In a previous article (Working with Augmentative and Alternative Communication Services), I mentioned the great opportunity for services to work together to integrate technology for clients, now there is specific commissioning for specialised Augmentative and Alternative Communication (AAC) services.

Specialised access solutions are provided after assessment by one of the sixteen AAC hubs in England to facilitate access to a client’s communication aid. Examples of specialised access includes switches or joysticks.

Where the client uses manual or powered mobility, it’s important for AAC services to communicate effectively with wheelchair services. This ensures discussions can take place to look at options for clients where the services overlap, often resulting in simpler and more cost-effective solutions.

Integrating technology particularly applies to powered mobility users who either use (or might use):

• a joystick to access their communication aid
• one or more switches to control their power chair or communication aid.

With many older power chairs, as well as those with standard control options, a separate device or joystick may be needed to access the communication aid if integration is not possible. Mounting a second joystick to a chair means that only one of the joysticks will be in the optimum position.  This is not an ideal solution, and also leads to a higher overall system cost, due to the extra joystick and its fitting, support and maintenance.

If a client uses one or more switches to control their power chair, an assessment will have already taken place to establish the optimum switch site and to look at the most appropriate kit available. A switch site for mobility may not be the optimum switch site for communication, but it is likely to be. While in theory it’s possible for one or more of those switches to access communication, it is unlikely the user will be able to independently switch between communication and mobility modes. This is not an ideal solution, and also leads to a higher overall system cost due to the extra switches and their fitting, support and maintenance.

Unfortunately, there is currently no easy solution to allow a person to drive and talk at the same time: users are required to make a choice.

At ACE Centre, we have worked with three clients recently and have been able to work with their local wheelchair service to integrate the two systems. The specialised AAC service provides specialist access devices, which may include power chair control options that are not normally provided by wheelchair services. Many communication aids are Bluetooth-enabled (and if they’re not, they can be) so, where a joystick is the most appropriate access option for the user, a Bluetooth mouse control module fitted to the power chair can allow the two systems to be integrated. Where switches are used to control a power chair, it may also be useful to consider whether they could be used to access the communication device, or whether one of them could be used for mode change.

In our three cases, we prescribed kits for Quickie Salsas which are not normally funded by wheelchair services, because they are not required for postural or mobility needs. The kits were added to the Salsa prescription forms and ordered with the chairs so that they could be factory-fitted as part of the chair builds. The wheelchair service simply charged for the additional parts. ACE Centre supports and maintains the additional kits and provides the same level of service that the clients receive for their power chairs.

It is not always easy, but this type of integration does lead to simpler solutions for the client.

Effective communication between services has been the key to enabling this type of integration of kit where it is funded by different services. It has prevented duplication of kit and helped to keep overall costs of the system down. We are extremely grateful to the wheelchair services concerned, who welcomed collaboration and ultimately provided a simpler, more integrated system for their clients.