey will verify each participant’s level of communication impairment according to function (i.e., speech intelligibility in conversation) and note primary method of communication (i.e., speech, speech with a communication aid or device, speech with a speech interpreter). Face-to-face interviews for the survey are needed as participants might have poor literacy or difficulty entering responses on to a written survey owing to their physical disabilities. Frequency counts and descriptive statistics will be calculated for categorical responses and content themes of open-ended questions identified13.

Outcome: This study will provide information on adults with physical and communication disabilities familiarity with and knowledge of Twitter, and their needs and preferences in relation to using Twitter for information and engagement. The results of the survey will also inform design of a Webinar series of online training modules in Study 2. In addition, the information gained in this study will guide the development of policies and practices that support adults with physical and communication disabilities to use Twitter for information and engagement.

Study 2 and Study 3 follow on and further information about these studies will be posted in 2015.

Further information about the study and Information For Participants will be circulated after ethical approval is granted by The University of Newcastle Human Ethics Committee.

Please contact Dr. Bronwyn Hemsley on (02) 4921 7352 or bronwyn.hemsley@newcastle.edu.au with any queries about this project.

Applying evidence to Australian Government Policy – You can too!

If you or a relative could not speak, you would want to know that there were many many people willing to advocate on your behalf that you receive the assessment, therapy, services, and support that you or your loved one would need to participate in everyday society.

Things all of us can do in January 2014 to help Communication for people with disability:

1. Respond to the Australian Government’s draft #NDIS legislation on disability inclusion

http://www.adhc.nsw.gov.au/about_us/legislation_agreements_partnerships/nsw_disability_services_act_review “Have your say” Deadline is 14 February 2014.

2. International Communication Project 2014 has a Twitter Handle https://twitter.com/ICP2014 and has a Pledge for Everyone to Sign at http://www.communication2014.com – do this in January and watch out for updates on the Twitter Handle.

3. Australian Government Parliamentary Inquiry: On different types of communication disorders in Australia and speech pathology services in Australia

The Twitter Hashtag for discussion of the Parliamentary Inquiry is #SpeechPathInquiry

http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Speech_Pathology Deadline is 21 February 

I am going to post my submissions on 1 and 3 on this blog, and update on my activities within ICP2014 as the year proceeds.

Start The Conversation #SLP2Bchat Mon 26 Aug 8pm AEST

According to Speech Pathology Australia (@SpeechPathAus on Twitter) 1.1 Million Australians struggle to communicate in their own language – this impacts negatively on their education, health, wellbeing, relationships, employment, and participation in many aspects of society.

This coming week (25 Aug-31 Aug) is Speech Pathology Week and it is a very important opportunity to  raise awareness in the general public about the many Australian children, adolescents, and adults who have communication difficulties. These people urgently need the wider public to understand a lot more about what they face, and what will help them.

Join us in a Twitter Chat (see topics below) with the tag #SLP2Bchat at 8pm on Monday 26th August AEST, designed to get Student Speech Pathologists in Australia into Twitter to Start a Conversation with the general public of Australia on all things Speech Pathology. 

The Twitter Chat will be moderated by @dmkennedy92 and the tag is #SLP2Bchat. We have students joining in from all over Australia at 8pm AEST.

Will your University also take part?

Other University student speech pathology groups can feel free to adapt and post the following information on their Facebook groups and have a similar chat in Twitter, any time during the week – just use the same tag #SLP2Bchat so that all of the tweets can be collected to show just how important Speech Pathology Week has been to these students in Australia. Here is the Facebook posting information that was used at the University of Newcastle with names removed:

SPEECH PATHOLOGY WEEK 25^th-31^st of August.

To celebrate Speech Pathology Week and allow student to become more familiar with Twitter for speech pathology learning we are having a Student-Led moderated Twitter chat on Monday the 26^th at 8pm. This is to ‘Start the Conversation’ about ‘Using Twitter to Converse’. Most speech pathologists and speech pathology students do not really feel confident in using Twitter, or are not sure what it might offer. This is an opportunity for those who are on Twitter or who would like to join up for the first time, to test it out to learn more. This event will be a way of chatting with other students be they University of Newcastle or from other universities within Australia and around the world. We are more than happy to help out if you need tips to sign up or start, and it is just a chance to have a go at Twitter and see what it has to offer for you. Speech pathology students in Twitter (in Australia) are called ‘SLP2B’. Just like ‘SLP’, but in training.

