Supporting the Communication of People who have Learning ...
Transcript of Supporting the Communication of People who have Learning ...
Communication – Getting It Right
Part 1
Speech & Language Therapy
Learning Disabilities Service
Housekeeping
Learning Objectives
To have an understanding of communication and the
communication difficulties of the service users that you
support .
To be able to change / adapt your skills to support
communication with your service users.
To be able to make environmental changes to support
your service users’ communication.
Picture Description
How was it for you?
What was easy?
What was difficult?
What strategies did you use?
What
is
communication?
?
8
Communication is
a two-way process by which information, thoughts
and feelings are exchanged.
both verbal and non-verbal.
involves both understanding and expression.
9
Communication is
affected by environmental factors.
fundamental to
i. the establishment of relationships
ii. maintenance of relationships
iii. participation in
i. social situations
ii. learning and work situations
Good communication requires:
Means of communication
Reasons for communication
Opportunities to communicate
A Model of Communication
Without a MEANS of communication,
you cannot express yourself
Without REASONS for communication,
there is no point in, or need to, communicate
Without OPPORTUNITIES,
there cannot be communication
12
Reasons for Communication
Social
Emotional
Attention seeking
Getting and giving information
Getting needs met
Making choices
To communicate effectively an individual must be able to:
understand ideas and information expressed by others
express ideas and information appropriately
remember information
In order to understand what has happened and what
will happen, we rely on:
Situational understanding based on:
previous experience (routines)
non-verbal clues (tone of voice, body
posture/movement, gestures)
visual and sensory clues (smells and sounds)
Linguistic understanding based on:
words and grammar
Situational Understanding
What happens next?
Key words are the main words in a sentence.
Key words are essential to the meaning of the
sentence;
- the words a person must understand to be able to
respond correctly.
Key words are the words which cannot be
understood through situational clues.
Words like “a” and “the” are not normally counted.
Give us a clue
A simple demonstration of situational understanding.
Article from journal
Communication skills are learned
Communication is one of the most complex
skills that we learn
People with learning disabilities are very
likely to experience communication
difficulties
Communication and Learning Disability
“At least 50% of people with learning disabilities
have significant communication problems with up
to 80% having some communication difficulties.”
“The Same As You?” 2000 The Scottish Executive
Some important changes have already happened but
KTL lists 52 important changes that need to happen
to make things better for people with a learning
disability. These range from communication to
housing.
“The Keys to Life” 2013 The Scottish Executive 10 year review of the
“Same as You?”
Communication and Learning Disability
Hearing Impairment
Prevalence of hearing impairment varies from 12.3%-47%.
(2004, The Scottish Health Needs Assessment Report)
Over 50% of people with Down’s syndrome are known to
have significant hearing impairment.
(2001, Down’s Syndrome Medical Interest Group)
Key word understanding
in Learning Disability
Many individuals who have moderate or severe learning
disabilities have understanding of spoken language at a
2-3 key word level.
The Communication Partner
People who support individuals regularly over-
estimate the comprehension ability of the client
they support.
This results in a mismatch between the
complexity of language that they use and the
comprehension level of the client.
Expressive skills
Articulation problem (speech)
Dysarthria
Dyspraxia
Phonological problem (sound system)
Language problem
Developmental
Specific language disorder
Social Communication Skills
Verbal
Tone of voice
Listening
How to have a conversation:
appropriate subjects
asking questions
Non-verbal
Eye contact
Facial expression
Taking turns
Distance
Touch
Autism and Communication
Triad of Impairment
Communication
Imagination
Socialisation
Autism and Communication
Odd intonation
Failure or errors in reading facial expression/body language
Poor timing in dialogue
Pedantic speech
Literal interpretation
Argumentative/compliant
Poor listening skills
Lacking tact
Imagination
Rigid thought process
Dislikes change and surprises
Likes rules and order
Special interests, obsessions
Repetitive behaviours, rituals
Unable to foresee consequences
Unable to see others point of view
Social interaction
Socially indifferent or isolated
Unable to read social cues
No grasp of social “rules”
No sarcasm/irony
Unable to empathise
Inappropriate eye contact
Communication and Challenging Behaviour
Mansell (2007) reports that at least 45% of individuals
whose behaviours challenge present with significant
impairments of communication
Communication
Communication impairment is a core risk factor for
challenging behaviour
Challenging behaviour is often a form of non-verbal
communication; a functionally equivalent behaviour.
Getting it Right!
How can we overcome
Communication Breakdown?
Promoting communication
Opportunities for individuals:
to engage with objects and people.
to affect their environment (cause and effect).
to request and choose things.
to reject and refuse things.
for turn-taking and for showing and giving things.
Clear consistent structure and routines.
Identify the communication opportunities when going
out with a client to the;
swimming pool
a café
the cinema
Supporting Communication
Signing
Photos, Pictures and Symbols
Real Objects
Adapting our communication
Every one uses non verbal communication
Can you order a meal?
Now what would you order?
42
Practical examples
Communication passports - books/ wallets
High tech communication aids e.g. Alpha talker, Step by
step, Dynamo
Diaries, timetables and shopping lists
Talking mats
PECS
Accessible information e.g. leaflets, support plans,
meetings
Lunch