Speaking and Being Heard
In the early days of my career, I apprenticed with a clinician who specialized in Augmentative and Alternative Communication (AAC). She was highly skilled and in tune with her clients, who used forms of AAC to communicate. One day, a young girl arrived for her therapy appointment. The girl wore ankle/foot orthotics on both legs and had a stilted gait. The therapy room had a charming child-sized table with matching small chairs.
While the clinician and the girl’s mother were involved in a conversation about the girl’s ongoing medical appointments, as well as the girl’s desire for more independence, the little girl made her way to the table and chairs. She appeared to hold on to the back of one of the chairs as a support. She attempted to sit down in the chair, but somehow inadvertently tipped the chair backwards and tumbled to the floor. Almost as if in slow motion, you could see a series of emotions cross her face, from surprise, fear, sadness, and frustration, to anger. She started to cry.
The clinician and the girl’s mother rushed to help her. The clinician switched the chair to an adaptive chair. Then, in an instant the clinician grabbed a single-switch voice output device and recorded the sentence, “I hate that chair!” She spoke the words loudly and emphatically. She placed the voice output device on the table and pressed the button. You could hear the words clearly and the emotional content of the message in the recording. The clinician offered the voice output device to the girl.
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The little girl pushed the button repeatedly. You could hear the message over and over, “I hate that chair! I hate that chair!” The little girl smiled and then started to laugh. The clinician partnered with the girl by smiling and commenting on the chair, “I hate that chair, too! It’s a silly chair.”
As a new clinician, I was in awe of this incredible moment exemplifying the power of providing an expressive modality to an individual. The child was suddenly able to communicate her thoughts. This episode formed the basis for a belief in the fundamental right of communication. As I’ve continued to work as a clinician, I’ve realized that this situation was also about the right to be heard.
As individuals, we often have strong emotions. We learn to find ways both to express these emotions, and to share them with an audience who understands us. As clinicians, we provide communicative intervention, and we may also be the audience. We can help a person feel “heard” and understood. Individuals with communication disorders may have many different challenges with sharing their thoughts and ideas. With every therapy session and every interaction, we have the opportunity to provide support with expressive output and also to validate the merits of each message. We provide legitimacy to every comment, from saying that you are angry at a chair, to deep and complex ideas. Communication is the expression and the audience – and we can provide both.