Tip of the Month - November 2020 - Using a Partner Assisted Scanning Communication Book with Adults
What do we mean by ‘physical access needs’?
When we talk about people having ‘physical access needs’, or ‘difficulties with physical access’, we mean that they don’t have adequate use of their hands to be able to physically touch/point to a communication book or device in order to use it.
Physical access difficulties can apply to low-tech (i.e. paper-based systems), or to high-tech systems. In this Tip of the Month, we’ll focus on using low-tech communication books.
Because the user is not able to physically touch the book or turn the pages, we need to support them to use the book in a different way. The way someone uses their communication system is called their ‘access method’. That’s where Partner Assisted Scanning comes in…
What is Partner Assisted Scanning (PAS)?
PAS is an access method used by some people who use AAC who cannot directly select words or phrases themselves using their hands or fingers to point. Options are presented to the individual either using auditory (reading the words) or visual (showing the words/pictures) scanning, or both. Visual scanning is when options are presented visually and the communication partner may point or use another method such as a light to highlight the items as they present them to the individual. Auditory scanning is where the words are read out to the individual. The individual will then select a word or phrase using a previously agreed sign or gesture e.g. head nod or vocalisation.
Low-Tech Communication Books
There are different ways a low-tech communication book can be made. They can have words only, or include symbols/pictures if the person needs or wants this. For adults who have good language and literacy skills, we may use words only. The book can have words, phrases or sentences, or a combination of all of these. Books are usually organised into topic categories based on what the person wants to communicate about. Examples of categories include: chat, food and drink, cares and needs, people, feelings etc.
At the front of the book there is usually a page which allows the person to select the category of words they want to use (i.e. a contents or index page). The communication partner presents these options, and the communicator selects the one that they want. Once they have selected the category, the communication partner then turns to the appropriate page in the book.
Once on the appropriate page, the communication partner then presents the rows and columns until the person selects what they want to say. Once someone is familiar with their communication book, they may want to add numbers to represent the pages and/or rows/columns. Then their communication partner can present the numbers corresponding to the pages or rows/columns to make the process faster. There is more detailed information about this below.
A person can also use a PAS Alphabet Chart, such as the one below, to spell out words/phrases which may not be in their communication book. This alphabet chart can be either included in the communication book, or separate to this.
Here are some photo examples of PAS communication books
 |  |
| Here is a book with numbers and letters. The communication partner may say “is it column ‘A’? B?" Or “row 1? 2? 3?”  |  |
 |  |
How do we use PAS?
1. Establish a positive ‘yes’ response
To use a communication book with PAS, you will need to ensure the individual has a way of making a selection. They will need to have a way of indicating ‘yes’. Whilst a ‘no’ is useful, it is not essential for using PAS. Repeatedly indicating ‘no’ can also be tiring for the person, so you may decide to use no response to indicate ‘no’.
The individual can indicate ‘yes’ in a number of ways, for example:
· Using their eyes to look at or “point” to a ‘yes’ symbol/word (which should always be on the same side). It is suggested that you stick it to the person’s wheelchair tray or standing frame so that it is always on the same side, regardless of who is communicating with the PAS user.
· Moving their eyes in a particular direction, e.g. “I look upwards to say yes”
· Nodding their head
· Saying ‘yes’ or an approximation of yes, e.g. ‘yeah’
There are a number of different ways that people can access a PAS system. Any established movement which the client has been using to indicate ‘yes’ previously would be appropriate to use with a PAS system. However, it would be advisable not to use a movement which can be involuntary or an emotional response such as a smile.
It is important that everyone working with the individual is familiar with their ‘yes’ response and if they have one, their ‘no’ response. Make sure you clearly provide this information for anyone working with/caring for them. It’s a good idea to write this really clearly on the low-tech communication system.
2. Decide how you are going to present the information to the person who uses PAS
Things to consider:
· How are you going to read or scan the words, by row or column first?
· Does the person need the information presented both verbally and visually?
· Are you always sitting on the same side when you present the options to the person?
· How are you highlighting options if you are using visual scanning? E.g. pointing, using a ‘frame’ which can be attached to a popsicle stick to surround the word/box, using a torch/flashlight.
· Are the symbols/words in the optimum font, size and colour for the person’s visual needs?
3. Make sure you are consistent
Whatever system you are using with PAS, you need to ensure that the information presented is always scanned through in the same order. This will help the individual to learn the system and to anticipate when they will likely get to the word or phrase they want to select. Make sure you write clear instructions on the back or front of the book if it is going to be used by multiple communication partners to ensure that everyone is using it in the same way.
Tips for using PAS
1. Clear your brain of any possible messages whilst you are assisting the individual.
2. Follow the order of the scan making sure you are consistent with the way other team members are using the system.
3. Keep the rhythm of your scan even.
4. Make sure you establish if they have finished their message or if they have more to say.
5. It’s a good idea to always include an option for ‘something else’, in case what the person wants to say is not in the book. You can then use a PAS alphabet chart (explained above) to allow the person to spell out their message.
Check out this video for a visual summary and a real life demonstration of PAS: https://www.youtube.com/watch?v=KyBkofHqBkY&list=PLdtbRx1dk8rJ6_eX7Xq1gdhj1vgUBoLmU&index=6
Here is another example of a real life use of PAS: https://www.youtube.com/watch?v=Ymvnc3dWOZY&list=PLdtbRx1dk8rJ6_eX7Xq1gdhj1vgUBoLmU&index=8
Created by Lauren Forster (Speech-Language Therapist) – July 2020
To download this Tip of the Month as a PDF, please click here
What do we mean by ‘physical access needs’?
