Communication Passports

Happy new year. We are beginning our year with a blog by Hannah Bradbury a first year Speech and Language therapy student from the University of Manchester. Hannah was on her first placement with us for four weeks in her first term. Hannah was invited to create her own communication passport and to create one with one of the pupils we are supporting.

Communication Passports

Communication is power. Without it, none of the living systems on earth could exist, as life itself relies on interactions between various organisms. It’s everyone’s fundamental human right to express ideas and feelings, and for many individuals, this comes as second nature. However, at any point in a person’s life, issues can emerge, complicating this process; some people face challenges in verbal communication due to various reasons, such as neurodevelopmental disorders, cognitive impairments, or medical conditions. In such cases, a communication passport can be a valuable tool to facilitate effective communication and enhance understanding.

Over the past few weeks, I have been researching communication passports in order to create one for a student who cannot use language as a form of expressive communication. By this, I mean that she has shown ability to understand simple English, but cannot respond or share her thoughts using language. This is due to her global developmental disorder, which delays the developmental milestones that most other people her age are meeting. I wasn’t sure where to start on this project: It was my first time coming across the term ‘communication passport’, and all the examples I had seen of them had been totally different - I had seen take form as paper books, fabric books, boxes of items, powerpoint presentations and more; the main purpose being that it is tailored to the individual it is being made for (Coakes et al., 2023). There were no black and white rules about what one had to be or look like, which although allows for creativity to flourish, can make for a challenging starting point.

Searching for inspiration, I decided to gather as much information on the student as I could. During my first session, observing the student’s classroom, one thing that particularly stood out to me was how passionate her teachers were to truly portray this student’s true colours, as a unique and wonderful human being. They explained that students who struggle to communicate using language can often be overlooked and misunderstood, and whilst listening to them speak so ardently about how important it is for them to be in an environment where they are appreciated and their needs are recognized and met, the penny dropped. This is where ‘the individual has an impairment, the disability is in society’ plays a role, as I realised that my job over the next few weeks, and the purpose of a communication passport would be to adapt the student’s environment to make communication between themselves and familiar or unfamiliar faces accessible to them. My plan was to create a communication passport to essentially acts as a translator, or a bridge between two parties that communicate in different ways.

After collating information from multiple sources, such as health documents, student profiles, observations, 1-to-1 interactions with the student and speaking with her teachers and parents, I had gathered a wealth of information. So much information in fact, that I had no idea how to organise and compact it to make it digestible and practical to read. What really helped me through this process was making a communication passport for myself.

It made me think: “Say I was going out for a coffee to meet a new friend for the first time. What would I want them to know about me?”. This is so important to consider when designing a communication passport, as they are intended to encourage the individual with impairment to communicate, acting as a vessel for conversation starters or meaningful interaction on a level that individual understands, rather than listing information about the owner for others to simply read. It is also important to consider the information a person connotes, as well as tells you straight up, for example, if the barista made them the wrong drink on this coffee meet-up and they respond frustratedly, this would typically suggest the individual is short tempered or rude, versus if they respond understandingly and empathetically, you would assume they are patient and kind. It is a good idea to write some of this information in the communication passport and help it determine your tone, in order to wholly sum-up their character. I found writing the communication passport in a first person perspective most useful, as it was as if you were talking to the student when reading it.

Being confident on the ultimate goal, I then faced the challenge of deciding what to include in the passport. How could I create something to aid communication between two individuals who are at two very different levels of symbolic development (see image below), whilst also supplying a substantial level of detail? The student is on the border between coloured photograph and real object level of understanding, and those who will use the passport with her, are most likely to be at a written word level. This is why I decided to make the passport physical interaction and sensory based.

Most Abstract

There were multiple things that lead up to this decision. First of all, after meeting the pupil ‘A’, it was clear to me how important touch and joint attention was for interaction and getting to know one another. I was unsure how to incorporate this concept in order to make a transportable and practical form, until I heard about sensory stories. Sensory stories do not just focus on images and writing (visual stimuli), but incorporate all the other senses too- smell, touch, taste, sound and movement- to make it a truly immersive experience (Yogendran, 2023). This is why I made as many pages in my communication passport complete with one or more objects that incorporated the different senses and that were linked to the written content.

