Page 216 - Handbook of Electronic Assistive Technology

204 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

Wales

In 2011, the Welsh Assembly published a review of AAC provision entitled A review of
Current Service Provision: Communication Aids (Welsh Government, 2011). This review
estimated the population who might benefit from AAC provision and the number of
people who might require high-tech communication aids, estimating this latter popula-
tion at 1540 people across Wales. As a response to this, a hub service for the assessment
and provision of high-tech AAC devices was set up, based within the All-Wales Electronic
and Assistive Technology Service at Rookwood Hospital in Cardiff. The Welsh government
invested approximately £1.3 million in the project over a 2-year period to fund equipment
for assessment and provision, as well as existing and new staff roles within the centre.

Northern Ireland

In Northern Ireland, the provision of AAC assessment and equipment is the responsibility
of the five health and social care trusts. A central specialist centre is located at the Belfast
Communication Advice Centre, which offers specialist assessment and an extensive loan
bank for trial and short-term loan. Recommendations for funding equipment in the longer
term are then made to the individual user’s health and social care trust.

Conclusion

It is certainly true that the advent of AAC as a specific and discrete field of clinical practice
and research is comparatively recent. Research evidence in the field is continually devel-
oping and recent changes in service structure within the United Kingdom should allow
more standardisation in the way that services are delivered.
In this chapter, frameworks for assessment, clinical practice, describing outcomes and
gathering and applying evidence have been presented and it is hoped that these will prove
useful to clinicians beginning work in the field. It is important to stress that the selection,
implementation and support of an AAC system is always a highly individualised process, with
many factors guiding clinicians involved. Above all, it is hoped that the multidisciplinary and
multistakeholder nature of the selection, provision and support of AAC systems is made clear.

Nikhil’s Case Study (Paediatric)

Background
Nikhil is a young man with cerebral palsy affecting all four limbs, Gross Motor Function
Classification System level V, Manual Ability Classification System for Children with Cerebral
Palsy level IV, moderate learning difficulties and right-sided esotropic strabismus (squint).
Nikhil was referred to a specialist AAC service by his local speech and language therapist at
the age of 10. On referral, he was described as a keen communicator whose current channels
included some vocalisations, a consistent yes/no and the use of facial expression. He had no
previous experience with high-tech AAC systems or devices, but had been provided with a
laptop and some educational software, which he accessed using two switches on a bespoke