On Talking to Severely Neurologically Handicapped Children
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On Talking to Severely Neurologically Handicapped Children

Volume 7, Number 1, January 1974, p. 14-16. Reprinted with permission.

Neurologically impaired children require consciously and thoughtfully tailored speech on the part of those conversing with them. Awareness of the need for “stripped down speech”, constant use of terms, allowance for time lag between reception and response, etc. can improve chances of success in communicating between the child and those dealing with him
 
In addressing severely handicapped, neurologically impaired children, we teachers may not be aware of using words and tones in which we have been addressed all our lives. We may not realize that there must be a more specialized manner of talking to these children because they are handicapped in ways that we are not. I would like to suggest here some specific ways to make communication easier, pleasanter, and more productive.

The first thing to remember is the importance of courtesy in all conversation; all people deserve respect and courtesy regardless of how handicapped or inefficient they may be. You’ve probably heard someone snarl, “Get over here!” and then you can almost hear the unuttered part: “You dope! You monster!” The tone of voice makes it as obvious as if it were spoken aloud. Nobody should be addressed like that; you wouldn’t want to be. Never use derogatory terms. If the child doesn’t understand exactly what you are saying, he can still understand an unfriendly tone of voice. It also makes an impression on other children who can understand, and indicates on your part a lack of compassion and understanding of a child and raises a question as to your suitability for your position as educator.

Be economical with your words. Don’t drown these children with talk. It’s not “Come and sit down over here near me, Ann dear,” it’s just “Sit down.” These children have difficulty in absorbing messages. The more concise we are the better. Maybe you can remember when you were first learning a foreign language. The only way you could understand was to latch on to certain key words the other person spoke. If you couldn’t pick out the clue words, you were lost. So, with these children, by dispensing with “Please,” “Thank you,” etc., you are not being impolite, rather you are saying politely, the bare bones of what you have to say.

Don’t preface a command with “would you like to?” Just give the command. Thus you eliminate the invitation for a negative answer or the possibility of no answer or response at all from a child who is unable to make a choice.

Allow always for a receptive lag. Remember that the child may not process what you say as rapidly as you speak, so you must pause and give him time to absorb what you are saying. Say what you have to say once. Wait about seven seconds. Then repeat the same words. The child may still be trying to process your first message and if you add a second one he will be confused. Maybe the first time he caught the first couple of words, and now he will latch on to the second couple of words. If he doesn’t get it by the time you count to seven after you have repeated the sentence, and if he is looking at you with all indications that he is trying to understand, then you help him to do whatever you’ve asked him to do and repeat the message again. What you are doing now is teaching him what you are saying.

As these severely neurologically impaired children develop they may be able to reach the point where you can add “please” and “thank you” or understanding sentences with qualifying clauses, etc. Then, of course, you expect to use and receive back words of courtesy and to have more complicated responses and more complicated communication.

Make sure that you have eye contact before you talk. It should be eye contact with you if it’s something you are saying to him, or eye contact with the particular object upon which he is supposed to be concentrating. If he’s not looking, you are not likely to get a relevant, meaningful response from him. Your eyes have to be on his eyes most of the time.
When you give directions, coach them in a positive fashion rather than in a negative. It’s much better to say, “Do this” than to say “Don’t do that.” When you say, “Don’t” you’re telling him what not to do, but you’re not giving him any alternative action to take. Tell him to “Sit down” rather than “Don’t run around.”

If ever there is an emergency, take for granted that these children are deaf, dumb and blind. You must act immediately; you don’t talk. If there is danger, grab the child as fast as you can. Never take for granted that these children will understand directions in an emergency; you have to take action for them. There are some impaired children who might respond to emergency orders, but in any emergency even those that we think can understand might panic, so you always act first. Talk later if you want or while you’re acting, but never assume that a child will respond to your speech alone if danger exists.

Always address the child in the same way. Don’t call him Jim one day, Jimmie another day, Honey another day, and James another day. He has to learn that one thing is his name and he has to identify with that name.

Be aware of the child’s best modality for receiving information. If a certain child understands better through his ears, talk to him if you want to teach him something. If he understands better through his eyes, show him. If he understands better through doing, put him through the movements. At other times you can work with him on improving the other modalities, but when your goal is to impart some kind of information, be sure you know which way is the easiest way for that child to absorb information, so that he is not using all his energy just trying to get the message, but can actually get the message and do something about it.

Keep your voice pleasant and firm. No need for roller coaster modulation, or shrieks of pure delight. With these children, “Good,” spoken in a quiet, warm tone is likely to stimulate the child to excitement.

Keep your volume low. With most children a quiet voice will evoke a quiet voice in return. Have you ever watched normal children outside? They yell at one another as they play together. It isn’t that they can’t hear, but one talks a little louder than the other and soon the whole conversation is held in yells. It is the same with these children. A loud tone of voice from you will get a loud tone of voice back, but that does not make for better communication. Sometimes, when you have to reprimand a child, doing it in a very quite voice, almost a whisper, but eyeball to eyeball, is a lot more effective than yelling at him. I think you can just as effectively show displeasure or just as effectively be stern by being quiet. Then, at least there is only one person out of control – the child – not two people, you and the child.

Finally, don’t speak fast to the child. If you want him to do something and you want him to do it fast, it is not going to make him do it faster if you say it faster. One way you can try to increase a child’s reaction speed is to say slowly, “When I say ‘Go’ you ______(insert whatever activity you are requesting). Ready? Go!” Say “Go!” very sharply. The startle effect can sometimes cause the child to jump into action. Repeat this routine, if necessary, until the child understands the word “Go” is the general trigger word for all action. “Now” can sometimes be a substitute for “Go.”

To conclude, remember that no matter what these children do that is irritating, that is foolish, they can’t help being what they are. Surely they would like very much not to be what they are if they could think about it at all. If you find your compassion wearing thin sometimes, ask yourself, “How would I like to wake up tomorrow and be this child, with all his problems, for the rest of my life?” Your own response to that crushing question should restore the fund of good will and respect for handicapped children that drew you to this kind of work in the first place. – Benhaven, 9 St. Ronan Terrace, New Haven, Conn. 06511
 

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