Transcript Communicating with Individuals with Developmental Disabilities

Developmental Disability
Etiquette
Patti Higgins, RN
CCBDD
(216) 736-2686
[email protected]
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DISABILITY ETIQUETTE
Presentation Objectives:
Identify the different modes of
communication that individuals with DD utilize
Discuss general communication strategies
when working with individuals with DD
Identify actions to take when individuals with
DD have behavioral issues.
2
Communicating with Individuals
with Developmental Disabilities
MYTH # 1
People with DD cannot
understand speech, let
alone medical
information
3
Premise #1


Many people with DD can
effectively communicate their
needs
People with DD have a wide
variety of communication skills
and abilities
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Premise #1 (continued)
5
Premise #1

Individuals who are
non-verbal can
communicate with
gestures and / or
body language.
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Premise #1 – Medical Info


Many people with DD are very involved
with their healthcare.
Healthcare providers may have to adapt
their physical environment and
interaction techniques.
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MYTH # 2
People with DD
cannot make
decisions
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Premise # 2
People with
developmental
disabilities
participate in
decision making
in a variety of
ways.
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PREMISE #2 (cont’d)


Many individuals with DD are their own
guardians
Many individuals with DD are capable of
informed consent for medical
procedures / treatment.
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MYTH #3
People with DD
are sick.
People with DD
are dependent
on others to
meet many / all
of their needs.
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Premise #3

Many people with DD
are not sick,
incompetent,
dependent, unintelligent
or contagious. They
are like the typical
population, i.e. healthy,
chronic medical
conditions, mental
health diagnoses and
acute care issues


People with DD have
master’s degrees, work
full-time, drive, own
businesses, participate
on committees, are
married and have
children.
They are individuals and
you use the same
assessment skills as
with typical population.
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Premise #3 – (cont’d)
Triage
Communication issues
Baseline health
Mirrors other individuals
that may be in shelters,
with mental health
issues, alzheimers,
elderly, typical
population.
Cooperative,
communcative and
compliant
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MYTH #4
People with disabilities can
access health care easily.
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Premise #4

Healthcare providers
may have to adapt
their physical
environment and
interaction
techniques.
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Premise #4



Talk to the person, rather than through their
caregiver or sign language interpreter.
If the caregiver needs to be involved in their
healthcare conversation, ask the individual’s
permission.
Listen patiently. Don’t complete sentences
for the person unless he/she looks to you for
help.
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Premise #4



Allow extra time for the
visit and give specific
directions.
Don’t pretend you
understand a person
with a speech disability
just to be polite.
Be prepared for various
devices or techniques
used to enhance or
augment speech.
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General Communication Strategies
N
O
U
S
S
R
(adapted from Seigel-Causey and Guess, 1989)
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Nurture



Develop a trusting
and supportive
environment
Show real interest in
communicating
Act and speak
naturally
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Opportunity


Communicate about what is happening
now
Provide choices
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U






“You” always play a key role in assuring
effective communication
Talk to the person
Ask permission to talk with whoever is
assisting them
Listen
Clarify
Restate
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Sensitivity




Recognize an individual’s readiness to
communicate
Respond at the person’s level
Recognize the communication modes of
the individual
Respond appropriately to all
communicative attempts
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Sender





Get the person’s attention
Present info using person’s receptive
mode
Repeat the message once, then restate
Rephrase using different words or
modes
Recognize all attempts to respond
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Sender


Treat Adults as
Adults
Do not shout at the
person with DD
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Receiver




Pay attention and be
aware
Ask for clarification
when needed
Be honest
Encourage individual
to use many modes
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Cognitive Disability


Use very clear, specific language
Be patient. Allow the person time to tell or
show you what he or she wants.

Condense lengthy directions into steps

Use short, concise instructions
(Commission for People with Disabilities, November 2007)
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Cognitive Disability

Present verbal
information at a
relatively slow pace,
with appropriate
pauses for
processing time and
with repetition if
necessary, e.g. “In
five minutes, we’ll
be going to lunch.”
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Cognitive Disabilities




Reinforce information with pictures or
other visual images
Use modeling, rehearsing and role
playing
Use concrete rather than abstract
language
Limit the use of sarcasm or subtle
humor
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Cognitive Disabilities

If you are not sure
what to say or do,
just ask the person
what he/she needs.
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Dealing with Behavioral Issues
Dual Diagnosis:
Individuals who have
both a mental illness
and a developmental
or intellectual
disability.
Increase incidence of
mental health issues with
in people with DD – may
be due to brain pathology.

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Behavioral Issues

“Unlike the general population, individuals
with a dual diagnosis may be more likely to
exhibit sign and symptoms of their disorders
in the form of behavioral outbursts including
verbal or physical aggression, self-injury,
property destruction, impulsive behaviors
and/or elopement .”
(Family Crisis Handbook, Donna Icovino & Lucille Esralew, Ph.D.
July, 2009)
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Behavioral Issues

Not uncommon for people with
Pervasive Developmental Disorder
(PDD) or Autism to display aggressive
behavior.
 May be a response to frustration, pain
and limited communication skills.
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Behavioral Issues

For individuals who
are non-verbal,
behaviors may be
their way of
expressing
frustration and/ or
pain.
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How to Cope with Behaviors
During a Disaster





Stay calm
Use verbal and non-verbal techniques
including relaxed body position
Limiting space by directing the person
to another room or area away from
others
Soothing tone of voice
Avoid giving commands
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How to Cope with Behaviors
During a Disaster



Identify feelings (if able)
Ask Caregiver for assistance with
behavior (may be aware of behavior
plan to de-escalate aggressive
behaviors)
Redirect to a different activity,
preferably something soothing
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Self-Injurious Behavior
For some individuals, i.e, people with autism
and those who are non-verbal, aggression
may be expressed by self-injurious behavior.
Head banging, hitting themselves, biting
themselves.
Interventions are the same as previously
discussed.
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A FINAL WORD
People with DD are individuals
with families, jobs, hobbies,
likes and dislikes, problems
and joys. While the
disability is an integral part
of who they are, it alone
does not define them. Don’t
make them into disability
heroes or victims.
Treat them as individuals.
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RESOURCES

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www.disabilityisnatural.com
Commission for People with Disabilities
(November, 2007)
The Ten Commandments of Communicating
with People with Disabilities www.ucp.org
www.peoplefirstohio.org
Ohio Developmental Disabilities Council
Self Advocates Being Empowered
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