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Whether you work with children or adults, in education or in another health or social care setting, total communication is a key component of any effective positive behaviour approach.
So what does that look like in practice? It means using a blend of language-based communication, non-verbal cues and symbol systems to enable individuals to express themselves: signs; pictures; photographs; posters; Makaton; lip reading; eye pointing; objects of reference; and clear, concise language, to name but a few.
When total communication is the bedrock of your organisation, you can more readily provide a safe, positive and inclusive environment for all. By using an appropriate range of strategies and methods, you can facilitate connection and ensure that all members of your community have a voice.
However, for individuals with English as a second or additional language, communication can sometimes be compromised (especially in relation to verbal, language-based exchanges), so it is essential that we explore ways to support these individuals, both on an everyday basis and, crucially, when they are in distress.
Barriers to communication
While many total communication strategies are helpful and appropriate for both English and non-English speakers, spoken language can often be problematic for speakers of other languages. If an individual is not fluent in English, they may struggle to articulate their thoughts, needs and feelings clearly (known as expressive communication). This can leave them feeling anxious and frustrated, and may result in behaviour if their needs are not met. They may also struggle to interpret what is being said to them (receptive communication), leading to deep-rooted feelings of disconnection and isolation.
This language barrier is compounded when an individual is in distress. When we are in a heightened state, our ability to interpret language and express ourselves verbally diminishes as the brain’s prefrontal cortex shuts down. Individuals with English as an additional language may then find themselves in a challenging situation where they do not understand verbal interactions and revert to their native language or behaviour of concern to try and express their needs. These blocked channels of communication can lead to escalation and the likelihood of an incident.
Whilst de-escalation is achievable in the short term, the long-term consequences of impaired communication, both expressive and receptive, can be severe and include social isolation, self-exclusion and feelings of disenfranchisement.
Facilitating effective communication
Many of the strategies listed below apply to all service users, whether English is their first language or not; however, you may need to tailor some of the methods when supporting those with English as an additional language.
1: Apply total communication strategies
When communicating verbally, it is important to use clear, concise language with simple, familiar vocabulary that is easily understood. Using fewer words and simple sentence structures can aid communication. In addition, try to avoid using slang or jargon that may cause confusion.
There may be incidences where spoken language is ineffective or inappropriate, and non-verbal cues and symbol systems are preferable. By their very nature, these remove the need to interpret spoken language and can reduce the pressure on communication. Just be aware of any cultural sensitivities when it comes to certain body language and signs or symbols; you may need to adapt these according to an individual’s background and heritage.
2: Show empathy and compassion
If you have ever tried learning a foreign language yourself, you will know just how frustrating it can be when you do not understand what is being said and cannot articulate what you want to say yourself. Any language barrier can feel incredibly limiting for individuals so it is essential to show empathy and compassion at all times. Put yourself in their shoes and try to see things from their perspective. Ask yourself, ‘What would I need if this were me?’ and ‘What are the specific barriers to communication that need to be addressed?’.
3: Be patient
Even when there is a level of comprehension between the native English speaker and non-English speaker, certain words carry different meanings in different languages, so we need to allow ample processing time to ensure that nothing gets lost in translation. This can be a real challenge when we are busy juggling multiple responsibilities and are under enormous time pressure, but a little bit of patience goes a long way and can be the difference between clear understanding and communication breakdown.
4: Involve the individual and their family
No matter what our setting, involving service users and their families in any decisions around care is key to providing the right kind of support. By forging strong relationships built on mutual trust and respect, we can gain valuable insights into what might work for an individual in everyday situations, but also when they are in distress.
Finding out more about our service users, actively seeking their feedback and building strategies around their profile can be an effective way of increasing agency and handing over control to individuals. Buy-in from their families can also be useful, but this will depend on the relationships between family members and may not always be appropriate. What is key here is engaging with the right family member at the right time.
5: Identifying translation and interpreting channels
Total immersion, or spending time surrounded by native speakers, can be an effective way to improve language proficiency. However, there will be times when translation by an expert is required. Having an interpreter (or, potentially, a bilingual family member) on hand can be a useful way to ensure that an individual is being clearly understood and has the opportunity to express their thoughts, feelings and needs; however, in reality, this is a resource that is often hard to come by.
Technology can fill the gap in human resource where translation is required and there are numerous apps and sites online that can help with this. A word of warning, however: such are the nuances of language and vocabulary that it is not always as simple as entering text and taking the response at face value, so depending solely on technology can leave staff and individuals exposed to miscommunication.
Universal language of care and support
As education professionals and health or care practitioners, our goal is to provide the best quality care and support to the individuals in our settings. The onus is on us to create positive, safe and inclusive environments where all can thrive, regardless of their communication needs.
High-quality care and support transcends language and by tweaking what we have in place for all service users and making sure staff are given the opportunity for ongoing training, development and reflection, we can ensure that everyone in our communities feels supported, valued and understood.