Music has had a marked impact on the life of many of my clients with learning disabilities. I particularly remember one lady, who was referred to me because, although she was forty- four, she had never spoken. However, staff in her residential home believed that Jean understood most of what was said to her. One of seven children, she was small and dark haired with pronounced scoliosis of the spine which affected her mobility. Jean lived in a residential care home with five other men and women of similar age and ability. Her favourite occupation was brushing the hair of a resident or member of staff, whether they liked it or not. Communication consisted of gestures and pointing to make her wishes known or if not understood, she would pull a member of staff towards the desired object . A wave of the hand meant she was either tired or going outside. Jean screamed and threw objects to gain attention or when frustrated. Somewhat disconcertingly, she had a permanent smile on her face which belied her mischievous intentions and confused those around her. There was little family contact, primarily because of their discomfort in not being able to make sense of Jean’s communication.
On my initial visit to see Jean, the radio in the kitchen was tuned into a popular station because overwraught staff had made the assumption that their preferred choice of music was also that of the residents. In the sitting room, the television was switched on, providing a constant drone of background voices, peppered with repetitive advertisements. At the time of my visit, there was only one CD player for communal use. The CD player was placed in the sitting room and because residents did not have their own personal CD players, there was little opportunity to discover musical preferences.
My experience as a foster mother of young children and also as a speech and language therapist in community and hospital clinics, had shown me that behaviour problems inhibit other aspects of development. I eventually left my profession in search of another, simpler way of working with adults and children with complex needs. Having studied the principles of healing and taught holistic therapies, my perception and approach has shifted radically.
Parents often cry out for help as they struggle to assert their authority, fearing that they may add to the difficulties that their child is already experiencing. I have endeavoured to reassure parents that this is usually not the case because once the child begins to control their behaviour within established parameters with the realisation that it’s their parents who are in charge not them, other problems often resolve amazingly quickly. This usually leads to a general improvement in all aspects of communication. + Read More
Angela was a tall frail looking woman in her forties with short dark hair and hunched shoulders. She spoke in a whisper and rarely made eye contact. Whenever Angela left the residential home in which she lived, she clung to her support worker, linking arms wherever they walked. She had been diagnosed with a genetic condition which affected her intellect and muscular coordination. Her hands would shake and she was often wobbly on her feet. Lacking confidence, Angela rarely spoke above a whisper and her care staff told me that they were concerned because she ate very little, becoming aggressive if requested to eat or to do anything she did not want to do. She was reluctant to talk to people and preferred to spend long periods in her room lying on her bed seemingly exhausted. Angela had had a boyfriend but he had tragically died of heart failure a year earlier, I was told that the subject was never mentioned by Angela or the care staff within the home because they were afraid of upsetting her. + Read More
Billy was thirty five years old when we met, he was grossly overweight and living in a residential care home with two other men with severe learning disabilities. His care staff said, ‘Billy doesn’t talk, he hasn’t said anything for years’ but when I questioned further, they said they thought he understood everything that was said to him.
When Billy was sixteen years old, a terrible thing happened which shook his family to its core. His elder sister was attacked and murdered when walking home after a night out with friends. The effect on Billy was catastrophic. Emotionally traumatised, he withdrew into himself. His parents were also grief stricken and unable to console him and give the comfort he needed. Medication had no effect on Billy’s mental state and a psychiatrist recommended ECT, electroconvulsive therapy. Billy’s parents told me that he had been afraid and had not wanted this option but they had been swayed by medical opinion and against their better judgement had allowed the treatment to go ahead. The consequences were devastating.
The series of electric shocks rendered Billy helpless and unable to function. He became totally passive, unable to feed or dress himself, emotionally and physically dependent and unable to communicate. In trying to deal with their own grief, his parents were unable to cope with the extra burden of looking after him. Devastated by the loss of not only their daughter but also their son, they reluctantly placed Billy in a community home for adults with learning disabilities. + Read More
Empowering the Client
Orthodox symptom focused therapy that endeavours to address impaired communication and social interaction, will not be effective in the long term, unless the feelings of the client and their support team are acknowledged, accepted and prioritised. Through my experience as a speech and language therapist and later as Principal of the Academy of Spiritual Sciences where I taught metaphysics and alternative therapeutic approaches, I discovered the importance of offering disadvantaged adults a plethora of healing choices. This offers them a different experience which impacts positively on every aspect of their life.
