Learning Disabilities: An Exploratory Study
Learning disabilities is caused by the way our brain develops. It appears they are triggered by a dysfunction of the central nervous system. For me having an insight into learning disability has provided me with awareness to the causes and the way care and treatment is provided. Markovna et al. 2004 define communication as a difficulty to receive, send and comprehend information as well as process verbal and non-verbal aspects. Communication is identified as one of the essential skills that students must acquire in order to make progress through their education and training to become qualified nurses (NMC, 2010). Communication can be defined as the process of transmitting information and common understanding from one person to another (Keyton, 2011).
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The biggest challenge I faced is communicating in a way clients understand and having the ability to alter the way I communicate when dealing with different illnesses. Communication with people with profound and multiple learning difficulties (PMLD) is vital as well as being aware of the different methods and being able to adjust to individuals needs. The ability to communicate effectively with those who may have different communication requirements enables affective delivery of care and minimizes any potential risks (Jackson et al. 2008). At the end of the day communication is a basic human right and is essential for therapeutic interventions.
I will use Kolb’s model of reflection as a framework to base my experience on. Kolb (1984) devised an experiential learning cycle. His model highlights the concept of experimental learning and looks at the transformation of information into knowledge. It focuses on analysing the understanding of a situation after it’s happened and then testing this knowledge on a new situation by recalling our observations and reflecting upon them.
The study of communication is important, because every activity involves some form of direct or indirect communication. Two common elements in every communication exchange are the sender and the receiver. A problem in any of the elements in the model can cause a disruption to the effectiveness of communication (Keyton, 2011). Nonverbal gestures, facial expressions, body position, and even clothing can transmit messages. Four types of barriers are process barriers, physical barriers, semantic barriers, and psychosocial barriers (Eisenberg, 2010).
Berlow (1960) devised a model of communication called the SMCR model (Source, message, channel and receiver). The main focus is on the relationship between the source and the receiver. One of the major flaws in Berlow’s model is that according to him both people need to same on the same level for effective communication to take place. However his model is seen
I observed that the challenging behavior that is demonstrated in these clients is a sign of not being able to understand what is going on and in those that struggle to communicate their feelings back. It is a demanding field that requires time and a lot of patience and a motivated interest in wanting to understand. I have had to be aware of my how my communication has been interpreted by those by using techniques that require them to confirm their understanding. This included using simple, short sentences and trying to avoid saying something that can be misunderstood. The most common methods I was exposed to on my experience were verbal communication, British Sign language (BSL), Makaton, the use of pictorials and words, making noises, slight aggression and most commonly the use of ‘touch’. I had the experience of learning basic sign language and was able to put this in to use with a member of staff who was deaf. As nurses we need to ensure that everyone’s way of communication is valued.
Facial expressions, body language and gestures are equally important as some clients were unable to understand speech therefore relied heavily on these methods. I was given the opportunity to see some of the communication aids that are available however there was not an opportunity to use them. It still provided me with a grounded knowledge of the resources that are available. A lack of effective communication leads to frustration. Frustration leads to withdrawal or anger and aggression expressed against self or others. This is seen as 'challenging behavior '.
Most of the clients I engaged with were diagnosed with downs syndrome and autism. Miller et al (1999) suggest that language and communication are key areas that affect the personal and social development of these conditions. I had a particular client who had both a physical and a learning disability. He had a condition called Fahr’s syndrome, which is a build up of calcium in the brain. His physical disability lead to him not being able to communicate and therefore has become mute. I had spent a lot of time in group based exercises where clients were all mixed together. It was an interesting experience to see how staffs deal with different learning disabilities and behaviors at one time. There were a few differences amongst the service users due to differences of behaviors and attitudes and disorders.
I also found that listening is the most important skill and often very challenging. Listening is an essential component of effective communication. Much of the communication that takes place between people is non-verbal and our faces and bodies are extremely communicative (Egan 2010). Being able to read non- verbal messages or body language is an important factor in establishing and maintaining relationships (Carton et al., 1999). Another common form of communicating with clients was with the use of touch, as a form of non-verbal communication. This yet again is an important component of therapeutic communication. Within learning disabilities, touch can be used as a means of reassurance (Gleeson and Higgins, 2009). As with all communication skills, touch needs to be used with care and respect.
