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Communication Assessment for People who engage in Behaviours of Concern (BoC) Module 2 : Communication Assessment PowerPoint PPT Presentation


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Communication Assessment for People who engage in Behaviours of Concern (BoC) Module 2 : Communication Assessment. Hilary Johnson, Nick Hagiliassis, Barbara Solarsh, Teresa Iacono, Jo Watson, Teena Caithness. Office of the Senior Practitioner, Disability Services, Victoria.

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Communication Assessment for People who engage in Behaviours of Concern (BoC) Module 2 : Communication Assessment

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Communication Assessment for People who engage inBehaviours of Concern (BoC)Module 2 : Communication Assessment

Hilary Johnson, Nick Hagiliassis, Barbara Solarsh,

Teresa Iacono, Jo Watson, Teena Caithness

Office of the Senior Practitioner, Disability Services, Victoria


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Building the Foundations for Effective Commn for Victorians with BOC Subject to Restrictive Practices

1.Identify the foundations of effective communication assessment through the development of a resource kit to support assessment and intervention in relation to communication and behaviours of concern,

Increase the capacity of speech pathologists to provide practice support to direct disability staff and others involved in the support of people subject to restrictive interventions.

3.Undertake an evaluation of the tool kit in a natural practice setting i.e., a residential support service


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Communication and Behaviour of Concern (BOC)

Can’t remember where this image is from…

Bio

Psycho

Social

Developmental

Model

Holland & Jacobson, 2001 in McVilly (2002)


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Incident Report

Martin pushed his chair away from the packing table. He stood up. Martin glared at Tim (staff member) and raised his clenched right fist. Tim told Martin to “Calm down”. Martin then walked over to Tim, hit him in the head with a closed fist and then punched the wall.

What more would you like to know?


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Martin seems to be always looking around checking things out.

More about Martin

I used to be frightened of Martin. Now we get along fine.

I would describe Martin as a hard worker. Once he has seen the job done once he can copy it.

We can tell if he’s having a good day

Martin doesn’t talk. He has a book with pictures but I’ve never used it. We just get along by talking and pointing to things.

You can ask Martin a question and he’ll nod for “yes”


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Information from Tim

Tell me about the incident

We’d only just gone into the packing room. Martin knows the routine. The job was set out on the table. The clients organised themselves and sat down. Then there was a telephone call and a knock on the door. I knew Martin wanted to start work, he pointed to the boxes and nodded. I said that everyone had to wait. Shona had answered the phone and I needed to answer the door. Then Martin reacted by pushing his chair away from the table, standing up, threatening me with a clenched fist, and then he hit me.


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Small Group Work

What do you know about Martin?What questions would you like to ask staff?What are Martin’s strengths and abilities?Is there anything you would like to explore further?What areas would you include when providing a communication assessment for Martin?


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Summary


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Communication Assessment (BoC)

Basic principles of speech pathology assessment apply.Key areas to consider:1.Identify the potential communicative functions 2.Profile communication abilities3.Observe current environmental barriers and identify solutions


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Opportunity BarriersThe Participation Model (Beukelman and Mirenda, 2005)


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Opportunity Barrier

Attitude


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Access BarriersThe Participation Model (Beukelman and Mirenda, 2005)


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Let’s hear what Martin has to say…

If Martin could talk – what do you think he would say about the incident?

I was ready to work. I like to keep busy. I saw the work on the table and sat down. I know this work, we had done it before, many times. I pointed to the work and nodded at Tim. I wanted to start. Tim said everyone had to wait. I was angry. I don’t like waiting, especially when I know what to do. I lost it.


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Information from Tim

Tell me about the incident

We’d only just gone into the packing room. Martin knows the routine. The job was set out on the table. The clients organised themselves and sat down. Then there was a telephone call and a knock on the door. I knew Martin wanted to start work, he pointed to the boxes and nodded. I said that everyone had to wait. Shona had answered the phone and I needed to answer the door. Then Martin reacted by pushing his chair away from the table, standing up, threatening me with a clenched fist, and then he hit me.


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Development of Hypotheses

Think of at least 5 reasons to explain why Martin hit Tim.

# 1 ___________________________________

# 2___________________________________

# 3___________________________________

# 4___________________________________

# 5___________________________________


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http://www.bedtime-story.com/bedtime-story


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‘A communication disability does not just belong to the individual. It belongs to the entire environment of which the individual is the focal point.’

Sandwell - Communication Aids Centre, UK


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Communication Assessment Kit (BoC)

Suitable for use by speech pathologists

23 Tests divided in 10 sections (see sheet)

Items meet most criteria for inclusion

Information can be obtained from the individual and or informants

Formal and informal measures are included that require skill in

Administration

Scoring or recording responses

interpretation


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Criteria for inclusion

Provides information in one of the key areas identified

Identification of the functions of the BOC

Profile of communication

Social and physical barriers and enablers

Appropriate for 1 or more of the following groups:

Children / adults with Dev Disabilities including ID,CP & autism

Children / adults with acquired disability including ABI, aphasia, degenerative neurological conditions

Available at no or reasonable cost

Easy to obtain

Information on validity & reliability if possible


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Assessment Kit: Domains

Including factors

Cultural

CALD

Education

Refugee

Socio-economic

Person at risk

Homelessness

Drug and Alcohol

Malnutrition

Medication

Criminal Justice

Personality / Attachment

Bio-Psycho-Social-Developmental Model


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Identify communicative functions of behaviours

  • Example from the kit:

  • DEWART, H. & SUMMERS, S. (1995) ThePragmatics Profile of Everyday Communication Skills in Adults. (Revised) Berkshire: NFER-Nelsonhttp://wwwedit.wmin.ac.uk/psychology/pp/index.htm

  • A. COMMUNICATIVE FUNCTIONS

    • RESPONSE TO COMMUNICATION

    • C. INTERACTION AND CONVERSATION

    • D. CONTEXTUAL VARIATION


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Range of Assessment tools

  • Include a range of assessment types

    • Structured norm based tests

    • Informant interviews

    • Structured sampling strategies

    • Structured observation

    • Informal Assessment


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Work in Pairs

Write some guidelines about how you would select assessments from the kit.


