Physical and Learning Disabilities and AAC

Services for children aged 5 +

The Disability Discrimination Act (DDA) defines a disabled person as someone who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities.

Disability

Physical disability: pertains to total or partial loss of a person’s bodily functions or a  total or partial loss of a part of the body

Learning Disability: a reduced intellectual ability therefore reduced ability to learn new skills and difficulty with everyday activities.

Causes: genetic factors, infection prior to or after birth, brain injury at birth or after birth or due to an unknown reason.

Severity

Physical and learning disabilities

Child disability is an emerging global health priority. Constitute about 4-6.5% of the population in many

countries (Rosenbaum, 2009)   In the UK, 7.3% of children aged under 18 years are

reported to be disabled as defined by the Disability Discrimination Act (DDA).

Epidemiology

Physical disabilities include : Muscular dystrophies, Acquired brain and spinal injuries hearing and visual impairment

Cerebral Palsy (CP) is the most common physical disability in childhood (Croot, Grant, Cooper, & Mathers, 2008). Approximately 1 in 400 babies born in the UK has some type of CP.

Learning disabilities: can be divided into two groups children with a general or specific learning disability,

It is estimated that there are 286,000 children (180,000 boys, 106,000 girls) age 0-17 in the UK with a learning disability.

Childhood disabilities

A child or young person has special educational needs if they have a learning difficulty or disability which calls for special educational provision to be made for them

Organisation of Services for children with SEN.  The system of support available to children and young people with SEN

and disabilities is very complex. Many problems prevent children and young people with SEN/D from

getting the support and services they need. Support should be available to ensure they have the same opportunities as everyone else and that they receive the necessary support to move smoothly into adulthood.

To do so, an effective, transparent and accountable system of support for children and young people with SEN/D is needed.

Special Education Needs (SEN) and Disabilities (SEND)

  Part 3 of this act is for Children and Young People In England

with Special Educational Needs and Disabilities. It places duties on local authorities and other services in

relation to both disabled children and young people and those with SEN.

It also places a duty on local authorities to identify all the disabled children and young people in their area and all the children and young people their area who have or may have special educational needs.

Children and Families bill (2014)

  Replace statements of special needs and learning difficulty

assessments with an education, health and care (EHC) plan for children and young people with complex needs.

Following an EHC assessment, the local authority must decide whether it is necessary for special educational provision to be made in accordance with an EHC plan.

This decision will be based on whether the education institution can be reasonably expected to provide the special educational provision that a child or young person needs.

Education, health and care plan

The Act places a duty on the local authority to ensure that a child or young person with an EHC plan is educated in a mainstream setting.

Exceptions - goes against the wishes of the young person or the child’s parent, or would impact on the efficient education of others and there are no reasonable steps that could be taken to overcome this.

Essential that mainstream schools are provided with sufficient funding to support children as overall, 89% of children with moderate learning difficulty, 24% of children with severe learning difficulty and 18% of children with profound multiple learning difficulty are  educated in mainstream schools (People with Learning Disabilities in England, 2011)

Presumption for mainstream education

Additional funding is available for local authorities to support children with SEND

Funding will be £45.2 million for 2014-15 and an estimated amount of £31.7million for 2015-16.

This funding is in addition to the £70million SEN Reform grant that local authorities have already received in 2014-15.

(Council for disabled children)

Funding for local authorities

to meet their needs, children with SEN are entitled to: core provision from the core funding which is for all children, element 1;

up to £6,000’s worth of extra provision, funded from the school’s notional SEN budget, element 2;

extra provision funded by top-up, from the local authority’s high needs block.

(Council for disabled children)

Funding within mainstream schools

Funding within special schools Most special schools receive £10,000 for each child with

SEN

Top-up funding will then be provided if necessary

This regime applies to maintained special schools, academy special schools, and non-maintained special schools.

All base funding for post-16 students with high needs will receive funding that post 16 students will normally receive.

With an additional £6,000 for each planned high needs place.

Post 16 funding

Some organisations include funding for children with physical and learning difficulties. These organisations support disabled children and young people in the UK.

