Communication Disorders: An Introduction for Community-Based Rehabilitation Workers

1. Principles of Communication: Development or Disorder

1 Principles of Communication Development or Disorder Development or disorder What is communication? Communication is an exchange of feelings, knowledge and wants between two or more people. It may be either non-verbal or verbal and includes everything from the subtle comfort and exchange between a caregiver and a young child to the sophistication of a lecture delivered to a professional group. While many animals give evidence of some abilities to communicate, human beings are set apart from other species by the sophistication of their language system for communication. Language and communication are not the same thing. Language is an accrued system of words and rules that makes it the most organized and sophisticated form of communication. When does communication development begin? Communication development begins with birth. A baby communicates primarily by voicing or vocalizing accompanied by changes in facial expression and then some gestures, e.g., pointing and looking. The nonverbal sounds at the beginning of life are usually expressions of internal states such as hunger or discomfort that the baby is experiencing. However, these non-verbal sounds are interpreted by people around the baby as 6 Communication Disorders communicating emotions or wants. The early vocal patterns begin to develop the shape of the speech heard around the child during the first year, so the children begin to sound like their English or Chinese or Russian parents. These are referred to as prosodic patterns or intonation. Adults use these patterns to interpret the infant's emotions and needs. In early communication, concern or love is communicated in response by the mother holding, touching or stroking the baby. Often caregivers add words that have a common meanIng or order to them. Alternatively, the mother may make up sounds or hum or sing to quiet the child. Children learn about communication through these moments of comfort. How long does communication take to develop? Communication skills continue to develop throughout life. Although the most rapid development in communication and language is in the first few years of life, children and adults continue to add new words to their vocabulary, and develop a new range of social skills as they learn to interact and talk with diverse groups of people. In school they acquire the skills of reading and writing as educational demands increase. How do we know if communication is normal or abnormal? Some disorders of communication are easily recognized. If a child does not learn to talk, or an adult has a stroke and loses the power of speech, or we hear a deaf person speak and recognize that voice quality is not normal, the disorder is obvious. However, some communication disorders are more subtle. The first sign of a vocal problem may be just a rough sound to the voice as if the speaker has a cold. In the early stages of acquired deafness the speaker may not know how to modulate the voice and it may be either too loud or too soft, or some diffiCUlt-to-hear sounds will be omitted from words. There can be no hard and fast definitions. What is required in some cases is to make an assessment about the effect communication has upon the speaker's social, emotional or educational functions. A speaker with a very mild speech problem may feel unable to fully participate in classroom or job opportunities because of the reactions of other people. In writing this book we have attempted to concentrate on the more severe and obvious forms of communication disorder. These will usually provide the most pressing problems to medical practitioners. The principles we describe will often be readily applicable to people with milder communication problems. As you develop more skill in listening to patients' talk and in observing their patterns of communication, you will be able to recognize what they do well and what may be hindering good communication between them and other speakers. From your observations and a basic knowledge of communication, you should be able to make recommendations for planning and management. Principles of Communication Development or Disorder 7 Principles underlying intervention Listed below are some of the principles of communication and intervention which we believe should underlie all communication training. 1. Our ability to communicate makes us feel human. Inability to communicate cuts off individuals from social and educational opportunities and may well lead to emotional disturbances. Access to the opportunity for communication training is an inalienable right. Every attempt should...