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Developmental Disability Etiquette

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... Ask Caregiver for assistance with behavior ... strategies when working with individuals ... Clarify Restate * Sensitivity Recognize an individual ... – PowerPoint PPT presentation

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Title: Developmental Disability Etiquette


1
Developmental Disability Etiquette
  • Patti Higgins, RN
  • CCBDD
  • (216) 736-2686
  • higgins.patricia_at_cuyahogabdd.org

2
DISABILITY ETIQUETTE
  • Presentation Objectives
  • Identify the different modes of communication
    that individuals with DD utilize
  • Discuss general communication strategies when
    working with individuals with DD
  • Identify actions to take when individuals
    with DD have behavioral issues.

3
Communicating with Individuals with Developmental
Disabilities
  • MYTH 1
  • People with DD cannot
  • understand speech, let
  • alone medical
  • information

4
Premise 1
  • Many people with DD can effectively communicate
    their needs
  • People with DD have a wide variety of
    communication skills and abilities

5
Premise 1 (continued)
6
Premise 1
  • Individuals who are non-verbal can communicate
    with gestures and / or body language.

7
Premise 1 Medical Info
  • Many people with DD are very involved with their
    healthcare.
  • Healthcare providers may have to adapt their
    physical environment and interaction techniques.

8
MYTH 2
  • People with DD cannot make decisions

9
Premise 2
  • People with developmental disabilities
    participate in decision making in a variety of
    ways.

10
PREMISE 2 (contd)
  • Many individuals with DD are their own guardians
  • Many individuals with DD are capable of informed
    consent for medical procedures / treatment.

11
MYTH 3
  • People with DD are sick.
  • People with DD are dependent on others to meet
    many / all of their needs.

12
Premise 3
  • Many people with DD are not sick, incompetent,
    dependent, unintelligent or contagious. They are
    like the typical population, i.e. healthy,
    chronic medical conditions, mental health
    diagnoses and acute care issues
  • People with DD have masters degrees, work
    full-time, drive, own businesses, participate on
    committees, are married and have children.
  • They are individuals and you use the same
    assessment skills as with typical population.

13
Premise 3 (contd)
  • Triage
  • Communication issues
  • Baseline health
  • Mirrors other individuals that may be in
    shelters, with mental health issues, alzheimers,
    elderly, typical population.
  • Cooperative, communcative and compliant

14
MYTH 4
  • People with disabilities can
  • access health care easily.

15
Premise 4
  • Healthcare providers
  • may have to adapt
  • their physical
  • environment and
  • interaction techniques.

16
Premise 4
  • Talk to the person, rather than through their
    caregiver or sign language interpreter.
  • If the caregiver needs to be involved in their
    healthcare conversation, ask the individuals
    permission.
  • Listen patiently. Dont complete sentences for
    the person unless he/she looks to you for help.

17
Premise 4
  • Allow extra time for the visit and give specific
    directions.
  • Dont pretend you understand a person with a
    speech disability just to be polite.
  • Be prepared for various devices or techniques
    used to enhance or augment speech.

18
General Communication Strategies
  • N
  • O
  • U
  • S
  • S
  • R (adapted from
    Seigel-Causey and Guess, 1989)

19
Nurture
  • Develop a trusting and supportive environment
  • Show real interest in communicating
  • Act and speak naturally

20
Opportunity
  • Communicate about what is happening now
  • Provide choices

21
U
  • You always play a key role in assuring
    effective communication
  • Talk to the person
  • Ask permission to talk with whoever is assisting
    them
  • Listen
  • Clarify
  • Restate

22
Sensitivity
  • Recognize an individuals readiness to
    communicate
  • Respond at the persons level
  • Recognize the communication modes of the
    individual
  • Respond appropriately to all communicative
    attempts

23
Sender
  • Get the persons attention
  • Present info using persons receptive mode
  • Repeat the message once, then restate
  • Rephrase using different words or modes
  • Recognize all attempts to respond

24
Sender
  • Treat Adults as Adults
  • Do not shout at the person with DD

25
Receiver
  • Pay attention and be aware
  • Ask for clarification when needed
  • Be honest
  • Encourage individual to use many modes

26
Cognitive Disability
  • Use very clear, specific language
  • Be patient. Allow the person time to tell or
    show you what he or she wants.
  • Condense lengthy directions into steps
  • Use short, concise instructions
  • (Commission for
    People with Disabilities, November 2007)

27
Cognitive Disability
  • Present verbal information at a relatively slow
    pace, with appropriate pauses for processing time
    and with repetition if necessary, e.g. In five
    minutes, well be going to lunch.

28
Cognitive Disabilities
  • Reinforce information with pictures or other
    visual images
  • Use modeling, rehearsing and role playing
  • Use concrete rather than abstract language
  • Limit the use of sarcasm or subtle humor

29
Cognitive Disabilities
  • If you are not sure what to say or do, just ask
    the person what he/she needs.

30
Dealing with Behavioral Issues
  • Dual Diagnosis
  • Individuals who have
  • both a mental illness
  • and a developmental
  • or intellectual
  • disability.
  • Increase incidence of
  • mental health issues with
  • in people with DD may
  • be due to brain pathology.

31
Behavioral Issues
  • Unlike the general population, individuals with
    a dual diagnosis may be more likely to exhibit
    sign and symptoms of their disorders in the form
    of behavioral outbursts including verbal or
    physical aggression, self-injury, property
    destruction, impulsive behaviors and/or elopement
    .

  • (Family Crisis Handbook, Donna Icovino
    Lucille Esralew, Ph.D.

  • July, 2009)

32
Behavioral Issues
  • Not uncommon for people with Pervasive
    Developmental Disorder (PDD) or Autism to display
    aggressive
  • behavior.
  • May be a response to frustration, pain and
    limited communication skills.

33
Behavioral Issues
  • For individuals who are non-verbal, behaviors may
    be their way of expressing frustration and/ or
    pain.

34
How to Cope with Behaviors During a Disaster
  • Stay calm
  • Use verbal and non-verbal techniques including
    relaxed body position
  • Limiting space by directing the person to another
    room or area away from others
  • Soothing tone of voice
  • Avoid giving commands

35
How to Cope with Behaviors During a Disaster
  • Identify feelings (if able)
  • Ask Caregiver for assistance with behavior (may
    be aware of behavior plan to de-escalate
    aggressive behaviors)
  • Redirect to a different activity, preferably
    something soothing

36
Self-Injurious Behavior
  • For some individuals, i.e, people with autism and
    those who are non-verbal, aggression may be
    expressed by self-injurious behavior.
  • Head banging, hitting themselves, biting
    themselves.
  • Interventions are the same as previously
    discussed.

37
A FINAL WORD
  • People with DD are individuals with families,
    jobs, hobbies, likes and dislikes, problems and
    joys. While the disability is an integral part
    of who they are, it alone does not define them.
    Dont make them into disability heroes or
    victims.
  • Treat them as individuals.

38
RESOURCES
  • www.disabilityisnatural.com
  • Commission for People with Disabilities
  • (November, 2007)
  • The Ten Commandments of Communicating with People
    with Disabilities www.ucp.org
  • www.peoplefirstohio.org
  • Ohio Developmental Disabilities Council
  • Self Advocates Being Empowered
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