Here are some examples of my planning:

After gathering information, and really breaking down what I wanted the communication passport to look like and incorporate, I was able to combine a few ideas from the examples I had seen and read about, as well as utilising what I knew about A:

-Black backgrounds help her focus on images and objects, so I made all the pages black, as well as the backgrounds of all the images and writing.

-Yellow is a colour she particularly engages with, so I have bordered all the images and writing with yellow

-She is strong and has a tendency to throw items when she is excited, so the book had to be soft and durable. Therefore, I made it out of sturdy fabric with cardboard inserts (to keep its shape).

-She needs minimal distractions to help her engage, and sitting in a dark room with a torch shining on one item at a time helps, so I inserted a torch

-She does not engage with anything in her lower field of vision, so I made all items and images removable so they can be held close to her face, at eye level

-She is moving onto further education, so details of her may change as well as her character, so I ensured that no items or written content are permanently fixed in. I did this by creating transparent pockets on all the pages for the images and writing to be inserted into, and also made fabric pockets and elastic strips to hold the items.

-She likes being messy, so the fabric I used for the pockets (which covers a lot of the pages) is a plastic material, as well as laminating any paper, so they can easily be wiped clean. I also put wet pipes in the pocket on the back page.

-She will be taking this on the go, so to help with transportation, I made sure that the book could be ‘sealed’ on the edge to keep it closed

-she uses aromatherapy to help establish routine, so I made the book scented. This scent is an essential oil that is different from others she uses in the class, so can be used by her to relate the smell to the communication passport

-Shining a light on items of interest really help her to focus on them, so I laminated the images with matt lamination, so that they don’t reflect and blur the photos when light it on them.

-Her and her family have busy lives, so I ensured to include any items that may need replacing or restocking in the book in the last page (I.e- batteries, glow sticks, wet wipes etc).

-She is also in an interaction based class, so I was sure to use some of the interactions I had found A to take a particular liking to, like hand massages and holding bright objects in front of her face. This can help her relax and engage, and maybe relate the communication passport to fun and for her to enjoy. I also thought the activities for A to carry out with whoever is reading the passport would be a good way of getting in know each other, as they can have fun together and let their guards down.- essentially breaking the ice in a way that is enjoyable for both parties.

-She responds well to bright, sparkly objects, so I made sure to include fairly lights, sparkly fabric, fluorescent fabric, torches (UV and normal), neon facepaint and a mirror etc.

Other things I had to take into account were:

-The order of the pages. I thought that knowing the information about how to communicate with her was most useful, so put this in first. This ensured that whoever is going through the passport with her knows how to go through the rest of the pages with her to help engage her.

-I managed to collect a wealth of information from A’s health records, speaking to her mother and teachers, and meeting her myself. I had to compact, organise and simplify this information so ensure it would all fit and would be digestible in the passport. I understood that it may be a challenge to multitask (reading the information whilst interacting with A), so I made the key details in bold, in case they need to skim over the written information and look at in more detail afterwards.

-how to get her parents involved. I was understanding that her parents must be very busy, however also knew the importance of making them feel included and valued. I ensured to plan my conversation with her mother beforehand, so that I was able to ask her questions efficiently and note down her answers in an organised way.

All in all, I am so grateful to have had this experience and opportunity. As a first year SaLT student, on my first ever work placement with university, I was not expecting to fall in love with a job so much. The opportunity to combine my academic skills with my passion for creativity has really been an experience I will never forget. I hope that this blog has helped begin to explain the endless possibilities of a communication passport and can be used as a tool for people interested in making one, or even just inspire others to create an accessible environment for those who need it. I can’t emphasise enough how much of an enjoyable experience it was being able to get to know such wonderful people, as well as have the chance to leave something behind, after my short few weeks working with Total Communication. I feel more motivated than ever to get my qualifications and get out in the field of speech and language therapy.

For further reading I would highly suggest having a look at the links in the referencing list. I found them very useful.

References:

Coakes , L. A., Little, T., & Drysdale, L. (2023). It’s My Book: Ownership of a Communication Passport. Communication Matters, 18(1), 21–23. https://www.communicationmatters.org.uk/wp-content/uploads/2019/02/cmj_vol_18_no_1.pdf

Yogendran, K. (2023, April 20). What is Sensory Storytelling? SAAAC. https://saaac.org/what-is-sensory-storytelling/#:~:text=Sensory%20stories%20incorporate%20all%20the

‌Millar, S., & Aitken, S. (2004). Personal communication passports : guidelines for good practice. Call Centre.