JCPSLP November 2017

Supporting social, emotional and mental health and well-being: Roles of speech-language pathologists

Talking about communication access and social inclusion Barbara Solarsh and Hilary Johnson

Speech pathologists around the world are starting to address the issue of social inclusion for people with communication disability, and a new lexicon related to communication inclusivity is emerging. Some terms are relatively new, such as communication access or inclusive communication, while others, such as communication disability, have been redefined in terms of the shift from the medical to the social model. The lexicon under review relates to the range of individuals who benefit from communication inclusivity as well as to environments that enable social inclusion for people with communication disability. The authors seek to open a discussion on the communication access terminology in current use, and examine the terms in relation to three dimensions: the model reflected; the people who are included; and the extent to which the term is understood in the broader community. The authors propose the identification of one set of terms to be used internationally. M any western governments have policies and practices to enhance social inclusion for people with a disability (Family and Community Development Committee, 2014; Ontario, 2008). Social inclusion is a complex construct and has been defined as “the interaction between two major life domains: interpersonal relationships and community participation” (Simplican, Leader, Kosciulek & Leahy, 2015 p. 18). Johnson, Douglas, Bigby, and Iacono (2009) stated that integral to social inclusion is the “consideration of processes that develop and maintain relationships with others” (p. 180). Until recently, the focus on processes to increase social inclusion has been limited, with the main strategy being the reduction of physical access barriers. This reduction has been promoted through the adoption of the International Symbol of Access now underpinned by legislation through the Disability Discrimination Act (Australian Government, 1992). The symbol and standards have been powerful tools that have encouraged positive

community change such as increased physical access to buildings and public transportation. While having a physically accessible community assists with community participation, there are additional, and specific strategies required to create social or communication access in order for social inclusion to occur. These include a skilled listener who can conduct a respectful interaction, communication resources to enhance face-to-face interactions and information presented in accessible formats. Practical strategies to reduce social barriers implemented to date may be due partly to the ratification and growing acceptance of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD; United Nations, 2006). The UNCRPD provided the first international recognition of the rights of people with communication disabilities and now underpins national and global policy aimed at improving the lives of people living with a communication disability (UNCRPD, 2006). Article 21 states that: [p]arties shall take all appropriate measures to ensure that persons with disabilities can exercise the right to freedom of expression and opinion, including the freedom to seek, receive and impart information and ideas on an equal basis with others and through all forms of communication of their choice. In particular, Article 21(b) refers to “[a]ccepting and facilitating the use of sign languages, Braille, augmentative and alternative communication, and all other accessible means, modes and formats of communication of their choice by persons with disabilities in official interactions” (UNCRPD, 2006). Using the UNCRPD as a framework, several groups internationally have engaged in promoting and furthering communication rights of all individuals (Collier, Blackstone & Taylor, 2012; Scottish Government, 2011; Solarsh & Johnson, 2017). An example of this type of work was a three-year awareness campaign to promote communication accessible environments conducted in Canada (Communication Disabilities Access Canada, 2015). In preference to utilising a medical model that focuses on an individual’s deficit or impairment, these groups approached the issue of communication accessibility through requiring environmental adaptations consistent with the social model of disability (World Health Organization, 2011). The key tenet that differentiates the social model from the medical model is the recognition of the role of the environment as a facilitating or handicapping agent. Social model approaches aim to reduce barriers and make

THIS ARTICLE HAS BEEN PEER- REVIEWED KEYWORDS COMMUNICA- TION ACCESS PARTICIPATION SOCIAL INCLUSION

Barbara Solarsh (top) and Hilary Johnson

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JCPSLP Volume 19, Number 3 2017

Journal of Clinical Practice in Speech-Language Pathology

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