Fred currently uses a communication board made by his family and support workers that has playing cards on the back. The speech therapist met with Fred to discuss possible adaptations to improve the speed and efficiency of the board. Any changes would need to be carefully considered by Fred and not remove his ability to play cards. Several suggestions were provided for enhancing access to the board, changing the layout and arrangement of letters, adding a message side, and potentially incorporating the board into a bound book with additional pages.

1. South Birmingham Primary Care NHS Trust West Midland Rehabilitation Centre
Suggestions for Adaptations to a Communication Board
For
Fred
October 2006
Chris Sherlock
Speech and Language Therapist
Access to Communication and Technology
Currently Fred has a communication/spelling board designed and made by his
family and workers at the centre where he lives.
The board has playing cards on the back which make it quite stiff and which
Fred can use to play a game. The board is an “old friend” to Fred and is
familiar to others.
At our appointment we discussed changes which could be made which might
improve the speed/efficiency of communication for Fred using a board.
Fred did not wish to think about changes at the time and this is
understandable as the board is familiar. The idea of changes might have
made Fred worry that he might loose access to his card game.
It is important to remember that these suggestions below are just that and
not instructions for change unless planned and discussed with Fred as they
are tried. Any of the ideas should be shelved if not useful. Sometimes the
ideas might be good for someone else even if not for Fred at the time.
Whatever changes Fred might be willing to try should only be made in
consultation with Fred and he should not lose access to his game.
Accessing the board
Fred is reported to use his board by moving his hand over the letters to point
to his message by spelling it out. He may also access the board by Partner
Assisted Scanning (PAS): this means that Fred’s communication partner (the
person he is talking to) needs to hold the board where Fred can see it and the
partner points to the rows and asks Fred to indicate (with a nod) the row he
wants. Once the row is selected then the communication partner moves
across the letters until Fred selects one (again with a nod) and so builds up
his message.
The idea of access also relates to how easily Fred can show that he needs his
board.
Enhancing access
Ideas that might enhance access to Fred’s current board or an adapted one
might be:
 Hanging the board where it can be seen easily by Fred. This would
mean that he would be able to eye point to it to show that he wants the
board. This would be useful if Fred finds it acceptable to have his
board out and “on display”
 Alternatively a sign could be placed so that Fred can move his hand to
it or eye point (look) to it to ask for the board to be got out. For example
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2. South Birmingham Primary Care NHS Trust West Midland Rehabilitation Centre
a sticker on the arm of his chair where he can move his hand to it. The
sticker can have “board please” or similar written on it
 Some instructions could be attached to the board that would help a
new carer use the board easily with Fred. This information should also
be in his care plan or what ever document is used to share and hand
over information about Fred.
 A write on/wipe off board of some sort or note pad and pen should be
kept near by so that it is easy for the communication partner and Fred
to keep track of the messages being shared. This is also a good way of
collecting things that are more often communicated so that they do not
need to be spelt but can be listed so that they are easy for Fred to point
to or can be spoken through by a carer so that Fred can indicate the
message he wants to communicate.
Physical properties of the board.
The board is firm and I am sure that this really helps. The board opens to give
both the messages and spelling side at once. This is a good thing and might
mean that the suggestions below for a landscape arrangement are not
appropriate but they may be worth considering.
The paper is white and it may be easier for Fred to see the letters on paper
that is pale yellow or pale green, these colours as a background have been
shown to be easier for people with impaired sight. White on black is also
sometimes helpful but this is harder to organize.
A copy (paper and or on computer with a written record of where) of the board
should be kept so that a new one can be made if the main one gets lost.
Design of the board
Currently the board has the letters of the alphabet arranged in alphabetical
order in a block and in portrait arrangement
ABCD
EFGH
Portrait: long axis IJKL
of the paper MNOP
QRST
UVWX
YZ
The size of the font (writing) seems to be suitable for Fred but it is sometimes
helpful to experiment.
The letters are also in capitals and in a font with “serifs” e.g. K (the flat bits
at the ends of the “sticks” of the letters are serifs). As we read more often in
lower case it can be easier to recognize the letters fast if they are in lower
case. Also serif fonts are known to be harder to read. This might make a
difference if some one is trying to read Fred’s spelling when the board is at an
angle to them or upside down to them, or if someone has aspects of dyslexia.
If the letters are more like those on a board at the opticians everyone one will
have the best chance of reading easily.
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3. South Birmingham Primary Care NHS Trust West Midland Rehabilitation Centre
It might be easier for Fred to reach all the letters across the page if they were
in landscape and were in a slightly different arrangement. These lay outs
would probably make accessing by PAS easier too.
a b c d
e f g h
i j k l m n
o p q r s t
u v w x y z
mistake space full stop
Yes other side No
Or
Landscape: mistake space full stop
Long axis of the yes no
paper a b c d
e f g h
i j k l m n
o p q r s t
u v w x y z
other side
The “other side” request makes it easier to get to the other side of the board
for example to the cards or the message (see below).
The AEIOU arrangement of the letters puts frequent letters at the early part of
a row preventing having to wade through others to get to them when doing
PAS.
The mistake etc aspects help correct when things might be going wrong in the
spelling etc.
Message side of the board
Fred’s message side of the board might be better in landscape too, with a font
that helps all readers.
Having the messages in squares or more spaced out might help with
indicating them unambiguously when pointing. If they are numbered then if
using PAS the order of speaking them will remain the same which is very
helpful. Some space might be left for more messages to be added by hand if
need be. Such messages might be those that come up more often on the
spelling side.
Add an “other side” request so that it is easy to know when to turn back to the
spelling page or the cards page.
Building more of a book
As the firm surface is helpful it might be good to put Fred’s pages in to a ring
binder so that he has firm surface but more pages can be added. If using poly
pockets for this it may be important to have non-reflective surfaces on these
and even boards in the pockets to stop movement of the pages. Alternatively
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the paper could be stuck on boards (like the back of an A4 note pad) and not
in poly pockets so that the surface stays matt and easier to see and move a
hand over. New ones can be made as and when needed, e.g. if something is
spilled on the page.
Pages might have tabs on them /dividers sticking out to help them be found
and turned to.
If a book is being made then pages could be added of things such as
 An “introduction to Fred” e.g. likes and dislikes and how he
communicates using the book and in other ways.
 family names, photos and relationships ( e.g. my nephew XXX is 19
and at XXX university)
 a “potted” life story
 card game rules
 favourite TV programmes/sports/music
 Having a calendar and a clock face (plus AM and PM) can also help.
 Having maps of the local area/ of the building/ of the UK/ world can
spark and maintain conversation.
These features might allow more of conversation/activities to develop if some
one was building the book and then others were reviewing such a book with
Fred. The features depend only on Fred’s interests and wishes but creating
such a book can be an interest as well as a longer term help.
Things that are very personal or private/medical probably do not have a place
in such a book. For some people this might be different and each person and
situation needs to be treated differently and sensitively in this area
Such books can be called a “life book”, “communication passport or
dictionary” or “supported conversation book” Indeed what is suggested above
is a combination of the main ideas implied by these terms.
I hope that that this is of help. Please ask if there are any queries
Chris Sherlock
Speech and Language Therapist
Access to communication and Technology
0121 627 8235
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