The right to communicate

Article 19 of the Universal Declaration of Human Rights (UDHR) stresses the fundamental right for a person or community to speak out, and receive information and ideas. Communication is thus a basic need and a human right, much like food and shelter. Language is often considered innate, and thus it is not only a basic human right, but indeed an instinct. People from any specific country may communicate in an exclusive way, understood only by their fellow countrymen, excluding foreigners and the like. Similarly, our communication system may exclude minority groups, such as persons with disabilities, through a lack of consideration for certain communication impairments. Disseminating ideas and thoughts may be a problem for persons with disabilities who have not acquired an effective communication method. One must note that such minority groups have an equal right to be present and involved in decision-making processes, particularly if the decisions affect them.

What is communication?

Communication is the way in which one expresses an idea, a feeling or an opinion. This may be done verbally or non-verbally and it must be perceived or heard by another person. Therefore for communication to occur, two persons must be present; the sender and the receiver (Sen, 2007). The sender conveys a message and the receiver attends and listens. The receiver then filters the message through his or her personal beliefs and communicates back in response, altering his or her role so that the receiver becomes the sender. This is referred to as the ‘Communication Chain’.

Communication does not refer only to speech. Verbal communication is important, yet language can be understood as an acquired method by which one conveys a message. Moreover, non-verbal communication involves non-spoken language such as; gestures, voice, pitch, and facial expression amongst others. Communication thus includes a myriad of methods such as body-language, written language, symbols, signs, pictures and sounds. It is interesting to note that non-verbal communication methods may often convey a clearer message than speech and are often even considered more powerful. Sigmund Freud stated: “Mortals can keep no secret. If their lips are silent, they gossip with their fingertips, betrayal forces its way through every pore” (Sen, 2007).

Different disabilities - different communication styles

It is crucial to consider the diversity of disability, and thus the different abilities and needs that an individual possesses. Often, even within a specific disability or disorder, there will be various ways of communicating effectively with an individual. For instance, individuals with an intellectual disability are more likely to face challenges in the development of communication skills, or the transfer of learned skills to daily activities. Thus the use of alternative communication methods may increase the opportunity for communication and thus increase their ability to decide on and participate in activities. On the other hand, individuals with autism may have difficulties that are more specific, such as difficulties with expressing themselves, while having a strong understanding of visual aids due to heightened visual processing. Thus using picture-communication methods may be particularly useful for communication with an individual with autism. Moreover individuals with dyspraxia, a motor speech disorder, will often have speech that is unintelligible and thus communicating may be difficult and frustrating for the individual. Alternative communication methods for people with dyspraxia such as communication boards and speech-generating devices, often result in more effective and satisfying communication.

Incidentally, one must also consider other disabilities such as visual or auditory impairments that may present the individual with communication barriers. For the visually impaired, being unable to access information, the potential danger posed by unreadable notices and the loss of privacy when documents are unreadable by the individual, can be very frustrating. The individual with hearing impairment has the normal capacity and potential to assimilate language and communicate should the appropriate methods be used and be available to the him/her.

Modes of communication (verbal, non-verbal, picture, sign)

As proposed by the social model of disability, communication problems emanate from a disabling society that is geared by individuals without a disability, for ‘normal’ communication. However, what is ‘normal’ communication? And who defines it?

We strive to promote a society that is diverse and flexible, one that challenges the imperatives of ‘normality’, in relation to the diversity of communication styles and formats. The idea of an Inclusive Communication Environment comes to light, an environment where individuals with a disability are empowered and involved in the planning, development and implementation of alternative communication methods. Accessible communication is fundamental for such an idea to materialise. Alternative formats include large print, large print with pictures and symbols, braille, accessible websites, audio description and sign language that in an ideal world, are available to all.

One must consider the alternative communication options that are available to us to aid communication with individuals with disabilities, and their ability to communicate with others. Augmentative and Alternative Communication methods (AAC) are methods used to replace speech for those who have problems in the production of spoken or written language. Such methods can be used as a permanent or a temporary aid and are useful to individuals with Cerebral Palsy, intellectual disabilities, Autism and Developmental Dyspraxia amongst others. These methods include unaided communication, such as signing and body language or aided approaches, like picture and communication boards and speech generating devices.

Picture Exchange Communication System (PECS) is an effective and widely used form of AAC. This method uses pictures instead of words to aid the individual’s communication. PECS is useful for individuals of all ages with communicative, cognitive or physical difficulties. Methods like these give such a population the ability or the freedom to communicate their needs and desires effectively, to be understood by those around them and to understand what others are communicating to them. Furthermore, it has been widely recognised that better quality of communication and interaction between people is correlated with a more positive quality of life and a more positive outlook on one’s future.

Tips on how to communicate with persons with disability

Persons with visual impairment:

• Address the person by his or her name so that they are aware that they are being spoken to.

• Direct the person verbally when offering directions.

• Inform the person when new furniture and objects have been removed or added to an area that they have become familiar with.

Note that people with a visual impairment can hear and speak, so they appreciate being asked for their opinion on matters that affect them.

Communicating with people with a hearing impairment:

• Place yourself within their visual field so that they are aware of your presence.

• Use eye contact so that the person is aware that they are being engaged.

• Use a pen and paper to communicate, if needed.

Communicating with a person with speech impairment:

• Do not raise your voice or pitch. Remember that most people with speech impairment are able to hear clearly.

• Do not be shy to ask them to repeat should they not have made themselves understood. It may be disrespectful to the person if one pretends to have understood him/her.

Communicating with a person with cognitive impairment:

• Speak directly to the person and not to the person assisting him/her.

• Speak clearly and use short sentences.

• Repeat yourself if it seems that the person has not understood.

Communicating with a person with a physical disability;

• When speaking with a person using a wheelchair it is best to speak to the person at an eye level.

• Always ask if he/she would like to be helped so as not to show control over the person.

• Avoid leaning on the wheelchair. Note that the wheelchair often becomes one’s personal space.

(Byron Shire Council, 2006)

In conclusion, it is crucial to make different communication methods available to all. Communication therapists work towards improving on the individual’s expressive and receptive skills. Early intervention increases opportunities for acquiring such skills. By making use of all communication options available, and becoming aware of the most effective way of communicating with different individuals, we are creating a society that is free of communication barriers. Ideally, a society where everyone is free to express themselves and to make themselves understood by those around them.

Josnef Agius, B. Psy

Professional Support Worker,

Aġenzija Sapport

Natasha Coppini , B.Psy(Hons), PGDip.Behaviour Analysis

Professional Support Worker,

Aġenzija Sapport