This article features in the first issue of Touching Base, our quarterly newsletter for professionals in the health and social care sector. If you would like to sign up for this newsletter, use the form at the bottom of this page.

In this article, we will give a broad overview of the priority practice themes that Sense Scotland’s Operational Support Team are currently taking forward alongside colleagues from across the organisation. We will expand on these themes in future issues to share our practice with you. Please get in touch if you would like to share your best practice with us.

Sense Scotland’s Operational Support team was established in 2022 and brings together colleagues from across the organisation who are involved in practice development, including lead practitioners and managers in communication, quality assurance, health and wellbeing, learning and development, research and operational service delivery. We collaborate with colleagues in the Health and Safety team, our Advisory, Early Years and Arts teams, and of course with colleagues engaged in providing direct support to people in our social care services across the country.

As the world still recovers from COVID-19, and as health and social care in Scotland faces considerable challenges, we are re-doubling our efforts to maintain and further develop our specialist practice areas. Our Learning and Development team are also developing a programme of specialist CPD workshops for our own staff teams, but keep an eye out for an external programme of events and workshops that we will make available.

In this article, we will draw attention to three of our priority themes and show how these have grown out of our long-established albeit constantly developing practice approaches:

• Communication
• Positive Behaviour Support
• How people experience the world (as a result of our different sensory, neurodevelopmental or health differences)

Communication

Communication has been the foundation of support at Sense Scotland since we began offering services over 35 years ago. In the earliest years, this centred around developing communication partnerships with people born deafblind, and over the years has expanded to include a wide variety of communication support needs associated with complex and sensory disabilities. We ground our practice in the belief that communication is, at its simplest, the way humans reach out and make connections with each other. It is a two-way process where people both give and receive information. Each and every one of us is naturally a communicator from the very earliest moments in life, and we constantly strive to find ways to connect with each other.

Researchers have learned what can happen if infants do not get responses to their attempts to make connections with others; first, they can become distressed and anxious as they make increased efforts to make connections. They then may become passive as they ‘give up’ on trying to get the other person’s attention. From this research, we have learned to ensure that all attempts at communication are responded to in ways that can be perceived by both partners in a communication partnership.

This grounds our view that we must always look for ways to match communication support to communication support needs so that we all become effective communicators. This could mean developing communication and language strategies using sensory modalities other than vision and hearing, especially the tactile modality; it may involve a whole range of alternative and augmentative communication strategies; it will also mean adopting inclusive communication approaches. We look forward to sharing our practices in these areas and learning from all of you about how effective communication partnerships are at the centre of all human connections.

Positive Behaviour Support

Communication is also at the centre of our approach to supporting people when they are distressed and anxious, especially when it manifests as behaviours that challenge. We have recently undertaken a comprehensive review of all our practices relating to behaviours that challenge and restrictive practices. Generally, we adopt Positive Behaviour Support strategies and, like other organisations, we recognise the need to develop attachment-focused support and trauma-informed practice. These ask us to consider someone’s distress not just in relation to short-term triggers and immediate contexts, but also longer-term impacts related to attachment and trauma. We also take into account the lived experiences of people who perceive the world in fundamentally different ways from many others, whether this relates to sensory or neurodevelopmental differences. Only by taking this fullest range of factors into account will we begin to understand anyone’s responses to the world around them.

In future issues of Touching Base, we would like to share our practices around reactive and proactive support strategies, particularly ways to expand communication repertoires so that people have alternative ways to express themselves. Furthermore, as we further develop our approaches, we would also like to discuss how communication breakdowns arising from different perceptual experiences of the world might lead to repeated trauma, and how this might impact someone’s level of anxiety.

How people perceive the world around them

This leads to our final priority theme: understanding how someone perceives the world around them. We have a range of functional assessment tools that help us find out how someone uses their vision and hearing. Our VILD (Visual Impairment Learning Disability) services have long supported their staff to become Vision Champions, and they also offer a comprehensive external vision assessment service. We have also pioneered publications over the years such as Vision for Doing, jointly written a number of years ago with the Scottish Sensory centre, and have similar functional assessment processes to understand how someone uses their hearing. All of our functional assessment tools and approaches are based around the fundamental question of why people appear to see or hear when they want to. Given our underlying view that people always make sense to themselves and get through life in the most straightforward manner to them, our job is to work out why this might appear like that.

We will also explore other senses such as taste and smell, and in particular the sense of touch. For many people supported by Sense Scotland, touch is their primary contact with the world around them, and we plan to share what we have learned about the tactile modality from our involvement with various European research networks. However, we would also like to explore what have been called the forgotten senses, including proprioception and the vestibular sense, and how these are understood from the perspective of sensory integration. These are hugely important to think about from the perspective of people with sensory impairments, but we know also through writings from people such as Temple Grandin that these senses can have enormous impacts for people on the autism spectrum.

One of the key ideas we explore in Sense Scotland is acceptance of whatever compensatory strategies and self-stimulatory actions people have developed for themselves. In a future article, we will explore this more fully, and introduce the concept of supporting people to smuggle information into their brains! It is crucial that, once we know how someone perceives the world around them, we maximise our support strategies around communication and environmental adaptations so that someone gains the maximum amount of information.

So join us in future issues of Touching Base as we explore these themes more fully in relation to person-centred support and how we use the arts, the outdoors, sports and everyday activities as vehicles to develop communication and to support people to maximise their ways of being in the world.

Written by Dr Paul Hart, Head of Operational Support, Practice Development and Quality