Admittedly, before starting to study Speech and Language Therapy in September 2020 I think I had been quite ignorant to how inaccessible the world can be for people with learning disabilities and communication impairments. That’s not to say that I thought that accessibility was unimportant, but I had never been immersed in a world that needed extra support to access the world around them. I did not consider often enough how society functions mostly for those who do not need the help. Since my placement with Total Communication Services CIC/ Elysium Healthcare I have started to notice all the work that needs to be done. I have started to notice the poor quality of subtitles on most video platforms, the lack of willing support and patience in fast paced services such as coffee shops, banks, and post offices. I have also noticed that what some people might consider to be the ‘small details’ are in fact huge details or even impossible for someone who does not have the capability for them. I’ve never felt myself become so eager to be involved in change.


During my time with Alison at Total Communication Services, I spent some time creating accessible leaflets on various topics, like an introduction to Autism and DBT therapy. I spent a lot of time thinking about how a lot the people who might require these accessible leaflets will struggle with these so called ‘invisible illnesses’ and might not think to ask for information in a more simplistic way.


In 2016, the introduction of the ‘Accessible Information Standard’ made it mandatory that all organisations that provide NHS care make ‘reasonable adjustments’ to their services so anyone and everyone can access their services in the same way. Some of the adjustments being made you could argue are still not good enough, and some services are seemingly only providing the bare minimum. Despite this, the Standard is a massive leap forward. My next question would be: Why can this standard not be projected into the rest of society?



The Royal College of Speech and Language Therapists (RCSLT) are definitely trying! In November 2020, the RCSLT announced a new symbol that can be displayed outside of shops and businesses to highlight that the business has people at hand to help those with communication difficulties. Our various lockdowns have not allowed me to experience this symbol in the big wide world yet, but I am hopeful *with everything crossed* that it will be used and embraced!


Being exposed to all of this information has made me really consider who and how I want to be as a future Allied Health Professional and Speech and Language Therapist. If one of my client’s needs accessible information, such as simplified resources to help them do their therapy outside of our sessions, I know that I, myself, will need to be more accessible than perhaps I would normally be. This might be in how much time we spend on goals, my voice and language, my initial approaches with them…there is so much I am yet to learn, and I am so keen to involve myself with people that can teach me.

Whilst with Alison at Total Communication Services, I was invited to a self-advocacy group that spend a lot of time looking at ways they can raise awareness for the need of further accessibility in society for people with Learning disabilities, like themselves. It was such a privilege to have them provide me with feedback on the accessible leaflets I had been making because who am I, someone without a learning disability, to make a document aimed at people with a learning disability and claim it is accessible? They let me know what language was too difficult to understand, what images were too abstract, whether the font was too small or unintelligible. I cannot thank them enough for helping me, teaching me, and making me aware of the details I would not have even considered. Co-production should be an essential part of creating documents for anyone with an impairment.


Marika Lomax

Student Speech & Language Therapist

My name is Gareth and I’m a self- advocate. I volunteer with Total Communication Services CIC and some time ago

I created the leaflet about autism - You can see it here https://753e2037-f764-4c1c-b2bf-ad4632bf81f7.filesusr.com/ugd/f5d6b4_2081dc1a1016497d9e221c65cf434821.pdf


Recently I have made a short film which shows 20 core vocabulary signs .

I think all care staff need to know some basic signing, just some basic idea of how to communicate would be a good start. Some people with learning disabilities are non -verbal and rely on signs to communicate. Imagine if people couldn’t speak

your language how isolated you would feel. It’s problematic.


We need to be inclusive to all needs, this means adapting our communication. It means meeting people on their terms on their level and using their ways of communicating.


Signalong generously gave us permission to share the signs with other self-advocates and we are grateful for their support. See link to watch the film: https://www.totalcommunication.org/training



Gareth Welford


Ciara is a first year Speech and Language Therapy student at the University of Manchester.

She recently had a joint online placement with Total Communication Services CIC and Elysium Health care.

As part of her placement she attended Total Communication Services Communication Advocates group and she had her first taster of signing as the group regularly practice Signalong.

Ciara then decided to research the different signing systems available and she wrote up her thoughts as a blog post.


Makaton and Signalong

Both are great systems and can really help a range of people from children to adults with learning disabilities who may be hearing impaired

According to the their website Makaton is the UK's leading programme for adults and children with learning or communication difficulties. They also have a TV presence for example, the CBeebies show 'something special' which is great for children learning Makaton. There have also been Makaton storylines in Emmerdale for those of you who like soaps, Makaton could be for you. There are currently over 1 million Makaton users. Makaton symbols are commonly used in public buildings such as hospitals and libraries to help people find their way around, you may be using Makaton in your daily life now without even knowing! Makaton is also continuously taught by a tutor in sessions which means you will have a go-to person to advise you on all your communication needs. Makaton tends to be more well known throughout the UK and there is even a "Makaton friendly" town in the UK, which is Romsey.


The main difference between Signalong and Makaton seems to be the way they are taught. Makaton is taught through continuous sessions with a tutor and Signalong is taught through learning the method then you can potentially independently learn further signs. This means using the skills taught by the tutor to copy the position of the hand, orientation, placement, and line drawing to copy the sign. This is great for people who want more autonomy over what they learn as you can learn about a specific topic you want to talk about. For example, learning signs about the topic of sexual awareness means can people have important conversations about consent or their sexual orientation. Signalong’s teaching method means you can actively keep learning new signs throughout your life without necessarily needing a constant tutor. Most of the signs will be recognised by British Sign Language (BSL) users because sign along has its roots in BSL. Signalong’s critical point is "one concept, one sign" this means that the same sign is not used for similar concepts. For example, in BSL the sign for 'doll and 'baby' are the same, however, in Signalong they are different. Therefore, people do not need to rely on context to help them explain. Signalong could be ideal for adults who want to learn specific signs quickly and especially for adults with a background in BSL. Signalong could be considered easier to learn because it shows specific ways of signing so you cannot get it wrong, this would be useful for adults with learning disabilities who may have been taught simple BSL previously and want direct instructions. BSL is a challenge because it is a language in its own right and has a different word order to spoken English. Both Makaton and Signalong are sign support systems and you speak as you sign the key words.


Both systems provide an effective way to communicate and can be applied at all ages. They are both very successful in enabling children and adults with Learning disabilities to communicate. Whichever system you choose, the important thing is learning one so you yourself can communicate effectively or you can listen and encourage others to communicate.

The self -advocates in the North West chose Signalong and this system has sparked a real interest for me in all signing.

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