Semester 1 Week 5

Question 1

what does PMLD stand for?

Answer 1

Profound and Multiple Learning Disability

Question 2

Is PMLD a clinical diagnosis?

Answer 2

no it’s more of a descriptive term

Question 3

characteristics of PMLD

Answer 3

no definitive set of characteristics for PMLD however often:
● More than one disability, with a profound learning disability as the most significant
● Significant difficulties communicating, requiring others who know them well to interpret their responses and intent
● Additional, complex needs,
● Coping behaviours which others may find challenging
● Pervasive and individuals require support all their lives
● Mental health difficulties

Question 4

why do people with PMLD often have unmet needs in regard to MH difficulties?

Answer 4

hard to identify anxiety, depression etc. if the person does not have a conceptual understanding of MH conditions and can’t communicate how they’re feeling

Question 5

what are people with PMLD at a higher risk of?

Answer 5

Morbidity
Mortality
Abuse (physical, sexual, neglect)
Mental health difficulties
Very poor quality of life

Question 6

2 stages of pre-verbal communication

Answer 6

pre-intentional communication
intentional communication

Question 6

4 stages of verbal communication

Answer 6

protowords
single words/developing vocab
word combinations
expansion of communicative functions

Question 7

what age is pre-intentional communication

Answer 7

0-6 months

Question 8

what is involved in pre-intentional communication

Answer 8

Initially reflexive: the internal state of the child affects his environment, and there is no intentional meaning.

Question 9

what age is intentional communication

Answer 9

6mnths - 1yr 3mnths

Question 10

what is intentional communication?

Answer 10

The infant has meaning he wants to convey.
The caregiver chooses what to respond to.

Question 11

what factors are important in infants developing from reflexive to intentional communication

Answer 11

1. Infant’s communicative intent
2. Caregiver(s) response to the infant
3. Interaction between the caregiver(s) and the infant

Question 12

what 4 signals are used by infants to intentionally communicate

Answer 12

gaze
smiling
crying
vocalisations

Question 13

how is gaze used in intentional communication

Answer 13

infant looks at the caregiver and the caregiver responds and encourages this

Question 14

what type of conversation does gazing develop

Answer 14

prototype conversation

Question 15

when does gazing develop into intentional communication?

Answer 15

2-4 months

Question 16

when does smiling develop into intentional communication?

Answer 16

6-7 weeks

Question 17

how is smiling used in intentional communication

Answer 17

Infant smiles in response to stimulation from his environment. Again the caregiver(s) respond and encourage this

Question 18

how is crying used in intentional communication

Answer 18

Crying indicates a physical need. Infant begins to realise that crying results in action, e.g. being fed, cuddled, attention, etc. initially reflexive

Question 19

when does crying develop into intentional communication?

Answer 19

2-4 months

Question 20

how is vocalisation used in intentional communication

Answer 20

babbling develops, caregiver responds to this

Question 21

when does vocalisation develop into intentional communication?

Answer 21

2-4 months

Question 22

what stages are of particular importance with PMLD

Answer 22

pre-verbal stage
early verbal stage

Question 23

when do difficulties become apparent with children with moderate learning disability

Answer 23

Children with MLD progress through the pre-verbal stage but difficulties become apparent in the verbal stages.

Question 24

when do difficulties become apparent with children with PMLD

Answer 24

Children with PMLD may never move on from the pre-verbal stage to the verbal stages at any point in their lives.

Question 25

3 stages of pre-intentional communication in PMLD

Answer 25

reflexive
reactive
proactive

Question 26

what is the reflexive stage?

Answer 26

The individual’s reflexive responses to own body and environment which familiar people interpret, e.g. different cries to indicate hunger, cold, pain.

Question 27

what is the reactive stage

Answer 27

The individual reacts to their own bodies and to their environment which others interpret, e.g. body stiffening is interpreted as dislike

Question 28

what is the proactive stage

Answer 28

The individual deliberately respond to objects and people, e.g. turning head is seen as ‘don’t want’

Question 29

why is communication important for people with PMLD

Answer 29

they are the most vulnerable people in our society.
communication reduces the risk of:
- lack of agency
- increased vulnerability to abuse
- MH difficulties
- over reliance on restrive behaviours and interventions by staff
- increased challenging behaviours
- staff over estimating person’s abilities

Question 30

what are the 5 good communication strategies recommended by the RCSLT

Answer 30

Standard 1:
There is a detailed description of how best to communicate with individuals.
Standard 2:

Services demonstrate how they support individuals with communication needs to be involved with decisions about their careand their services.

Standard 3:
Staff value and use competently the best approaches to communication with each individual they support.

Standard 4:
Services create opportunities, relationships and environments that make individuals want to communicate.

Standard 5:
Individuals are supported to understand and express their needs in relation to their health and wellbeing.