Listen and learn

Jenny Morris explains how listening and asking the right
questions can help young people with communication problems engage
with others.

All those working with children and young people are urged to
listen to and consult with them. But how do you do that when the
child or young person has a communication impairment? How do you
listen when you’re not sure how much they understand and you
have difficulty understanding them?

In carrying out research about young disabled people who have
high levels of support needs,1 I came to realise how
much we have to learn from children and young people themselves
about how to meet their communication needs. I was also struck how
many times young people identified the problem as being located in
the adults around them and not in their communication impairment
per se. As one girl said: “I don’t have a speaking problem.
Other people have a listening problem.” And yes, I did have a
listening problem when I interviewed her – I couldn’t
understand her speech and panicked which made it worse. I pretended
I understood her because I was too embarrassed to keep asking her
to repeat herself. I talked too much myself and didn’t allow
enough time for her to respond to my questions.

In doing the research, I was also struck by how many young
people had reached the end of their schooling without their
communication potential being fully realised. Some young people
were surrounded by those who understood how they communicated. They
experienced high levels of interaction with others and were fully
involved in both everyday decisions and bigger choices. Others had
very few people in their lives who acknowledged their ability to
communicate and interact with others. When children and young
people are treated as if they cannot communicate, some react with
anger and frustration while others switch off. One mother, for
example, told me how her daughter had spent most of her time at
school asleep. It was only when she changed schools, and teachers
and other children starting interacting with her that she “woke up”
and responded.

When an adolescent had good experiences of having their
communication needs met, it was often because one or two people had
recognised their potential when they were younger. One boy told how
his first memory of someone recognising his ability to communicate
was in primary school: “It was a teacher. It was exciting. She took
time.” Often it was parents, or other family members, who first
recognised potential: “My first memories of being understood and
being able to make myself be understood were when I was about four.
My mother worked out I could say yes and no.” For this girl, “yes”
is looking to her right and “no” is opening her mouth.

Another girl remembers a physiotherapist “who learned to
understand me very well. She was good at making eye contact with me
and I think she understood how I was feeling at the time. She knew
when I was in pain and would talk with me about it. I was very fond
of her and she always took the time to understand what I was
saying.”

Young people had such a lot to say about how people could better
facilitate their communication that we decided to use their
experiences to write a guide for social workers, personal advisers
and others working with disabled children and young people with
communication impairments. Many of these professionals have a
responsibility to consult with children and young people and to
ensure that their needs – including their communication needs – are
assessed and responded to. Yet few of them have specialist
expertise around communication impairment.

The guide is aimed at these non-specialists. It provides a list
of resources and organisations which specialise in different
aspects of communication. It also contains advice – based on the
views of young people themselves and of experienced social workers
and speech and language therapists – about how to go about working
with someone who has a communication impairment, and how to judge
whether their communication potential is being realised.

Young people who were consulted during the course of writing the
guide identified that negative attitudes and poor communication
skills of non-disabled people caused them the most problems. They
also shared experiences of inappropriate and outdated equipment; of
communication books which didn’t contain the words or symbols
that were important to them; of not being able to have their
preferred communication aid with them at all times.

However, young people also had some really positive advice about
how to consult with them and maximise their communication
potential. One important starting point is to never believe it if
someone says to you, “He can’t communicate,” or “It’s
impossible to find out his views or feelings.” Everyone expresses
preferences and if you can recognise how they indicate whether they
like or dislike something you are receiving a message from them.
That is communication and it can lead to the child or young person
having choice and control in their lives if these messages are
acted upon.

When it comes to judging whether a child or young person’s
communication needs are being met, the young people had lots to
say.

They thought it important to find out:

  • How the young person prefers communicating: they may have been
    given a particular communication system but this may not be what
    they use most naturally.
  • How they make choices.
  • How they ask for basic needs to be met.
  • How they attract attention.
  • How they ask for something that’s not there.
  • How they indicate that they don’t want something/have had
    enough/want a change.
  • How they share experiences of interest to them.
  • How they express opinions and/or show their feelings.
  • How many people are competent in communicating with
    him/her.
  • How they socialise with their peers.

Many of the young people we consulted relied on a communication
book or piece of equipment. They thought that those working with
them should find out:

  • How they access the communication system.
  • Whether the communication system is available to them all the
    time.
  • How they indicate that they want to use it.
  • Whether there is anything they would like to change about their
    communication system.
  • Whether other access needs are getting in the way of using a
    communication system or piece of equipment, such as seating or
    mobility needs, suitability of computer keyboard, mouse or monitor,
    size of communication book, etc.
  • Whether the communication system has the words/pictures/symbols
    about the things important to the young person.
  • What opportunities there are for adding words/pictures/symbols
    and how often does this happen?
  • If the communication system is compatible with the young
    person’s first language and with their parents’ first
    language.
  • If the young person has more than one language does the
    communication system accommodate this?

These checklists provide examples of the positive advice that
children and young people with communication impairments have to
give. If we are not to deny them their human right to communicate
we need to pay close attention to such advice.

Jenny Morris is an independent researcher.

1 J Morris, A Lot to
Say: A guide for social workers, personal advisors and others
working with disabled children and young people with communication
impairments
, Scope, 2002, Available free from Scope, 6 Market
Road, London N7 9PW. Tel 020 7619 7341. E-mail:

information@scope.org.uk

 

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