Signalong & Makaton - The Great Debate
It is recognised that the use of sign is an effective form of communication for some people who have a learning disability and their communication partners. Some of the article below was written in 2000, after a huge amount of work to introduce a sustainable approach to sign-supported communication. This was led by Speech and Language Therapy in the NHS and the local advocacy group and the article focuses on the work in a North West service in the 1990’s. The author no longer works for the NHS but now leads the Community Interest Company Total Communication Services CIC: www.totalcommunication.org
Throughout the 1970s, signing systems were introduced to people living in long-stay institutions who had communication impairments. Signing enabled people to express themselves using a different modality and supported people’s understanding of spoken language and context.
Makaton was the most widely recognised and used signing systems throughout services for people who have a learning disability.
In common with many social care settings in the 1980s, a Learning Disability Service in the North-West funded an individual to become a registered Makaton tutor. This person was able to provide training and support to a number of people, resulting in an increase in effective communication. Unfortunately, the tutor retired from training in the early 90s, and the service within the local area had no-one able to provide recognised training/signing training. I was appointed as the first full-time Speech and Language Therapist working with adults with learning disabilities in 1992, and quickly became aware that signing was a real challenge across many of the social care settings. By this stage, the only time staff remembered to sign was when I walked into the day centre! It helped that I co-incidentally shared a surname with the former signing tutor.
This lack of training resulted in a number of challenging situations:
Staff lost signing skills due to lack of support, revision and resources.
People entered the service from institutions and education with signing skills and were supported by staff who had not had access to relevant training.
Children were exposed to sign, but, as they moved through school, the continuity was dependent on an individual teacher’s skills and experience of signing.
People were beginning to participate in their local community following resettlement from the long-stay institutions. The community, however, did not have the signing or awareness skills required to establish and maintain relationships.
There was an inconsistent approach to the training of parents and families.
The above factors contributed to increased levels of frustrations for all communication partners. Other areas of concern included the decrease in accuracy of the signs as people (staff) formed them. Adaptation of signs to suit individuals and their needs is acceptable, but communication partners need to form signs in a consistent fashion to help prevent communication breakdown.
In the early 1990s, any materials were limited. In a pre-digital world, correspondence was via letter or phone call. Updates to vocabulary were not circulated and we had no way of finding out if any were planned. Makaton had a restricted vocabulary and did not meet the needs of people whose lives had become fuller and who needed to communicate an increased variety of messages, including expressing their sexuality or personal needs. Some services, such as Somerset, developed their own signing system. I visited Somerset in 1994 to look at their county-wide approach and their innovative approach to total communication.
The number of service users requiring input from Speech and Language Therapy back in the North-West service was huge, with a potential caseload of around 800, and resources scarce, so service managers in the local town agreed to release support workers to be trained as Total Communication Coordinators. We agreed the TC Coordinators would help to plan a large event, which aimed to raise awareness of the importance of communication across the range of services via different workshops held over three days.
The awareness of the potential of signing as a form of communication prompted a signing debate at the first event, which we christened the ‘Total Communication Conference’. The conference was an event for people with learning disabilities and support staff. It ran annually for five years, and throughout the event, around twelve workshops exploring all forms of total communication were offered.
For the very first of these Total Communication Conferences in 1996, the issue of signing was explored. The workshop was facilitated by the Oldham Civil Rights Group, made up of people with learning disabilities. The group considered why previous attempts to encourage signing borough-wide had not succeeded, and whether Makaton provide adequate accessibility in terms of vocabulary, training and resources, and what the available alternatives were.
The group considered the difference in the way Signalong was taught. A major plus point was the potential for sustainability of the approach. The methodology of learning handshapes, orientation, placement, movement and direction meant that course attendees were able to work out how to create a sign which they hadn’t seen produced just by the descriptions underneath the illustration. This is a key difference and fundamental to the approach. Once trained, Signalong empowers people to be able to develop their sign vocabulary and not be reliant on other courses in the future.
Over the next year, research and consultation took place throughout the borough to establish the need for signing training across services. The results showed a clear lack of signing awareness, knowledge and experience, and the massive need for a consistent approach.
At the 1997 Total Communication Conference, a wide variety of representatives from Health, Social Services and Education services in Oldham met with people who use the service and members of the civil rights group, to plan future developments for the implementation of a signing initiative. The different signing systems available were considered. The group decided that the Signalong system would be piloted, and that a special interest group would monitor progress and consider the development of a borough-wide policy in the use of sign to support people who have a learning disability.
