Scope

This article introduces just a few of the many ways we can improve the effectiveness of our communications with people with learning disabilities. We will discuss five strategies.

Maximizing the hearing environment

It is estimated that over 40% of people with a learning disability have hearing difficulties. In addition, we know that many people with learning disabilities have undiagnosed hearing impairments and that often their carers/advocates may be unaware of a hearing difficulty. A hearing impairment has the potential to interfere with effective communication. Consequently, if you, or any other professional/carer, have concerns regarding a person’s hearing status you can refer them for a hearing check via their physician.

As well as directly affecting a person’s ability to hear the speech of others, to discriminate between particular speech sounds and to monitor one’s own speech production, a hearing impairment can also affect a person’s attention. We all have different levels of attention (short/long) and our ability to attend is typically influenced by what is happening around us and how we are feeling at the time. Being interested in something tends to increase our attention span, whereas worry/anxiety reduces attention levels (e.g. visiting the dentist). In order to ameliorate potential adverse effects of poor hearing and low attention levels, it is good practice to:

• reduce background noise
• face the person you are talking to, so they can see your mouth and face
• use a normal tone of voice
• speak at a normal/average rate, i.e. don’t talk too quickly
• use signs, gestures and pictures to back up your speech

Using familiar vocabulary

The collection of words a person or group knows and uses is their vocabulary. Now, when we speak to another person we may use words that are not in the other person’s vocabulary, i.e. the words may be largely meaningless unless they are explained. Take a look at the following.

“I was so so…aggranoyed!”

The word aggranoyed appears to be an assemblage of ‘aggravated’ and ‘annoyed’. It is a so-called neologism, i.e. an invented word or phrase with a newly coined meaning. Neologisms may not be readily decipherable.

Do you know what a gemini tooth is? Perhaps you’d only know this if you are a dentist (and most likely an American dentist). Apparently it’s a tooth that starts to part and develop two crowns. I didn’t know this because this phrase was not in my vocabulary. In fact, the phrase ‘gemini tooth’ is an example of jargon, i.e. specialized vocabulary used by persons in the same work or profession. Clearly, using too many jargon words when communicating with people with learning disabilities (or anyone for that matter) will impede effective communication.

What is this mouth-watering food?

What do you call the above sweet dessert? Is it a /skɒn/ (rhymes with the word con) or a /skəʊn/ (rhymes with the word cone)? How you pronounce this will likely be influenced by your accent. An accent is the distinctive way an individual/group pronounce speech sounds, words and phrases and which is typically associated with a particular nation, locality, social class, and similar. We need to be aware of how we pronounce certain words when communicating with people with learning disabilities, as the person’s ability to generalize (e.g. realize that /skɒn/ and /skəʊn/ refer to the same thing) may be reduced.

In summary, owing to such things as our age, job, level of education, cultural background, and similar, we each have a different vocabulary. Different professions have a jargon that may be exclusive to the profession – certainly, jargon words are less likely to be understood by people who are not familiar with them. If it’s necessary that someone understands a particular word then you may need to expose the person to the word beforehand – perhaps through sending relevant literature, phoning a carer to enlist their support in introducing the word, and so on.

Making negatives positive

There can be a tendency for people with learning disabilities to interpret negative phrases positively, e.g. ‘You can’t go home yet’ may be responded to as ‘You’re going home’. So, try to use positive instead of negative phrases: perhaps, ‘You need to stay here for a while’ rather than ‘You can’t go home yet’.

Exercise in making negatives positive

Read the following negatively structured phrases and suggest an alternative positively shaped phrase that may be more readily interpretable for each one.

• You can’t go home yet
• Don’t bite my finger
• You mustn’t forget to clean your teeth
• Don’t talk when the mirror’s in your mouth
• You shouldn’t scrub your teeth sideways

Suggested answers

Re-framing

Re-framing is a method of changing the meaning of something in order to change attitudes. It helps us look at issues differently, and from several different viewpoints. For example, we can re-frame…

• a problem as an opportunity
• unkindness as lack of understanding
• …etc

Exercise in re-framing

Take a look at the following labels and see if you can re-frame them in order to provide a different, more positive, viewpoint.

• distractible
• impulsive
• overactive

Suggested answers

Here are some suggested answers provided by Melanie Cross (2006):

Distinguishing between metaphorical and literal language

Don’t get confused between metaphorical language and literal language: when you say, ‘I laughed so loud, my sides split’…well, they didn’t really, did they? Consider where the following creatures live.

I’ve got butterflies in my stomach!

I’ve got a frog in my throat!

I’ve got crow’s feet around my eyes!

I think you get the point – these creatures don’t actually live in our bodies, do they? It’s another example of how we use metaphorical language on an everyday basis. But beware of using too many metaphors and idioms when communicating with people with learning disabilities. Try to say exactly what you mean. It may seem blunt because we often use metaphorical language to ameliorate the impact of some of the things we want/need to say to people. However, many people with learning disabilities will interpret statements literally.

In general, Inferring can be difficult for people with learning disabilities. The situation can arise when a speaker makes an inference rather than saying exactly what they mean, e.g. I’m thirsty instead of I’d like a drink please.  Inference is often used when giving difficult information in order to reduce its impact. However, a person with a learning disability may not grasp the intended meaning. So, avoid using too many inferences: say what you mean even if this seems blunt.

References

Cross, M. (2006) Communication & Behaviour: Exploring the Link I CAN Conference 2006.