Kent and Medway Communication and Assistive Technology (KM CAT) Service
Our KM CAT service identify and work to meet the needs of those requiring specialist alternative and augmentative communication (AAC). We also support local therapists by providing training and equipment.
On this page
For details of how to refer to us, including criteria and our referral form.
Referral information
Prior to referral
An assessment must be carried out prior to referral to KM CAT.
NHSE requires that patients accessing our service are referred from a professional, preferably a Speech and Language Therapist (SLT) in a statutory service role i.e. an NHS / local authority / education funded professional involved in the patient’s care.
Referral criteria
Our provision-only service is available to community therapists for patients registered to a GP in East Kent or Swale, who has need of a communication aid.
To access this service, the referring therapist must have completed an assessment with the client, identified the appropriate equipment, and be able to provide ongoing support and training to the client.
To determine whether your patient meets our criteria, please refer to the decision chart below.
Download our detailed specialised AAC criteria documentIf your client does not meet the criteria for specialist AAC service involvement, they may still be able to access funding for AAC equipment through alternative routes.
Download our guidance for help with purchasing AAC equipmentClarification regarding Referrals to NHS England Specialised AAC Services - September 2019
NHS England Specialised AAC Services have been advised by the NHSE responsible Commissioner, Carolyn Young, that we have a duty to be equitable to all patients and that we require that patients accessing our services are referred from a professional, preferably a Speech & Language Therapist (SLT) in a statutory service role i.e. an NHS / local authority / education funded professional involved in the patient’s care
If there is an Independent but no statutory SLT employed, the Specialised Service will seek to refer to a statutory Speech & Language Therapy Service. Where this is not possible (for example, if there is no NHS Speech & Language Therapy service – see 4 below), there is an expectation that funding would need to be in place for the Independent SLT/Practitioner to commit to supporting not only the AAC assessment but also the implementation of resulting prescribed recommendations and/or equipment
If there is only an Independent SLT/Practitioner in place, any statutory service employed professional involved in the care of a patient can send in the referral to the Specialised AAC service, with the support of the Independent SLT/Practitioner. The Specialised AAC service would then undertake an assessment (inviting the Independent SLT/Practitioner to the appointment) and prescribe the equipment that meets the needs of the patient
If there is no local NHS provision (as is often the case, for example, for adults with lifelong conditions such as Cerebral Palsy), Specialised AAC services will endeavour to seek local SLT support. In the interest of supporting such clients, who have been lifelong users of Voice Output Communication Aids, Specialised AAC services may accept referrals for these clients without a local SLT, but would raise this as a concern with the local SLT Manager
As per 3 above, ‘Equipment Only Requests’ made by Independent SLTs / Practitioners must be supported by the local professional (statutory service employed) multidisciplinary team. The Specialised AAC service will then quality assure the equipment request and either purchase the equipment, or carry out their own assessment as they deem appropriate
The NHS England Commissioner and the Specialised AAC Services are aware that there is a variation in what local SLT Services are able to support; a key focus of our work programme currently being undertaken is to support and develop expertise within these local services.
Services will interpret on a case-by-case basis.
See: “Commissioning Policy: Defining the boundaries between NHS and Private Healthcare” April 2013 Reference NHSCB/CP/12 NHS Commissioning Board page 8:
“An individual who has chosen to pay privately for an element of their care, such
as a diagnostic test, is entitled to access other elements of care as NHS commissioned treatment, provided the patient meets NHS CB [commissioning Board] commissioning criteria for that treatment. However, at the point that the patient seeks to transfer back to NHS care:
The NHS CB is at liberty to request the patient be reassessed by an NHS clinician
The patient will not be given any preferential treatment by virtue of having accessed part of their care privately, AND
The patient will be subject to standard NHS waiting times”.
For further information, please contact Carolyn Young (NHS England Commissioner) via email: Carolyn.young2@nhs.net.
Some examples
Private Rehabilitation Centre - A privately run rehab centre with its own SLTs funded by the local authority to care for an individual – referrals would be accepted
Charitable Special School - A privately run special school with their own SLTs, funded either by the school or LEA – referrals would be accepted.