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NSW DHS Assessment Processes (DRAFT)courtesy [email protected]

Reviewing the Service Request

Consent

Assessment outcome

Personal safety

Indirect Assessment

Direct Assessment

Writing report


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Communication Skills of Individuals

  • Receptive communication skills

  • Speech Production and intelligibility

  • Expressive communication skills

  • Pragmatic communication skills

  • Literacy skills


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Communication Skills: Receptive Skills

Understanding questions

Yes/ no questions –acquiescence or “yea saying”

Either / or questions – recency

Leading questions

Repeated questions

‘Short-answer’ or specific questions

Questions with a negative or double negative

Questions with complex or abstract vocabulary and sentence structure

Multiple questions


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Communication Skills: Receptive Skills

Understanding instructions

Understanding information

The meaning and definitions of some words

Ambiguous words and sentences

Figurative language

Problem solving


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Communication Skills: Expressive Skills

Syntax

  • sentences fragmented, illogical, morphological errors

    Semantic

  • ‘survival’ vocabulary

  • word finding problems

  • use non-specific language (e.g. thing, stuff)

  • difficulties with using slang

    Narrative


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Communication Skills: Pragmatic Skills

Strengths

  • turn-taking strategies

  • greetings and conversational initiations

  • maintain and expand conversational topics

  • requests for clarification.

    Difficulties

  • Inability to ‘code switch’

  • inappropriate non verbal behaviours

    Environment and conversational partners

  • power or status differences

  • communication breakdowns


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Range of Assessment tools

  • Include a range of assessment types

    • Structured norm based tests

    • Informant interviews

    • Structured sampling strategies

    • Structured observation

    • Informal Assessment


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Relationship between medical & BOC

http://www.cddh.monash.org/products-resources.html

The CDDHV have developed a number of Fact Sheets on topics and issues related to developmental Disability Medicine.

http://www.healthinsite.gov.au/topics/Intellectual_Developmental_and_Learning_Disabilities

http://www.intellectualdisability.info/


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Relationship between Mental Health Issues

Adults

Anything by Nick Bouras and Geraldine Holt (UK)

The ESTIA Centre

http://www.estiacentre.org/freepub.html

First Aid Mental Health

http://www.mhfa.com.au/documents/manuals/id_manual_March09.pdf

Children and Youth

Inspire Foundation www.inspire.org.au delivers online programsfor young people that prevent youth suicide and improve mentalhealth and wellbeing.

Includes a library with access to past documents. Maybeuseful for students with mild ID.


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Relationship between sensory & BOC

Positive Solutions in Practice

From Seclusion to Solutions Issue No 2 2007 OSPSensory environments

Sensory rooms

Multi-sensory rooms

“In order to reduce behaviours of concern additional therapeutic strategies are needed.”

Positive effects on behaviour


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Relationship between CALD & BOC

http://www.adec.org.au/

Raising Kids Together November 2008

http://www.dadhc.nsw.gov.au/dadhc/People+with+a+disability/Raising+kids+together.htmSudan, Afghanistan, Iraq

http://www.dhi.gov.au/Multicultural-Mental-Health-Australia/default.aspx


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CHILDREN ONLY

ADULTS ONLY

KIERNAN, C. & REID, B. (1987) Pre-Verbal Communication Schedule. Berkshire: NFER-Nelson

No longer available

BLOOMBERG, K.,WEST, D. Johnson, H. & IACONO, T (2009).The Triple C Checklist of Communication Competencies – Assessment

Manual and Checklist. Melbourne, CRC


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The Triple C Checklist of Communication CompetenciesBloomberg, K., West, D., Johnson, H. & Iacono, T. (2009)

up

ua

ii

sb

se

UP – Unintentional passive communication

UA – Unintentional active communication

II – Intentional informal communication

SB – Symbolic (basic) communication

SE - Symbolic (established) communication


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interAACtion & Triple C stagesBloomberg, K., West, D., Johnson, H. & Iacono, T. (2009)

up

ua

ii

sb

se

preintentional

intentional

unintentional

intentional

non-symbolic

symbolic

1

2

3

4

5

6


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Communication & BOC

In recognition of the growing evidence1 supporting a significant link between communication difficulties and challenging behaviour, comprehensive assessment of behaviour should be informed by a recent and detailed communication assessment (ideally undertaken by a qualified Speech Pathologist).

1Balandin, S. (2002) Editorial, ISAAC Bulletin, 67, 2.

NSW Department of Ageing, Disability and Home Care Behaviour Support: Policy and Practice Manual. Guidelines for the provision of behaviour support services for people with an intellectual disability. Part 1: Policy and Practice January 2009 p.21


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