To communicate with a child who is multi-sensory impaired, you need to:
- know the child well - know how s/he communicates, know what s/he is interested in and may want to communicate about
- follow the key approaches in working with deafblind children - building trust, being consistent, helping understanding, taking time, following the child and being supportive.
- understand the factors affecting his or her communication at any given time. These will include general factors, and also some specific to communication:
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- what opportunities the child gets to communicate
- what responses s/he gets
- whether the most appropriate communication modes and/or aids are being used consistently and skilfully
Assessing communication
Many deafblind children communicate in idiosyncratic ways, and the signals they send may be hard for others to interpret. An observational assessment can help to identify how children are communicating and what they are communicating about. The earlier a child's communication development, the more necessary this is.
The choice of communication modes and aids needs to take account of both the child and the environment. A number of assessment schedules can be used to find specific information about children's communication. Speech therapists with experience in working with deafblind children, or your local teacher of children who are multi-sensory-impaired, will be able to help here.
Receptive and expressive communication
There are two sides to communication. Receptive communication is our understanding of other people's communication to us. Expressive communication is what we communicate to others.
Understanding comes before expression. A child will not be able to ask us for a drink, for example, unless s/he understands what a drink is, and that we can provide it. You need to make everything that happens to the child as understandable as possible. Using consistent routines will help a child to recognise activities. Using cues to signal what will happen next will help the child to anticipate. Cues may use any sensory channel available to the child - they may be objects, sounds, smells, places, movements and/or pictures. They may occur naturally (for example, the smell of cooking and the sound of the dinner trolley) or be deliberately introduced (for example, songs for particular activities).
Encouraging communication
Recent research has emphasised the importance of following a child's lead in communication, and of responding to any signals that they give. Approaches such as Intensive Interaction have this as their central principle. As a child's communication develops, more formal communication modes may be introduced. It is vital, however, to maintain a child's confidence that they can influence events. Giving them opportunities to use their current skills in a wide range of situations is at least as important as moving on to the next stage.
