See our Adult Special Needs and Learning Disabilities Home Page for a full list of information about adult learning disabilities, and links to information and strategies relating to communication.
Behaviour and Communication
Some adults with learning disabilities may display inappropriate or challenging behaviour. Although there are many reasons for this type of behaviour, it can often be linked to a breakdown in communication. When someone is unable to express themselves, or is confused, this is when behaviours may occur.
Be Aware of your Language level
Some individuals with learning disabilities may have a difficulties with understanding and receptive language. Their level of understanding may appear better than it is because they learn to follow the cues of others, or because they may use words and sentences. However, spoken language may not necessarily be functional. When their is a breakdown in communication because an individual does not understand or becomes confused, challenging behaviour can occur.
Behaviours can also occur because an individual does not have the expressive language skills to express his needs and wants, for instance, if an individual is unable to tell you he is in pain.
There are many ways to adapt your communication to help individuals understand. For instance, pitching your language at the right level and reducing the complexity of your sentences. Other individuals may benefit from the use of visuals, sign, or objects of reference to help them understand or make choices.
The Minimal Speech Approach
The minimal speech approach focuses on using one or two key words rather than a sentence when communicating with adults who have difficulties with understanding. The minimal speech approach can be used with adults or children with a severe communication delay. Just using single words can often be much more effective than sentences. There is now evidence to show that simplifying language not only helps individuals with autism and learning disabilities have a better understanding of language, but also has positive effects on behaviour and encourages more interaction and responses. Behavioural difficulties often occur because individuals do not understand what is happening or what other people are expecting. By simplifying language, inappropriate or challenging behaviour may be avoided.
When using language it is also important to avoid using abstract language and terms. Initially it is probably best to stick with nouns (coat, cup) and verbs (run, swim), rather than use adjectives (big, old), prepositions (in, behind), pronouns (he, mine), or time concepts (tomorrow, this afternoon). Adding further cues alongside single word commands can also facilitate understanding. Using visuals, a sign or gesture, or objects alongside the speech can give the individual further cues. It is also worth noting, that if you use visuals etc, still use single words, as a longer sentence can distract from the other cue.
Intensive Interaction
Non-verbal individuals who have major learning difficulties or “severe” autism are often very difficult to interact with. Not only do they have major difficulties understanding, but may also be unable to express their own needs or feelings. By “severely” autistic, I refer to those individuals that are non-verbal, non-communicative, and often described as “in their own world”. These individuals have difficulty following instructions and may also display challenging behaviour if approached or encouraged to do something.
Intensive interaction tries to create a communication environment that is enjoyable and non-threatening to the individual with autism, or severe learning difficulties. In some respects the model of the approach is taken from the way we first start to communicate with naturally developing infants, where interactions are short, and involve noises, touch and eye contact. Interactions are brief but can grow over time. Ultimately we are looking for the individual to:
- Accept our presence
- Allow some presence in personal space
- Attend to another person (even fleetingly at first)
- Allow and use some touch
- Engage in eye contact
- Use facial expression
- Focus on body language and facial expression
- Take turns in communicative behaviour
- Take turns using vocalization which may start to have meaning
- Experiment with communication
- Learn cause and effect
The individual becomes an active participant who is motivated to communicate and who will take the lead and feel a sense of control over the communicative situation. Through this approach carers can make a connection with an individual, create an enjoyable exchange, reduce challenging behaviour, and develop communication skills. To begin with, sessions may be very short, but expanded over time and be varied in activity. Sessions should take place several times daily on a one-to-one basis.
Applied Behaviour Analysis
Using Applied Behaviour Analysis (ABA) new skills are taught by breaking tasks into small steps and working through these steps. Prompting, Shaping and Rewarding are used to motivate the individual to complete the steps. ABA can be part of a comprehensive program, or used to attempt to teach individual tasks, new behaviours, and replace inappropriate or challenging behaviour.
Ideally, having the skills of a psychologist to help with assessment and programs is the ideal, but this is not always possible. However, there are many things we can do to try and change or replace challenging or inappropriate behaviour. To replace behaviour we need to find the cause of the behaviour (antecedent), monitor what behaviour occurs, and what the consequences and function of that behaviour are. We need to observe and assess, and define the behaviour and measure it. When we know the causes and consequences of the behaviour, we can look at how to replace it.
For more information about communication difficulties, and ideas and strategies to help communication, see our Resources, or for specific fact-sheets about adult special needs and learning disabilities and information and strategies for improving communication go to the Downloads Section.
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