Unity/501/0598

Support individuals with sensory loss with communication
Unit code/601/5252

1/4/2012 Maxine Clough

1.1
Communication: The sending and receiving of messages between people. The message can be about information, ideas or feelings and can be by spoken or written word or gesture. Facial expression, tone of voice and body language are also important elements of communication.
Language: May be spoken, written or signed. Sounds or symbols are grouped together to form meaningful words. Symbols or words are grouped together to form meaningful phrases.

1.2
The cultural environment that people grow up in can have surprising effects on how they interpret the world around them. This became apparent during a Washington D.C. murder trial in 2002. A deaf man was convicted of stabbing to death two of his classmates at Gallaudet University. At his trial, the defendant said that he was told to do it by mysterious black-gloved hands. His delusions did not come in the form of spoken language. He was told to commit these brutal murders through sign language--his mode of communication. Another example is provided by Guugu Timithirr language speakers of the Cape York Peninsula in north eastern Australia. This group of Aborigines do not have words for left, right, front, or back. They use absolute rather than relative directions. When they refer to people or objects in their environment, they use compass directions. They would say "I am standing southwest of my sister" rather than "I am standing to the left of my sister." Critics of the Sapir-Whorf hypothesis would point out that the Aborigines who speak this language also usually learn English and can use left, right, front, and back just as we do. However, if they do not learn English during early childhood, they have difficulty in orienting themselves relatively and absolute orientation makes much more sense to them
1.3/5.1/5.2
Autistic Spectrum Disorders: Developmental disability affecting the way the person communicates with and relates to people around them. People with autism have difficulty relating to others in a meaningful way. Social interaction, social communication and imagination are impaired. Difficulties range from severe to mild. I presently support a gentleman who is Autistic I started working in Bradgate close in October 2010, at this time this gentleman displayed aggression towards some staff members he was destructive towards the property. In one month there were 16 incident reports. Staffs were reluctant to support him out in the community, due to his behaviours. These behaviours however were on occasions due to the approach and the communication towards him; for instance this gentleman as routines which he has to do he cannot be rushed.
The staff that worked in this house had worked in there for many years, and was initially managed by united response, in 2009 Northwest Community Services took the contract over and the staff came with the package. Unfortunately they were quite stuck in their ways. Everything seemed a challenge, personal care, was hit and miss. I was asked by higher management to formulate a morning routine and an evening routine. This I did. The reason I was asked was I had no problems in delivering his care. What you would normally do when you arrive at work; greet everyone asking how they have been etc... This Does not apply to this gentleman he does not like being approached, if you carry on about your business he comes to you this is then permission to interact with him. Communication is more than speech and writing. Most of us are unaware that we are communicating in many different ways even when we are not speaking. We are rarely taught about this mostly non-verbal form of communication in school even though it is very important for effective interaction with others. We informally learn how to use gestures, glances, slight changes in tone of voice, to alter or emphasise what we say and do, we learn these highly culture bound techniques over the years largely by observing others and imitating them. When I came into the house I made observation of how this gentleman reacted to others. If he was given two many choices he would respond with a no thank you; losing out all together. Sometimes individuals would say “come on we’re gong out put your pad and pen away”. He would decline the activity. Whereas I would get his coat and say would you like to put your coat on, he would do this I would then say would you like a bag for your pad and pen he would repeat me which would indicate yes. We would then go out. Now to date I am the only person that has taken him on a bus. The staff have all changed there is only one of the original staff left; I share my method of working, which this gentleman responds to having a positive outcome With this gentleman, however, the rest of the team still have problems with supporting him. I feel he hears what they say but he sees a conflicting communication, which leads to him declining...
2.1
Whether a sensory loss is acquired or congenital it impacts on the person. This discussion will look at the impact of Deaf/blindness. If an individual is born deaf Congenital Deafness - Adventitious / Acquired Blindness Individuals who are labelled congenitally deaf-adventitiously blind are those who are born hearing impaired or deaf and experience a severe vision loss or blindness later in life. The most common, and in fact, the leading cause of all deafblindness, is Usher Syndrome (National Retinitis Pigmentosa Foundation, Inc., 1991). The visual field loss resulting from RP is progressive. Degrees of vision and hearing loss, and the age of onset vary considerably among individuals and types of Usher syndrome. In fact many individuals are unaware of their visual loss until their late teens, 20s or even 30s. A young adult with Usher syndrome is typically educated in a residential school for people who are deaf or in classrooms for students who are deaf or have hearing impairments. British Sign Language (BSL) is typically the student’s primary language, and ties with the deaf community and immersion in deaf culture may be very strong. Young adults with congenital deafness and adventitious visual losses who are BSL users will typically need to make a gradual transition to tactual signing and other tactual, non-visual communication methods. These individuals have never heard sound, so learning has been geared around using other methods of communicating from the onset.
However, Acquired Deaf/blindness
Individuals labelled adventitiously deaf are those who experience sensory loss later in life, trauma, particularly brain injuries resulting from automobile and/or motorcycle accidents, are a disturbing and increasingly more common cause of adventitious sensory losses. Individuals who are adventitiously deaf are educated and typically have employment histories as “hearing individuals”. “The word ‘traumatic’ is too mild to describe the (adventitious) sensory loss of hearing. It is more than a sensory loss; the person’s self-image is shattered. This person now has two choices: survive with a shattered self-image or reconstruct a new self image”. These individuals, who are educated in a “hearing world”, use speech as an expressive form of communication. However, they will need to learn new communication skills systems rapidly. Psychological, social, vocational, living, and recreation aspirations will require rebuilding and new skills will need to be learned.

