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Alice
Frame, MA - Program Coordinator, Disability Health Unit - MDHHS
First responders may encounter individuals who are nonverbal
or have limited speech. Communicating with people one on one helps the
responder understand the situation and act accordingly. Understanding how to best solicit information from and assist non-verbal or limited speech individuals ensures this can still happen.
Verbal abilities fall on a spectrum – not all individuals
who are non-verbal are completely mute. Avoid making assumptions about why an
individual may be non-verbal – limited or no speech does not mean that a person
has limited cognitive abilities. There are many reasons a person could be
non-verbal:
- Developmental and/or intellectual disabilities –
certain types of intellectual and/or developmental disabilities can affect the
larynx, vocal cords, or other body part used in speech; intellectual
disabilities can also cause limited speech due to significant cognitive
limitations.
- Autism – nearly a third of all individual with
autism are either non-verbal or use very limited vocabulary.
- Brain injury – certain types of brain injury can
affect the physical process of making and projecting sounds
- Psychiatric disorder – individuals with
selective mutism, a type of anxiety disorder, have an inability to speak in
certain social settings or contexts. This can stem from existing psychiatric conditions
or can be caused by trauma.
- Deafness – to be clear, being deaf doesn’t cause
muteness. Some people with hearing limitations may choose to no speak because
they cannot gauge their volume or judge if their words are coming out
correctly. This is particularly common among people who have been deaf their
entire lives.
There are several ways the first responder can communicate with someone who is non-verbal. Each person is unique and may be able to communicate in one or more ways. Below is a list of some of the different methods to use.
- Ask yes or no questions – many people who are
non-verbal will still be able to nod or shake their heads. Asking yes or no
questions allows them to answer without needing any extra supplies or
equipment.
- Provide a pencil and paper – if open ended
questions are required and a person cannot vocalize the answers, he or she may be able
to write it down. This assumes that he or she can read and write in English and is
literate.
- Pictures and gestures – if a person has an
intellectual disability, limited use of their arms, or doesn’t speak English, he or she
may be able to point to pictures or use gestures to explain what happened.
- Assistive technology – some people who are
nonverbal use assistive technology to aid in communication. Assistive devices could be anything from
picture boards to phone apps and are things that the individual would likely
already have in their possession and know how to use.
There is no way of knowing a person’s level of
verbal ability going into a situation. Therefore, plan for all the above –
routinely carry paper and pencils and images of different types of emergency
situations. The more prepared a responder is, the less he or she will have to
scramble in the moment to find them.
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