Category Archives: service delivery

Being a Field Servicing Technician in the Assistive Technology Team

In this post Phill, one of our new Field Service Technicians tells us about his role.   If this is something that interests you, or someone you know, then we have a position out to advert at the moment so please have a look and get in touch!


Tell us what the job of Field Servicing Technician in the Assistive Technology Team involves?

Phill, one of our field service engineers.

Phill, one of our Field Service Technicians

No two days are ever the same. One day you may be refurbishing equipment that has been returned ready to be returned to another client or setting up a device for other members of the team. You could be installing a system for a client or carrying out a routine service. But the best part of the job is that every day you can make a real difference to someone’s life. This could be something as “simple” as letting someone control their TV using a different style of controller to enabling someone to communicate who may not be able to speak.

What was your previous field servicing experience?

Previously I worked as a service engineer for a large international company on high end devices from numerous manufacturers. The equipment I worked on was in almost every sector from Healthcare to banking, Small single offices to international  companies.

How does this role compare to your previous field servicing experience?

Previously I was just a number in a service division of an international company. Now I’m part of an amazing team of people who are all working towards providing the best possible service possible. Everyone goes the extra mile to help our clients.

What would you say to someone else coming into this role?

If you really like helping people and working with technology then this is the job for you.

Tell us about a client you recently visited, what did you do?

One of the first visits I attended was to watch a colleague install an environmental control system. After we had completed the install the reaction from the client and her Husband  was fantastic. Being able to control the TV and adjust her chair made such a difference. A more recent visit I have attended was for a young man who is not able to communicate or use standard devices to control his TV, Radio or go on Facebook. All this is now controlled from one device. Although he couldn’t talk we still had a laugh with each other after I told him I was going to make his device tune the TV to Classic FM. We settled on Heart FM

Anything else?

The Barnsley AT Team

The Barnsley AT Team

If you want a new challenge in a rewarding field, working as part of a fantastic team in a great environment then this could be the move your looking for.

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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.

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:

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).

Be a Field Service Engineer with a difference

We are currently recruiting for field service engineers.  This is not your average field servicing job though – this post is rewarding and challenging in equal measure. In addition, there are routes to personal development including working towards registration as a clinical technologist within the NHS.

These roles are key to our team’s ability to install, service,  maintain and repair the communication aids and environmental controls that our team provides to individuals with severe disabilities.

You will have to have a strong electronic/computing engineering background and the ability to communicate with a range of people and have an excellent ability to fault find and fix problems. You will also enjoy being a part of a supportive and dynamic team.

Read more about the job on the NHS Jobs page.  You can also see more about what we do on our website.

Choosing the right vocabulary package – a Barnsley AT Team study session

Members of the Barnsley AT Team met recently to spend some time looking at the evidence behind several different vocabulary/language packages for communication aids. This is a key and frequent discussion within the team and we organised a session to help develop our thinking on this.  It also links with the forthcoming research project we will be involved with funded by the  National Institute for Health Research and in collaboration with Manchester Metropolitan University (more on this later!).

Vocabulary packages can broadly be grouped into: taxonomic (categories), schematic (activities), alphabetic, iconic encoding, visual scene displays and idiosyncratic (personalised). Some systems might use several of these methods to organise vocabulary. For this session we chose to looked at the evidence around Visual Scene Displays (VSDs) and considered the following literature (some published in peer reviewed journals, some ‘grey’ literature):

  • Drager, Light et al (2003) The Performance of Typically Developing 2½ Year Olds on Dynamic Display AAC Technologies with Different System Layouts and Language Organizations
  • Drager & Light (2010) Designing effective visual scene displays for young children. 

This work suggest that visual scene displays may:

  • be most beneficial for young children and people with significant cognitive or linguistic difficulties (e.g. Learning Disability, Aphasia, Brain Injury);
  • provide a high level of contextual support;
  • enable communication partners to engage and support the person with communication needs by providing a framework and context from which they can scaffold a conversation;
  •  support real life events and experiences as they happen, by providing a supportive narrative;
  • be highly personalised/replicate real life experiences;
  • provide language in context;
  • shift the focus away from expressing wants and needs and towards social interaction and exchange of ideas and information;
  • reduce cognitive demands by reducing visual processing;
  • access linguistic concepts via episodic memory not semantic memory;
  • exploit human capacity for rapid visual processing of visual scenes.

The above studies also discuss the limitations of VSDs suggesting that:

  • Children with motor difficulties may find it harder to access hotspots on a VSD than symbol grids.
  • VSDs may be more visually complex than evenly spaced symbols in a grid.
  • VSDs are labour intensive to produce and maintain.
  • Jackson, Wahlquist and Marquis (2011), found children performed better with a grid layout and made more mis-hits with VSDs.

We also looked at the paper: “Critical Review: Which Design Overlay is Better Suited for Early Assisted AAC Intervention in Preschoolers: Visual Scene Displays or Traditional Grid Layouts? ” Kaempffer (2013).

