Lights, camera, action: how we used video to support a student with complex communication needs

The Westminster School, Sandwell, is a specialist provision for pupils with moderate learning difficulties (MLD) aged 7-19. Over the last few years, the school has started to see a change in its cohort with an increased number of pupils with severe learning difficulties (SLD) and complex learning difficulties and disabilities (CLDD). This group now represents around half of the school population.

Our communication challenge

The rapid change of needs in the school has required staff to review their pedagogy. We have staff on the school team who are very experienced and skilled, but even for these practitioners, some learners come equipped with new challenges! Staff now encounter pupils with complex communication needs and require practical strategies to improve the quality of teaching and learning.

As a school, our challenge has been to embed these strategies into our practice. Young people with severe learning difficulties require different a pedagogy to those with MLD. Imray & Hinchcliffe (2014) assert that it is crucial that teachers gain a deep knowledge of the individual differences in each child and make plans within a meaningful context to engage children and secure the very best outcomes for them.

As these strategies are acquired and used, it is essential to highlight good practice. We also need to adapt our strategies because the needs of our more complex pupils frequently change, the school needs processes that allow for the evolution of strategies rather than rigid ones.

The emphasis is on the positive strategies used in interactions so the practitioner can use them more in future.

Our approach to communication

We worked closely with our local authority’s Educational Psychologists (EPs) who have been using a strategy across Sandwell, which looks at the interactions between practitioners and pupils. This strategy, Video Interaction Guidance (VIG), uses short clips of video which usually feature one-to-one work between the pupil and their communication partner. In collaboration with the practitioner, the VIG supervisor analyses the relationship and interactions.

VIG also provides a set of principles for practitioners and their supervisors to work with. The emphasis is on the positive strategies used in interactions so the practitioner can use them more in future. VIG has a secure evidence base, which recognises the positive impact that this intervention has on communication partnerships. As a school we believed that this system could help us to gain an insight into what works best for our SLD and CLDD learners.

A typical VIG intervention is as follows:

1. A meeting was planned with the VIG supervisor where we decided on the focus of the project, also known as the ‘helping question’.
2. A recording of the pupil and communication partner is taken by the VIG supervisor. If this doesn’t work for you, the communication partner can also take the recording (as we will show later).
3. The VIG supervisor analyses clips and crops short recordings (approx 10 to 40s) where the pupil initiates the communication.
4. A meeting is then coordinated by the VIG supervisor. The clips are shared with the communication partner and the supervisor leads them to discuss and analyse what they see. VIG principles are used to understand how communication is developed. In his meeting, the communication  partner highlights the positive aspects of what they have observed and aims to do more in future.
5. Further recordings are taken and the same process is repeated, usually three times. More than three cycles can be used, if necessary.

Video can be a useful reflective and analytical tool for a practitioner, particularly which could go unnoticed during the actual session.
Caldwell, 2006

Our work with Satnam

Following the initial VIG training for one member of school staff, we ran a pilot study with one of our pupils. Satnam has a diagnosis of autism, obsessive compulsive disorder (OCD), mental health difficulties and epilepsy. He is non-verbal and does not engage with typical alternative and augmentative communication (AAC) strategies, such as Picture Exchange Communication System (PECS) or communication books. Pedagogical strategies that he responds well to include Demand Reduction and Intensive Interaction, when he is willing.

He began to struggle in school after having seizures. After this time, he was less likely to communicate and felt safer being away from other people. He has self-injurious behaviors that seem to be linked to his communication difficulties. His parents, school staff, EPs and speech and language therapists all decided that communication and wellbeing were priorities for him so we decided to trial VIG.

In collaboration with an EP, class teacher and parents, we assigned a helping question, which sets the priority for the VIG process. Our helping question was, ‘How can we encourage spontaneous communication for the purpose of enjoyment?.’

We then recorded an impromptu session of Satnam, a key stage five student, enjoying a painting session alongside his communication partner and an observer. From the recording, we identified three short clips, which showed good practice and some evidence of attuned interactions. We then analysed this in a ‘shared review’ with his communication partner who used the VIG principles of attuned interactions and guidance to summarise her session. These included: receiving and then responding; giving and taking short turns; equal contributions; and waiting attentively (Kennedy et al, 2011). The clip showed pupil-led communication, but without shared enjoyment and spontaneity. The communication partner took on board the discussion and we formed a practitioner-led action plan for future sessions.

We were starting to see more spontaneous communication and an improved relationship between Satnam and his communication partner

Video can be a useful reflective and analytical tool for a practitioner, particularly for noting meaningful behaviours which could go unnoticed during the actual session (Caldwell, 2006). We adapted VIG for Satnam because we felt that reducing the number of people present would reduce the risk of harm to self and others. His complex communication needs also mean that he is unlikely to participate in communication for enjoyment at set times so we decided to use recordings taken by his communication partner at a time when he felt safe and was more likely to instigate communication. With no observer, this process looks more like Video Enhanced Reflective Practice (VERP), which aims to improve effective communication in the situation in which it naturally occurs (Kennedy et al, 2015). The most significant difference between VIG and VERP is having a supervisor observing and recording the sessions.

A second recording was taken without the observer, and three examples of good practice selected and analysed in a shared review. We were starting to see more spontaneous communication and an improved relationship between Satnam and his communication partner as she carefully followed his fleeting initiations.

This very attuned member of staff was using a range of skills, such as Makaton and Intensive Interaction, to great effect. The shared reviews showed that, even though she was working with a pupil with limited communication needs, she fully understood the connotations of his actions, such as knowing when his initiations were communication based or sensory seeking, and was able to respond appropriately. Despite this, Satnam, who was unaware of the recording being taken, decided the communication was becoming too intrusive and ended the session. We discussed this in the shared review where we once again decided on our next steps.

Our evaluation

The third recording was taken and shared with excitement. In this video we observed an extended interaction with similar processes to previous recordings, but we were now able to pick up on the enjoyment factor between both Satnam and his communication partner as he spontaneously started to nod his head. His communication partner shared this by imitating similar actions which eventually led to Satnam creating more vigorous nods followed by head circles with a visible smile across his face.

The evaluation of the pilot focused on Satnam’s enjoyment of communication. We were not interested in the number of times he showed enjoyment but rather the quality of it. VIG aims to deepen and extend the dialogue, not increase the frequency.

The concept of ‘enjoyment’ is clearly subjective. On separate occasions, the videos were shared with his communication partner, the EPs, the teaching staff, the senior leadership team and the whole school staff. The groups included staff who were unfamiliar with Satnam and staff who had worked very closely with him for a number of years. It was clear from discussions with these groups that we all agreed we were seeing Satnam enjoying communicating, which is evident in the recordings.

Results

The process’s success lies in the moments of enjoyment that were shared between Satnam and his communication partner. Due to his complex communication needs, it would not have been realistic to aim for a substantial amount of time engaged in communication for enjoyment. However, and also due to the complexity of his needs, every moment that he enjoyed communicating was significant.

VIG led to this outcome by enabling those working with Satnam to hone in on the aspects of their practice that supported his communication the most. Rather than using live observation we were able to record, play back and reflect on crucial initiatives, and avoided having an observer or somebody who might detract from these moments. Using this process has allowed us to personalise learning experiences and find the key to building positive communication.  The process increased the amount of time that he spent being happy, comfortable with and close to another person at school. It is for this reason that the trial can be judged to have been a success.