In nursing touch may be one of the most important of all non-verbal behaviors (Nessbit et al 1982). I have come to observed that touch displays care especially when clients are unable to express their feelings in any other way.
Learning disabled clients are classed as vulnerable due to their lack of ability to understand the society. Healthcare professionals need to understand client’s needs and assist by using the right methods. I have understood that people with learning disabilities have the right to be treated the same as every other individual. The idea proposed by the Department of Health (DOH, 2001) that all current students should have an awareness into the field is essential as we will come across individuals with both learning and physical disabilities and will need to be aware of how to manage these challenging situations.
Communication is the process of transmitting information and common understanding from one person to another. The elements of the communication process are the sender, encoding the message, transmitting the message through a medium, receiving the message, decoding the message, feedback, and noise. A number of barriers retard effective communication. These can be divided into four categories: process barriers, physical barriers, semantic barriers, and psychosocial barriers.
Conclusion
Reflection helps focus on the client’s perspective, and as such encourage person-centered communication. The main principle in using reflective skills involves identifying the clients’ core message and offering it back to them in your own words. Communication is fundamental to nursing and can be used to provide advocacy and empowerment to the clients. Communication is an essential skill in order to build a rapport with clients.
References
Berlow (1960)
Department of Health (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century
Eisenberg, E.
M. (2010). Organizational communication: Balancing creativity and constraint. New York, NY: Saint Martin’s
Gleeson, M., Higgins, A., (2009) Touch in mental health nursing: An exploratory study of nurses’ views and perceptions, Journal of Psychiatric and Mental Health Nursing, p382-389.
Jackson, S, Read, J. (2008) 'Providing Appropriate Healthcare to People with Learning Disabilities ' British Journal of Nursing (Learning Disabilities Supplement), 17 (4), pp. 1-10.
Keyton, J. (2011). Communication and organizational culture: A key to understanding work experience. Thousand Oaks, CA: Sage
Kolb D. A. (1984) Experiential learning: Experience as the source of learning and development Englewood Cliffs: Prentice Hall
Markovna, Z., Tupper, D. (2004) Communication disorders and personality. Springer
Mencap (2008) ‘The arts and people with profound and multiple learning disabilities (PMLD)’ at www.mencap.org.uk/guides
Miller
Nessbit-Blondis, M., Jackson, B.E. (1982) Non-verbal communication with patients, Back to the human touch. Second edition. New York. John
Wiley
Nursing midwifery council (2001). Introduction to communication skills. Standards for pre-registration nursing education
The biggest challenge I faced is communicating in a way clients understand and having the ability to alter the way I communicate when dealing with different illnesses. Communication with people with profound and multiple learning difficulties (PMLD) is vital as well as being aware of the different methods and being able to adjust to individuals needs. The ability to communicate effectively with those who may have different communication requirements enables affective delivery of care and minimizes any potential risks (Jackson et al. 2008). At the end of the day communication is a basic human right and is essential for therapeutic interventions.
I will use Kolb’s model of reflection as a framework to base my experience on. Kolb (1984) devised an experiential learning cycle. His model highlights the concept of experimental learning and looks at the transformation of information into knowledge. It focuses on analysing the understanding of a situation after it’s happened and then testing this knowledge on a new situation by recalling our observations and reflecting upon them.
The study of communication is important, because every activity involves some form of direct or indirect communication. Two common elements in every communication exchange are the sender and the receiver. A problem in any of the elements in the model can cause a disruption to the effectiveness of communication (Keyton, 2011). Nonverbal gestures, facial expressions, body position, and even clothing can transmit messages. Four types of barriers are process barriers, physical barriers, semantic barriers, and psychosocial barriers (Eisenberg, 2010).
Berlow (1960) devised a model of communication called the SMCR model (Source, message, channel and receiver). The main focus is on the relationship between the source and the receiver. One of the major flaws in Berlow’s model is that according to him both people need to same on the same level for effective communication to take place. However his model is seen
I observed that the challenging behavior that is demonstrated in these clients is a sign of not being able to understand what is going on and in those that struggle to communicate their feelings back. It is a demanding field that requires time and a lot of patience and a motivated interest in wanting to understand. I have had to be aware of my how my communication has been interpreted by those by using techniques that require them to confirm their understanding. This included using simple, short sentences and trying to avoid saying something that can be misunderstood. The most common methods I was exposed to on my experience were verbal communication, British Sign language (BSL), Makaton, the use of pictorials and words, making noises, slight aggression and most commonly the use of ‘touch’. I had the experience of learning basic sign language and was able to put this in to use with a member of staff who was deaf. As nurses we need to ensure that everyone’s way of communication is valued.