The Topics we will discuss in the hour include:

Break the ice – 5 mins:  Tell us if you’re here – and what you would be studying if you weren’t studying speech pathology?

T1. How would you describe your speech pathology student life (SLP2B) life in a tweet?

T2. What is an obvious, funny, charming or unusual SLP2B trait?

T3. What has been your favourite area of SLP thus far?

T4. Twitter is great for sharing resources and links – what’s your top tip for a great website or blog for Speechies or Speechie students?

Being in the chat will help students to learn how to send a tweet, how to reply to a tweet, how to use a hashtag, and how to network up and connect with other students and speechies who are in the chat as well. You are more than welcome to ask NAME or NAME any questions or would like to get a few tips before Monday night. We have lots of ‘how to tweet’ resources. But the easiest way is to sign up, put up a picture, put something in your bio, and follow me. I’m happy to do it through Facebook or Email CONTACT or on twitter. My twitter handle is HANDLE NAME and the hashtag that will be used for the chat will be #SLP2B. Don’t be shy there is a wonderful learning resource right at your finger tips.

#ASHA13 Navigating Twitter Terrain

ASHA Convention #ASHA13 American Speech-Language-Hearing Association 

Thursday 14th November 6.30-7.30pm (Chicago USA).  

Speech Language Pathologists Navigating Twitter Terrain: Publishing, Exchanging Information, and Engaging in Online Spaces

Presenting Authors: Bronwyn Hemsley, Tricia McCabe, Caroline Bowen

Abstract

The workshop will begin with a panel presentation of three papers on research, teaching, and practice in relation to Speech Language Pathologist’s use of Twitter in relation to other social media. These papers will inform small group discussions on three scenarios around the use of Twitter by speech language pathologists.

Background

Speech language pathology has, like the medical, nursing, and occupational therapy professions, experienced an increase in the uptake and use of social media Twitter for professional learning and networking on a global scale (Chaudry et al., 2012). More than any other social media platform, Twitter is known for its speed not only in publication but in response times and engagement – put to good use during emergencies (Bruns et al., 2012a, 2012b) and in tracking public health issues (e.g., Dredz, 2012; Lamb et al., 2012). Given its speed of publication and the rapid spread to a diffuse network, professional associations worldwide now recognize a need to provide guidance to their members on its use. With this recognition comes acknowledgement by associations that there are many ethical, legal, and practical issues to consider when health professionals venture into such public engagement online, and on a global scale (Bowen, 2012). In this panel presentation we will explore recent research, clinical practice, and teaching experiences involving the use of social media (Yahoo Groups, Twitter, Facebook and Blogs) to highlight various aspects of the use of Twitter in speech language pathology that are relevant to all stakeholders.

In Twitter, as in any other public social media forum, health professionals must repeatedly and conscientiously decide what information to exchange while negotiating the boundaries of: personal and professional identity or relationship; public and private engagement; being within and across discipline spaces; working in or across public and private spaces. Despite the stated central purpose of Twitter being for information exchange, there is to date little research to guide clinicians in their use of Twitter for professional purposes, including continuing professional development purposes. There is no information available on how Twitter might be used as a mode of practice by speech language pathologists. This panel aims to engage with the audience in determining what is important to individual SLP delegates either as a consumer of Twitter information, a producer of Twitter information, or as the subject or object of a Tweet. These areas will be canvassed specifically regarding speech language pathology, and in the context of other social media channels and other purposes for using the social media platforms.

 

METHOD

Part A: Panel Presentations

Three short presentations based on recent research will be delivered to stimulate discussion during the following panel.

• Dr Bronwyn Hemsley will present the results of recent research, 22 students and academics were included in focus group research exploring the use of Twitter for teaching and learning speech language pathology.
• Dr. Tricia McCabe will enlarge upon the emerging professional and ethical issues raised by students of speech language pathology along with the hopes and concerns for academics in regards to how to prepare professional students for a future successful and ethical practice in a social media environment.
• Dr Caroline Bowen will discuss Twitter relative to electronic communication, including on- and off-list posts to listservs and Yahoo! Groups, blog posts and public and private blog comments, and private, sometimes confidential or sensitive information that is entered in contact forms on websites. Caroline will illustrate some of the ethically, morally and legally  ‘murky territory’ of the social media landscape, and unexpected pitfalls and a range of benefits of life online (Bowen, 2013).