2.2
Communication impairment is a hidden disability which is isolating and distressing. Opportunities are reduced People often cannot explain the pain and frustration they feel. The loss of confidence and self-esteem can affect their personal and social relationships.

3.1/3.2
Picture book has been suggested for the gentleman whom I support. The way in which it is used is two show him two pictures, for instance, one of the horses, the other of the market and then he picks which activity he wishes to do. This on the face of it seems a very simple method of communicating your wishes however, with the gentleman in question it is not that easy, because he cannot make the relationship between those pictures and going out of the door to do those activities. If we were to use this method for him to select his meal he could be very disappointed when the food came because it would not look just like the picture and being has he does not have full capacity this may only agitate him. He has no concept of the days of the week. Yet some members of the team have asked him Thursday if he would like to go bowling on Sunday then wonder why he is not happy!
4.1
There are many new devices on the market that assist individuals with sensory loss, electronic devices that speak back to you, which would be good if you were blind, but not very useful if you were deaf, the most important point is to work closely with OT’s and assess the capabilities of the individual, what they would be able to understand and make themselves understood with. And try a range of communication aids; see which one works for the person. It maybe, that an individual may use a different method, in different situations.
4.2/4.3
Another gentleman who lives in the same house would not be able to use pictures to express himself he understands what you say, but is not able to speak clearly enough for others to understand. He does have a few makaton signs that he uses, but he is the relying on the staff member understanding them. I have done level one BSL to try and encourage him to sign, by speaking and signing together, but he shows no interest. I feel that he has no interest in communicating, he makes a certain noise when he is telling you that he is going to the toilet, and another when he wants a drink. He more than likely thinks we are daft. Because he understand perfectly well. We modify are language keeping it simple usually gets the best results and he is less frustrated by our inability to understand him.
6.2
In relation to my own work communication with the individuals I support is very important I need to know that I am meeting there needs and there wishes. Being able to communicate removes barriers the individuals that we support are happier therefore that makes me happier when everyone uses the same methods of communication offers continuity to the service users, when new members of staff join the team we ensure that they understand how to communicate with the service users. What approaches are best and what not to do that may upset the services users.