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?

?

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Communication is

a two-way process by which information, thoughts

and feelings are exchanged.

both verbal and non-verbal.

involves both understanding and expression.

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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

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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

Gesture and Sign

Every one uses non verbal communication

Can you order a meal?

Now what would you order?

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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