Charitable Day Centre - A privately run day centre with their own SLTs (+MDT) funded by social services to look after the people attending the centre – referrals would be accepted
Local Education Authority (LEA) School with LEA(School) funded SLT– referrals would be accepted
Independent SLT funded by parents, who is seeing the child in LEA school – referrals would not be accepted without support from school
Independent SLT seeing a patient at home with no involvement of school or local NHS SLT service – referrals would not be accepted before seeking local SLT involvement – ask GP to refer to local SLT.
Making a referral
If a patient is registered to a GP in east Kent or Swale and assessed with a clusterbox - make a provisional-only referral. The referrer must have received clusterbox training from KM CAT prior to making a provision-only referral.
If a patient has complex communication needs meeting the service criteria - make an assessment referral.
If a patient has communication difficulty and the therapist is unsure how to proceed - make a consultation referral.
If your patient does not meet our criteria for assessment or provision, we are still happy to give advice.
Referral form
You will need Adobe Acrobat to view the form. Please view the guidance notes for each section of the form by clicking on the blue 'i' symbol.
Download our referral formPlease note, if you would like to edit the referral form on a PC, We recommend using Adobe Acrobat Reader DC or Pro DC as these offer the best compatibility with the form.
Please send a completed referral form to acat.service@nhs.net.
Provision only referrals
If requesting an iPad or iPod App, then please note that we cannot accept the referral unless the e-mail address for the patient's iTunes account is stated (question 12.7.)
Consultation referrals
The aim of a consultation is to support the referrer when they are unsure how to proceed, and may be face to face, or a phone consultation. The client is not present for the consultation.
Using videos when making a referral
Video recordings of patients can provide valuable information and help us process referrals.
Refer to our guidance on how to take video recordings for clients of AACClusterboxes
A clusterbox is a collection of AAC equipment issued by KM CAT to local therapist groups, containing each type of equipment available for provision by KM CAT in areas that we cover.
The purpose of the clusterbox is to make equipment readily available for use by local therapists to use in their assessments.
Once the local therapist has identified a suitable communication aid for their patient, they can make a referral for equipment provision (East Kent and Swale) or seek funding, i.e. charity or private provision (West Kent, Medway & DGS).
To make effective use of our clusterboxes, we recommend that therapists attend one of our training days. For access to our provision-only service, this training is mandatory.
Download our guidance for informing clients about confidentiality risks associated with cloud-based appsTo help you identify the right app for your client, these tables compare their features, highlighting their similarities and differences:
Clusterbox photo and symbol based apps comparison table Clusterbox text based apps comparison tableClusterbox contacts
Dover: call 0300 123 0785 or email kentcft.aslt@nhs.net
DGS / Sittingbourne: call 01795 418300 (ext. 2061) or email vcl.dgss-salt@nhs.net
Willing to loan to therapists outside of their organisation - please contact first with requestCanterbury / Coastal: call 0300 123 0785 or email kentcft.aslt@nhs.net
Thanet: call 0300 123 0785 or email kentcft.aslt@nhs.net
West: call 0300 123 0785 or email kentcft.aslt@nhs.net
Medway: call 01634 382213 or email laura.daniels@nhs.net
Willing to loan to therapists outside of their organisation - please contact first with requestDarent Valley: call 01322 428593 or email dgn-tr.sltdvh@nhs.net
Willing to loan to therapists outside of their organisation - please contact first with request.
Book training with KM CAT
Please take a look at our training levels before booking onto a session to ensure it is relevant for you. Please contact the KM CAT office if you want to discuss this further on 01227 864083 or acat.service@nhs.net.
Introductory: These courses are aimed at anyone who would like to know more about Augmentative and Alternative Communication (AAC). The attendee does not require any experience in this area.
Beginner: These courses are aimed at people who are newer to AAC but are likely to implement it in their role. Orto those who would like a refresher.