Part B: Small Group Discussion on Scenarios

Using the short presentations as the context for discussion, and asking delegates to draw upon their own experiences, each presenter will facilitate one of three small discussion groups on hypothetical scenarios.

Conclusion: Large Group and Questions

Outcomes of the small group discussions will be collated in the large group and a final summative statement on priorities for future clinical research areas on the use of Twitter will conclude the session. There will also be time for questions to the panel. This presentation will follow the ethical guidelines of internet research and publication (Williams, 2012) in that no information that might identify parties to social media interactions will be provided in this presentation. We will also ask the audience to respect confidentiality surrounding information known from Twitter that might not be general knowledge.

 

REFERENCES

Bowen C. (2012). Webwords 44: Life online. Journal of Clinical Practice in Speech-Language Pathology, 14(3), 149-152.

Bowen C. (2013). Webwords 46: Social media in clinical education and continuing Professional Development. Journal of Clinical Practice in Speech-Language Pathology.

Bruns A, Burgess JE, Crawford K, Shaw F, (2012) #qldfloods and @QPSMedia: Crisis communication on Twitter in the 2011 South East Queensland floods – Research Report p1-58. Retrieved from: http://eprints.qut.edu.au/48241/

Bruns A, Liang Y, (2012) Tools and methods for capturing Twitter data during natural disasters, First Monday p1-8

Chaudhry, A., Glode, M., Gillman, M., & Miller, R. S. (2012). Trends in Twitter use by physicians at the American Society of Clinical Oncology Annual Meeting, 2010 and 2011. Journal of Oncology Practice, 8(2),  173-179.

Dredze, M. (2012). How social media will change public health. IEEE Intelligent Systems. 27(4), 81-84.

Lamb, A., Paul, M. J., & Dredze, M. (2012). Investigating Twitter as a source for studying behavioural responses to epidemics. AAAI Fall Symposium on Information Retrieval and Knowledge Discovery in Biomedical Text. Retrieved from http://www.cs.jhu.edu/~mdredze/publications/aaai_2012_flu_concern.pdf

Williams, S. G. (June 2012). The ethics of internet research. Online Journal of Nursing Informatics (OJNI), 16 (2), Available at http://ojni.org/issues/?p=1708

Favourite Words as Voted on Twitter

A few weeks ago I gave a lecture on ‘Vocabulary Selection’. Before the lecture, I asked ‘what are your favourite words?’ on Twitter. These are the words people gave in one hour in reply [*spelling as submitted by people in Twitter]

• amazeballs
• ambiguous
• arrogate
• Australia (Auslan sign version)
• babushka
• balderdash
• block
• cantankerous
• chocolate
• codswallop
• conglomerate
• convolution
• cornerstone
• dexamethasone
• disentangle
• disingenuous
• eclectic
• effluvia
• expression
• facetious
• fecund
• floral print
• Fundamental dichotomy
• fuzzy
• glaikit
• gusset (with scottish accent)
• ha
• harbinger
• indubitably
• inverinate (a village) (with scottish accent)
• kittypuss
• lexicon
• love
• nincompoop
• numinous
• obstreperous
• ominous
• ostentatious
• peripatetic
• poppycock
• sauvignon blanc
• somnolent
• spectre
• stramash (with scottish accent)
• strong emotion words swear words, excitement love despair think 4 weddings and a funeral
• supercillious
• tantalising
• tantalising
• Twitter
• underpinning
• undulate
• unprintable expletive
• vicarious
• vociferous
• vociferously
• wallydraggle
• widdled

#AACaware “October is International ‘Augmentative and Alternative Communication’ Awareness Month

If you see this tag on tweets #AACaware it relates to an international awareness month run by #ISAAC (International Society for Augmentative and Alternative Communication)  for anything to do with Augmentative and Alternative Communication (any form of communication that is not speech, that helps people who cannot rely upon natural speech to communicate).