Some examples include: Able kidz Action for kids Children today Mencap

Funding from private organisations

Mencap is the UK’s leading charity for children and adults with learning disability.

Royal Mencap Society is funded by a mixture of income generated from providing statutory services to individual people with learning disabilities and by receipt of donations and grants from individuals and organisations.

Donations such as:◦ £12 could pay for one Bag of Ability so a family can tell sensory stories at

home◦ £20 could pay for a bag of books that can be used for a number of

storytelling sessions◦ £40 could pay for all the resources needed for two sensory storytelling

sessions

Charities

What is AAC?

Gesture

Symbols

Signing

Communication Boards

Communication Books

Voice Output Communication Aids (VOCAs)

What is Augmentative and Alternative Communication ?

AAC covers a vast range of techniques

which support or replace verbal communication

High Tech Vs. Low Tech

Aided Vs. Unaided Communication

Who Uses AAC?

Individuals who cannot effectively use conventional speech to communicate

may use augmentative and alternative communication (AAC) systems to

compensate for a lack of speech or to replace, or augment, unintelligible speech

(Ganz et al., 2012)

AAC is typically prescribed when children are struggling with learning to

communicate with speech or if they are at risk for having delayed speech

development because of a diagnosed condition such as Down syndrome or

autism.

Who requires AAC in the paediatric population?

Acquired Stroke

Head injury

Progressive neuromuscular

Friedreich’s Ataxia Muscular dystrophy Myasthenia gravis

Congenital Cerebral palsy

Cleft palate and craniofacial malformations

Syndromic conditions Profound and multiple learning

difficulties ASD

Developmental delay

The Benefits of AAC

Improves quality of communication

Improves the effectiveness of communication

Reduces challenging behaviour

Increases assertiveness

- Increased educational opportunities

- Increased social opportunities - Improvements in quality of

life and independence

Inclusive education of students with AAC needs is possible and desirable, with clear benefits for the

focus students, their peers, parents, and the school community at

large

’Most children interviewed reported that their AAC system

was useful to them

Soto, Muller, Hunt and Goetz, 2001

Clarke, McConachie, Price and Wood, 2010

• Communicate• Make friends in and out of school• Participate in and out of school• Build relationships with family and

friends

AAC in the SEN Paediatric Population

• Be able to make choices• Learn and explore the world

around them• Being able to communicate

effectively and make choices will undoubtedly have an impact on behaviour

The Pressing Need for AAC

Communication is crucial. Recognising that is right in terms of equity for those in need and right in the national interest as we all wish to cut the costs of failure and increase the productiveness of our country.

Bercow Report, 2008

“Without communication no-one can ever really know you”.

Martin Pistorius

The Pressing Need for AAC in the UK

Just over 0.5% of the UK population could benefit from some kind of AAC

provision

That means 529/1000 people. This population mainly includes people

with complex conditions.

Of this 0.5% of people, 0.05% would benefit from some kind of

powered AAC device.

97.5% of the population requiring AAC is

dominated by those with;

Alzheimer's/dementia, Parkinson’s, ASD,

Learning disabilities, stroke, cerebral palsy, head injury, profound and multiple learning disabilities and motor

neurone disease.

Children with SEN are amongst the most needy and vulnerable

They have the most severely limited life choices. It is important that they gain as much funding as possible to

improve quality of life for them and their carers. The school years are the most integral for learning and

have more structure than the preschool years, therefore increased funding is needed for both mainstream and special schools for children 5 +.

These children and young people need your help !!!

AAC provision has been identified by the government as having the most problems in service provision.

There are many references in the literature related to funding difficulties for the provision of powered communication aids.

There are few studies which examine the benefits that AAC brings to users however those that do demonstrate measureable benefit.

• Funding arrangements for services and equipment is the issue of most concern for AAC users, communication partners and professionals

• Frustration relating to the time taken to identify that they would benefit from AAC

• Funding difficulties in provision of communication aids

• Lack of support

• Disparity in provision