Tyrone
This story is about a little boy with cerebral palsy. At four and a half, Tyrone (not his real name) was said to be at a 12 month level developmentally. His communication was developing, but was limited. He understood single words but not sentences; he had no useful speech, but was beginning to use his voice to cry, make pleasure sounds and produce some vowel sounds. Tyrone’s movements and fine motor control were limited because he was floppy and had poor balance. This made it difficult to participate in many ways, including communication.
A team approach has made all the difference to Tyrone’s communication development. One of the first goals was to find a stable seating position. The physiotherapist and the speech & language therapist worked together to find a stable sitting position. This meant that Tyrone was able to see objects that were being offered, and learn that he could choose one by eye pointing and reaching. Next, an E-Tran frame was introduced, with photographs rather than objects; this gave a consistent (and more portable) way for options to be presented, and paved the way towards the introduction of an electronic communication aid.
However, there were other skills to develop, including the motivation to communicate. Like many children growing up with severe communication difficulties, Tyrone could sometimes be quite passive. Joint rebound sessions were a very successful way of encouraging meaningful communicative choices in a motivating activity. The speech & language therapist worked regularly with classroom staff within the classroom, and with the consistent approach between therapy and classroom, Tyrone has become much more responsive. Tyrone’s parents have joined assessment and therapy sessions, so they are fully involved and can use the most effective approaches consistently at home as well.
Tyrone was referred early on to the regional communication aid centre. Initially, the specialist speech & language therapist recommended that he should develop scanning and switch control before trying out a voice output device. This advice was helpful in directing the local team. Tyrone has done lots of work on visual scanning and using switches with a range of activities. He is now ready to be reviewed by the communication aid centre, and the team are excited about the possibility of trying him with a dynamic screen communication aid.
Early intervention, multi-disciplinary working, and early advice from the regional communication aid centre have all helped to make sure that Tyrone has the most appropriate therapy programme. As a result, he can already communicate and participate much more and is on the right track for successful introduction of an electronic communication device.
The message is: don’t take communication for granted. Everyone communicates in some way, but a person with complex needs may not develop to their full potential without the right kind of help. With positive expectations and input from everyone in the team, Tyrone is learning to enjoy the full power and pleasure of communication.
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