Case Study: Simon – Laying the Groundwork for Communication Through Assistive Technology at Oakwood
Simon is a client at a Leonard Cheshire rehabilitation centre who was referred to our Assistive Technology team by regional partner, the ACE Centre. Following a stroke that significantly impacted both his communication and vision, our AT team is now collaborating with his on-site Speech and Language Therapy team to support Simon to rebuild his ability to express himself, with a particular focus on communication technologies that match his abilities and preferences.
Eliminating communication barriers with the right tool
To begin supporting, our Assistive Technology team used Talking Mats—a visual communication tool that allows people to express views, make choices, and indicate priorities even when verbal communication is difficult. This was the first time Simon had used Talking Mats, and the team began by introducing simple, concrete topics, such as “communicating with family,” and asked Simon to place cards on a scale from “Important” to “Not Sure” to “Not Important.”
Each card represented a specific type of communication, such as giving directions, maintaining a conversation, being included, or telling a story. With guidance, Simon placed each card where he felt it belonged. After the initial placements, the team revisited the choices with him, using the visual arrangement as a starting point for more detailed discussions—providing an opportunity for him to revise any choices or clarify his priorities. This gave the team rich, person-driven insight into Simon’s communication goals and helped them shape a support plan that aligns with what matters most to him.
A set up for success
In this context, Talking Mats served as a highly effective pre-assessment tool. It allowed the team to capture nuanced information in a way that honoured Simon’s preferences and gave him agency despite the challenges he faces in complex verbal communication. The team will return to these same categories and priorities in future sessions, using them to track Simon’s progress and evaluate how well the assistive technology tools are helping him achieve his goals.
Simon had previously used two-switch scanning with a Grid Pad, with one switch for scanning and another for selecting. However, this setup was difficult for him to use effectively due to his low vision and the need to constantly shift focus between the screen and the switches. Recognising that this method didn’t match Simon’s strengths or needs, our Assistive Technology team worked with his SLTs to redesign the system to better suit his strengths.
The new configuration uses audio scanning rather than a visual interface. The Grid Pad now reads aloud the options in the communication array, allowing Simon to close his eyes, listen for the option he wants, and tap anywhere on the screen to select. This adaptation reduces visual strain, leverages Simon’s auditory processing skills, and compensates for his limited motor control—making the technology far more accessible and functional for him.
Meaningful motivators
Early training sessions with this new system have focused on building Simon’s confidence, familiarity, and response timing. In one training exercise, for example, the team will ask Simon to listen for a category like “country,” and then guide him to stop the scroll at the correct moment. Once he hears the right category, such as “country,” he taps the screen to select it. Then, within that category, he listens for the target word—such as “England”—and taps again to stop the scroll.
This approach supports Simon in developing auditory memory, reaction timing, and a more intuitive understanding of how to navigate multi-level communication systems. The team places equal emphasis on encouragement and pacing—reminding Simon to stay relaxed and not worry too much about “getting it right.” This helps ease any stress or performance anxiety, reinforces trust, and keeps the training sessions engaging and positive.
What makes this work particularly meaningful is the collaboration across professionals and organisations. Through our partnership with ACE Centre, the flexible expertise of our Assistive Technology team, and his on-site Speech and Language Therapy team, we work with Simon to establish goals to collectively work towards across his support systems. Simon now has access to tools and support that are tailored specifically to his needs. From pre-assessment to customised interface design and early-stage training, Simon’s case demonstrates how person-driven, interdisciplinary support can lay the foundation for meaningful communication—even in complex cases.
This case highlights the importance of both adaptive technology and adaptive approaches. By centring Simon’s goals and leveraging tools like Talking Mats and audio-based Grid Pad interfaces, the team is supporting Simon not only to communicate—but to re-engage with the world on his own terms.
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