AAC includes communication boards, books, and speech devices, the use of sign or gesture and many strategies and techniques to help people with little or no speech to communicate. AAC helps many people around the world – but so few people really know what AAC really ‘is’ in the world, as it is so rarely seen. Things are changing though – with more and more media reports on the good stories of the impact AAC can have when a person has good access. Almomst everyone knows someon who has difficulty communicating – #AACaware awareness month is to make sure everyone knows a lot about the many types of communication aids and techniques that can help people to understand to be understood in society.

For more information about International AAC awareness month (October) go to www.isaac-online.org and http://www.isaac-online.org/english/international-aac-awareness-month

AND in Australia, look at this (silent) morning tea! I am sure they would be happy to share resources that are used in tis kind of ‘work site’ event. http://www.scopevic.org.au/index.php/site/supportus/morewaystocontribute/silentmorningtea

 

 

 

 

 

 

#ISAAC2012 So I’m going there in a few days …

MY WEEK AT #ISAAC2012 International Society for Augmentative and Alternative Communication – Pittsburgh, 28 Jul -4 Aug 2012.

If I am not tweeting papers I am in meetings: #ISAAC2012 and my tweeting depends on what #internets are available in the rooms.

Pre-Conf: Short presentation at the patient-provider communication Pre Conference Workshop (Saturday, July 28) Pressman & Blackstone

Meeting: Council (Sunday, July 29 – 9 am – 6 pm: Westin Hotel, Washington Room)

Meeting: Presidents (Monday, July 30 – 8 am – 9 am:  Convention Center, Room 336)

Meeting: Publications (Monday, July 30 – 11:45 am – 12:45 pm:  Convention Center,

Room 336)

Paper:  Tuesday July 31 9:15AM – 10:15AM “Access to Communication” – CAFE Communication Access Framework and Evidence: Communicatively Vulnerable Populations in Clinical Settings Bronwyn Hemsley; Elizabeth Worrall; John Kis-Rigo; Robyn O’Halloran; Sophie Hill20 Minute Presentation, within 60 Minute Session

Meeting: Chapter ISAAC-Australia (Tuesday, July 31 – 11:30 am – 1 pm:  Convention Center, Room 326).

Poster: Tuesday July 31 2-3.30pm Poster Hall Glossary of Terms: Developing and Translating an AAC Glossary: ISAAC engages with students, volunteers, and social media. Bronwyn Hemsley, Paul Andres, Kaely Bastock

Meeting: Conference 2014 (Tuesday, July 31 – 1 pm – 3 pm:  Convention Center, Room

336)

Meeting: Awards & Membership Meeting (Wednesday, August 1 – 2:15 pm – 3:45 pm:

Convention Center Room 316)

Meeting: Website and Translations Meeting (Thursday, August 2 – 10:30 am – 11:30 am:

Convention Center Room 336)

Meeting: Research (To be confirmed: Thursday, August 2 – 12 noon – 1 pm: Convention

Center, Room TBD)

Paper: 1-2pm Conference Workshop. Factors within the ICF affecting interactions of people with cerebral palsy using AAC in hospital. Bronwyn Hemsley; Susan Balandin; Linda Worrall

Our Symposium at #IASSID2012 on July 10 2012 at International Association for the Scientific Study of Intellectual Disabilities

And so we go to … #IASSID2012 International Association for the Scientific Study of Intellectual Disabilities Halifax, Canada – on Tuesday 10th July 2.30-3.30pm

Symposium: Health communication: Participation of people with I/DD in hospital settings [Chair: Bronwyn Hemsley, The University of Newcastle]

1. People with I/DD communicating in hospital: Needs and experiences reveal barriers and facilitators to better communication (Bronwyn Hemsley, The University of Newcastle)
2. Communicative interactions in hospital for people with little or no functional speech: A Norwegian perspective (Susan Balandin, University College, Molde, Norway)
3. ICF as an organizational framework for collaborative efforts related to AAC (Charity Rowland, Oregon Health Sciences University, Portland Oregon)

OVERVIEW OF THE SYMPOSIUM

People with I/DD have high health service utilization rates and frequently encounter barriers to effective communication in health settings.  Problems in communicating basic care needs and information to staff impacts negatively upon their healthcare experiences, satisfaction, and patient safety.  In this symposium we will present the results of recent research conducted across three continents examining:

INTRO – Bronwyn – 5 minutes (Very brief – ICF, definitions, populations)

(a) perceptions of key stakeholders on the use of AAC in hospital and their views on the potential for collaboration to improve communication,

SUE (15 minutes): Can give overview of research in Australia and Norway that has both published results on the problem, and new data on the issues from the perspective of communication partners (nurses) in the setting, including absence of info on disability in training etc etc Australian results also have views of paid carers, adults with CCN, family carers etc – all converging to problems relating not only to the person but to their communication partners and the context,setting, time, collaboration, etc. Roles of paid and family carers will be explored.

