Interacting with a Person with Communication Difficulties

Many disabilities affect the way in which a person is able to speak. Common disabilities which affect speech include cerebral palsy, stroke, deafness and others. Traditional modes of communication may not be available when dealing with patients with these disabilities. The health care practitioner must be aware of and address these issues up front, so that he or she will be able to make the person feel comfortable to share information while avoiding moments of awkward silence, miscommunication of information and conveying an attitude of disrespect.

People who have a speech impairment may use a variety of ways to communicate.

  • The use of an augmentative communication device
  • The use of an interpreter
  • The use of "sign cards"
  • Using speech (which may at times be difficult to understand)
  • American Sign Language
  • The use of nonverbal communication

It is important for the health care professional to find out the person's preferred method of communication as early in the examination and use it throughout the visit.

  • When interacting with a person with a speech impairment, never assume that the individual has a cognitive disability just because he or she has trouble speaking.
  • Move away from a noisy source and try to find a quiet environment for communicating with the person.
  • If the person with a speech impairment has a companion or attendant, talk directly to the person. Do not ask the companion about the person.
  • Be considerate of the extra time it might take for a person with a disability to finish a sentence or complete a task. Let the person with the disability set the pace in walking or talking. When conversing with a person who has difficulty speaking, do not interrupt or finish sentences for that person.
  • If you do not understand what the person has said, do not pretend that you did. Ask the person to repeat it. Smiling and nodding when you have no idea what the person said is embarrassing to both parties. Instead, repeat what you have understood and allow the person to respond.
  • When you have difficulty conversing on the phone with the person, suggest the use of a speech-to-speech relay service so that a trained professional can help you communicate with the person. Either you or the person can initiate the call free of charge via the relay service.
  • If the person uses a communication device, make sure it is within his or her reach. If there are instructions visible for communicating with the person, take a moment to read them.
  • Do not make assumptions about what a person can or cannot do based on his or her disability. All people with disabilities are not alike and have a wide variety of skills and personalities.
  • Consider asking questions that require short answers or can be answered by nods of the head or gestures if that is the individual's most comfortable method of communication.
  • When speaking to a person with a hearing impairment who uses speech reading, be sure to stand in a well-lighted area (not backlit, and keep hands, other objects and food away from your mouth when speaking).

Compiled From:

University of Kentucky Engaging Differences Project, retrieved December 2002. http://www.uky.edu/TLC/grants/uk_ed/interactiontips6.html

American Federation of State, County and Municipal Employees, AFSCME, retrieved December 2002. http://www.afscme.org/publications/3118.cfm

For more information about interacting with a person with communication difficulties:

Community Resources for Independence: http://www.crinet.org/interact.php