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Communicating with people with intellectual disabilities: a guide for general psychiatrists

  • Liz Boardman, Jane Bernal and Sheila Hollins

Summary

Good communication is central to psychiatric consultation. It informs assessment, diagnosis and treatment, and is an important part of empowering people to take more control of their own mental health. But active listening and personally tailored explanations may require additional skills and may need to be practised in the context of ethical and legal frameworks. In this article we consider the additional impairments that occur in people with intellectual disabilities who use psychiatric services and describe practical steps that can be taken by clinicians and service providers to overcome these impairments, to make reasonable adjustments and to ensure that patients obtain maximum benefit from services.

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Copyright

Corresponding author

Professor Sheila Hollins, Division of Population Health Sciences and Education, St George's, University of London, Cranmer Terrace, London SW17 ORE, UK. Email: hollinss@parliament.uk

Footnotes

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Declaration of Interest

S.H. is Executive Chair of Beyond Words. J.B. is a co-author of books in the Books Beyond Words series.

Footnotes

References

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ACE Centre (2010) What is a communication aid? ACE Centre.
Anderson, MD, Sherman, JA, Sheldon, JB et al (1997) Picture activity schedules and engagement of adults with mental retardation in a group home. Research in Developmental Disabilities, 18: 231–50.
Arlinger, S (2003) Negative consequences of uncorrected hearing loss: a review. International Journal of Audiology, 42 (suppl 2): S1720.
Barron, D, Winn, E (2009) Effective communication. In Intellectual Disability Psychiatry: A Practical Handbook (eds Hassiotis, A, Barron, DA, Hall, I) 319. John Wiley & Sons.
Bell, DM, Cameron, L (2008) From Dare I say … ? to I dare say: a case example illustrating the extension of the use of Talking Mats to people with learning disabilities who are able to speak well but unwilling to do so. British Journal of Learning Disabilities, 36: 122–7.
Bernal, J, Hollins, S (1995) Psychiatric illness and learning disability: a dual diagnosis. Advances in Psychiatric Treatment, 1: 138–45.
Blair, J, Glaysher, K, Cooper, S (2010) Passport to health. Learning Disability Today Jan: 2830 (available at http://www.intellectualdisability.info/how-to./). Accessed 21 Aug 2013.
Bradley, E, Hollins, S (2013) Books Beyond Words: Using Pictures to Communicate. Journal of Developmental Disabilities, 19: 2432.
Bradshaw, J (2001) Complexity of staff communication and reported level of understanding skills in adults with intellectual disability. Journal of Intellectual Disability Research, 45: 233–43.
Caldwell, P (2011) Intensive interaction: using body language to communicate. St George's, University of London (available at http://www.intellectualdisability.info/how-to../). Accessed 21 Aug 2013.
Caldwell, P (2012) Listening with All Our Senses. Pavilion.
Charlop-Christy, MH, Carpenter, M, Loc, L et al (2002) Using the Picture Exchange Communication System (PECS) with children with autism: assessment of PECS acquisition, speech, social–communicative behavior and problem behavior. Journal of Applied Behavior Analysis, 35: 213–31.
Clare, CH, Gudjonsson, GH (1993) Interrogative suggestibility, confabulation, and acquiescence in people with mild learning disabilities (mental handicap): implications for reliability during police interrogations. British Journal of Clinical Psychology, 32: 295301.
Cole, A, Gregory, M (2004) Green Light for Mental Health: A Service Improvement Toolkit. Foundation for People with Learning Disabilities.
Coupe O'Kane, J, Goldbart, J (1998) Communication before Speech. David Fulton Publishers.
Department for Constitutional Affairs, Department of Health, Welsh Assembly Government (2007) The Mental Capacity Act: Easy Read Summary. Department for Constitutional Affairs (http://www.dca.gov.uk/menincap/mca-act-easyread.pdf). Accessed 21 Aug 2013.
Department of Health (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century. Department of Health.
Department of Health (2010) Making Written Information Easier to Understand for People with Learning Disabilities: Guidance for People who Commission or Produce Easy Read Information – Revised Edition 2010. Department of Health.
Einfeld, SL, Ellis, L, Doran, CM et al (2010) Behaviour problems increase costs of care of children with intellectual disabilities. Journal of Mental Health Research in Intellectual Disabilities, 3: 202–9.
Elliott, K, Forshaw, N (2001) People with borderline-mild learning disability. In Communication and Mental Illness: Theoretical and Practical Approaches (eds France, J, Kramer, S) 236–50. Jessica Kingsley Publishers.
