Transcript Speech and Language Skills - Liz Boardman

Speech & Language Skills for the
LD Psychiatrist
Liz Boardman
Speech & Language Therapist
(Intensive Support Team)
Learning Disabilities Service
14th January 2011.
Aims and Objectives

To raise awareness of communication
difficulties faced by people with learning
disabilities

To provide practical communication
strategies.
Learning Disabilities and Communication

One in three people with learning disabilities are likely to
have problems with their sight or hearing, or both.*

50-90% of people with learning disabilities have
communication difficulties.**

About 60% of people with learning disabilities have some
skills in symbolic communication using pictures, signs or
symbols.**
*Taken from Foundation for People with Learning Disabilities www.fpld.org.uk
**Taken from BILD factsheet www.bild.org.uk
Common Communication Difficulties

Limited vocabulary (Leudar 1997) and difficulty formulating
sentences
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Auditory memory difficulties

“Borrowed” expertise by repeating others’ words and phrases as
their own (Kernan & Sabsay 1997)
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Difficulties with conversational repair

Difficulties with asking for feedback i.e. asking questions about what
you’ve been told

Difficulty understanding abstract concepts

Use of strategies to hide difficulties e.g. feigning understanding;
giving response listener wants (Kernan & Sabsay 1997)

Difficulties with predicting information and inferring consequences
Understanding is dependent on:
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Attention and motivation
Memory
Vocabulary
Sentence length
Sentence complexity
Feedback and questioning
Abstraction
Spot the vocabulary problem…
Taken from Eastaway, R & Askew, M (2010) Maths for Mums and Dads. London: Square Peg
ANXIETY
makes
it
very
difficult
to
process
language
Corandic
Corandic is an emurient grof with many fribs; it
granks from corite, an olg which garkers excarp by
glarching the corite and starping it in trankerclarped strobs. The tarances starp a chark which is
exparged with worters, branking a slorp. The slorp
is garped through several other corusces, finally
frasting a pragety, blinkant cranle: coranda.
© Weaver,C. Psycholinguistics and Reading: From Process to Practice. Winthrop Publishers Inc (1980)
1. What does corandic grank from?
2. How do garkers excarp the olg?
3. Does corandic taste nice?
Expression
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Language ability
Speech production
Social skills
Experience of failure
Limited opportunities
Pragmatic Language Problems
Difficulties with:
Expressing communicative intent e.g. poor non-verbal
communication; word-finding difficulties; difficulties
initiating communication.
Conversational management e.g. poor turn-taking;
difficulties with staying on topic; difficulties with changing
topic appropriately.
Presupposition (awareness of what others may know) e.g.
tactless; ignores listener’s perspective; too much/not
enough information given; inappropriately familiar.
Difficulty with irony, metaphors etc.
Taking It Literally…
Taken from Eastaway, R & Askew, M (2010) Maths for Mums and Dads. London: Square Peg
How to help - Communication
When you are talking:
 Avoid complex vocabulary and jargon.
 Be consistent- use the same word every time
 Break longer sentences into shorter “chunks”.
 Say what you mean- avoid metaphors.
How to help (2)

Tell the person the topic you’re going to talk
about, before giving explanations.
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Try giving prompts to get more information
e.g. “Where did you go?” “Who did you see?”
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Check the person’s understanding of the
words and phrases they use.
How to help (3)
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Don’t ask multiple questions
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Check the person has understood:
a) the main point
b) any important details.
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Repeat the important information.
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Explain the consequences- don’t expect people to
be able to predict them.
How to help (4)

Give the person TIME- to process what
you’re saying, and time to respond.
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Provide repair strategies- ask if they need
you to say it again; have any questions.
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Remember, it is easy to overestimate
someone’s level of understanding
because they can talk.
Inclusive Communication
INCLUSIVE COMMUNICATION
touch
speech
facial
expression
gesture
sign
pictures
objects
writing
drawing
Making things easy to read and
understand
•The language
•Vocabulary
•Acronyms
•Layout
•Font font
•Size size
•Bullet points
•Pictures
•Photos
•Symbols
•Internet graphics
Word definitions
Mental health issues
Assessment
Psychiatrist
Hallucination
Case Study

You are prescribing anti-psychotic medication
for a lady with mild-moderate learning
disabilities.

How would you go about explaining what the
medication is for; potential side effects; how
she needs to take it.
Useful websites
Easyhealth www.easyhealth.org.uk
Easyread information (including videos) on a range of health matters.
See A Picture of Health also www.apictureofhealth.southwest.nhs.uk
Talking Mats www.talkingmats.com
Useful pictorial rating scale method which can be used to ascertain people’s
opinions about their likes/dislikes; accommodation; medical treatment etc
Books Beyond Words
www.rcpsych.ac.uk/publications/booksbeyondwords.aspx
Picture books on a range of topics: Epilepsy; Going to the doctor etc. Help
people prepare for an event or deal with an issue. Some free online copies
are available (see website).
The Elfrida Society www.elfrida.com
Easyread leaflets on antipsychotic and antidepressant medication.
More information about Communication and
Learning Disabilities…
NHS Evidence
www.library.nhs.uk/learningdisabilities
Lots of articles in the Communication section, plus comprehensive (!) DoH
guidelines on producing easyread information.
Kelly, A. (2001). Working with adults with a learning disability.
Milton Keynes: Speechmark Publishing Limited.
Useful introduction to communication and learning disability, with lots of
information on communication assessment and communication strategies.
Covers the whole range of learning disability.
Contact…
Liz Boardman
Intensive Support Team
Learning Disabilities Service
(01872) 385739
[email protected]
Speech and Language Therapy Department
West Resource Centre
(01209) 219251
Speech and Language Therapy Department
East Resource Centre
(01208) 79525