Work with us!

The Barnsley AT Team

We are recruiting to a number of positions in our team – we are looking for Technical staff and also Speech Therapists and Therapy Assistants.   If you wish to apply, or know someone who may be interested, please see the listings on NHS jobs below.

Technical Staff: Do you have a technical background but want to work in a more rewarding role, making a real difference to the lives of individuals with disabilities? We are looking for Technicians, Field Service Engineers and Clinical Technologists to work in our nationally recognised Assistive Technology Team.

If you have a technical background and an interest in electronic Assistive Technology, we have a number of posts open, according to your skills and experience:

• Equipment Technician (Assistive Technology)
• Mechanical Technician (Assistive Technology)
• Field Servicing Technician (Assistive Technology)

If you are a registered Clinical Technologist, or have a defined route for completing registration:

• Clinical Technologist-Assistive Technology Mechanical Specialist
• Clinical Technologist – Assistive Technology Electronics Specialist

Therapy Staff: Are you a Speech Therapist or Therapy Assistant with a specific interest in AAC and Assistive Technology?

• Speech & Language Therapist (Assistive Technology Specialist)
• Therapy Assistant/Technical Instructor

Find Out more about our team and the services we provide on our website.

Unspoken voices: Gathering perspectives from people who use Alternative and Augmentative Communication (AAC)

This blog post is from Katherine Broomfield – Speech and Language Therapist, Gloucestershire Care Services NHS Trust. Kath has recently been successful in achieving an NIHR Doctoral Research Fellowship, will start her PhD with Prof Karen Sage of Sheffield Hallam in 2017 and will be working with our team as part of this.

---

I lead the local AAC service in Gloucestershire; part of the adult speech and language therapy service. We assess and provide basic communication aids such as low-tech, paper-based systems and direct-access, high-tech devices. In a quest to improve our service, I was interested in how to reinforce the quality of the assessment and support that we provide to people in need of communication aids. I also wanted to understand how to improve people’s experience of using them. In 2014, I secured funding from Health Education England South West to carry out a clinical academic internship at the Bristol Speech and Language Therapy Research Unit, under the supervision of Professor Karen Sage.  The objectives of the internship were to: a) search for research literature about how to best support the implementation of communication aids, b) carry out interviews with service users and c) consider areas for further research.

The literature search uncovered limited information about why some people use communication aids effectively and others do not; nor what ‘successful communication’ means to people who rely on communication aids and what they feel best supports them to achieve this. The services users I interviewed reported very different views on successful communication aid use. They also provided some interesting insights into how to improve the support that NHS services provide when issuing AAC equipment. The number of participants in the interviews was small however and they were all adult users of one particular device. By the end of the internship, I had generated more questions than I had answered.

I chose to apply to the National Institute for Health Research (NIHR) for funding to carry out further research into the perspectives of users of communication aids. In February 2016 Prof Karen Sage relocated from Bristol to a post at Sheffield Hallam University (SHU) Centre for Health and Social Care Research. This provided me with the opportunity to establish a team to help me with my research project from the vibrant health research community in Sheffield and, more specifically, to approach Simon Judge at the Barnsley Assistive Technology Team. Simon agreed to join Prof Karen Sage, Prof Karen Collins (SHU) and Prof Georgina Jones (Leeds Beckett University) in supporting me to develop my research proposal, complete the funding application and, if successful, to supervise me while carrying out the research.

At the end of last year I was awarded NIHR funding. My project aims to develop a greater understanding about why people do and do not use communication aids and how they view success with using them. I plan to carry out a more extensive and specific literature review focusing on user perspectives and outcomes for communication aids. I will then complete a series of interviews with young people and adults who use communication aids at different points across the AAC pathway – from assessment and provision of equipment to the use of communication aids in people’s homes, schools and communities. The ultimate aim of the project is to develop a patient reported outcome measure (PROM). The PROM will be made available for use by NHS services to gather the perspectives of people who use communication aids about the equipment and the support they receive.

The project is one aspect of my PhD training programme (the Clinical Doctoral Research Fellowship, or CDRF) targeted at developing practicing NHS clinicians into academic researchers. This scheme is part of the current drive to improve the use of research evidence within NHS services.

I am really looking forward to working closely with people who use communication aids and their friends, families and carers throughout this project. I am also excited about the opportunity of working closely with the team at Barnsley Assistive Technology whose clinical work and research I have admired for some time. I will be setting up my own blog imminently to keep people informed about the project – but in the meantime, I am contactable via Simon and the team. I am passionate about good communication and I still have a lot to learn about AAC, so please get in touch!

 – Katherine Broomfield, Speech and Language Therapist, Gloucestershire Care Services NHS Trust.

