Sally Boa and Joan Murphy Funded by NHS Education Scotland Conducted by Talking Mats Limited

Communication Matters outcome measurement project Aims: “To provide information to service providers and users in order to equip them with knowledge about tools that are appropriate to identify change associated with services and an individual’s communication skills”

Points arising Confusion between assessment and outcome measurement Lots of Outcome Measures and assessments being used Why do we collect data? – To improve our individual practice – To provide feedback to others

Literature review Methods Review questions and data extraction Findings

Methods Rapid Review (Khangura et al 2012) – “streamlined approach to synthesising evidence” – Systematic search but a quick overview of existing research on a topic

Review questions Which Outcome Measures (OM) are used in Health, Education and Social Services? What are the purposes of the measures? How do these relate to AAC? Are there any gaps in the literature?

Papers screened Google scholar, ASSIA, Cochrane reviews – Total: 5121

Full papers read Google scholar: 5 ASSIA: 109 Cochrane reviews: 31

Data extracted Author; Year; Country; Population; OM Outcome measures mentioned in papers – Total number: 72 Categorisation: – Global/disease specific – Measuring what? – Valid and reliable? – Application to AAC?

Global outcome measures AUSTOMS Barthel COPM EQ5D Expanded Disability status scale FIM/FAM Frenchay Activity Index GAS Nottingham Health Profile TOMS

Other measures Disease specific – Functional Assessment in Multiple Sclerosis (FAMS) – Aphasia Communication Outcome Measure Age specific: – Gross Motor Function Measure (Paediatric) – Mental Status Questionnaire (older people) Aimed at patients – COSSS Children's Overall Satisfaction with Schooling Scale – measure yourself medical outcome profile (MYMOP) Aimed at carers – Carers of Older People in Europe (COPE) Index – Family Impact of Childhood Disability measure

Things to consider Validity and reliability of measures What are they measuring? Are they relevant to AAC?

Survey Survey Monkey Twitter Scotland, UK, International Friday 1 st – 8 th March Total responses 153

Sector

Geographical location

Profession

Extent of knowledge

Purpose

Outcome measure usedNumbers None used58 Care Aims9 TOMs9 GAS3 Talking Mats3 CODES Framework2 EFFC2 Functional Communication2 AFROM Advocacy projects Outcomes1

Outcome measure usedNumbers Carer feedback1 East Kent Outcome Scale1 Emotion Talks1 Goal setting1 In house1 Sarah Blackstone’s Circles1 Sign List1 Talking Points1 VASES1 WAB1

Frequency of use

Value

Why do we need Outcome Measures? I am not sure what an outcome measure is... Demonstrates the value of interventions....

Strengths It allows therapists to be outcome led and aim for functional, achievable goals that are personal to the patients It provides consistent approach across whole caseload Allows us to check as a multi agency team that we are all assessing clients similarly within reasonable limits

Limitations No way of demonstrating outcomes with different types of AAC Difficult to share with service users Not formally evidence based or standardised. Difficult to prove effectiveness if measured against others Too formal Not consistently used in social settings More difficult as intervention for higher tech users usually cuts across a multi disciplinary/agency setting where it is harder to agree and measure outcomes

Expert panel days Presentation of literature review and survey What is an Outcome Measure? Directions for future work

Main points arising from expert panel days Agreed on what we mean by ‘Outcome Measure’ Agreed on what is the best measure to use in AAC Identified the need for a measure to be workable across agencies

Definition of an outcome measure Outcome Measures should:  Measure change  Are repeated over time  Can be used across clients, settings and disciplines  Can be used to give feedback to services, professionals, carers and clients (about what works as well as what doesn’t)  Are robust/standardised/well respected  Inform discharge  Are short and straightforward to use  Allow for comparison with different types of AAC/No AAC

Main contender for outcome measure in AAC TOMs AAC (still in development – needs to be tested for reliability and validity)

Final report available on our website