Learning Disability Today
Supporting professionals working in learning disability and autism services

New supported decision-making toolkit for people with communication difficulties

A new supported decision-making toolkit for people with communication difficulties has been developed to aid professionals working with people with speech, language and communication needs (SLCN).

The toolkit was created on behalf of the Royal College of Speech and Language Therapists (RCSLT) by three academics with a background in speech and language therapy: Hannah Atkinson, Dr Mark Jayes and Dr Anna Volkmer.

According to the Mental Capacity Act (2005), a person is not to be treated as unable to make a decision unless ‘all practicable steps’ to help them to do so have been taken without success. The toolkit considers what ‘all practicable steps’ might look in practice.

What is a mental capacity assessment?

According to the RCSLT, if people working with or caring for a person think that an individual may struggle to make a decision, they should complete a mental capacity assessment.

This assessment looks at the person’s ability to understand and think about decision options and weigh these up in order to make a decision. This could be everyday decisions about what to eat or what clothes to wear, or bigger decisions such as where to live, how to spend large amounts of money or what medical treatment to have.

The mental capacity assessment will indicate whether the individual can make a decision independently, with support, or needs others to make it on her/his behalf, in her/his “best interests”.

Ensuring the individual has the best chance at making a decision for themselves

The toolkit lays out five tips for professionals to ensure the person they are supporting has the best chance at making a decision for themselves. This includes researching, ensuring you are in the right environment and have the right resources on hand, planning ahead, keeping track and simplifying language.


Atkinson, Jayes and Volkmer suggest the professional finds out what helps the person to communicate and what could hinder them. This includes checking for any written recommendations, asking people who know the person and gathering information on what kind of support or adjustments the person may need.


Professionals should also ensure they have the basics in place, such as finding a quiet and private environment, checking the person has working glasses and hearing aids if required and providing a pen and paper for writing or drawing.

Planning ahead

It is also important to think about the language you are going to use during the assessment (see below) as well as providing some non-verbal communication strategies e.g. gesture, videos, pictures.

Keeping track

Professional must document how they supported the person’s communication needs to make a decision. This includes noting down which communication methods were most and least effective and how the person expressed themselves.

Simplifying language

Professional jargon or words that are less commonly used can make things more difficult for people with SLCN. It is therefore important to use simple language to avoid any confusion.

For example, instead of using the word accommodation, use home or house. Instead of prescribe medication, use give medicine or tablets.

Atkinson, Jayes and Volkmer also suggest using active (not passive) sentences, making one point per sentence and avoiding using too many pronouns.

To access the full toolkit, click here.

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