This service offers specialist assessment and intervention advice for children whose communication and learning may be constrained by significant motor impairment.
Assessment of the child’s developmental skills using methods that take motor impairment into account will precede any practical advice regarding support for communication and learning.
There will be a particular emphasis on developing a detailed understanding of the child’s communication skills, including not only the child’s level of receptive language but also his/her current ability to use movement, vocalization and vision as basic expressive communication tools.
Guidance will also be offered on optimization of positioning with advice on the child’s seating needs, where appropriate.
For those children whose expressive language skills lag significantly behind their receptive skills, advice will follow on use of augmentative communication strategies and equipment to support spoken and/or written communication skills.
Advice on strategies and equipment will include, where appropriate, advice on the selection and use of sign and gesture vocabularies, symbol charts and voice output communication devices. Advice on strategies and equipment may also include advice on the development of switching skills, with an emphasis on selection of appropriate switch linked activities as well as on decision making about switch type and position.
The team can address a wide variety of referral questions, including the prognosis for speech development, the role of intervention to promote speech clarity, concerns about potential visual impairment and the impact on communication and learning, selection and presentation of symbol vocabulary, selection of communication software or device.
For children whose local areas are served by a specialist AAC team, liaison will establish if specific advice on communication software or equipment is required from our team or if this will be provided locally.
This service sees children up to the age of 16 with any type of physical disability including cerebral palsy, neuro-muscular conditions, head injury or dyspraxia.
Referrals to the service can be initiated by the child’s parents, school, medical or therapy contacts, but must be accompanied by a letter of support from the child’s Community Paediatrician. They should be addressed to Kim Bates, Speech and Language Therapist, or Dr Jenefer Sargent, Consultant Paediatrician, Neurodisability.
On receipt of a referral, pre-visit questionnaires will be sent to the child’s family and local therapists. Local therapists and representatives from the child’s school are invited to attend the appointment.
The initial assessment lasts approximately three hours. At this visit, children and their families, and local professionals, have the opportunity to clarify the questions raised in the pre-visit questionnaires. Further relevant background information is obtained. The child’s medical history, previous investigations and diagnoses are reviewed.
The team then work/play with the child to complete any remaining aspects of the assessment necessary towards answering the questions posed. Parents are present throughout.
The initial assessment team will vary according to the needs of the child, but will generally include a speech and language therapist, occupational therapist, and a paediatrician. Other professionals, including an assistive technologist and a clinical psychologist, will be part of the team as appropriate.
At the end of the assessment, the child, parents, local team and specialist team members meet together to discuss findings and conclusions, to discuss communication goals, and any other recommendations, for example, advice on further medical investigation.
For some children a second appointment may be required to complete assessment, and this may take place in the child’s school.
A short summary of assessment findings will be given to parents on the day of assessment; a full written report will be completed later and sent to the child’s family and relevant professionals, as agreed with the child’s family.
The service has a loan library of communication software and equipment. Where appropriate, a loan can be arranged. Following the loan, a report will be prepared summarising the outcome which can be used to support and future requests for purchase.
You can contact the Developmental and Augmentative Communication Service on 020 7405 9200 ext 1144.