1. Starting from Scratch Setting up an AAC Assessment Service Alison Webb Speech and Language Therapist alison.g.webb@cft.cornwall.nhs.uk

2. An AAC assessment service for Children in Cornwall was jointly commissioned by Health and Cornwall Council in September 2009

3. The Team then Alison Webb SLT 1 day per week Anne Williams AAC Officer 1 day per week

4. What you will hear about Barriers to Multi- disciplinary working How to provide a service on limited hours, with a limited budget The development of our referral pack The development of our service Pathway Case studies through the Pathway The need to provide training and development on low tech solutions The continual need to revise the above What worked and what didn’t!

5. Barriers Working across 2 agencies Clarifying roles Sharing documents Accessing documents Videos Lack of time Lack of resources Lack of team leader

6. How did we do it? Limited hours - Involve local SLT Limited budget - Use loan equipment from suppliers, rather than having a bank of aids Strict referral criteria New waiting list

7. Referral Pack 3 months in development We used: Previous service forms Ace Centre Oxford forms Discussed the importance of video Service Leaflet

8. Referral Pack Consent to video Child Support Team information Background Information Form

9. Service Pathway Link to old pathway

10. Case studies Kyle Harvey Millie

11. Kyle Age 15 Learning Disabilities – Special School Referred April 2010 Little experience of Speech Output Loaned Go Talk Lost Interest/School not supportive Loan of Tellus Smart August 2011

12. Harvey Age 9 Down Syndrome and Learning Difficulties Mainstream School Referred October 2010 Little experience of Speech Output Using Clicker 5 at present About to trial Fizzbook

14. Millie

15. Age 10 Epilepsy and Learning Difficulties Special School Referred May 2010 Had Go Talk and Communication Book Had seen Dynavox Express and trialled a Springboard Lite successfully

16. Millie - Decisions Dedicated aid Weight and screen size important 3 to compare Discussed with parents Loan of Dynavox V came available

17. Pre-requisites Comprehension level is above expressive level - as determined by SLT report Understands and demonstrates Cause and effect Shows Intentional Communication – the child is a Developing Communicator (as in Communication Development Profile) Has the ability to generate one form of consistent and reliable movement e.g. hand, eyes, foot Has a communication system in place, e.g. signing, communication book with evidence of use across 2 settings (e.g. home/school) Has had experience of speech output device, e.g. Big Mack, Go Talk, Clicker 5 Commitment to AAC (home/educational settings) – CAACAT Service Leaflet shared with parents/carers/education Has a communication passport

18. What we’ve changed Referral system Documentation Service Pathway – National standards Triage system The team AAC awareness in community– AAC reps, training, equipment, shared drive information

19. What Works Casework meetings Objective sheets Triage Drop Ins SLT involved Programmer identified Equipment List Team leader Discharge from Team 3 heads are better than 1 What Doesn’t Not having a loan store Only having 1 day a week Video storage Cross agency documents Not having an overall leader Having 2 people with the same name/initials

20. The Team now Alison Webb SLT 1 day per week Ann Nicol OT 2 days per week Anne Williams AAC Officer 1 day per week Team Leader – Mel Meadows