Creating opportunities

Also called Communication opportunities, Opportunities to communicate, Opportunity barriers

A person with a good device, good vocabulary and trained partners can still have nothing to say, because their day gives them nothing to say it about.

What it is

Creating opportunities means arranging a person's day so that there are reasons to communicate: decisions that are theirs to make, news to tell, people to tell it to, things that go wrong and need fixing, jokes to share. A well-supported person can be silent for the simple reason that every need is anticipated, every question is answered by a carer, every day is the same, and nobody's asked their opinion since the review.

Researchers in AAC call these opportunity barriers, as opposed to access barriers, and they're the ones that remain once the device is sorted. The device is a voice. Opportunities are the things to say with it.

Who it can help

Adults in care settings and supported living, above all, where days can be highly organised and very quiet. Children in classrooms where the AAC user is spoken about but rarely spoken to. People with profound and multiple learning disabilities, whose choices are often made for them out of habit. People with dementia.

It's the natural next step after communication temptations, which are set up for early communicators. Opportunities are for people who already can, and don't, because there's no point.

How it works

Count the opportunities in a day. Really count: how many times was this person asked a real question, given a real choice, or told something new that they could react to? In many services the honest answer is under ten, and several of those were "do you want a cup of tea". A speaking adult gets hundreds.

Then build more in. Choices that matter: what to wear, what to eat, where to sit, what to watch, who to sit with, when to go to bed. Roles: the person hands out the post, takes the register, chooses the music, orders in the cafe. Things going wrong on purpose (the temptation idea, grown up). News: a photo from home, a story from the weekend, something to tell someone about. Partners who don't know the answer: a new volunteer who has to be told how the person takes their tea.

And time. An opportunity that's offered and closed in two seconds because the trolley's moving on isn't one. Wait time turns an offer into an opportunity.

Getting started

Pick one meal a day and make it a conversation: a choice of two things, a comment about the food, a question about the afternoon, and ten seconds of quiet after each.

Give the person one job that involves telling someone something: reporting the weather, choosing the music, checking who's in.

Put something new in their system every week, from their real life: a photo of the weekend on the Talk board as a personal card, so there's something to show and say on Monday.

Where to get help

Communication Matters publishes guidance for services on building communication-rich environments. Mencap and BILD cover it for adult learning disability services. Speech and Language UK addresses classroom opportunities. The Care Quality Commission expects people in registered services to be involved in decisions about their care, and a communication-poor day is evidence that they aren't.