MY TOP RESOURCES

FIONA BUCK, JOANNA KERR AND SHEENA NINEHAM ARE SPEECH AND LANGUAGE THERAPISTS IN THE ADULT TEAM AT PORTSMOUTH CITY TEACHING PRIMARY CARE TRUST (TEL. 023 92286147). IN 2003 THE DEPARTMENT FORMED AN APHASIA ACTION GROUP TO DEVELOP AND IMPLEMENT AN APHASIA STRATEGY FOR PORTSMOUTH. THESE TOP RESOURCES FORM AN INTEGRAL PART OF THE STRATEGY, WHICH WILL BE REPORTED IN DETAIL IN THE SPRING 2008 ISSUE.
1. IN-HOUSE COMMUNICATION SCREENING TOOL Developed locally, this easy to administer portable profile is used as part of our initial communication assessment. It allows for both high and low level screening of expressive and receptive skills and also incorporates items with which to assess reading and writing. The screening tool helps to establish a baseline early on without the pressure of more formal testing and highlights areas that will need further exploration. Designed to fit in an A5 plastic wallet, it is an invaluable part of therapists equipment. 2. EVERYDAY OBJECTS When you need to do an impromptu assessment, everyday objects are really useful. These could include things: around the clients environment (cup, plate, chair, table) in your bag (pen, purse, money) on yourself (watch, ring). These are quick and useful tools to look informally at a clients comprehension levels and expressive abilities. If the objects are from the clients own environment they have the added advantage of being familiar and therefore more functional. 3. CONVERSATION RAMPS BOX The concepts of Conversation Ramps and Supported Conversation were originally developed by Connect - the Communication Disability Network (www.ukconnect.org). We took this idea and developed a Conversation Ramps Box as part of promoting the use of supported conversation with our clients with aphasia. Our boxes include items to facilitate conversation, such as a pen, paper, maps, magazines and picture symbols. Pen and paper can be used for word choices, for writing or for clients to express themselves through drawing. Maps can be used to ascertain where the client lives, where theyve been on holiday or where their extended family lives. All our speech and language therapy departments on acute and community hospital sites now have a portable conversation ramps box to take onto the wards, on domiciliary visits or to out-patient clinics. We also keep conversation ramps boxes at stroke rehabilitation areas for use by the multidisciplinary team. 4. THERAPISTS LIFE STORY BOOKS Speech and language therapists sometimes suggest that clients and / or their families construct a life story book as a means of providing a focus for supported conversation about topics relevant to the client. Life story books are also a means of enabling staff to understand and get to know the client a little better, especially those with severe aphasia. Everyone in our department was encouraged to construct their own life story book. It is very useful to be able to show an example of a completed life story book to a client and / or their family. Our own life story book can be used to start and then model supported conversation for example comparing information about places we have each lived. It has also been useful for us to personally experience the amount of time it takes to select specific pictures and photos and to construct the book. 5. USING COMPUTERS In 2005 the Portsmouth speech and language therapy service invested in laptops, printers and software for use with clients with aphasia. Each base now has ready access to a laptop. The laptops contain a wide range of Bungalow and REACT software (both www.propeller.net) as well as Boardmaker (www.mayer-johnson.com). We work through selected exercises with clients. In some settings we leave the laptop with the client so they can go through exercises at their own pace. We also use websites in therapy. Two in our favourites list are: the moving articulogram at www.uiowa.edu/ ~acadtech/phonetics/# the training package of how to teach specific internet skills from the link at www.shrs.uq.edu. au/cdaru/aphasiagroups/index.html. 6. ALPHABET CHARTS, LETTER AND NUMBER TILES Our in-house communication screening tool includes a laminated alphabet chart. The chart is set out so that each line starts sequentially with a vowel. We also find it useful to carry a set of letter tiles (from Scrabble or Hangman games) or letter cards (such as Kan-u-Go) for anagrams, completing words and so on. A laminated set of number tiles is also useful for auditory comprehension or recall tasks like telephone numbers. 7. COMMUNICATION FOLDERS We came up with the idea of developing personalised folders for clients with aphasia at one of our in-house aphasia workshops and this was taken forward by Lynn Dangerfield and Jenny Wilk. We decided to give the folders to clients as soon as appropriate after their stroke so information was available at an early stage. Included are aphasia-friendly resources such as a personal passport template, information about stroke and being in hospital and conversation ramps such as maps and picture charts. Information for the family is also provided in the folder, including local and national support organisations and ideas to help facilitate communication. The key benefits are that the folders are accessible, client-centred, long-term and dynamic and remain with the client throughout their aphasia journey. They are helping to improve communication access and to empower our service users with aphasia. 8. APHASIA RESOURCE FILE The adult speech and language therapy service here is spread across two acute and four community hospital sites. The therapists therefore decided to review our leaflets and exercise sheets to ensure they were all up-todate and appropriate. The resulting Aphasia Resource File contains a rationalisation of all the updated written sheets and leaflets, information on supported conversation and a collection of updated core exercises. There is also a selection of aphasia-friendly information sheets. The files are now located in each of the six bases which ensures there is a standard resource in each speech and language therapy department. 9. COMPREHENSIVE APHASIA TEST (CAT) We really like this assessment. Its described by the authors as a quick and comprehensive profile of aphasia. Whilst not quick it is certainly thorough, and offers a controlled and standardised assessment of all modalities. There is an excellent manual which must be read in some detail before embarking on the assessment with a client. Not only does it look at the impairment level but also addresses disability in a way which lends itself to goal setting. The Comprehensive Aphasia Test (2004) by Kate Swinburn, Gillian Porter and David Howard, see www.psypress.com/brochures/cat.pdf. 10. HOW TO SERIES Low tech communication systems are an essential and integral part of supporting people with speech and / or language difficulties. However they are often neglected - possibly because people may not understand how they can be used to help the communication process. In view of this Cathy Harris, a previous member of our department, developed aHow toseries. This provides a step-by-step guide on how to use an alphabet chart with auditory scanning, a phrase chart, a pacing chart, a communication passport, a talking photo album, a life book, a picture communication chart, a communication book, written word choices and Talking Mats (www.talkingmats.com). These have all been amalgamated into a folder, with a copy in each clinical base. The laminated sheets can be photocopied, which saves therapists spending time writing down instructions for clients and carers.

SHEENA NINEHAM, JOANNA KERR and FIONA BUCK