Communication and Communication Aids at Highbank

At The Priory Highbank Centre, we support and treat people whose ability to communicate has been affected by a Traumatic Brain Injury, Acquired Brain Injury, or another neuro-degenerative condition such as Motor Neurone Disease, or Multiple Sclerosis. We understand that being able to communicate is one of the most important aspects of our patients’ care and recovery therefore we have expert Speech and Language Therapists (SLTs) at The Priory Highbank Centre, who are fully trained and experienced in working with a wide range of communication difficulties.

Being able to answer ‘yes’ or ‘no’, expressing a choice, making decisions and expressing pain or sadness is imperative to leading a fulfilled and independent life – something we all may take for granted in everyday life.

Following a patient’s admission we begin by trying to establish a consistent ‘yes’ and ‘no’ response. This could be done by:

  • Verbally speaking the words
  • Finger-pointing to flash cards "Yes" and "no" cards
  • Blinking (e.g. once for yes, twice for no)
  • Pressing a switch
  • Eye-pointing to flash cards (e.g. up for ‘yes’, down for ‘no’)

Establishing these responses gives an individual a means of controlling their world again, which is something that they might not have had for a considerable amount of time. It enables them to communicate their needs, wants and wishes – provided that the right questions are asked. This is a valuable start for someone who has had no formal mode of communication since their injury. Some of the conditions related to communication that our SLTs treat at Highbank include:

  • Aphasia (word-finding difficulties)
  • Dysarthria (muscle weakness affecting speech intelligibility)
  • Dyspraxia (motor planning difficulties)
  • Higher level language difficulties like misunderstanding humour or idioms
  • For our patients who don’t have any means of communicating, we ensure our therapy teams think about their own communication – ensuring that they explain what they’re about to do and why – even if the person doesn’t respond in a way that we can interpret. We encourage using as many cues as possible – tactile (touch), auditory (sound), visual – to help somebody understand what is about to happen to them. For example with oral care we encourage our Healthcare Assistants to tell the person they’re going to brush their teeth, showing them the toothbrush and toothpaste, and giving them a tactile clue by touching the side of their face they are going to begin on.

    The Priory Highbank Centre approach

    We meet with all our new staff going through our two-week induction process to talk to them about the importance of communication, what might happen with regards to communication after a brain injury, what an SLT’s role is, and where they will find each patient’s Health Action Plans.

    For patients who require additional support in communication, we consider Alternative and Assistive Technology (AAT). This supplements or replaces somebody’s ‘normal’ verbal communication. Often patients begin using ‘low-tech’ AAT – for example, an alphabet board that somebody points to letters on, or a bespoke communication book with symbols, single words, or photos on.

    We encourage the concept of ‘Total Communication’ – incorporating communication into everyday activities, and sometimes basic low-tech AAT can help somebody to find a method of communicating that works for them. Other patients are encouraged to use ‘high-tech’ AAT – devices such as iPads, or more specialist equipment using eye gaze technology or switch access. These patients are referred to a specialist service or company for assessment by an Assistive Technology Specialist. Following their recommendations, we are able to apply for a short or long-term loan of equipment, or funding for a device, giving somebody a more permanent means of communication and environmental control.

    SLTs work in conjunction with the rest of the multidisciplinary team – for example joint sessions with Physiotherapists targeting a patient’s facial and oral movements, with Occupational Therapy establishing ‘yes/no’ responses using switch access, or with Psychological Communication Groups. They also work closely with the Generic Therapy Assistants, writing therapy programmes for them to carry out regularly with patients.