The Communication Partner
Communication is a two-way process. The person 'listening' (the communication partner) is as important as the person 'speaking'.
When developing a communication system with a person who has a number of disabilities, the communication partner is very important because they interpret the reactions of the individual to different experiences. Every movement, gesture and vocalisation has a meaning. Understanding all of these takes time, patience and a positive attitude towards the individual's ability to communicate.
Yes & No
Finding out how the person indicates 'yes' and 'no' might seem really basic, but it is very important. If the person is not able to speak, they will not be able to say "yes" or "no"; depending on their physical abilities they might not be able to nod their head for 'yes' or shake their head for 'no'. It is very difficult to have a conversation with someone, to ask them a question, or even to find out basic information - for example "Does it hurt here?" - if you cannot understand their communication for 'yes' and 'no'.
You might have to say to the person, "Show me how you say Yes", "Show me how you say No". People who are not able to speak have developed a whole range of methods for indicating 'yes' and 'no', for example:
- looking up for 'yes' and down for 'no'
- blinking their eyes once for 'yes' and twice for 'no'
- a tight fist for 'yes' or an open hand for 'no'
- pointing at the words 'yes' and 'no' printed on cards
- moving their foot up for 'yes' and keeping it still for 'no'
Finding a system for signalling reliable 'yes' and 'no' that can be understood by a range of people can take some time. However, it provides a good starting point for future communication.
Signing and Gestures
Signing and gestures provide a visual clue to what is being said. Some people with severe speech difficulties also have problems understanding and remembering what is said to them. Signing and gesturing as well as speaking can provide the individual with additional clues which can help them to understand what is being said. For some people body language, gestures and signing might be the most effective way they have to express themselves.
Real objects can be used to encourage people to choose; for example, holding up a bottle of Cola and a bottle of orange to give someone a choice of drink. Objects can be used to let an individual know what is going to happen; for example, letting someone feel their swimming costume before putting it in a bag might let that person know that they were going swimming. Objects used in this way are sometimes called 'objects of reference'. It is essential that the same item is always used to signify the same event. See the section on Using Objects of Reference for more details.
Some people are able to look at photographs and understand what they mean. Instead of using objects of reference you could maybe use photographs of familiar objects around the house, such as toys, fruit, TV, family and friends. Photographs can be used in exactly the same way as objects of reference, that is, to let the individual know what is going to happen, to let them choose what they want to do, to let them tell you something. You might start with giving the person a choice of two photographs, and gradually increase the number of choices of photographs.
Communication Possible At All Times
It is important that the person with multiple disabilities has access to their means of communication at all times. It can be useful to have their communication method visible, for instance:
- timetable of the day displayed three dimensionally using objects of reference
- appropriate photographs or symbols on the wall in the canteen
- appropriate pictures up round the sand pit or water tray
- pictures/objects available or pinned to the wall above the bathroom sink.