Facial expressions, body language and gestures are equally important as some clients were unable to understand speech therefore relied heavily on these methods. I was given the opportunity to see some of the communication aids that are available however there was not an opportunity to use them. It still provided me with a grounded knowledge of the resources that are available. A lack of effective communication leads to frustration. Frustration leads to withdrawal or anger and aggression expressed against self or others. This is seen as 'challenging behavior '.
Most of the clients I engaged with were diagnosed with downs syndrome and autism. Miller et al (1999) suggest that language and communication are key areas that affect the personal and social development of these conditions. I had a particular client who had both a physical and a learning disability. He had a condition called Fahr’s syndrome, which is a build up of calcium in the brain. His physical disability lead to him not being able to communicate and therefore has become mute. I had spent a lot of time in group based exercises where clients were all mixed together. It was an interesting experience to see how staffs deal with different learning disabilities and behaviors at one time. There were a few differences amongst the service users due to differences of behaviors and attitudes and disorders.
I also found that listening is the most important skill and often very challenging. Listening is an essential component of effective communication. Much of the communication that takes place between people is non-verbal and our faces and bodies are extremely communicative (Egan 2010). Being able to read non- verbal messages or body language is an important factor in establishing and maintaining relationships (Carton et al., 1999). Another common form of communicating with clients was with the use of touch, as a form of non-verbal communication. This yet again is an important component of therapeutic communication. Within learning disabilities, touch can be used as a means of reassurance (Gleeson and Higgins, 2009). As with all communication skills, touch needs to be used with care and respect.
In nursing touch may be one of the most important of all non-verbal behaviors (Nessbit et al 1982). I have come to observed that touch displays care especially when clients are unable to express their feelings in any other way.
Learning disabled clients are classed as vulnerable due to their lack of ability to understand the society. Healthcare professionals need to understand client’s needs and assist by using the right methods. I have understood that people with learning disabilities have the right to be treated the same as every other individual. The idea proposed by the Department of Health (DOH, 2001) that all current students should have an awareness into the field is essential as we will come across individuals with both learning and physical disabilities and will need to be aware of how to manage these challenging situations.
Communication is the process of transmitting information and common understanding from one person to another. The elements of the communication process are the sender, encoding the message, transmitting the message through a medium, receiving the message, decoding the message, feedback, and noise. A number of barriers retard effective communication. These can be divided into four categories: process barriers, physical barriers, semantic barriers, and psychosocial barriers.
Conclusion
Reflection helps focus on the client’s perspective, and as such encourage person-centered communication. The main principle in using reflective skills involves identifying the clients’ core message and offering it back to them in your own words. Communication is fundamental to nursing and can be used to provide advocacy and empowerment to the clients. Communication is an essential skill in order to build a rapport with clients.
References
Berlow (1960)
Department of Health (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century
Eisenberg, E.
M. (2010). Organizational communication: Balancing creativity and constraint. New York, NY: Saint Martin’s
Gleeson, M., Higgins, A., (2009) Touch in mental health nursing: An exploratory study of nurses’ views and perceptions, Journal of Psychiatric and Mental Health Nursing, p382-389.
Jackson, S, Read, J. (2008) 'Providing Appropriate Healthcare to People with Learning Disabilities ' British Journal of Nursing (Learning Disabilities Supplement), 17 (4), pp. 1-10.
Keyton, J. (2011). Communication and organizational culture: A key to understanding work experience. Thousand Oaks, CA: Sage
Kolb D. A. (1984) Experiential learning: Experience as the source of learning and development Englewood Cliffs: Prentice Hall
Markovna, Z., Tupper, D. (2004) Communication disorders and personality. Springer
Mencap (2008) ‘The arts and people with profound and multiple learning disabilities (PMLD)’ at www.mencap.org.uk/guides
Miller
Nessbit-Blondis, M., Jackson, B.E. (1982) Non-verbal communication with patients, Back to the human touch. Second edition. New York. John
Wiley
Nursing midwifery council (2001). Introduction to communication skills. Standards for pre-registration nursing education