 

 

 

Oral Histories and Legacies

Leaving an oral history or legacy is something that can be important to those with life limiting conditions.  Our team works with people with communication difficulties who rely on AAC systems to communicate and I (Nicola) was curious to investigate what services are available for people with life limiting conditions to leave a legacy for friends and families. I have had client’s that have left letters and planned their funerals using AAC systems that family have found subsequent to their death.  I have also had requests that family copy information that is stored on the systems to remember the person by.  However, I had felt that I was unable to support or guide people to services if they do want to leave something for their friends and family, so I went to find out more.

Legacy Service

My self and our team’s clinical psychologist met with the organiser from a local hospice, who coordinate a team of volunteers who support people with life limiting conditions to create an oral history for friends and family. This service has been running since 2013 when it was set up as part of a research project by the University of Sheffield and Macmillan Cancer Support.

The Macmillan service will support people referred to their service to create an audio recording. They do this in a number of different ways and will be guided by the individual.  They offer an interview, desert island discs, personal histories and memory boxes.  They use a crib sheet, but it is very much what the person wants to talk about and the facilitator just offers encouragement.

To do this, the service uses high quality recording equipment, funded by donations, the microphones on the system are small and frequently the person will forget that they are using them.  Recordings can be done either  on site or at the person’s home.  They need a quiet room and the service will offer emotional support.  The service then uses software called “audacity” to edit the audio together – so that the person does not need to do it in one go.  The service reported finding that the process can be beneficial for the person as a reflective exercise.

The Macmillan service have discussed using video with clients – however feedback so far has been that this would not be positive, including for reasons that the person could see physical changes in themselves. This may change in the future as younger people live their lives through social media.

Once completed, the person signs a consent form for who they want to access the recording. A CD is produced or people can have it in a digital format.  They can also consent to have the recording saved with the University of Sheffield as part of the research project to develop a growing oral social history to help future generations connect with real people from the past.  There is very little other research on the topic of leaving oral histories and legacies by people with life limiting conditions.  The research reported benefits for the participants and the importance of it being their voice.

Legacy using AAC

The service in Sheffield does support people with communication difficulties and have found that this takes more planning.  They did have one person referred to their service who used a communication aid, but following discussions this person did not follow through as she felt that the voice was not hers.

I now feel that I can discuss and offer sign post to services that will enable our clients to complete this, if that is what they want to do. It is a very personal thing and is not for everyone. When possible it should be offered prior to deterioration or loss of speech, but this is not always possible.  The hospice now feels that the local AAC service can support them if they have issues support people who use AAC to access the service.  For client’s using AAC it may be a matter of leaving the information in other ways such as in writing, videos, photographs as well as through their communication aid.  If you work with people using AAC I would urge you to offer and support people to enable them to leave a legacy behind and not be held back by their communication issues.

BBC Accessibility Champions

In August Vicky Johnson and Marcus Friday from our Team were invited to present to the BBC accessibility champions event at BBC Media City in Salford.

BBC Media City, Salford

This day was organised to bring together many BBC accessibility champions. The group included people who design BBC websites and apps to ensure accessibility. The audience consisted of programmers, user experience designers, researchers and testers, business analysts, assistive technology users and accessibility specialists.

The BBC now has approximately 85 accessibility champions which span across many BBC departments, eg TV, radio, sport and children’s. Presentations were given to explain the ways in which the champions ensure that accessibility is considered early in the design process, and that testing is carried out as a website, app or game is developed.

‘Physical’ ICT Accessibility

Vicky and Marcus, from the Barnsley AT team, were invited to speak at the event in order to provide the audience with an insight into how users with severe physical impairments access technology. The focus was on their clients who predominantly have upper limb physical impairments and sometimes have associated visual and cognitive difficulties. An overview of the Barnsley AT Team was provided, along with some powerful case studies of clients using their AT systems to enable computer access, control of the environment, and access to communication.

Three breakout sessions took place in the afternoon and we listened to the Head of Accessibility and Accessibility Specialists provide an insight into the developments in the accessibility of BBC output in recent years. Part of the discussion focused on how to ensure that breadth of BBC output is accessible to those with visual, cognitive or physical difficulties.

Looking to the Future

The day ended with a fun session spent in the Blue Room. The BBC have dream jobs where Technologists are employed whose role is to keep aware of new mainstream developments which may have an application or scope for development of interest to them.

We tried the Amazon voice recognition system called Echo which uses the protocol IFTTT (if this then that) which provides a flexible system, where for example the system recognises your request and you program it to perform any number of actions e.g. control your environment, interact with an app in order to order a taxi or food or action another command programmed in other IFTTT enabled apps. We also had time to try Google Glass and a relatively cheap head worn display called Glasshouse.

It was a privilege to meet some of the people behind the iPlayer TV and radio apps, including the Good Food site. Overall, it was an informative and enjoyable day which has opened up the opportunity for Barnsley AT Team to work further with the BBC.

Specialised Services for AAC and Environmental Control: An Update

There have been big changes within the Barnsley Assistive Technology Team over the past three years, we have been steadily recruiting more team members as we expand our services across the Yorkshire and Humber region as part of the staged roll-out of Specialised Services for AAC and Environmental Controls. You can read more about the history of this process on our website.