Memory and Perception
Imprinted memory from past experience is held within our cells and within the subtle energetic field (aura) which envelops and nourishes our physical body. Our memories are continually being triggered and reinforced by events and interactions in everyday life, which unknowingly ‘kick starts’ automatic behavioural response. Our view of the world is restricted by our beliefs, which are shaped by earlier experience, unrelated to our current circumstances. Our perception of the world may therefore be skewed. We all make choices which are dependent on what we perceive to be true. Therefore, in order to choose and respond differently, we must make a conscious effort to pause before responding, re evaluate our current circumstances and then respond in a totally different way. Easier said than done!
Caroline was a forty six year old woman, who was referred by her doctor because of learning difficulties and deafness. The doctor hoped that any attempt to improve Caroline’s pronunciation of speech sounds would improve her communication and quality of life.
Caroline had had a cleft palate repair as a child and lack of oxygen during the repair had left her with a marked speech impediment. To communicate Caroline used a combination of gesture, signing (Makaton – a language programme using signs and symbols) and speech. Her speech was muffled and unclear due to the excessive nasal resonance caused by the cleft in her palate, although her articulation of single words was clearer than connected speech (sentences). + Read More
Ten year old Henry, was referred to me by his paediatrician who was concerned about his deteriorating health. She wondered if Henry was still grieving for his grandmother, who had unexpectedly died twelve months earlier. Henry had had a close relationship with his Grandma and both he and his mother would have been traumatised by her sudden disappearance from their lives. I was told that Henry used a wheelchair because of poor mobility and coordination. His paediatrician believed that his understanding of speech was limited and informed me that Henry made sounds to communicate rather than words. He had a diagnosis of autistic spectrum disorder.
Henry must certainly have been struggling to make sense of his new living arrangements because I discovered that his family i.e. his mother, her partner and his maternal aunt, had all moved into his grandmother’s house after her death. It was therefore a house full of memories for them all. Henry’s mother was also having difficulty coming to terms with the loss of her own mother and family members were adjusting to living together for the first time in somewhat bizarre circumstances.
Norman, a forty eight year old man with learning disabilities, was also blind. He was small in stature and looked permanently worried. I was told that his vision had been severely impaired after he had sustained a detached retina in both eyes at the age of 43. Unfortunately, he had refused to stay in bed after the operation and as a result his vision had not returned. Norman had been incarcerated in a large asylum hospital from the age of six. He was eventually discharged from the hospital in the late 1980s. When we met he had moved to a small group home in the community with two other men, where he received 24 hour monitoring and assistance.
His care staff requested my help because they were concerned. Norman was becoming increasingly disinterested in walking and was in danger of losing his mobility. The staff team were also worried about Norman’s behaviour because although he enjoyed being outside on a summer’s day and would stand at the garden fence in the sunshine, his mood would change suddenly if he was disturbed . When this happened, he would lose his temper, kick over garden pots and pull up flowers. + Read More
Having worked for several years in a school for children who were severely physically and intellectually disabled, I came to the conclusion that children with communication impairment prefer to be involved with music, movement and play rather than those activities that have an expectation of interaction. However when there is a difficulty with communication, the ability to interact in play will also be restricted and these children will often prefer to isolate themselves from other children to create their own world.
Children who find it hard to express themselves through words and language remind us to be accurate, brief and clear in our communication. Our body language and tone of voice need to match what we are saying so that we don’t give a conflicting message. To avoid confusion and misunderstanding, it may help to offer multi sensory aids (music, objects, pictures, sounds, fragrances) to cue the child into the activity. Encouraging the child to listen, feel, see, touch or smell means that they don’t have to rely on only one channel of communication in order to understand the words being used, or the request being made.
When Paul was referred to me, I was in the midst of juggling my work as a speech and language therapist within the National Health Service with my Academy of Spiritual Sciences holistic therapy training. I had received an urgent telephone call from his sister, telling me that Paul had Down’s syndrome and had lived with his parents in a busy seaside town until tragically, after a short illness, his father and mother had died of heart attacks within months of each other. Following the intervention of social services, Paul had to move away from the only home he had known, to live with one of his older sisters. The sister with whom he was now living, was a single parent with a little boy of her own. Paul and his sister came from a large family, however all was not well because the brothers and sisters were not on speaking terms with each other. At a family meeting, the other siblings had been against Paul living with any other member of his family, although this particular sister had wanted to take responsibility and care for him.
When I met Paul, he had a very marked stammer (stutter) and his breathing was shallow and fast. He told me of ‘nice dreams’ when his Mum came to talk to him and asked him how he was. He said that he told her he was fine and said that his Mum told him that she was missing him a lot.