Kaempffer reviewed the literature on VSDs and found results of studies looking at VSDs to be inconclusive and limited. Kaempffer was also critical of methodology and statistical analysis used in studies into VSDs. Only one study has included children with communication needs and some studies have suggested grid layouts may be more appropriate.

Our team concluded that VSDs should still be considered as part of the AAC assessment process. However although the literature suggests that emergent AAC users and adults with cognitive impairments may benefit from VSDs, from this session we could not see strong evidence to suggest particular groups of individuals or situations in which VSDs may be most useful.

A number of software packages are available that support VSDs, these include:

  • Tobii-DynaVox Compass, Sono Primo
  • MultiChat 15/Touch Chat HD app
  • Therapy Box Chatable & Scene and Heard

Have you used VSDs with a communciation aid user, have we missed some important literature? We would love to hear about your experience!

References:

Drager, K., Light, J., Speltz, J., Fallon, K., Jeffries, L. (2003). The Performance of Typically Developing 2½ Year Olds on Dynamic Display AAC Technologies with Different System Layouts and Language Organizations. Journal of Speech, Language, and Hearing Research, 46(2), 298-312.

Jackson, C., Wahlquist, J., Marquis, C. (2011). Visual Supports for Shared Reading with Young  Children: the Effect of Static Overlay Design. Augmentative and Alternative Communication, 27 (2), 91-102.

Kaempffer, A (2013) Critical Review: Which Design Overlay is Better Suited for Early Assisted AAC Intervention in Preschoolers: Visual Scene Displays or Traditional Grid Layouts? Poster presentation at University of Ontario. Unpublished/peer reviewed, but available as PDF.

Light, J., Drager, K., & Wilkinson, K. (2010, November). Designing effective visual scene displays for young children. ASHA Conference. Lecture conducted from Philadelphia, PA.. Conference presentation avaliable as a PDF.

Launch of the new Yorkshire and Humber AAC Clinical Excellence Network

On 21st October twenty-two professionals from across the Yorkshire and Humber region came together for the inaugural meeting of the AAC Clinical Excellence Network in Leeds. The group is affiliated to the Royal College of Speech and Language Therapists, but membership is open to any professional working within the field of AAC across the Yorkshire and Humber region.

On the agenda was the official swearing-in of the committee members, followed by the AGM. We then shared our experiences of this year’s Communication Matters Conference which was also held in Leeds, on the 13th-15th September.

Andrea Kirton gave the group an update on the role of the Barnsley Assistive Technology Team in its role as the Specialised Service for AAC and Environmental Controls (EC). For further information please see our website pages at: www.barnsleyhospital.nhs.uk/at/

Helen Robinson talked to the group about the extensive range of training opportunities offered by the Barnsley AT Team. The current courses we offer and dates available are on our website www.barnsleyhospital.nhs.uk/assistive-technology/services/training-courses/ – but please also get in touch with ideas or requests for training.

Finally, each professional gave the group an update on how AAC is currently provided in their local team. As part of the Barnsley AT Team’s role as the Specialised Service for AAC and EC we are rapidly expanding the areas we cover and it is really valuable for us to understand AAC provision across the region. Over the coming months members of our team will be meeting with local services to discuss how our service will support their clients with AAC.

There was certainly a real buzz about the CEN and attendees were pleased to have the opportunity to come together and discuss AAC. We did have quite a long list of people who wanted to attend but couldn’t due to the room capacity. Our next meeting is at Henshaw’s College, Harrogate on 20th January 2016 and we will have a much bigger room so hopefully all those that wish to attend will be able to! Tickets will be available via our eventbrite site shortly.

We hope to see you at the next meeting!

MND Study Day Success!

Yesterday we delivered our first Motor Neurone disease Study day here at the Barnsley Assistive Technology Team. This was developed in response to increasing demand from professionals in or area for training around assistive technology for this client group.

Helen Robinson and Marcus Friday presented to a wide range of professionals from across the region, including; Speech and Language Therapists, Occupational Therapists and Regional Care Development Advisors from the MND Association.

We covered Alternative and Augmentative Communication methods and Environmental Controls, with a mix of teaching, discussion and hands on exploration of the equipment. We also shared some of the initial data from a recent  focus group with people living with MND and their carers at SiTRAN in Sheffield, which was lead by Simon Judge from our team.

We were joined by our guest speaker, Jennifer Benson, Speech and Language Therapist, who kindly came along to tell us about her experience of using the Model Talker speech synthesis software. Jennifer is soon jetting off to Orlando, Florida, to talk about this process and we are sure they will be as impressed with her presentation as we were!

The day generated lots of discussion around assistive technology for people with MND and we received some fantastic verbal feedback from attendees at the end of the day.

The MND study day is one of the many training opportunities we are currently offering. For details of further courses and workshops please visit our website page: www.barnsleyhospital.nhs.uk/assistive-technology/services/training-courses/