Semester 1 Week 5 - Learning Disability pt 2 Flashcards
what does PMLD stand for?
Profound and Multiple Learning Disability
Is PMLD a clinical diagnosis?
no it’s more of a descriptive term
characteristics of PMLD
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
why do people with PMLD often have unmet needs in regard to MH difficulties?
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
what are people with PMLD at a higher risk of?
Morbidity
Mortality
Abuse (physical, sexual, neglect)
Mental health difficulties
Very poor quality of life
2 stages of pre-verbal communication
pre-intentional communication
intentional communication
4 stages of verbal communication
protowords
single words/developing vocab
word combinations
expansion of communicative functions
what age is pre-intentional communication
0-6 months
what is involved in pre-intentional communication
Initially reflexive: the internal state of the child affects his environment, and there is no intentional meaning.
what age is intentional communication
6mnths - 1yr 3mnths
what is intentional communication?
The infant has meaning he wants to convey.
The caregiver chooses what to respond to.
what factors are important in infants developing from reflexive to intentional communication
- Infant’s communicative intent
- Caregiver(s) response to the infant
- Interaction between the caregiver(s) and the infant
what 4 signals are used by infants to intentionally communicate
gaze
smiling
crying
vocalisations
how is gaze used in intentional communication
infant looks at the caregiver and the caregiver responds and encourages this
what type of conversation does gazing develop
prototype conversation
when does gazing develop into intentional communication?
2-4 months
when does smiling develop into intentional communication?
6-7 weeks
how is smiling used in intentional communication
Infant smiles in response to stimulation from his environment. Again the caregiver(s) respond and encourage this
how is crying used in intentional communication
Crying indicates a physical need. Infant begins to realise that crying results in action, e.g. being fed, cuddled, attention, etc. initially reflexive
when does crying develop into intentional communication?
2-4 months
how is vocalisation used in intentional communication
babbling develops, caregiver responds to this
when does vocalisation develop into intentional communication?
2-4 months
what stages are of particular importance with PMLD
pre-verbal stage
early verbal stage
when do difficulties become apparent with children with moderate learning disability
Children with MLD progress through the pre-verbal stage but difficulties become apparent in the verbal stages.
when do difficulties become apparent with children with PMLD
Children with PMLD may never move on from the pre-verbal stage to the verbal stages at any point in their lives.
3 stages of pre-intentional communication in PMLD
reflexive
reactive
proactive
what is the reflexive stage?
The individual’s reflexive responses to own body and environment which familiar people interpret, e.g. different cries to indicate hunger, cold, pain.
what is the reactive stage
The individual reacts to their own bodies and to their environment which others interpret, e.g. body stiffening is interpreted as dislike
what is the proactive stage
The individual deliberately respond to objects and people, e.g. turning head is seen as ‘don’t want’
why is communication important for people with PMLD
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
what are the 5 good communication strategies recommended by the RCSLT
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.
