We have supported Sam since his transition out of his family home, where he grew up, and into a United Response supported living service in Teddington, Richmond upon Thames. Moving to a new community, alongside new support staff and housemates, was understandably a lot of change for Sam to cope with.

Sam is a very social person and a great communicator, but due to his disability, he cannot speak verbally. Instead, he aims to get his message across using Makaton hand signs and pictures. In addition to this communication barrier, he has shaky hand motor skills that mean his Makaton can appear ‘slurred’.

Initially, Sam, his social circle and his support staff faced a number of communication-related challenges that caused Sam to display challenging behaviours. The first was adjusting to his new support staff and routine. Sam often became distressed because he could not sign the names of the people supporting him and didn’t fully understand where he was going or what would be happening next.

He also had trouble getting to know his two new housemates because they did not understand Makaton hand signs, which made Sam very upset. Another source of frustration for Sam was being out and about in the community as staff would have to communicate with the people he met for him – and, as a sociable guy, he wanted to have these conversations himself.

Finally, Sam missed his parents and wanted to communicate with them on a regular basis. He didn’t enjoy using the telephone, however, because staff would have to do the talking on his behalf, which meant he couldn’t have one-to-one time with his family.

New person-centred methods of support

To remedy the above, United Response staff started working closely with the service’s speech and language therapist to explore methods and tools Sam could use to communicate more effectively.

Firstly, we designed communication charts and signs to support Sam’s daily schedule. These combine Makaton signs and staff photographs to create activity planners, food charts and cleaning rotas that Sam and his housemates can all understand.

We worked with Sam to find new ways for him to communicate; now when Sam likes something he shows this by putting two thumbs up and, when he dislikes something, he puts two thumbs down.

Assistive technology

Sam Skypes his parents via his iPadWhen he got his first iPad, it was a revelation for Sam and the staff who work with him. Once staff had been trained to help him use the technology, a whole new world of communication opened up for Sam.

Now he documents his social activities to spark conversations with those around him, uses the iPad to teach Makaton symbols to his housemates, and regularly Skypes his parents.

He is more in control of his communication, whether it be sharing photos of what he’s been up to or videos on subjects that interest him with his friends and support staff; catching up with his family in private; or using it to get his message across to new people.

Sam enjoys a drink he has ordered independently in a local pub
When Sam first attended his local pub, for example, he took pictures of the drinks he liked best so he could show them to bar staff to order independently.

Nowadays, Sam is so well known in the pub that he no longer needs to use his iPad as he has taught staff the Makaton signs for his preferred drinks.


The iPad has been particularly valuable in supporting the other people in the house to understand the way Sam communicates and learn Makaton signs. Sam arranged weekly sessions with his housemates where he would connect his iPad to the TV and they would play Makaton-based games together, which was great fun and taught them these skills.

Within a few weeks, Sam had begun to build stronger relationships with his housemates and they started to see why he might become upset when misunderstandings arose.

Some truly social enterprises

Sam using his iPadSam has since set up a social enterprise teaching schools and the wider community Makaton skills and signs, as well as leading fortnightly Makaton sessions for his friends at the Teddington service. Recently, for instance, Sam’s Makaton group attended an after-school club for local children with disabilities to pass on their Makaton knowledge to the next generation.

Sam also takes an active role recording the work of other United Response social enterprises in Richmond using his iPad, such as photographing gardening projects completed by the Garden Gnomes.

Staff are currently working with Sam to learn more about social media. He has created a personal Facebook account via his iPad so he can keep in touch with family and friends, and he loves uploading pictures to Facebook because they can be instantly shared.

Most recently, thanks to donations to our community grants programme, Sam has started successfully promoting and running his own car-washing enterprise through social media. Assistive technology really has changed his life, and he is now happier and more sociable than ever before.

Laura Cook, web and digital communications assistant.