Developing: These courses are aimed at healthcare professionals who have some awareness and experience of implementing AAC.
To book or for more information about any of our training, please email your enquiry to acat.service@nhs.net.
Registration and participation
All training sessions will start promptly at the time specified. Registration will commence 30 minutes prior to the start of training.
Trainees are requested to turn off mobile phones, tablets and laptops during the duration of the training session(s).
Cancellation, changes and late attendance
Please inform us at the earliest opportunity if you are unable to attend. We may charge for cancellations received within 72 hours of the start of the training.
In the case of an unavoidable delay, attendees should phone 01227 864083 and the trainers will be informed. Attendees will be advised on whether their attendance is still appropriate.
KM CAT reserve the right to cancel or make changes to the planned training; changes could include date, venue, and/or training format. Cancellation or changes to planned training will only take place in extenuating circumstances such as staff sickness, under or over subscription of training, or adverse weather conditions.
Students
Please check with the trainers whether it is appropriate for students to attend with their supervisors. We will do our best to accommodate them if numbers allow. Unsupervised students will not be accepted on training courses without their supervisors. Please note that specific student training is offered by KM CAT.
Feedback
Your feedback is requested after every training session. We would be most grateful for your comments to enable us to improve and adapt our training as appropriate.
Available sessions
Intro to KM CAT (Introductory)
14 September 2023 – Webinar – 9am-9.45am
This brief session covers referral criteria for assessment, what support we can provide and what equipment we can provide.
GoTalk Now App (Beginner)
No upcoming dates
A brief introduction to the range of GoTalk iOS Apps which can be used to make simple symbol, photo & phrase-based communication systems.
Clusterbox (Beginner)
28 September 2023 – Webinar – 9am-11am
This is essential training to look at what’s in your local cluster box. It includes tips on how you can assess your clients for AAC and ideas on how support your clients to use it successfully.
Face-to-face drop in sessions - 14th and 15th June 2023.
KM CAT website and FREE resources (Beginner)
No upcoming dates
This quick and easy training session covers everything that is on our website, from free resources to “how to” videos, case studies to referral criteria.
Talking Mats (small fee) (Developing)
Upcoming dates to be confirmed
This training will help you to:*
Use Talking Mats to support the children and adults you work with to share their feelings, thoughts and views.
Reflect on your own communication.
Learn how issues that arise can be explored further through careful planning.
Discover our Talking Mats research and evidence base.
Connect with practitioners around the world.
*extract taken from Talking Mats Foundation
Managing communication for deteriorating conditions (Developing)
No upcoming dates
This session covers early management, intervention timing, assessment, low tech options, and other relevant services, for a range of deteriorating neurological conditions including MS, MSA, PSP and MND.
Top Tips for AAC and IG (Beginner)
20 April 2023 – Webinar – 9am-10am
This training will highlight some of the main considerations around information governance, data management and privacy that you need to be aware of when it comes to AAC. Also, top tips about what to watch out for yourselves and what information you might want to share with your clients.
How to train an effective communication partner (Developing)
18 May 2023 – Webinar – 9am-10am
Communicating using AAC is very different from using natural speech. Using AAC to communicate can break up the flow of conversation, and may be misunderstood. It takes support from communication partners, who have the right skills and tools to help them get the most out of communication. This can lead to a more rewarding and fulfilling interaction for both parties.
We will discuss strategies that will help you to support your client’s relatives and carers to facilitate effective conversations.
Text based apps (Beginner)
6 July 2023 – Webinar – 9am-10.30am
This training should help you find the right text-to-speech app for your clients. It will cover popular Clusterbox apps such as Predictable and ProLoQuo4Text as well as android and lower cost apps.
AAC and Aphasia (Developing)
4 October 2023 – Webinar – 9am-10.30am
Finding AAC solutions for people with aphasia can be tricky. This training discusses the challenges, assessment process and AAC options for people with aphasia.
Voice and Message Banking (Introductory)
19 October 2023 – Webinar – 9am-11am
Find out about the voice and message banking process, as well as important things to consider to support your clients.
