Griffiths, Tom

Hale, Catherine

English

University of Dundee Online Publications

                                                                    University of DundeeWhat can combined TOM-AAC data tell an AAC Service about the difference we maketo clients?Griffiths, Tom; Hale, CatherinePublication date:2018Document VersionPublisher's PDF, also known as Version of recordLink to publication in Discovery Research PortalCitation for published version (APA):Griffiths, T., & Hale, C. (2018). What can combined TOM-AAC data tell an AAC Service about the difference wemake to clients?. Poster session presented at Therapy Outcome Measures Connect, Birmingham, UnitedKingdom.General rightsCopyright and moral rights for the publications made accessible in Discovery Research Portal are retained by the authors and/or othercopyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated withthese rights. • Users may download and print one copy of any publication from Discovery Research Portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain. • You may freely distribute the URL identifying the publication in the public portal.Take down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediatelyand investigate your claim.Download date: 17. Aug. 2023Addenbrooke’s Hospital    Rosie Hospital What can combined TOM-AAC data tell an AAC Service about the difference we make to clients? Tom Griffiths and Catherine Hale Communication Aid Service East of England (CASEE) Our Service • Established in 2016, the Communication Aid Service East of England (CASEE) is a regional service offering specialist augmentative and alternative communication (AAC) input to  six counties – Bedfordshire, Cambridgeshire, Essex, Hertfordshire,  Norfolk and Suffolk – with a total population of 6.2 million. • The service has a multi-disciplinary team including Speech and Language Therapists, Occupational Therapists, Clinical Technical Professionals, Educationalists and Administration Staff. • The service is Specially Commissioned by NHS England for the provision of complex, “high-tech” AAC systems and devices to people meeting nationally agreed criteria. • In the period April 2016 – August 2018, 352 clients were seen and  174 final systems were issued. Collection and Use of TOM-AAC Scores •  TOM-AAC is a subscale of the Therapy Outcome Measures (Enderby & John, 2015) which aims to measure the impact of AAC provision on: Impairment, Activity, Participation and Wellbeing. The use of this outcome measure was recommended by the national AAC outcomes measures working party and was adopted by all Specially Commissioned AAC Services across England. •  The CASEE Team collects data for all clients at the initial assessment (baseline) and review appointment (outcome). Methodology Baseline and Outcome data were collated following a case note and database review, with data drawn from all clients given both scores  (n = 133) Compliance Baseline scores were given to 220 of 352 clients (62.5%) Outcome scores were given to 133 of 174 clients (76.4%) Discussion •  Clients issued with high-tech AAC devices showed a mean increase across all but one domain •  Large range in scores indicated that this is a heterogeneous group •  One-Way ANOVA indicated no significant difference in outcome between diagnostic groups Change in TOM-AAC Score (Baseline – Outcome; Across all diagnostic groups)  Descriptor Mean Change Standard  Deviation Range Participation (n = 133) + 0.654 .749 4.5 Activity (n = 133) + 0.654 .793 4.0 Wellbeing (n = 113) + 0.226 .547 4.0 Carer Wellbeing (n = 26) + 0.231 .751 4.0 Support (n = 23) No Change .879 3.5 Correlations Pearson’s correlations conducted to see if relationships existed between any descriptors:  • Highly significant correlation between cognitive and comprehension impairments  (r = .802 n = 133 p = < .005) • Highly significant correlation between changes in activity and participation  (r = .642 n = 133 p = < .005) • Highly significant correlations exist between wellbeing, activity and participation •  Activity (r = .259 n = 113 p = .006) •  Participation (r = .288 n = 113 p = < .005) • Higher scores in verbal output are negatively correlated with activity outcomes  (r = -.205 n = 133 p = .018). In clients with MND, this correlation is more significant  (r = -.682 n = 18 p = < .005) • In other degenerative conditions where there is more cognitive involvement, higher cognition scores are partially correlated with increase in activity (r = .532 n = 16 p = .034) Reference: Enderby P & John A (2015) Therapy Outcome Measures for Rehabilitation Professionals: 3rd Edition. Guildford: J & R Press  Conclusions This single-centre study uses TOM-AAC to provide more evidence that provision of AAC can increase functional communication, which in turn increases participation and involvement. Where clients’ wellbeing was scored, this also increased.  Correlations exist at outcome between activity and participation and cognition and comprehension.  The relationship between verbal output at baseline and activity outcomes may indicate that clients who are still speaking / more able to speak at time of provision make less use of AAC systems.  In degenerative conditions with cognitive involvement, some evidence is emerging of a positive correlation between cognition at point of provision and activity outcomes. 

What can combined TOM-AAC data tell an AAC Service about the difference we make to clients?

https://discovery.dundee.ac.uk/files/96710179/TOMS_Connect_Poster.pdf

What can combined TOM-AAC data tell an AAC Service about the difference we make to clients?

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