Ten top tips:
Checklist for meetings with a person who has communication support needs
This section has been reproduced from ‘Working with Child and Adolescent Mental Health, The Central Role of Language and Communication’ with the kind permission of Dr Susan McCool)
This checklist guides practitioners to think about ten different ways in which the communication support they offer could potentially be enhanced, in face-to-face contacts with children and young people. This could be daily interactions or specific meetings. Practitioners may wish to use the Summary Table at the end of this resource to self-evaluate current practice, identify development goals, and monitor progress.
1. Prepare:
Do I gather enough information about the person’s communication support needs in advance of the meeting and prepare accordingly?
2. Predictability through structure:
Does the person understand in advance the purpose of our meeting, its duration, and when any scheduled breaks will happen? Is there a clear plan for how events will unfold?
Do I ensure we stick to the plan wherever possible?
Do our meetings begin with a reminder of the plan?
Do I provide simple explanations for any deviations from the plan, and do I check that’s ok?
Do our meetings end with an accessible re-cap?
Are next steps always made clear?
3. Comfort:
Do I manage the environment to minimise the impact of sensory stressors such as noise, visual distraction, light, temperature, touch, and smell?
Do I ensure a private, comfortable space, if needed?
Do I schedule enough breaks – and does the person know when to expect them?
4. Social certainty:
Does the person understand the purpose of the meeting in advance?
Can the person bring a supporter if they wish? If so, is each person introduced?
Do I avoid assumptions by providing clear explanations about how the system works?
Do I explain what my role is?
Do I make sure that we agree expectations about each participant’s role and contribution to the meeting?
Do I set up a structure to make sure that we take care to avoid interruptions, and that one person speaks at a time before allowing someone else to speak?
5. Alert to fluctuating communication support needs:
Do I expect that most children and young people with mental health vulnerabilities will have communication support needs?
Am I aware that significant communication support needs can occur, on a transient basis, even in people who do not typically have such needs, especially at times of stress or ill-health?
Do I anticipate that communication support needs can vary significantly in response to physiological, situational, and psychological variables, especially stress-related factors?
Am I alert to the range of signs and signals that indicate additional support for communication may be needed?
Do I minimise distractions and make sure I have the person’s attention?
Do I use the person’s name often, and make sure I maintain their attention?
Do I respond flexibly to changing individual needs?
6. Simplify language and concepts:
Do I make sure that I use only clear, everyday words? Do I avoid jargon?
Do I avoid ambiguous language such as metaphor, inference, or irony?
Do I avoid sarcasm and other forms of linguistic humour, especially in moments of tension or stress?
Am I clear and direct in my communication, rather than falling back on ‘politeness conventions’ such as using euphemisms or relying on implication?
Do I avoid acronyms or explain them if they come up?
Do I avoid complex grammatical constructions? For example, saying the relatively simple ‘First we’ll look at your worry ladder then we’ll look at your emotions chart’ instead of saying ‘we’ll look at your emotions chart after we look at your worry ladder’.
Where possible, do I avoid conditional language? For example, utterances beginning with ‘assuming that…’ or ‘supposing that…’
Do I use active voice rather than passive voice? For example, saying ‘Joe, the dietician, wrote a report’ rather than ‘a report was written by Joe, the dietician’.
Do I repeat key points in different ways?
7. Bite-sized chunks of language:
Is my talk split up into small amounts that can be easily processed?
Do I emphasise key words?
Do I pause between each chunk of language?
8. Check communication is clear and effective:
Am I aware that many children and young people understand less than I may think?
Do I anticipate that the person is unlikely to clearly signal any breakdown in their understanding?
Am I aware that the person may even go to considerable lengths to mask their lack of understanding?
Do I therefore check that my communication is effective, in a meaningful way?
Specifically, do I avoid simply asking ‘do you understand?’
Do I use simple visual scales (e.g., emoticons expressing a range of certainty/confusion) to establish the person’s level of understanding?
Do I encourage the person to seek clarification? Do I help them to find verbal and/or other ways to do this? Do I provide prompts for them to do so?
Do I ask the person to summarise key points in their own words or pictures (explaining that this lets me know I’ve been clear)? For example, do I say ‘tell me what I said’ or ‘tell me what we’ve agreed to do’?
Do I ask what would make communication better, offering suggestions where appropriate?
9. Visual support alongside verbal communication:
Is verbally conveyed meaning made tangible for the person by using visual support?
Is the level of visual support flexibly adjusted according to the person’s preferences and fluctuating needs (e.g., written labels, gestures, pictures, drawings, photographs)?
Where appropriate, is there visual support for what will happen in the meeting (e.g., a visual schedule)?
Is there a visually supported record of what is discussed in the meeting (e.g., visually supported conversations)?
To aid recall, is the person provided with take-home records of visual support used or developed in the meeting (e.g., through photographs digitally captured and sent)?
10. Extra ways to get the message across:
Do I encourage the person to use means other than talking to help convey their thoughts, feelings, experiences, or preferences? For example, this may be through:
Creating and/or simply sharing photographs, drawings, cartoons, or music;
Sheets of emoticons or selections of feelings cards to support discussions of more abstract terms;
Likert scales, rating scales, ‘ladders’, ‘icebergs’, ‘pyramids’, ‘thermometers’, and ‘traffic light’ systems can be very useful to represent feelings and reactions, especially if their meaning is supported with pictures, symbols, and/or colour-coding;
Timelines and flowcharts can help represent sequences of events or show cause and effect;
Sorting symbols into categories can help (e.g., things I’m confident about/not confident about/not sure);
Having prompt cards available can make a difference in encouraging people to express that they don’t understand or that they need help. Examples include’/ I don’t understand’, ‘Say that again please’, and ‘What does that mean?’.
Communication support focus | Target for enhancement |
Preparation for meetings | |
Predictability through structure | |
Comfort | |
Social certainty | |
Alert to fluctuating communication support needs | |
Simplify language and concepts | |
Bite-sized chunks of language | |
Check communication is clear and effective | |
Visual support alongside verbal communication | |
Extra ways to get the message across |