FACTORS INFLUENCING COMMUNICATION
المؤلف:
ALAN RANDLE
المصدر:
Caring for People with Learning Disabilities
الجزء والصفحة:
P29-C2
2025-10-06
401
FACTORS INFLUENCING COMMUNICATION
There is a multitude of factors that influence communication between practitioners and service users. This section will focus on some of these barriers. Adults who may exhibit behavior that could be described as challenging will provide the clinical example here, as many challenging behaviors can be seen as a method of communication, and attempts should be made to understand these very important messages. The labelling of someone with challenging behavior may induce fear and create a cyclical pattern of communication and contact being avoided with people who have idiosyncratic ways of communicating. The main factor that will be addressed is that of ‘attitude’ – not only the attitude of the service user, but more so the attitude of the practitioner. Attitude can be conveyed through tone of voice and touch.
The beginning outlined one of the basic models of communication, i.e. there is a sender who initiates communication, the message being sent and a receiver of the communicated message. There are many factors that can influence this process; some of them will be considered here. The list below illustrates some of the possible factors that can affect any communicative encounter:
• personality
• mental state
• culture
• levels – of communication and understanding
• environment/context
• power imbalance/dynamics
• gender
• language – difference and use, e.g. jargon
• previous knowledge/experience
• attitude
• intentionality/perception – meaning
• non-verbal communication.
The above list is by no means exhaustive and we have considered some of the areas in the preceding material. There is insufficient space to address all these important factors. However, during the following discussion, some of the factors will be combined, such as mental state and attitude. One very important aspect that needs to be taken seriously into account when considering these factors is that they do not only affect communication from the service user’s perspective, but they will also affect us and will influence how we communicate with people. The important component here is with regards to the encoded message produced by the sender and the decoding process required of the receiver of the message (Lerner 2003). For example, if service users were asked before an interview how they were feeling, they may give a brief social response and merely say ‘Fine, thanks’, using a rather sharp tone in their voices. However, you may observe that they were wringing their hands and pacing the floor (non-verbal cue), indicating that they were perhaps feeling a little nervous or anxious. Therefore, the encoded message of ‘Fine, thanks’ (verbal) would have been accompanied by the non-verbal cues and the underlying message might have been ‘I don’t feel like talking right now’. You may have picked up on all these cues that were implicit in the message and decoded the message appropriately and decided not to take the conversation any further. In this instance, their anxiety or mental state influenced the overall communication encounter.
However, communication does not always go so smoothly, particularly with adults with learning disabilities. McKenzie (2001) considered communication with adults with learning disabilities and compared their recognition of emotional states in themselves and in other people. Adults with learning disabilities may not recognize feelings or emotional states within themselves or others. ‘Worry’ is one of the most difficult feelings to recognize, as ‘worry’ could be taken to mean nervousness or anxiety, for example. Therefore, when people with learning disabilities feel anxious, they may exhibit challenging behavior or even some other emotional state. Stenfert-Kroese et al. (1997) discuss personal meaning and behavioral issues, and note that:
‘. . . professionals who work with people with learning disabilities sometimes describe the behaviors of their clients in a seemingly objective but meaningless way (e.g. attention seeking) rather than specifying the possible motivation or emotion driving that behavior (e.g. wanting to make more friends or feeling bored or lonely), thus ignoring the meaning of the behavior and labelling a person’s wish for human contact in a negative way.’
(Stenfert-Kroese et al. 1997, p. 3)
The skill that the practitioner requires is to consider what is going on for the service users and what is happening around them. This includes your influence and how you might be affecting the communicative encounter. McKen zie’s (2001) work also identified that photographs that included contextual information assisted adults with learning disabilities in choosing emotional states more correctly rather than pure line drawings. This therefore makes it important for us as practitioners to consider what is happening around a service user, rather than only taking into account what is immediately taking place, or the task (McKenzie 2001).
Challenging behaviors may take various forms and have a variety of meanings (Hodges 2003). In addition, the person may prevent the very thing that is wanted or wished for, i.e. communication. For example, some challenging behavior may push people away from them when what is longed for are understanding, contact and communication. Hodges (2003) provides us with some simple guidance when considering individual service users’ behaviors. She suggests that ‘Having behavior understood is essential for the mental health of the client’ (Hodges 2003, p. 96). She continues by outlining that practitioners may avoid interacting or engaging with individuals who exhibit challenging behavior due to the difficulties associated with not knowing what is being communicated and this may be awkward or uncomfortable for the practitioner. Hodges (2003) also acknowledges that this is often unintentional on the part of the staff. Therefore, the skill required here is to take the risk and try to understand what is being communicated, even if we find this difficult. Service users who are trying to communicate something by exhibiting challenging behavior may not respond in the way that would be considered as most appropriate when someone is trying to help and understand them. However, the effort that staff put into trying to understand these service users is likely to be well received on some level by them.
From a person-centered perspective, Pörtner (2001, p. 11) offers some guidance for us to consider here. She suggests that we do not always succeed in decoding service users’ ways of expressing themselves, but that we need to take it seriously and to hold on to the fact that the expression has meaning for the service users.
The issue of the care environment and challenging behavior has been acknowledged by Kevan (2003). This work highlights an essential factor when considering communication with adults with learning disabilities who can be described as challenging. Kevan (2003) draws our attention not only to the expressive communication of behavior, but more importantly to the receptive difficulties that adults with learning disabilities may encounter. Returning briefly to our basic model of communication, i.e. sender – message – receiver, the receptive aspect is linked with the receiving of the message. Therefore, service users may not have received the message you sent due to their inability to decode the message accurately because of their limited cognitive abilities. Therefore, it is important to know the abilities of service users in order to ensure that your communication matches their abilities. In addition, adults with learning disabilities may miss important information if there are other distractions surrounding them. Also, they may not be able to track a complicated conversation and process the information quickly enough to contribute at the most appropriate moment (Fraser 1997). Taking these factors into consideration may minimize the chances of an episode of challenging behavior’s taking place.
One particular area that may create a potential situation for challenging behavior to occur is the loss of an important relationship. Service users often have limited social contact with others and build friendships with care staff. The ending of a shift or, more importantly, when a member of staff leaves a care service means that it is vital to end and finish any relationships that have been established appropriately and sensitively (Mattison & Pistrang 2000).
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