Communication for Health
When a person has complex communication needs, for example, when they cannot communicate using speech, or perhaps they can talk but can struggle to say what they want or need to say, telling other people what is wrong can be very difficult.
There has been a lot of progress in understanding how to support people with complex needs to communicate in recent years. Many people who were thought to be unable to use communication systems in the past now are able to access different ways to communicate, for example, using their eyes or different parts of their body.
Even if people are not yet able to use a communication book or device to talk, it is still very important that they have help to understand medical and dental information. Some of the resources in Part 1 – Planning which use photos or pictures can help with this. Most people find that visuals make it easier to understand information. If visuals don’t work for the person due to vision impairment, then it is still important to verbally explain things, and to use touch and tangible objects to help the person to understand.
Some people may not be able to let us know that they are listening or paying attention. Its still important to explain health related information and to prepare people for any health related appointments, explaining what will happen, why, and providing reassurance. It can be very difficult to know how much a person with high supports needs understands, so it is important to ‘err on the side of caution’ and make sure they are always given important information about their health.
The main goal for many families is to find a way that the person can tell them when they are sick or in pain. Some people can learn to point to symbols on a communication board to tell us when something is wrong. Other people are able to use their eyes to tell us their message – this is called using eye gaze. This link explains what eye gaze means: Introduction to Eye Gaze Devices For people who cannot point or use eye gaze, a communication strategy called Partner Assisted Scanning is helping many people previously thought unable to access communication books or devices.
This video explains about Partner Assisted Scanning
Some families have been able to use partner assisted scanning to help a person with high support needs to give some clues or tell them what is wrong, or if they are in pain and where.
People with complex communication needs can often learn to use a communication board or system which has language to tell us what is wrong given enough time and the right supports. For some individuals this may even take a few years, but is well worth it if it means the person can one day tell us when they are uncomfortable, sick or in pain.
We know now that people learn to use communication boards and systems through ‘modelling’. Modelling means that everyone around the person uses the communication system to talk so they can learn how it is used by watching, with no pressure being put on the person to use it themselves.
This video explains about what modelling is and why its helpful.
Even if a board to talk about when something might be wrong is the only thing you model, this can be worth doing so a person can tell us when something is wrong. Modelling for health purposes just means that every time you experience pain or illness, you use the board to tell the person so they can see it used in real situations. Communication boards need to be designed for each individual in ways which work for them, but will have words such as on this Medical Communication Board from the Queensland Department of Communities.
Language which might be useful in person’s communication system includes: a visual pain scale which can be a simple 3 stage scale (no pain – some pain – lots of pain) or more complex depending on the person’s needs body outlines or visuals of different body parts to help locate sources of pain or visuals for different body parts common types of pain or illness, equipment and procedures common in medical settings
However the person communicates, it can be helpful for people with complex communication needs and their families or supporters to design a Communication Instruction Card to take with them in the ambulance or to hospital to efficiently tell paramedics, doctors and nurses know how they communicate. Here is a sample card you can use as a template: Communication Instruction Card
For more information on planning to support communication in hospital settings for people who use communication systems, ‘Planning for AAC in Medical Settings’ by AssistiveWare shares 6 key strategies to reduce the vulnerability of people with complex communication needs in hospital.