(b) factors within the hospital environment impacting upon communicative interactions for children and adults with I/DD with little or no speech, and

BRONWYN (15 minutes): Can give results coming in relating to the ICF and observations of adults with Intellectual Disability and CCN, and CP and CCN – in hospital. Also outline study on use of the ICF in developing a code set on 75 other studies intervening for patients with communication vulnerability (ie the broader population of people with difficulties communicating) in progress.

(c) a purposefully selected core set of communication-related factors in the ICF-CY

CHARITY (15 minutes): Presenting on children who use AAC in the school setting and studies relating to the Code Set within ICF-CY.

PULLING IT TOGETHER

Bronwyn (5 minutes)

The ICF / ICF-CY as a collaborative tool to guide assessment and intervention goals in the healthcare setting, and future research.

Factors affecting preparation for hospitalisation and use of generic or customised AAC systems to improve communication. Directions for future research and design of interventions for improving communication in hospital for people with I/DD will also be discussed.

Outcomes of ‘#SPAconf2012’ Workshop on Communication in Hospital for adults with developmental disability

Outcomes from #SPAconf2012 Speech Pathology Australia National Conference, Hobart, 24-27 June 2012.

Workshop: AAC in Hospital for Adults with Developmental Disability and Complex Communication Needs [Hemsley, B., Balandin, S., & Worrall, L.]

Attended by 30 Speech Pathologists – majority working in hospital settings and with adults, some SLPs in schools, community health, and adult disability services.

After hearing the findings of recent research outlining the experiences of adults with complex communication needs in hospital, speech pathologists discussed how we can make a difference – what needs to happen or to be implemented that goes beyond ‘provision of communication aids’ and a focus on ‘tools’ for communication. Participants were encouraged to ‘think online’ and ‘think tech’ and also to consider not only the patient but the provider and the health setting, and the wider environment for communication as being important. The items discussed were written down and are arranged here according to common categories across the four participant groups. Of note is the common strategy suggested of addressing broader hospital quality assurance procedures (measuring communication access), creating an ‘alert system’ and increasing strength of procedures at admission and assessment, considering management guidelines for staff similar to the dysphagia management guidelines, and providing universal communication supports on the hospital ward.

Awareness of Patient’s Communication Method/Needs in Hospital Policy and Procedures: Promoting Communication Access

• Hospitals might adopt SCOPE’s communication access symbol
• Include ‘communication access’ in EQUIP (Australian Council on Healthcare Standards) achs@achs.org.au
• Key stakeholders are given the patient experience (to change attitudes) like the ‘CEO sleepout’ campaign and action re CEO and community awareness of homelessness
• Adapting/Adopting the US Joint Commission ‘Roadmap for Hospitals’ of the US
• The Joint Commission: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. Oakbrook Terrace, IL: The Joint Commission, 2010.

Alert system for ‘complex communication needs’

• Card, armband, alert system etc with client (Universal)
• Same process as “hearing/allergy” alert for patients with complex communication needs (e.g., on chart, on patient band)
• Visual alert for above the patient’s bed to alert that they have communication difficulties, with picture of the device / tool
• Alert re communication impairment or AAC needs on electronic record – carry over between admissions and departments, wards etc.

Admission Information / Assessment

• Communication screen similar to dysphagia screens in use by nurses
• Initial assessment needs identification of key communication partner/resource.
• Guidelines for communication management (? Similar to dysphagia management in hospitals?)
• Patient-controlled e-health record: SLP to encourage clients to have one.
• Community based care plans – request at admission
• Advocating for clients with limited communication
• Easy English rights/responsibilities
• Engage with legal units in hospitals on this issue (esp re communication in consent, information)
• Medicolegal focus – does patient have capacity with or without the communication aid, to give consent?
• Include patient communication needs in nursing initial assessment
• Routine part of nursing handover
• Carer education, nursing education re here and now, during the admission of a patient with complex needs, coaching and modelling
• Patient education ‘don’t leave your voice at home’
• SLPs to ensure patients complete the patient feedback form
• ALL of the above linked to a broader awareness and advocacy (i.e., beyond SLP)

