Communication Strategies of Adults with Severe Disabilities

Abstract

Individuals with significant developmental disabilities are often considered by others to be dependent and incompetent. They are frequently defined by their deficits rather than their abilities. New concepts such as self-determination have challenged researchers and service providers to think differently about the abilities of individuals considered to have severe intellectual disabilities. Analysis of communicative events between individuals with and without severe disabilities provides evidence that individuals who are often considered least able to do indeed communicate, asserting control over their environments and activities. Careful attention to communication reveals that behaviors that on the surface appear to be random, maladaptive, or challenging are purposeful, even useful. The author proposes that embedded in each communicative act, there is a drive toward self-determination, but that in order for self-determination to be actualized, communication partners must learn to apprehend, and respond appropriately to, the messages. ndrew is labeled profoundly mentally retarded ~ and autistic. He attends a day treatment center A with other adults with severe disabilities. Although Andrew does not speak, his care provider states that she understands his preferences, moods, and thoughts: &dquo;Andrew is really into the newspaper and news.&dquo; How did the care provider arrive at her conclusion?Pat has cerebral palsy, uses a wheelchair, and is considered to have severe mental retardation. She is unable to talk or walk and has minimal use of her hands. Although she has little voluntary movement, Pat appears to be able to communicate with her speech therapist: &dquo;She always lets me know when I got it ... it took me a while to figure out what she was talking about.&dquo; How does the speech therapist know when she has understood Pat's messages? Bart lives in a group home with five other young men who have autism. He has minimal speech and appears to pay little attention to activities in his home or to other people. Bart's records indicate that he cannot read. While playing a word completion game, Bart encountered the word &dquo;CAME_.&dquo; He uttered the word &dquo;smokin&dquo;' and selected the letter L to complete the word. Is the caregiver correct in assuming that Bart had meant &dquo;Camel,&dquo; the cigarette brand? Andrew, Pat, and Bart are considered to have severe intellectual disabilities. Their records are filled with evidence of what they cannot do.Yet, it appears that with people who are close to them, all three manage to make their thoughts and feelings known. According to their caregivers, each one communicates ideas. This article explores communication and self-determination among individuals who are thought to have the most severe disabilities.It examines the role of the communication partner in assuring that the message has been heard.

‘It’s my home and your work’: the views of a filmed vignette describing a challenging everyday situation from the perspective of people with intellectual disabilities

“…In this study, participants were being aware of the other when they defended the staff’s actions. This attitude is supported by previous studies showing that people with intellectual disabilities act in a defensive way and at the expense of their own decision-making (Goodley, 2000; Olney, 2001). In light of the self-efficacy theory, such institutional constraints can negatively influence a person’s self-efficacy beliefs and well-being (Bandura, 1997).…”

“…According to Olney (2001), staff often assume that people with severe challenges such as intellectual disabilities are so globally impaired that they cannot know what they want. Furthermore, staff seem to have a selective view of their interactions with people with intellectual disabilities; that is, certain communications are rewarded with attention, while others are ignored.…”

Care, communication and educational needs of primary care nurses to treat disabled patients

“…Moreover, PCN should be trained to employ strategies in order to engage DP in their treatment. [29][30][31] Focusing on the educational needs, there is no significant difference between PCN who do (not) exclusively treat PD at home. When interpreting these data, it is important to take into account that these 'groups' of PCN were constructed and compared in a case-controlled, retrospective manner.…”

Parent Involvement in Meaningful Post-School Experiences for Young Adults With IDD and Pervasive Support Needs

“…This critical finding highlights a common misinterpretation that selfdetermination is characterized by independent performance of behaviors or selfsufficiency (Wehmeyer, 2005). The participants' children needed supports throughout each day, thus acting volitionally as the causal agents in their lives required their parents to engage in sensitized listening (Olney, 2001) in order to interpret their preferences (Brown, Gothelf, Guess, & Lehr, 1998). Even when the parents weren't sure of their children's preferences, they were guided by their attitudinal facilitators emphasizing high expectations, their children's interests, and what was typical for someone of the same age.…”