Development of an online training course for communication partners supporting adults with complex communication needs who use Augmentative and Alternative Communication in a residential care setting

Abstract

ntroductionLanguage usually develops rapidly during early childhood. However, for individuals with disabilities, the development of language and communication skills can be challenging. For some of these individuals with complex communication needs (CCN) who live in residential care settings, direct support workers are usually their primary communication partners. However, research has shown that direct support workers and other communication partners often fail to engage in behaviours or strategies that support individuals with CCN, especially those who require Augmentative and Alternative Communication (AAC). AAC is an umbrella term for methods which either add on to natural speech, such as gestures and sign language, or are alternatives to speech, such as electronic communication devices. Previous studies have shown that training can support both individuals who use AAC and communication partners’ skills, but these have focused on children who use AAC, family members and educational assistants and not adults being supported by professionals in residential care settings.This study aimed to explore what factors influence whether an online training course using programmed instruction specifically designed for communication partners can effectively enhance their knowledge and understanding of the value of AAC to people who use it, and their confidence to implement AAC strategies. The research was conducted in an adult residential care organisation that supports individuals with a range of CCNs, which sponsored the research and where the lead researcher works. A multistage mixed-methods design was used and the research was split into two phases: Phase one of the research focused on gaining the views and opinions of participants on a proposed online training using a mnemonic developed by the researcher (AAC IS MY VOICE) incorporating key communication skills from research. Phase two of the study aimed to explore how the proposed online training amended following feedback collected in phase one impacted trainees’ knowledge, understanding of AAC and confidence to implement AAC strategies. MethodsPhase one of the research used online surveys to collect both qualitative and quantitative data from 36 participants comprising those who use AAC, managers and direct support workers from the sponsored organisation, AAC professionals and individuals with experience in delivering training. The proposed training was amended following analysis of this data to reflect participants’ views and opinions. Phase two used a pre-post and follow-up online training design and participants were recruited from multiple residential care settings (including the sponsoring organisation). 55 participants in total registered for the trainingcomprising operational or service managers, home managers, assistant managers, and support workers from within residential settings and residential components of educational settings, such as residential colleges, which support an adult who uses AAC. Nine of these participants completed all components (Pre-training, 5 post-module assessments and followup).ResultsKey quantitative findings from phase one that informed the amendments to the training were that the majority of participants would not change the mnemonic AAC IS MY VOICE; managers and support workers identified all communication skills as an area requiring more training and understanding; and people with experience in AAC, in particular individuals who use AAC, considered a practical hands-on element to the training as extremely important. The key qualitative findings from phase one were the importance of considering the following areas in any training: communication partners having knowledge and awareness of different communication skills, giving users multiple opportunities for communication and support about training in different environments and activities, and what respectful communication might look like.Key findings from phase two highlighted that participants’ knowledge of what AAC includes and the value of AAC increased for most participants after completing one training modulethus providing evidence to suggest that participating in this online training can impact participants’ knowledge and understanding of the value of AAC to people who use it.Participants confidence to implement AAC approaches also increased following completion of the online training.Summary of implications/recommendationsThis is the first-known study to use online training using programmed instruction for direct support workers in residential care settings. This study also provided the opportunity for individuals who use AAC to be actively involved when discussing a proposed online training. Individuals who use AAC mentioned behaviours they wanted communication partners to have such as not rushing and respecting their communication. Behaviours identified link to communication skills previously used in AAC training, such as providing time. This study has shown how communication partners confidence can be impacted by online training.

Date of Award	Nov 2023
Original language	English
Awarding Institution	Coventry University
Sponsors	Norwood-Ravenswood
Supervisor	Rob James (Supervisor), Om Kurmi (Supervisor), Tanya Rihtman (Supervisor) & Annette Roebuck (Supervisor)