Communication in an FCA includes how a person expresses information, understands it and takes part in decisions. Spoken conversation is only one way to do this.
The assessment should use a workable communication approach and explain any limits on the information gathered.
Tell the practice what helps
Before booking, describe your preferred way of communicating and any arrangements you need. This may include written questions, extra processing time, a support person or communication equipment.
Augmentative and alternative communication, often called AAC, includes methods that support or replace speech. The assessor needs to understand how you use your communication system rather than assume that a conventional interview will provide the best account.
Seeds FCA appointments are by video only and require a screen and a working video connection. Tell us how you communicate so we can discuss support during the video appointment. Confirm these arrangements before booking.
Consider different settings
Someone may communicate comfortably in a familiar conversation but need help with a medical appointment, a complex letter or an unexpected change. Another person may communicate more effectively in writing than during a call.
The assessor should ask about those differences. Fluency in one setting does not establish understanding in every setting, and a pause or brief answer does not establish lack of understanding.
Where understanding matters, it should be checked appropriately. Nodding or agreeing should not be used as the only evidence that a person has understood an important decision.
Explain the support already used
A supporter may rephrase information, help prepare questions or assist the person to use a communication aid. Record what that help involves and when it is needed.
The participant's communication should remain distinguishable from the supporter's account. When someone contributes their own observations, the report should say so. Disagreement should be explored rather than resolved automatically in favour of the more fluent speaker.
Language differences also need care. Needing language support is not, by itself, evidence of disability. An assessment must avoid confusing unfamiliarity with English or a service system with a functional impairment.
Recognise the limits of the assessment
An OT can describe communication as it relates to activities and participation. Some questions require a speech pathology, hearing or other specialist assessment. A general FCA should identify that need rather than imply it has completed the specialist work.
Useful recommendations explain the activity, the communication barrier and the support proposed. They should also reflect the person's preferences. The goal is not a more conventional-looking conversation; it is an assessment in which the person can contribute and their communication needs are accurately understood.