Making communication aids easier to use (Beginner)
9 November 2023 – Face-to-face – 9am-11am
This session provides top tips and ideas on how you can make standard communication aids (eg: Lightwriter, iPad, communication charts) easier to use for those patients with physical difficulties eg: tremor.
Useful resources
Please use the headings below to access useful resources.
There may be support for your patient available through a number of charities and associations. Please see the charities page in our patient pages for more useful links.
ACAT Tech Tips Video - Redeeming App on iPad video
A step-by-step guide on redeeming apps that have been provided by KM CAT.
Factors to consider when choosing an AAC device video
An introduction to what factors need to be considered when deciding which AAC device may benefit your patient.
The consideration of access for AAC video
A brief explanation on what access is, why it is crucial to the successful implementation of AAC, and how to assess for access.
Partner assisted scanning
Partner assisted scanning is used when an individual has difficulties or is unable to point to letters on an alphabet chart when communicating.
Partner assisted scanning involves the conversation partner pointing to and/or saying the letters in turn, which the individual then selects.
Guide to partner assisted scanningVocabulary gathering sheet
When planning low-tech communication aids and vocabulary packages for your patient it is helpful to gather as much information as possible to personalise vocabulary.
Guidelines to gathering vocabulary for low-techHow to support and use Low-Tech AAC
This guide is aimed at therapists looking to implement low tech AAC with their literate clients.
It may also help give an indication of a client’s communication abilities when considering referral for high tech AAC.
It covers:
strategies to help with communication partner training
tips on using different types of low tech AAC
dealing with different situations.
It also contains links to a number of new and existing printable resources which can be customised for your clients including:
yes/ no cards
Instructions for how to us various methods of low tech AAC
communication cards to aid communication partners
communication passports.
Choosing an AAC device for your client (where they do not need specialist assessment)
An introduction to what factors need to be considered when deciding which AAC device might benefit your patient.
Watch the factors to consider when choosing an AAC device video
How can I support my client to use their device - access
A brief explanation on what access is, why it is crucial to the successful implementation of AAC, and how to assess for access.
There are many ways that alphabet charts can be arranged. Below are a few for you to try with your AAC user to find out what suits them best.
Factors to consider include their familiarity with a keyboard layout (QWERTY vs. ABC), whether colour contrasts may help with visual problems.
Someone might access an alphabet chart by:
Pointing (the user points to the letters)
Partner assisted scanning (where the partner points to the letters)
Auditory scanning (if the individual is unable to see the chart, then the partner can read out the categories/word or phrase lists or letters of the alphabet).
ABC
Black on White chart - Letters only Black on White chart - Letters and spaces for phrases Yellow on Blue chart - Letters only Yellow on Blue chart - Letters and spaces for phrases Colour-coded AEIOU alphabet chart (with numbers) Alternative AEIOU alphabet chart**(Ace Centre, acecentre.org.uk)
QWERTY
Black on White chart - Letters only Black on White chart - Letters and spaces for phrases Yellow on Blue chart - Letters only Yellow on Blue chart - Letters and spaces for phrasesHigh Frequency Lettering
The letters on these charts are arranged so that the most frequently used letters in the English language are the quickest to access - this can significantly speed up message construction when using partner-assisted scanning.
Black on White chart - Letters and spaces for phrases Yellow on Blue chart - Letters and spaces for phrasesEye pointing is using your eyes to indicate your choice by looking at it. It is useful for individuals with established good vision and clear eye movements. Eye pointing can be used to access several different types of eye pointing communication aids.
Yes and No Cards
You can use eye point with Yes and No Cards (Please see the Yes /No Cards section below)
E-Tran Frame
An E-Tran frame is a sheet of stiff, transparent plastic, which symbols, words or letters can be stuck on. The user can eyepoint to their choice.
A Megabee is similar except it has a battery and screen to display what has been chosen.
The E-Tran and Megabee are available in the Clusterboxes and from a number of UK suppliers.
