JCPSLP Vol 14 No 2 2012

schools, not in the adult sector. Only recently, in 2011, were speech therapy positions created in the adult sector. Historical use of signs in MINDS In the past, manual signs from different signing systems were used in MINDS schools. School-based speech therapists, employed by MINDS, collated booklets and developed their own videos of basic functional signs and gestures as a medium for dissemination of information to involved parents and teachers. The school’s sole therapist, working with large caseloads, cited “time-consuming”, “energy-exhausting” and “repetition of work” as factors accounting for the pitfalls in information dissemination (on manual signs) to the various people involved in caring for the clients. With respect to the adult sectors at MINDS, there was no system at all for dissemination of this kind of information. Indeed, several challenges were faced, particularly as our clients transitioned across settings: from schools to the adult In 2008, MINDS speech therapists acknowledged the need for an organisation-wide common signing approach. The implementation of a common signing approach was recognised as an essential step towards enhanced quality of service delivery to the clients at MINDS, aligning communication methods across the schools, adult sectors, and home (Loh & Singh, 2011). Approved by the organisation management (for financial years 2009–2011), the KWS&G Project was an initiative by the MINDS Allied Health Professionals Hub (made up of 11 multidisciplinary team members). Their aim was to look into the possibility of implementing a common signing approach within the organisation to cater to the communication needs of our clients within MINDS. The learning and use of KWS&G may be compared to learning a language and/or embracing a new “culture” of communication. People need to be immersed in an environment where a common communication method is being used. Johnson, Douglas, Digby, and Iacono (2009) further highlighted that addressing attitudes of adult communication partners may result in persons with intellectual disabilities being supported more effectively. The communication partner’s use of the AAC system signifies a valuing of the AAC system; it is through this that the communication partner promotes learning of the system by the AAC user, and everyday AAC-use to others in their environment (Johnson et al., 2009). Interestingly, studies have found that staff caring for persons with intellectual disabilities were more likely to use verbal communication, irrespective of the mode of the communication of their communication partner or their perceived communicative competence (Bradshaw, 2001). The goal of an effective signing environment to support persons with intellectual disabilities cannot be pursued in isolation (Lodge-Miller & Elfenbein, 1994). Rather, commitment from many people (i.e., senior management, principals, teachers, parents) involved in the care of clients is essential to the successful implementation of a common signing approach within an environment. employment-training development centres. An initiative by the Allied Health Professionals Hub

is adopted from American Sign Language. Prior to our involvement in the project, we knew little about KWS&G and thought that the approach consisted of a unique set of signs to be used specifically for persons with disabilities. KWS&G is used by hearing children and adults who cannot speak or have speech that is difficult to understand. KWS&G typically borrows signs from the deaf community of the host country. While both speech and sign are used together, only the key words of a spoken sentence are signed (e.g., “Can you help me open the box”?). As a first step, we investigated the uptake of KWS&G using Auslan (Australia) as an interim common signing approach to meet the immediate needs of the clients within a MINDS school as part of the pilot study for 2011. Auslan was chosen because we wanted to use training materials and resources related to KWS&G (Australia) that

were readily available to facilitate the pilot study, rather than reinventing the wheel. Indeed, the ultimate long-term intention of the MINDS Allied Health Professionals Hub is to develop Key Word Sign, incorporating Signing Exact English that could cater specifically to the needs and culture of our local context in Singapore. Specifically, our project team was exploring the potential for creating a “culture” of signing environment as a long- term goal which, in this instance, was using KWS&G as part of a total communication approach when interacting with persons with intellectual disabilities. An action research framework (Morton-Cooper, 2000) was adopted for the pilot study, aimed to help us to critically reflect on our work practices and arrive at some consensus regarding the kind of services to better cater to our clients, and the reason(s) for providing the service(s) in a particular way. Parents and teachers involved were trained using KWS&G via a train-the-trainer model, after one of the team members (a speech therapist) attended a KWS&G Presenter Training Course in Melbourne, Australia in 2009 to be Singapore’s first qualified KWS&G Presenter (Scope, 2010). It was anticipated that the findings from the pilot study would help guide decisions with regards to KWS&G use within the entire organisation. Aims The pilot study aimed to explore 1) the attitudes and perceptions of teachers, parents, and students towards KWS&G use as part of a total communication approach, and 2) the willingness and abilities of teachers and parents to use KWS&G with greater accuracy, confidence, and frequency when communicating with their students/ children, after having received training.

The pilot study Setting the scene

In Singapore, the sign language that is most commonly used by the deaf community is Signing Exact English which

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JCPSLP Volume 14, Number 2 2012

Journal of Clinical Practice in Speech-Language Pathology