Emerson, E, Hatton, C, Felce, D (2001) Learning Disabilities: The Fundamental Facts. Foundation for People with Learning Disabilities.
Gerenser, J, Forman, B (2007) Speech and language deficits in children with developmental disabilities. In Handbook of Intellectual and Developmental Disabilities (eds Jacobson, JW, Mulick, JA, Rojahn, J) 563–79. Springer.
Grove, N, Walker, M (1990) The Makaton Vocabulary: using manual signs and graphic symbols to develop interpersonal communication. Augmentative and Alternative Communication, 6: 1528.
Hollins, S, Sinason, V (2000) Psychotherapy, learning disabilities and trauma: new perspectives. British Journal of Psychiatry, 176: 32–6.
Hollins, S, Sireling, L (2004) When Dad Died (3rd edn). Books Beyond Words.
Hollins, S (2010) Books Beyond Words: telling the whole story in pictures. (available at http://www.intellectualdisability.info/how-to../). Accessed 21 Aug 2013.
Hollins, S, Banks, R, Curran, J (2011) Ron's Feeling Blue (2nd edn). Books Beyond Words.
Hollins, S (2013) Using Books Beyond Words in Therapy and in the Clinic. Beyond Words.
Kernan, KT, Sabsay, S (1997) Communication in social interactions: aspects of an ethnography of communication of mildly mentally handicapped adults. In Language and Communication in People with Learning Disabilities (revised edn) (eds Beveridge, M, Conti-Ramsden, G, Leudar, I) 229–53. Routledge.
Michael, J (2008) Healthcare for All: Report of the Independent Inquiry into Access to Healthcare for People with Learning Disabilities. Department of Health.
Millar, S, Aitken, S (2009) Personal Communication Passports as a Way of Consulting and Representing Children with Communication Disabilities, to Ensure Consistent Care. Communication Aids for Language and Learning (CALL) Centre, University of Edinburgh (http://www.communicationpassports.org.uk/Common-Assets/spaw2/uploads/fles/intropassports.pdf). Accessed 21 Aug 2013.
Murphy, J, Cameron, L (2008) The effectiveness of Talking Mats® with people with intellectual disability. British Journal of Learning Disabilities 36: 232–41.
Nind, M (1996) Efficacy of intensive interaction: developing sociability and communication in people with severe and complex learning difficulties using an approach based on the caregiver–infant interaction. European Journal of Special Educational Needs 11: 4866.
Park, K (2003) A voice and a choice. Special Children Magazine 153: Feb/Mar.
Parkes, G, Mukherjee, R, Karagianni, E et al (2004) Characteristics and outcomes of referrals to a psychotherapy service for people with intellectual disabilities (ID) (Proceedings of the IASSID World Congress, 2004 (abstract)). Journal of Intellectual Disability Research 48: 311.
Paul, R, Hare, KP (2009) Assessing speech, language and communication in autism spectrum disorders. In Assessment of Autism Spectrum Disorders (eds Goldstein, S, Nagleri, JA, Ozonoff, S) 171208. Guilford Press.
Powell, G (1999) Current research findings to support the use of signs with adults and children who have intellectual and communication difficulties (available at http://www.makaton.org/Assets/researchPapers/powell1999.pdf). Accessed 21 Aug 2013.
Prosser, H, Moss, S, Costello, H et al (1998) Reliability and validity of the Mini PAS-ADD for assessing psychiatric disorders in adults with intellectual disability. Journal of Intellectual Disability Research 42: 264–72.
Raynor, D, Theo, K (2012) Health literacy: is it time to shift our focus from patient to provider? BMJ 344: e2188.
Reiss, S, Lewitan, DW, Szysko, J (1982) Emotional disturbance and mental retardation: diagnostic overshadowing. American Journal of Mental Deficiency 86: 567–74.
Shields, J, Hare, D (2001) Communication and mental health in people with autism and Asperger's syndrome. In Communication and Mental Illness (eds France, J, Kramer, S) 262–6. Jessica Kingsley Publishers.
Smiley, E, Cooper, SA, Finlayson, J et al (2007) Incidence and predictors of mental ill-health in adults with intellectual disabilities: prospective study. British Journal of Psychiatry 191: 313–9.
Sterkenburg, P, Schuengel, C, Janssen, C (2008) Developing a therapeutic relationship with a blind client with a severe intellectual disability and persistent challenging behaviour. Disability and Rehabilitation 30: 1318–27.
Stoner, JB, Beck, AR, Bock, SJ et al (2006) The effectiveness of the picture exchange communication system with nonspeaking adults. Remedial and Special Education 27: 154–65.
Tuffrey-Wijne, I (2012) How to Break Bad News to People with Intellectual Disabilities: A Guide for Carers and Professionals. Jessica Kingsley Publishers.
World Health Organization (2010) International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Version for 2010. WHO.

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Communicating with people with intellectual disabilities: a guide for general psychiatrists

  • Liz Boardman, Jane Bernal and Sheila Hollins
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