Instructions on using the E-Tran with letters - download and personalise List of abbreviations for speeding-up E-Tran use - download and customise (credit: ACE Centre)Watch this video to see the E-Tran in action (credit: ACE Centre)
Eye Talk
EyeTalk is a new low-tech tool designed by KM CAT which looks similar to an E-Tran frame.
It is designed to be held by the conversation partner and the user can eyepoint to the group of letters they want. The conversation partner will then turn to the corresponding page and the user will again eye point to the letter they want.
This reduces the cognitive load of a 2-step process. It is also suitable for users with colour-blindness or contrast issues.
It is a PDF document which can be printed, laminated and bound using wire or plastic comb binding.
EyeTalk - Printing Instructions EyeTalk - Alphabet only EyeTalk with numbers - Alphabet with numbers 0-9Please acknowledge KM CAT when using or sharing this resource.
Watch this video to see Eye Talk in action, and read Tony's story
As the EyeTalk and EyeTalk with numbers are new tools, we would love to hear any feedback you have. Please get in touch!
Speakbook
Speakbook looks similar to an E-Tran frame, but is more portable and can have multiple page with personalised messages. There are 2 versions; one which navigates by colour and one by shape (suitable for people who are colour blind).
It was developed by Patrick Joyce, who had Motor Neurone Disease. We have chosen to host a copy of the English version, however there are versions available in other languages on the ACE Centre Website.
Speakbook Version 3 (navigate by colour) Speakbook Version 4 (navigate by shape) Speakbook Printing InstructionsSpeakbook is published under the Creative Commons Attribution -Share Alike 4.0 International (CC BY-SA 4.0) licence.
When it is difficult to understand an individual’s yes or no response through speech and/or gesture, YES/NO cards can be helpful.
Place them at a distance from each other, for example hold one in each hand, the individual can then make a choice by pointing, eye-pointing etc. It is useful to check that you have understood correctly before moving on.
Top tip: consider presenting the YES/NO cards on the same side each time, for example YES is always in the right hand and NO is always on the left; this will make it quicker and easier for the individual.
Colour coded YES/NO cardsAuditory Scanning Phrase List
(Adapted from Linda J. Burkhart linda@Lindaburkhart.com www.lburkhart.com - taken from acecentre.org.uk/resources/)
If an individual is unable to see a phrase chart, then you can read aloud the options, for example categories or words, for the individual to choose from (selection is made through yes/no questioning). This is called Auditory Scanning.
While this method can be slow and cognitively demanding, for some individuals with poor vision it is sometimes the only solution.
An auditory scanning phrase chart divides options into categories so that the individual can first set the scene, for example ‘Do something’, and subcategories so that they can then select a specific message, for example ‘Newspaper’. The phrase chart can also include an option for using a spelling board.
The categories and subcategories on an individual’s auditory scanning phrase chart can be adapted to meet their specific communication needs.
Auditory scanning phrase chart - personalise, print and laminate for useA Phrase List for Repairing Communication
This list of phrases can be used by an individual to help them repair communication breakdowns by selecting an appropriate phrase, for example ‘This is not what I meant’.
The phrase list can be modified in order to be used for any other topic.
This resource also includes advice on the different ways in which the individual can access the phrase list, for example through pointing to the written phrase they want.
Phrase list for repairing communication - customise, print and laminate for useA Low-tech Example that Uses Core Vocabulary Across Pages
This is an example of AAC which gives the individual the flexibility to combine words in order to form messages.
It contains frequently used words (core words) such as ‘like’, which can be selected to start a message and which remain constant across pages; it also contains some personalised vocabulary under the ‘food and drink’ category such as ‘fish and chips’, which can be either used on its own or combined with core words.
Below is a link to this particular AAC example; however, since only the ‘food and drink’ category has been personalised here, the rest of the categories would also need to be personalised before this resource can be used functionally.
Low-tech AAC food + core + top page exampleLow-tech AAC Pages - Needs Chart and Speech Therapy
A single page containing keywords or phrases which are linked to a particular context, for example mealtimes or going to the hairdresser, and which can assist the individual with their communication needs.