At school – preparing for hospital

• Collaboration between parents/carers with school staff prior to hospitalisation
• educating peers to provide peer support
• Community professionals being paid and supported to have links and provide info to hospital based services about the client’s communication
• Interagency acceptance of communication supports and sharing information
• Increased focus on communication for all patients
• Teaching generalization skills to child in the classroom – have nurses come to the classroom.
• Teach the child to use the system when they go to GP or school nurse/sick bay.
• Focusing on communication needs in the school program.

Communication aids / communication supports in hospital

• Universal communication supports on all wards – e.g., ?iPADs
• Pictorial supports (generic universally available)
• Communication passports for all clients – key info re communication
• Organisation ‘Quality Assurance’ re care for clients in all settings à link to funding
• Lines of communication with community SLP and hospital SLP
• Developing resources
• Staff training – senior management? Mentors? Specialists, esp re terminology.
• make sure they have a personal communication dictionary for them, maybe with a specific tab for hospital ? can we put this on the web somehow so nurses can access it? Can we link it to e-health?
• Hygiene – infection control – use of laminated low tech, aid placed in ziplock plastic bag/dry pack; touch screens work with covers? Gloves; pre-shower, establish communication with low tech waterproof or non-verbal unaided strategies in wet areas.
• Communication aid – labelled with Bradma/ID sticker. Policy re who replaces/fixes it?
• Need to be listed as a valuable to be covered by hospital insurance
• Standard basic ward low tech kit (see several resources on the Patient Provider Communication Website, US).

I would like to thank all participants in the #ASHA2011 and #SPAconf2012 workshop discussions – each workshop contributed important insights and builds upon the strategies suggested by participants in each of the research projects undertaken to date. This information will be used to guide implementation research and the movement of findings into policy and practice to improve communication in hospital for adults with developmental disabilities and little or no speech.

Two conferences – Two continents : #ASHA2011 and #SPAconf2012 – Workshop Outcomes will be posted here

Wednesday 27th June 2012 – Speech Pathology Australia National Conference, Hobart, Tasmania.

Title: AAC Communication in Hospital: Adults with Developmental Disability and Complex Communication Needs

The aim of this workshop is to build upon the findings of recent research to develop actions pertinent to community-based and hospital-based speech pathologists in the support of adults with developmental disability who use AAC. Outcomes of the workshop will include ‘top 10 strategies’ for improving preparedness for communication to overcome several common barriers to communication in hospital.

The workshop will include presentation of the findings of recent research (15 minutes), small group discussions of groups considering either pre-hospital or in-hospital actions that might be taken to improve communication (30 minutes), large group development of policy, practice and procedural strategies to improve communication for this vulnerable group in hospital (30 minutes), and directions for future research and training to empower clinicians in all settings towards removing environmental barriers to communication in hospital (15 minutes).

Results of previous research will be integrated with the clinical experiences of workshop participants to build ‘evidence based policy’ and practice in supporting adults with developmental disability who use AAC. The results of this workshop will be published and available freely online for the future use by clinicians who seek to improve communication in hospital for adults with developmental disability.

We expect that clinicians in both hospital and community settings will contribute valuable insights on the clinical implications of our program of research exploring barriers to and strategies for better communication in hospital. Participants will have an increased understanding of the evidence base and directions for future practice and policy that might improve hospital experiences for many patients in hospital who struggle to communicate.

Notes from #ASHA2011

BEFORE hospital: communication inventory, gesture communication, create generic tools, contact with healthcare team member, referral to SLP department at hospital, priority pre-admission interview, provide parents with advocacy info, call ahead of time, students can make procedure boards and pictures, creating medical communication ‘passport’.

IN hospital: creating communication boards, use of visuals, nursing staff being a bridge to communication, having contact numbers for SLP in the community, knowing about triggers to upset/behaviour/stimulation, use of schedules, issue of handover, safety, interests, topics, regulating activities, small communication aids.

ENVIRONMENT: audits, checklists, implmentation science, training others on Standards, electronic medical record, communication as a competency, having ‘champions’ in the system.