We are now almost at the end of this process. We currently cover most areas within Yorkshire and Humberside and will be accepting referrals from all CCG’s by the end of the year. Information regarding our care pathway and how we work with local services can be found on our website:

• www.barnsleyhospital.nhs.uk/assistive-technology/about-assistive-technology-at/augmentative-alternative-communication-aac/
• www.barnsleyhospital.nhs.uk/assistive-technology/about-assistive-technology-at/environmental-control-ec/

Supporting Local Services

We are keen to work with local services to support them through this transition period and beyond. We have already visited lots of teams to talk about our service and how we can work with each other to support people using AAC and Environmental controls.

We also offer a wide range of free training courses which can be delivered in your local area. Details of our curriculum are also on our website: www.barnsleyhospital.nhs.uk/assistive-technology/services/training-courses/

We are also trying to bring together local services to share and learn from each other. This includes setting up and arranging the Yorkshire and Humber AAC Clinical Excellence Network meeting which has been running for almost a year now. The group meets every four months to discuss a range of Assistive Technology issues and serves as a useful forum for networking and CPD.

Also on our website is a range of resources, including our popular ‘local services resource pack’ which details products and resources which local professionals will find useful: www.barnsleyhospital.nhs.uk/assistive-technology/services/resources-and-information/

NHS England have also recently published guidance about AAC provision from local and specialised services. This is a useful reference for local commissioners and managers when considering AAC provision: www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/03/guid-comms-aac.pdf

---

We have received lots of positive feedback so far and are enjoying getting to know the professionals across the region supporting AAC and Environmental Controls. If you have any questions about our service or would like to arrange for us to visit your team, please email barnsley.at@nhs.net

To receive further updates and news from the Barnsley Assistive Technology Team, please sign up to our mailing list (we send a message or two per month).

Accessibility in Information Technology Lecture

I recently gave a lecture at Sheffield Hallam University about the importance of building accessibility options into information technology. Dr. Peter O’Neill had invited me to speak – he is a senior lecturer at Hallam, and runs courses on mobile applications. These students could be designing the apps we use in a few years time, so it was great to have the opportunity to explain why it is important to consider accessibility during the software design process.

Following the lecture we received the following very kind feedback – thank you!!

“What struck me the most watching Vicky’s presentation is how recent evolutions in the computing user experience are already being considered for the potential uses in assistive technology. Most notably with the leaps being made in home automation and advancements in gesture based input. Similarly, I also absolutely fascinated by the input methods we already have in use – I especially had no idea that eye tracking software was so capable.

This is especially useful as we have been talking about how best to grant users access to the assistive mode in our game. The presentation has encouraged me to think creatively and far outside of the box for this problem. I was previously stumped, but after seeing other solutions we have in use I feel inspired.”

“I thought the presentation as a whole was very useful and provided lots of valuable insight into the different accessibility requirements. It was also very useful to see examples of devices which have been adapted for assistive technology, showing how different methods can be interpreted using physical implementation rather than just software based.

It was also very interesting to see how the devices are used in a real world situation, as demonstrated through the videos shown in the presentation. This gave a good idea for how I could interpret assistive technology into the mobile app we are currently developing in the module. One particularly useful discussion was the need for high contrast images (yellow text on black background, for example) as this will be one of the essential things to consider for our app.

To summarise, I think the presentation as a whole is key to understanding the needs and uses for assistive technology in application development as well as many other areas. I hope Vicky can return in future years so other students can be enlightened on the topic and gain further understanding.”

Multi Sensory Keyguide

Working with clients with visual impairments offers challenges within the field of AAC that are unique and can require imaginative solutions to enable the client access to their device.

After supporting  a young child with no functional vision for numerous months, progress  in terms of his ability of navigating through the ‘pages’ of his language package on his communication aid was limited. This child was  accessing  his 45 location Wordpower language package set via a standard key guard and appeared initially to be making good progress in terms of remembering where specific vocab items were located.

As a navigation strategy, the child was supported to place his hand at the top left of his  device and then move down the columns and then from  left to right across the rows. He was able to press a few  cells  before his chosen cell and used the auditory feedback to cue him in as to where he was on the page. However after a period of use of this method  his progress appeared to have plateaued and his targeting  was not getting more accurate.

After discussion with one of our mechanical techniologists a multi sensory keyguide was developed using the department’s new laser cutter. This keyguide was layered – the top layer splits the page into eight sections and then on the bottom layer within each section six shapes (circle, star, square, triangle, diamond, oval) are cut. In this way the child is provided with a sensory code/cue for each cell of the vocabulary package and this should allow himself to orientate himself and more easily learn the use of the system.

Multi sensory keyguide showing layered shapes

Multi sensory Keyguide showing vocabulary

We are looking forward to reviewing this child and seeing if this multi sensory keyguide has supported his ability to learn his AAC language package more effectively.