Communicating with Nonverbal Clients
I (Molly) recently had the amazing opportunity to attend the American Music Therapy Association’s national conference in Minneapolis, Minnesota. The conference is an opportunity to meet other professionals, share ideas, and learn from cutting-edge research. Today I’d like to share a few things I learned from Peggy A. Farlow’s presentation on strategies to communicate with nonverbal clients.
It can take considerably more time and effort to communicate with nonverbal individuals, but it is essential to provide opportunities for self-expression. When clients are unable to express their needs, desires, and preferences to those around them, maladaptive behaviors tend to increase in frequency and severity. Whatever signals your nonverbal client uses to communicate, make sure to verbally state what you see to make sure you understood the client’s meaning. If a signal is unclear, ask for clarification by saying something like, “Did you mean yes?” If the client gives several unclear signals, they may want to ask or answer a different question. It’s okay to ask, “Is there something else you’d like to talk about?”
The most common communication system for nonverbal clients is direct selection, which allows the client to communicate by pointing to a picture on a language board. In order to use direct selection, clients need to have selective attention to visual stimuli and motor ability to indicate a choice. If the client is not able to isolate one finger to point to a symbol on a language board, they can indicate their choice with a stylus, head movement, eye gaze, or even a laser pointer!
Direct selection can also work with more advanced language boards. For example, clients who spell can use an alphabet board like the one pictured above to spell out questions and answers. The therapist should verbally state each letter to make sure they understood the client’s signal.
Indirect selection works well for clients with very limited motor ability. The client communicates by giving a yes signal when the therapist points to the desired picture on the language board. Usually, the therapist will point to each row of the language board until the client gives a yes signal. Then the therapist will point to each column until the client gives the yes signal. In this way, the client can communicate without pointing to the language board.
My favorite part of Farlow’s presentation was learning about the ETRAN system, which stands for eye transfer. The therapist holds up a transparent language board, and the client uses eye gaze and/or head movements to select a symbol on the board. High-tech ETRAN systems use a large, plexiglass board, but you can make a low-budget version with sheet protectors!
You can find the slides for Farlow’s entire presentation here. I hope you’re as inspired as I was!
-Molly, Music Therapy Intern