Developments and Sustainability
By January 1998, there were eight Signalong Tutors in the local area. These included Speech and Language Therapists, Information Workers, a Drama Therapist and a Community Support Worker. By mid-1998, another eight tutors, funded by Education, were trained. Private service providers who at the time were offering support in the area, such as United Response and Independent Advocacy Services (IAS) have also funded tutors. We were trained by Gill and Mike Kennard, and for a while, there were more Signalong tutors in our local area than in the rest of the country.
The number of tutors has enabled an increased number of staff to be trained in Signalong. Tutors within the town updated each service on progress made and new Signalong resources, which they shared across services.
As the years rolled on we continued to develop our approach to teaching and encouraging sign. Each workshop at the annual Total communication conference had to use a variety of means of communicating, from using object and pictures through to teaching signing vocabulary.
At the Total Communication Conference 2000, we held a Samba workshop, incorporating signing, symbols, and objects wherever possible. Gill and Mike Kennard attended this conference, and my abiding memory of the closing ceremony is of them dancing to the samba band, with huge grins on their faces.
During the Total Communication Conference 2000, members of Burys’ Samba band, Zambura, attended on a voluntary basis, and their support was much appreciated. Zambura was an inclusive group with some very proficient drummers also having learning disabilities.
The aims of the session were as follows:
To experience Samba music and dance.
To explore rhythm and movement as a form of communication.
To be creative and have fun.
During the sessions, we looked at different aspects of communication, including communication through music and dance. For example, different rhythms can help express mood or urgency. We offered choices of instruments and a choice between drumming and dancing, gaining an insight into people’s methods of making choices. Support workers were encouraged to include information gathered from the workshop in a personal communication profile or dictionary. Over the three days, staff were encouraged to look for opportunities for communication, whether by choosing an instrument, learning a new sign, or responding to a facial expression. Basic signing was introduced.
During the conference workshop, participants were provided with a workshop booklet with photographs of Samba schools from across the world. The booklet contained information about the aims of the workshop and copies of the signs which were introduced. A list of ideas suggesting activities to do after the workshop was included.
Also at the 2000 event, representatives from Adult and Children’s Services reviewed how the use of Signalong was developing. The initial hopes and aspirations of the working party, which was established, in 1996 were revisited. The energy and resources spent over the five years were recognised. The belief that signing should be a valid and respected form of communication which is used and understood in the wider community was still held.
The review of the situation prompted this reflection:
All representatives felt that in order to ensure that progress continues, guidelines needed to be developed. This would ensure that future development and maintenance of Signalong would not depend upon individuals.
The work on signing is an example of joined-up thinking, and how services can work together towards a common goal. It was a real achievement to bring together a common approach to signing across a range of services for people of different ages. Adult services need to be aware of the needs of tomorrow’s adults in advance, to enable appropriate planning of services. Children with disabilities are learning to expect an opportunity to have their say, services need to be prepared to meet their requirements. Strong bonds need to be formed between all services that should not be dependent on individuals’ efforts. These bonds need continuous reinforcement with commitment and energy. None of us would pretend that the signing situation in the town is now perfect, and we still have many goals to achieve. The implementation and continual monitoring of Signalong over a number of agencies is our biggest challenge.
In Terms of the Present Day
It is gratifying to see that despite the radical cuts, Signalong is still taught across age ranges in the town and that there is less likelihood that children and adults move between settings and lose their communication partners. I don’t think I will ever understand why it is acceptable to stop using a communication approach once someone moves between settings. This is something which wouldn’t happen to a physical aid such as a wheelchair.
I still promote Signalong in my practice and remain a Signalong tutor.As a practitioner who can be commissioned into a service for a few days only to leave having delivered training, I feel Signalong is the only option where I could feel comfortable knowing that course attendees are equipped to continue independently.
The Total Communication Services CIC website is a testament to the work of self-advocates in promoting signing for support staff. Gareth, a self-advocate with autism who is a volunteer for Total Communication Services CIC, feels strongly that support staff need access to core vocabulary, and with the support of Signalong, we regularly share the core vocabulary signs.
https://youtu.be/CFxdXPn2fH0 (Gareth’s film on YouTube)
https://www.totalcommunication.org/training (TC training page)
Speech and Language Therapist
Director of Total Communication Services CIC