Talking About QoL

People will access QoL in a number of different ways. The methods included are just some suggestions, remember to think about the person and what suits them best. Communication partners should be fully supportive of people accessing QoL in the way that suits them. It is hoped that people can access the resources no matter how they communicate.

The focus person should direct the areas they want to discuss whilst at the same time be supported to discuss all of the topics regularly. If the person does not want to choose the topic, cover all areas in turn. If the focus person prefers to only concentrate on one area of QoL, offer them the opportunity to repeat the preferred area of discussion as well as one of the other topics. If the focus person never wants to discuss any of the topics you should be curious about why. Is this an area of life that is very difficult for them?

The resources contain a questionnaire, symbols to use with talking mats and Aided Language Displays (ALD). It is expected that people may also use their communication devices and bodies to express their opinion on QoL. However, both are so personalised that there are guidelines and suggestions but no specific resources.

When using the resources you may want further information about why the person has answered in a particular way. It is important not to presume or lead the person to a specific answer. For example if they say something about a friend, you could ask if it is a school friend, a work colleague, someone they know online, from a particular place, or someone else. If the person is commenting on something about their lifestyle a good place to start is by asking if it is a person, place, thing or something else. For further information about potential follow up questions for the resources please see the relevant section communication, physical health, lifestyle, mental health, relationships. Below is an idea for follow up questions overall.

The Clues book on the Ace Centre website is a free resource that may be helpful for following up questions in a way that doesn't lead the person into a particular answer.

There are a few different ways you can access QoL

Click on a section for a more detailed description

Questionnaire

Filling in the questionnaire takes around 15 minutes for an experienced AAC user using partner assisted scanning to give basic answers. To get more detailed answers, it can take about an hour, These sessions can of course be split. If this is possible for the AAC user the questionnaire is probably the easiest resource to use. The advantage of this is that you can easily record the answers and you are ensuring that you are covering all of the areas in one session. Ideally the AAC user can then expand on any of the questions as they choose. This can be achieved by writing a sentence or two on an area of their choosing after finishing the questionnaire.

If you like the idea of the questionnaire to record the answers but think answering all the questions in one sitting would be too much you could create multiple questionnaires.

Here is a link to a video of someone completing part of the questionnaire

Talking Mats™

These resources should be printed and cut into individual symbols. For longevity you could laminate them. If the person prefers things to stay in one place you can use Velcro backs and a carpet mat.

If you are not familiar with Talking Mats there is training available both online and in person. Here is a link to the website for more details Talking Mats | Improving communication, improving lives

Talking Mats use symbols to help a person discuss their views on a particular topic.

Figure 1. A digital talking mat the topic is shown by the symbol on the bottom of the diagram. The top scale is the three symbols at the top of the page. Top scales differ according to the subject area. There are recommended top scales for each set. The options (the symbols in the middle) about the specific topic are then placed under the specific heading on the top scale according to the person’s opinions.

When all the symbols have been placed, starting from the right to left, ask the person if there are any changes they want to make to their answers. Offer opportunities for the person to say more about any of the topics both during and after the Talking Mat. Giving opportunities for discussion regularly allows people to discuss what they want whenever they are ready. It is always recommended that the words to discuss QoL are added to a robust communication system and the AAC user knows how to access them.

Here is a video example of doing a Talking Mat.

People who are Talking Mats trained and have access to either digital or paper resources may want to use their resources. Over time you may want to add in additional symbols that are particularly relevant to the person you are supporting. Please consider if the subject is covered by one of the other areas and ensure that you are adding choices for the person to communicate more about what they want to discuss.

Communication devices

Due to the diverse nature of QoL discussions and AAC language systems no specific pages have been created. It is recommended that the following is added to the device

Rating scales
Language from the Talking Mats and ALD
Specific words that you would use to have conversations about quality of life

Aided Language Displays

An Aided Language Display (ALD) is a single page that contains symbols relevant to a particular topic or activity. The vocabulary is limited which can provide focus but it does make it hard for a subject as broad as QoL. There is one ALD that is for the AAC user to give feedback perhaps whilst watching the video, looking at the PDFs or during a discussion. The other ALDs have vocabulary that is related to each topic.

To use an ALD you point to the symbols whilst you are speaking the words aloud.

If you decide to create your own ALD to use language that is more suited to the person discussing their QoL please remember to include pronouns and a no.

Body language

People who have not yet had exposure to use AAC can access the QoL resources. People often develop ways to communicate through their natural body language, which is recognisable by familiar communication partners. When looking at the resources together observe everything the person is saying using their bodies, facial expressions and vocalisations. If you would like to understand more about recognising and using natural body language for communication here is a short video explaining it for yes/no. The same principles can be applied for other natural gestures.

Of course when people are only using their bodies it can take longer to know exactly what they are reacting to. Refer to the suggestions given in each of the different topics.

Rating scales

For those using the questionnaire to discuss everything at once it is recommended that you use the same rating scale for each question. This makes it easier and quicker to answer the questions.

When you are having further discussions these rating scales may be useful

Amount rating scale

Quality of Life rating scale

Time rating scale

Everyday conversations

As the QoL resources are a way to ensure people are leading a good life the concepts and ideas should not be restricted to formal sessions. This not only runs the risk of being forgotten about but also may leave people with the impression that they should only be commenting on the things that are happening in their life within those sessions. Ideally communication partners can be using the resources of the person's AAC to discuss things that are happening in their lives and referring back to the concepts in QoL as they arise. Communication, physical and mental health, relationships and lifestyle choices happen everyday so there will be plenty of opportunity.