Here are the links to 2 different examples of AAC pages, which can be printed and laminated for use:
'Needs' pageAn AAC page that focuses on basic needs, for example ‘Need suction’ or ‘I’m anxious’, and which can be used across contexts.
‘Speech Therapy’ pageAn AAC page containing messages specifically related to Speech Therapy sessions, for example ‘I want to work on my spelling’.
Text based communication book template
Text-based communication book template(Credit: ACE Centre) - customise, print, laminate and bind to use.
Symbol and photo based AAC should be personalised to the user. Below we have some examples of different symbol and photo-based options.
Visual Scene Example
This is an example of a paper-based version of a Visual Scene Display (e.g. Scene and Heard app). A visual scene display is a picture or photograph which depicts a situation, place or experience with individual elements representing people, actions or objects.
This provides contextual cues and can be particularly useful for people who struggle with symbol recognition or navigation of a communication book with lists of words/symbols. These can be especially useful for people with aphasia or autism.
Communicating in a café - a Visual Scene Display examplePhoto Based Examples
This is an example of a photo-based breakfast choice chart.
Breakfast choice chart - a photo based AAC exampleSymbol Based Examples
This is a simple needs chart without core vocabulary.
Symbol-based needs chartThis is an example of a symbol based communication chart with core vocabulary. Core vocabulary can be used across many situations, it can be combined with the topic based fringe vocabulary. Having a mixture of core and fringe vocabulary increases the amount of communication functions that can be fulfilled e.g. as well as requesting they can comment, question, ask for help etc. Core vocabulary should be consistently placed in the same position in a communication book.
Shopping - topical symbol page with core vocabularyVocabulary Gathering Guide
When developing a symbol or photo based book you may want to use our vocabulary gathering guide.
Vocabulary gathering guideCommunication Passport
There may be times when more information is needed for unfamiliar communication partners. For example, during a hospital admission or respite.
The Communication Passport can be helpful in giving extra useful information about the individual who uses AAC. It can be printed and written on or customised before printing.
This communication passport is based on original work by Gloucestershire NHS Foundation Trust. Produced by Widgit Software in association with Sarah Stancer A&E Sister (2009) Royal Berkshire NHS Foundation Trust.
Download the Communication PassportCommunication Cards
A communication card tells people what to do when communicating with you.
Here is some useful advice from Communication Disabilities Access Canada © 2013
Keep your instructions short and simple.
Focus on telling people what you want them to do when communicating with you.
It may be useful to have different cards for different places.
Keep your communication instruction card in a place where you can easily show it to people.
Apps Wheel
Call Scotland have published an AAC apps wheel, which provides a fairly comprehensive overview of communication apps for iPad.
Comparison Tables
To help you identify the right app for your client, these tables compare their features, highlighting their similarities and differences.
Photo and symbol-based apps comparison table Text-based apps comparison tableVoice and Message Banking
Please see our voice and message banking pages for information you can share with your client on this topic.
The Motor Neurone Disease Association also has a webpage providing information on voice banking. While this is aimed at professionals who work with MND patients, the information may be applicable to other conditions.
How To Redeem Apps
If you are supporting a client to redeem a gifted app, please watch the video which guides you through the process.
Using eye gaze technology
High and Low Tech AAC for a Literate Client with a Slow Degenerative Condition
The patient has Parkinson's disease, which affects his speech. His physical and cognitive abilities, and his literacy are assessed, following which he is tried with three text-based aids.
He is provided with a high-tech aid, and a low-tech aid for days when he is poorly and is unable to access the high-tech aid.
Download the High and Low Tech AAC for a Literate Client with a Slow Degenerative Condition case study informationLow Tech AAC Outcome for a Progressive Condition
The patient has MS, which affects her speech and her ability to cope with cognitive loads. Her physical and cognitive abilities, and her literacy were assessed.
Following assessment, high-tech AAC was recommended against, in favour of a low-tech aid.
Download the Low Tech AAC Outcome for a Progressive Condition case study information