When we talk about people having ‘physical access needs’, or ‘difficulties with physical access’, we mean that they don’t have adequate use of their hands to be able to physically touch/point to a communication book or device in order to use it.
Physical access difficulties can apply to low-tech (i.e. paper-based systems), or to high-tech systems. In this Tip of the Month, we’ll focus on using low-tech communication books.
Because the user is not able to physically touch the book or turn the pages, we need to support them to use the book in a different way. The way someone uses their communication system is called their ‘access method’. That’s where Partner Assisted Scanning comes in…
What is Partner Assisted Scanning (PAS)?
PAS is an access method used by some people who use AAC who cannot directly select words or phrases themselves using their hands or fingers to point. Options are presented to the individual either using auditory (reading the words) or visual (showing the words/pictures) scanning, or both. Visual scanning is when options are presented visually and the communication partner may point or use another method such as a light to highlight the items as they present them to the individual. Auditory scanning is where the words are read out to the individual. The individual will then select a word or phrase using a previously agreed sign or gesture e.g. head nod or vocalisation.
Low-Tech Communication Books
There are different ways a low-tech communication book can be made. They can have words only, or include symbols/pictures if the person needs or wants this. For adults who have good language and literacy skills, we may use words only. The book can have words, phrases or sentences, or a combination of all of these. Books are usually organised into topic categories based on what the person wants to communicate about. Examples of categories include: chat, food and drink, cares and needs, people, feelings etc.
At the front of the book there is usually a page which allows the person to select the category of words they want to use (i.e. a contents or index page). The communication partner presents these options, and the communicator selects the one that they want. Once they have selected the category, the communication partner then turns to the appropriate page in the book.
Once on the appropriate page, the communication partner then presents the rows and columns until the person selects what they want to say. Once someone is familiar with their communication book, they may want to add numbers to represent the pages and/or rows/columns. Then their communication partner can present the numbers corresponding to the pages or rows/columns to make the process faster. There is more detailed information about this below.
A person can also use a PAS Alphabet Chart, such as the one below, to spell out words/phrases which may not be in their communication book. This alphabet chart can be either included in the communication book, or separate to this.
Here are some photo examples of PAS communication books
| |
| Here is a book with numbers and letters. The communication partner may say “is it column ‘A’? B?" Or “row 1? 2? 3?” | |
| |
How do we use PAS?
1. Establish a positive ‘yes’ response
To use a communication book with PAS, you will need to ensure the individual has a way of making a selection. They will need to have a way of indicating ‘yes’. Whilst a ‘no’ is useful, it is not essential for using PAS. Repeatedly indicating ‘no’ can also be tiring for the person, so you may decide to use no response to indicate ‘no’.
The individual can indicate ‘yes’ in a number of ways, for example:
· Using their eyes to look at or “point” to a ‘yes’ symbol/word (which should always be on the same side). It is suggested that you stick it to the person’s wheelchair tray or standing frame so that it is always on the same side, regardless of who is communicating with the PAS user.
· Moving their eyes in a particular direction, e.g. “I look upwards to say yes”
· Nodding their head
· Saying ‘yes’ or an approximation of yes, e.g. ‘yeah’
There are a number of different ways that people can access a PAS system. Any established movement which the client has been using to indicate ‘yes’ previously would be appropriate to use with a PAS system. However, it would be advisable not to use a movement which can be involuntary or an emotional response such as a smile.
It is important that everyone working with the individual is familiar with their ‘yes’ response and if they have one, their ‘no’ response. Make sure you clearly provide this information for anyone working with/caring for them. It’s a good idea to write this really clearly on the low-tech communication system.
2. Decide how you are going to present the information to the person who uses PAS
Things to consider:
· How are you going to read or scan the words, by row or column first?
· Does the person need the information presented both verbally and visually?
· Are you always sitting on the same side when you present the options to the person?
· How are you highlighting options if you are using visual scanning? E.g. pointing, using a ‘frame’ which can be attached to a popsicle stick to surround the word/box, using a torch/flashlight.
· Are the symbols/words in the optimum font, size and colour for the person’s visual needs?
3. Make sure you are consistent
Whatever system you are using with PAS, you need to ensure that the information presented is always scanned through in the same order. This will help the individual to learn the system and to anticipate when they will likely get to the word or phrase they want to select. Make sure you write clear instructions on the back or front of the book if it is going to be used by multiple communication partners to ensure that everyone is using it in the same way.
Tips for using PAS
1. Clear your brain of any possible messages whilst you are assisting the individual.
2. Follow the order of the scan making sure you are consistent with the way other team members are using the system.
3. Keep the rhythm of your scan even.
4. Make sure you establish if they have finished their message or if they have more to say.
5. It’s a good idea to always include an option for ‘something else’, in case what the person wants to say is not in the book. You can then use a PAS alphabet chart (explained above) to allow the person to spell out their message.
Check out this video for a visual summary and a real life demonstration of PAS: https://www.youtube.com/watch?v=KyBkofHqBkY&list=PLdtbRx1dk8rJ6_eX7Xq1gdhj1vgUBoLmU&index=6
Here is another example of a real life use of PAS: https://www.youtube.com/watch?v=Ymvnc3dWOZY&list=PLdtbRx1dk8rJ6_eX7Xq1gdhj1vgUBoLmU&index=8
Created by Lauren Forster (Speech-Language Therapist) – July 2020
To download this Tip of the Month as a PDF, please click here