When Autism Speaks: Impaired Verbal Communication
Impaired verbal communication is classified as a decreased, reduced, delayed or absent ability to receive, process, transmit, and use a system of symbols (NIH). Verbal communication is conveyed through a vocalization system of sounds that forms into a language. The capacity to effectively learn how to communicate is not solely based on the words that are being formed, but the sending and receiving of the information. According to the Diagnostic and Statistical Manual of Mental Disorder (DSM-5), children with autism are considered to have a neurological and developmental disorder that begins during the early childhood and has the potential to last throughout a person’s life. Autism is a “spectrum” disorder that can affect an individual in many ways such as behavior, interactions with others, learning, and willingness to communicate (NIH). These symptoms could be related to sensory changes that involve the hearing or vision (Wayne, 2017). Several obstacles may arise when caring for an individual that may be autistic and have impaired verbal communication to express oneself. Often times misunderstandings are conceived. It is the duty of the nurse provide care for these individuals, to establish a care plan that has goals/outcomes, identify what can be assessed, how to intervene, and the capability to educate others on the appropriate way to provide care for these individuals.
What is Autism?
According to The Nurse Practitioner Journal, Autism Spectrum Disorder is considered a neurodevelopmental disorder that impairs social communication and social interactions (Weill, 2018). This disorder has no respective of person, however, it occurs more frequently in about one in 42 males and one in 189 females, no matter racial and ethnic group, and across all socioeconomic levels (Weill, 2018). About one in 68 children have ASD. Some of the most common signs and symptoms of ASD and impaired verbal communication are individuals become more focused on a certain object, rarely make eye contact, and fail to engage in typical babbling with their parents (NIH). Children may appear to develop “normally” until around the age of two or three at this point research have shown that there is a disconnect and children begin to withdraw and become socially isolated from groups (CDC). Therefore, when providing care for these individuals and their families, the nurse should find out the appropriate and effective ways to communicate. This will allow the nurse to formulate a plan on how to educate the individual and families about self-care or areas that may need strengthening as well as display the individual’s skills and needs. The environment around individuals with autism that are impaired verbal communicators may affect their willingness and desire to communication (Wayne, 2017). Nurses should be aware of the surroundings.
Goals and Outcomes for Individuals with Impaired Verbal Communication
Sensory deficit is a defining characteristic of an individual with autism that is also impaired verbally (NIH). As a nurse when caring for individuals with impaired verbal communication some common goals and outcomes should be as follows learn ways to decrease anxiety based on the environment around individual and families, be sure they are able to formulate a complete thought in a goal-directed manner, and provide effective opportunities for them to spend time with one or two other individuals while completing a structured activity (Wayne, 2017). This will strengthen the individuals with the understanding on how to provide self-care. However, in order to complete these goals for individuals that are autistic and have impaired verbal communication nurses have to be able to plan therapeutic nursing related interventions.
The nurse should show willingness to learn what the individual needs and pay close attention to any nonverbal cues that are displayed. Autism affects the skill to speak, therefore, the need to set objects within a person’ reach is necessary. Allow time for the individual to respond because remembering that communication is a challenge for these individuals is a plus. The inability to communicate can be frustrating, encourage the individuals when they have done well and acknowledge their frustration. Frustrations are not only formed for the individual with impaired verbal communication, but also for the individuals providing care.
According to Journal of Autism and Developmental Disorders, the development of expressive and receptive communication between a caregiver and a child begins in infancy. (Bottema-beutel, Yoder, Hochman, Watson, 2014). These manifestions persist into adolescence and adulthood (Vogan, Lake, Weiss, Robinson, Tint, 2014). This disorder is identified in “childhood”, but persist into adolescence and adulthood, according to Family Relations (Vogan, et al, 2014). The enormous amount of time and energy needed to attend to individuals with ASD that have impaired verbal communication generates high levels of caregiver role strain (Vogan, et al, 2014). Leading to frustrations and confusion for everyone involved in providing care. Finding time for “self” will help with challenges that may arise and provides a safe, inclusive environment for individuals with impaired verbal communication. The nurse should be sure to educate the families about ways to integrate family time and the willingness to set aside “special” time for each person.
Nurses should advocate for inclusion and suggest that individuals be placed in general education settings to reduce isolation (Camargo, Höher, Ganz, Hong, Davis, et al 2014). Find ways to make those with impaired verbal communication feel included in their care and experience. There are variety of ways to provide care for individuals with impaired verbal communications such as speaking with an occupational or speech therapist, knowing what to do about being burnout as a caregiver, and effective ways to communicate.
- Weill, V.A., Zavodny, S., Sounders, M. C. (2018). Autism spectrum disorder in primary care. The Nurse Practitioner, 43(2), 21-28. 10.1097/01.NPR.0000529670.62188.1a
- Bottema-beutel, Kristen; Yoder, Paul J; Hocman, Julia M; Watson, Linda R. (2014). The role of supported joint engagement and parent utterances in language and social communication development in children with autism. Journal of Autism and Developmental Disorders, 44(9), 2162-74. 10.1007/s10803-014-2092-z
- Vogan, V., Lake, J. K., Weiss, J.A., Robinson, S., Tint, A. et al. (2014). Factors associated with caregiver burden among parents of individuals with ASD: Differences across intellectual functioning. Family Relations, 63(4), 554-567. 10.1111/fare.12081
- Camargo, S. P., Höher, R.M., Ganz, J., Hong, E. R., Davis, H., et al. A review of behaviorally-based intervention Research to improve social interaction skills of children with asd in inclusive settings. Journal of Autism and Developmental Disorders, 44(9), 2096-116. 10.1007/s10803-014-2060-7
- CDC. Autism Spectrum Disorders- Signs & Symptoms (2019).
- Wayne, G. Impaired Verbal Communications: Nurselabs. (2017).
- U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. National Institutes of Health. NIH Publication. No. 19-MH-8084. (2018).
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