Communicating with Individuals Who Are Non-Verbal in an Emergency

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Communicating with Individuals Who Are Non-Verbal in an Emergency

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.