Striving to Close The Gap Between First Responders and Indi…

This can be compounded in a variety of situations. In the in- stance of natural disasters and especially when a PWD needs to be evacuated/relocated, EFRs need to be aware that individuals who are nonverbal or those with complex communication needs (CCN) may have a communication “system” (aka augmentative/alterna- tive communication [AAC] device, “talker,” iPad, or other name for their system) that they use to communicate. EFRs are often not aware of how important these systems are for the individual in being able to respond with their personal or health information. If it is not known that these systems are used or the location of the devices at the time of the emergency, the EFRs may not be aware to send the devices with the individual. This leaves the PWD un- able to communicate enroute and while at the new location. This can be a difficult situation for the person who is displaced as well as frustrating for those who are trying to communicate with them. This may result in not gathering needed information to provide adequately for that individual’s needs. At one in-service, an EFR verbalized how frustrating it would be on the part of the rescuer to not have a means to understand the individual who needs to be rescued. He noted that he would feel “helpless to know exactly what to do to assist.” This demonstrates the need for a training directly related to improving the commu- nication skills of EFRs in regard to individuals who are nonverbal or who have complex communication needs. Should the individual who uses an AAC system be separated from a known caregiver (as in the case of the caregiver’s illness or perhaps an accident where transportation to a medical facility is necessary), having access to the communication system is critical for the PWD to be able to summon assistance. This may involve contacting 911, explaining the situation to the responding EFRs, or even making arrangements for other people to step in as care- givers. The EFR needs to understand the communication system should not be viewed as “a toy” or “entertainment” for the individ- ual and instead be viewed as a critical piece of medical equipment used for communication to ask or answer questions. It should be viewed in the same way as a walker or wheelchair is viewed as a mobility device. All of these devices help support the individual in their independence to the fullest extent possible, so EFRs should be diligent in ensuring the individual they are helping has access to their device(s). EFRs need to be aware that communication devices may be accessed in different ways. They may communi- cate through direct selection or scanning by using various body parts to control their device. This will differ between individuals depending on their physical and cognitive abilities. Addition- ally, EFRs need to be aware that AAC devices may not have the emotion or inflection in the voice output in the same way spoken speech does. This lack of inflection may not reflect the individu- al’s emotional state when giving information. It is important that the EFR respond to the message they are trying to convey. Some individuals will also use nonverbal language to supplement their communication, so EFRs need to be aware of that, as well. In 2016, during an event to raise awareness of communicat-

ing with individuals with complex communication needs (CCN), it became evident that members of a local fire department did not have the necessary skills to address the needs of one of the participants. Casey, a young man with cerebral palsy who was accessing his communication device with his foot, volunteered to answer questions from people who were attending. These two firefighters were strongly encouraged to engage Casey in a con- versation. While they were reticent to do so at first, introductions were finally made and Casey asked them a question. His question was,“If my dad has a heart attack and I call 911 to ask for help, how seriously will they take my call?” The EFRs were momentarily left speechless as to how to answer his question and then replied,“We don’t know.” Upon realizing the seriousness of the question, the firefighters requested more information to be better prepared in a situation such as this. This request led to the development of an in-service that would ultimately be shared not only with that fire department but with the county sheriff’s department, the city police department of Fort Wayne, and various smaller towns and counties in the area in 2017. Given the positive response to the in-service, grants were secured in 2018, to provide the necessary funds to take the in-services to many first responder departments across the state. The value of the in-service was spread from de- partment to department by word of mouth in addition to mail, email, and phone calls to set up trainings. By 2019, approximately 1800 EFRs in Indiana had received the training. In 2020, COVID-19 brought a stop to trainings, but some trainings took place in Mon- tana and Michigan in 2022-23. The training is a one and one-half hour long combination of lecture, videos, role-playing scenarios, and question/answer. During the lecture, information is disseminated concerning who uses AAC, such as individuals with developmental or acquired dis- abilities. Videos and lecture also highlight how individuals access their devices, either through direct selection or scanning. One key component of the lecture is the presentation of crime statistics, as this demonstrates the increased vulnerability of PWD. In addition to the crime statistics, EFRs receive guidance on facilitating con- versations and social skills such as asking the individual to repeat if the message is unclear. In person demonstrations are provided as well as videos of in- dividuals as they access and use their own devices. The videos were created specifically for the training program. They and their caregivers were excited at the opportunity to be a part of educat- ing EFRs on such a critical issue for them. In the videos individu- als with CCN offered information and/or advice on how to bet- ter interact during conversations and were encouraged to make comments directly related to emergency situations and/or their possible needs. The EFRs reported having a better understand- ing of their need to be patient as the person communicates and how the AAC systems can be a reliable way to gather information about the emergency situation. Stressed during the training was the need for the EFR to listen to the actual victim and not fully rely on information received from other individuals at the scene. This is particularly important in cases of suspected abuse (phys-

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