The Need is Individual
May 8th, 2008There are a lot of reasons why someone might not use language “normally”. Yet, despite this, it is often assumed that there are two options for someone to communicate: the “normal” way and a given person’s favored solution. I’ve seen this two option approach not just from non-disabled people, but also from people with communication disability (the second option, in that case, is often their option). I’ve also seen a lot of armchair language experts, who haven’t had the benefit of reading even the most basic of literature on communication disabilities - and thus are condemned to reinvent the wheel poorly. Unfortunately, sometimes these armchair language experts are someone’s only hope for communication - so when inferior solutions are chosen, it becomes a human rights issue. Having the appropriate communication tools is a human right.
There are two subject areas someone investigating communication alternatives needs to know about: the different difficulties that people may have and the different approaches to solving the difficulties. I’m going to talk about the different difficulties here, as I believe the solutions are a lot more obvious once it is understood that, for instance, that different people don’t talk (or hear) for different reasons, and thus the approach to providing communication tools may differ between different people.
The most obvious reason people don’t communicate well with speech (expressively or receptively) is for physical reasons. Someone who has their vocal cords removed during throat cancer surgery or who no ear drum will obviously need different means of communication. Even in this group, though, there are significant differences among people - some may be able to make some sound and/or hear some sound - and that changes the approach. The approach for someone with literacy who loses access to some form of communication later in life is different than the approach that is necessary for someone without literacy. And other disabilities still factor in: does the person understand language? Do they have word finding issues? Can they type? How is their eyesight? Etc.
Another reason people might not communicate typically is due to a problem in the interface between the brain and the communication organs (ears, vocal cords, lips, etc). The organs may be typical, and cognition may be typical for this person, but something gets “lost” before communication can be sent or received in a typical way. An example might be severe CAPD (central auditory processing disorder) or some forms of cerebral palsy. There may or may not be other disabilities present, such as motor control issues (someone with cerebral palsy may have hard to understand speech and difficulty using a computer keyboard, for instance).
Other people have difficulties processing language itself. Language is a complex area of cognition, and involves a lot of different mental processes, any one of which may impact someone’s ability to handle language. Some people might have trouble remembering which “word” to use (I put “word” in quotes, because they also may have trouble not just with spelling and sounds of words, but figuring out which abstract symbol or picture represents which word). Others may have trouble with different verb forms, or the idea that something could be past or future tense. Others may have trouble with sequencing and short term memory - two important areas for building sentences and paragraphs, regardless of the symbol set used to represent words.
The good news is that there are communication techniques to give us the tools to communicate, regardless of the reason for our communication disability. But often they are very individual, and what works for one person won’t work for another, even when both people have the same label (”autistic” for instance).
This checklist (PDF format) is an example, used by the Oklahoma Assistive Technology Center, of the types of questions a professional will ask to match communication techniques to an individual’s needs. I think there are some problems with the checklist (specifically, non-performance doesn’t always indicate lack of ability; and the checklist is written only with children in mind), but it gives an idea how complex providing communication can be. It’s far more complex than “If someone can’t speak, give them a speech synthesizer.”