Kent and Medway CAT Changes and Referral Guidance January 2016

NHS England National Criteria An individual who would access a specialist AAC service would: Have a severe or complex communication difficulty associated with a range of physical, cognitive, learning or sensory deficits. Have a clear discrepancy between their level of understanding and ability to speak. Be able to understand the purpose of a communication aid. Have developed beyond cause and effect understanding. And may: Have experience of using a low tech AAC device which is insufficient to enable them to realise their communicative potential.

Additional provision for Kent The Kent and Medway CAT Service is jointly commissioned to support children and young people with Special Educational Needs (SEN) who have complex written communication difficulties. For this reason our criteria can also include children and young people who: Have complex physical difficulties which mean standard methods of accessing computers are not effective and appropriate and require a specialist approach. Require advice, for example, regarding their progression in Assistive Technology (AT) use where appropriate curriculum software and alternative computer access devices have been trialled and evaluated. Require involvement to introduce technologies associated with alternative means of recording. Referrals will be accepted from health, education and social care professionals working in local teams. The forms are of most use when completed by the team around the child or young person and their family.

The Kent and Medway CAT Service for Children and Young People The Kent and Medway CAT Service provides a regional service for specialist multi-disciplinary assessment, intervention and review of specialist communication and assistive technology needs. In response to the National NHS England Service Specification to deliver Specialist AAC services, the Kent and Medway CAT Service will be providing intervention based on a hub and spoke model. This means that at a ‘hub’ level, we provide services and facilities to a wider regional community as well as children and young people within Kent.

The Kent and Medway CAT Service for Children and Young People The purpose of The Kent and Medway CAT Service remains: ‘To work in partnership with schools and families to provide communication and assistive technology solutions that enable children and young people to enjoy themselves, develop independence, participate and achieve.’ The Kent and Medway CAT Service operates a single point of referral system to access the different interventions available from the service.

As a regional central point, Kent and Medway CAT Service can provide: Assessment: A specialist multi-disciplinary approach to an assessment, intervention and review of a child or young person’s AAC/AT needs. The assessment may: Lead to the selection and provision of specialist assistive technology. Lead to a loan to explore effectiveness of a recommended selection of equipment. Assessments may be offered that will not provide equipment. These assessments will: Provide the Kent and Medway CAT Service staff with an opportunity to explore complex communication in more detail. Not lead to provision at that particular time in the child or young person’s development.

As a regional central point, Kent and Medway CAT Service can provide: Consultation: The Kent and Medway CAT Service offer a consultation where involved professionals, school staff and parents attend a meeting in which a multi- disciplinary team from The Kent and Medway CAT Service provides advice and devises a joint action plan. Training: The Kent and Medway CAT Service provides regular training opportunities from The Old Railway School for AAC and AT related knowledge and skills support. Bespoke training relating to AAC and AT strategies in school settings can be requested if there is a need for training to be tailored and delivered specifically for a setting, school or group. Bespoke training is chargeable to cover cost implications.

The Referral form The Referral form is now available on the KELSI website: or search on ‘Kent CAT Kelsi’.Referral form We are no longer accepting referrals on the old referral form; or consultation requests over the phone or on old forms. The referral form can be completed electronically and then printed off and sent in the post with signatures. If you require this form in an alternative format, please contact us. Please note: Section 3.4: This referral will not be processed without information from this section. Section 3.5: We will return referrals if they do not enclose reports or details of interventions listed in this box. Please note instructions before section 5 re: Complete sections …. Or sections …. Please keep information concise. Key points are sufficient. Attach additional page(s) where necessary. If child has physical needs or ASD diagnosis, we will send out for more detailed information once CYP accepted. This saves people completing sections unnecessarily on main form.

Case studies – progress to assessment Tracy (mobile child with some verbal skills) Clear discrepancy between receptive and expressive language skills described and demonstrated with language assessment results. Tried and evaluated a range of light tech voice output communication aids. Motivated to communicate but losing confidence because of unintelligible speech. Albert (mobile child with ASD) Clear discrepancy between receptive and expressive language skills described and demonstrated with language assessment results. Expresses likes, gives information, directs a person or activity, describes something. Not interested in light tech voice output communication aids; motivated by other technology. Demonstrates understanding of cause and effect and understands what they do has an impact.

Case studies – progress to assessment Andrew (complex) Ongoing advice sought from other agencies. Age appropriate literacy and numeracy skills. Range of functions of language including requesting and giving information, yet limited by lack of expressive means to communicate. Tried and evaluated a range of low tech resources, for example, core and fringe vocabulary communication book. Jonny (written recording) Verbal with complex access issues. Description and examples of cognitive ability which is age appropriate or above. Clear description of access methods tried and evaluation of why they didn’t work.

Case studies – progress to consultation Appropriate level of information supplied to match appropriate level of advice to give. Unsubstantiated sweeping statements. For example, ‘held back by disability’, ‘technology will help’, ‘can select accurately from a large number of symbols’. Oliver (mobile child with some verbal skills) Reacts to familiar objects and recognises some signs, photos and symbols BUT does not demonstrate understanding of cause and effect and does not understand what they do has an impact. Understands one key word level with some concepts (hungry). Relies on routine, regular event, signing and symbols to enhance understanding. Using symbols for choosing from two only. Language functions used only to express wants, dislikes and to request.

Case studies – progress to consultation Maddie (complex) Discrepancies in information which indicates difficulties in assessing her. Spiky profile that does not demonstrate foundation skills. Little discrepancy between comprehension and expressive skills. Yvonne (written recording) Indicated at expected national curriculum levels for her age. Equipment trialled specific to computer access needs.

References for compiling checklists The Core AAC curriculum – Scope. Assessing students’ needs for assistive technology – WATI. A comparison of pre-curriculum levels and developmental assessment frameworks – Martin, Sargent, Price and Thomas. Communication development profile – Charlotte Child. Communicative competence for individuals who use AAC – Light, Beukelman and Reichle. Communication, curriculum and classroom practice – Latham and Miles. Speaking and listening within P-scales – Leicestershire LEA. P-scales. AAC skills inventory – BVSD assistive technology team. Functional communication profile – Kleiman. Functional communication classification system – Cerebral palsy league. Preverbal communication schedule (PVCS) – Kiernan and Reid.

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