JCPSLP November 2017

communities more inclusive for people with communication disabilities through environmental adaptations. In 2014, a consortium of speech pathology professional bodies from six countries established the International Communication Project (ICP). The aims of the ICP support and further extend Article 21 by encouraging “people around the world to join together and make a difference in the lives of people living with a communication disability” (www. internationalcommunicationproject.com). Exploring the current lexicon for communication access At Scope’s Communication and Inclusion Resource Centre, staff members (including SLPs) are creating communication access in the community by offering education, training, and capacity building support to businesses and services. Once the communication access standards have been met, and verified by an audit process, the Communication Access Symbol (Figure 1) is awarded. The definition of communication access states that “Communication access occurs when people are respectful and responsive to individuals with communication difficulties, and when strategies and resources are used to support successful communication” (Johnson, West, Solarsh, Wyllie, & Morey, 2013, p. 7). However, SLPs at Scope are wrestling with the application of current communication disability terminology in the context of social inclusion. Adoption of the social model has led to a shift in emphasis from the disability itself to environmental support needs (attitude, knowledge, skills and practical resources) that arise from the disability. This shift reflects a move from clinical supports exclusively offered by a SLP to improve an individual’s communication skills, towards community supports that may be offered by community members in order to facilitate successful communication in mainstream social settings. What is being described are adaptations to the environment in which the people, the setting and available communication resources, facilitate communication for anyone in that place. Yet, medical terminology and a focus on impairment still pervades discussions. In light of this tension, the use of clinical terms such as communication disorder, impairment or difficulty that focus on an individual’s impairment need to be reconsidered in relation to the role of environment as discussed by the World Health Organization (WHO, 2007). An example of reinterpretation is the increased use of alternative terms to communication disability such as complex communication needs (Balandin, 2002), communication support needs (Law et al., 2007) and complex communication support needs (K. Anderson, personal communication, 29 May 2017). In addition, terms emphasising the importance of the environment have appeared. Terms such as aphasia or autism friendly focus on environmental adaptations to enhance participation of specific diagnostic groups, in addition to more general communication adaptations (Howe, Worral & Hickson, 2004). Other overarching terms such as communication friendly environments, communication access , and inclusive communication have also come into use in the last decade (Money, 2016; Pound et al., 2007; Scottish Government, 2011; Shepherd & McDougall, 2008; Solarsh, Johnson, & West, 2012). This discussion paper aims to present a description of the terms commonly used in discourse around creating communicatively accessible environments and identify the dilemmas in selecting the most appropriate terminology. Further, the authors hope to open a dialogue on appropriate

and acceptable terminology to provide a common lexicon. We propose that such terminology avoids stigmatising or promoting an underlying medical condition, and rather recognises and promotes the need for environmental adaptations. The following questions may help guide the ensuing discussion and assist with refining the conceptual frameworks that inform practices. 1. What collective term is appropriate for the people who benefit from environmental adaptations that facilitate communication? 2. What term should be used to refer to an environment that enables this level of inclusion? 3. What do we call the process of creating responsive, inclusive communication environments? Discussion A total of 12 terms have been identified from three sources: (a) discussions and relevant documents from national and international SLP colleagues involved in communication access activities; (b) discussion with communication access assessors (employees with complex communication needs); and (c) feedback from members of the Victorian Communication Access Advisory Groups (Solarsh, Johnson, & West, 2012). Of the 12 terms, six refer to communication characteristics of the individual ( communication disability , communication disorder/impairment , communication difficulty , complex communication needs , communication support needs , and complex communication support needs ), and six refer to environmental adaptations that include communication ( aphasia friendly , autism friendly , communication friendly , communication access , dementia friendly , and inclusive communication ) (see Table 1). Each term has been analysed in relation to three features that the authors consider desirable for socially inclusive contexts: (a) the model that is reflected by the term, (b) the inclusivity of group/s that would benefit from having communication supports, and (c) whether the term is transparent to the broader community.

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Figure 1. Communication Access Symbol

Terms referring to the individual The terms that have been identified as relating to an individual include a person with (a) communication disability, (b) communication disorder/communication impairment, (c) communication difficulty, (d) complex communication needs (e) communication support needs and (f) complex communication support needs.

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JCPSLP Volume 19, Number 3 2017

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