Tag Archives: Research

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.





Data – Perceptions of the Design of Communication Aids

 'Silence' - A communication aid keyboard

‘Silence’ – A communication aid keyboard

We have recently had a paper published about some research we carried out in 2010 about users’ perceptions of the design of voice output communication aids. As well as the paper, you can also download and read the report about the project on the D4D website (free login required).

Part of this research was to carry out a national survey to people who used communication aids and professionals who worked with them.  The survey asked people how they felt about their communication aids.

We have now released the data that we gathered to allow others to work on it too:

A few notes, if you want to work with this data:

  1. It is particularly important to take into account how the questions were asked in the original survey: they were grouped as sections. Respondents did not consider each question in isolation.
  2. There were two versions of the questionnaire (with the same core data). These are available to download: the users’ survey; and the professionals’ survey.
  3. The survey was also published online using LimeQuery (the setup file for this is available on request) and also available in a simplified language, and also symbolised versions.
  4. The qualitative information gathered in the survey is removed to preserve anonymity.

We have published the questionnaire under a Creative Commons licence. Please respect this and attribute the source. Better than this – please get in touch with us if you plan on using this data so we can discuss it.

We hope to re-run the survey in the near future – and plan to change some of the content and design based on what we learnt the first time.

Award winning paper

Assistive technology professionals can often be accused of not having a good understanding of what their clients need. One of our recent research papers, however, suggested that this is not necessarily the case – and that professionals do seem to understand the needs of users well. This paper was recently selected to receive a ‘highly commended’ award by the journal publishers.

The paper was based on a focus group with assistive technology professionals who had provided speech driven environmental controls. These devices allow a person to use their speech to control equipment around them. Environmental control provision is well established in the UK, but anecdotally we felt that speech driven systems were not being commonly provided. This research set out to look at some of the reasons for this.

As well as suggesting that professionals are able to empathise well with users’ needs, the research suggested that professionals are cautious about using speech driven systems because of concerns over reliability.  Most professionals had, however, recommended or provided such a system to meet specific needs, though generally in combination with a back-up system to cope with any ‘safety critical’ functions.

You can read more in the paper, which as part of the ‘Literati Award’ you can download for free for a limited period.