Saturday, February 6, 2010

Who knows?

Lost wordsImage by kool_skatkat via Flickr
One of the things people always ask me when they learn that I work with people who don't use speech to communicate is this: "Yes, but, how much do they really understand?"

And I always respond in the same way: "Just because someone can tell me verbally that they understand what I'm saying doesn't mean that they do."

My policy (if in fact one can call it a "policy") has always been to treat people as if they're understanding me. I figure it's the most respectful approach. And I'd way rather err on the side of presuming competence than insult someone by assuming incompetence. 

Usually, for me anyway, the more salient issue is whether or not I understand what the people I call "my clients" are trying to say to me.

Last week, for instance, I could clearly see that B was trying to communicate something to me. He wasn't doing it in a particularly effective way, but he was clearly trying very hard and being quite patient. He'd stand up, repeating his action in almost exactly the same way each time, and then he'd pause, waiting for me to miraculously get it.  

I didn't. 

Well, really, I couldn't. He wasn't giving me enough information. 

It was obvious that B perceived my attempts to hear him, because when I said to him, "I'm not understanding you" he'd sigh, and he'd try again. 

I encouraged him: "Use the music to tell me." 

And he picked up and tossed the instruments on to the floor, retrieving them and throwing them again. Over and over.

After, I swear, ten or twelve times of making this effort with no hope of my figuring out what he was trying to say, we just sat there together. 


Neither one of us could fix this. 

So we sat. In silence. And we felt fully how frustrating it is to not understand. To not be understood. To not know. And to not be known. 

I wondered, as I sat with him, if what he really needed me to understand is that this is his experience of silence. 


Adelaide Dupont said...

Yes, because you can control and change your understanding to the situation.

A lot of bad things happen when you try to control someone else's understanding.

(I'm not saying orient or pay attention).

And the mutual thing is so important.

What about the other things we presume which are not so measurable as competence?

Roia said...

"What about the other things we presume which are not so measurable as competence?"

Well, first off, we're a presumptuous lot. Heck, I'm willing to bet the folks I'm a music therapist to have their own assumptions about who I am and how I'm going to behave as well.

Second, do you think competence is truly measurable? I'm not so sure I believe it is.

I've always liked the Martha Leary and Anne Donnellan assertion (from their book, "Movement Differences and Diversity in Autism/Mental Retardation: Appreciating and Accommodating People with Communication and Behavior Challenges", 1995, DRI Press):
"Our position is that it is not true and not helpful to believe that people are born with some quantity our western society calls intelligence that places maximum limits, or at least predictable constraints, on their ability to learn and do." (p. 31)

Thanks, Adelaide, for your, as always, thoughtful comments.

Nikki Belshe said...

This post was meaningful to me! Thank you!

Roia said...

Thanks for stopping by, Nikki! Glad it has meaning for you. It is all about meaning, isn't it?

Adelaide Dupont said...

No, I don't think competence is measurable.

It doesn't have an upper or a lower limit (a floor or a ceiling).

You can't tell how long or how high it might be.

It can be an intuition or an impression or a belief.

Roia said...

Quite agreed, Adelaide Dupont. Quite agreed.

Anonymous said...

I love this post too. I work with a lot of children (preK up to High school) who are nonverbal. The kids show you so many things without words. I see things in their eyes (eye gaze, eye contact), I see things in their body language, in their participation in sessions, in their reactions to songs they really like, etc. I find them so interesting! IT is a very challenging but very important thing I think we need to better teach at the university level of Music therapy-working with nonverbal clients who do not have a goal of verbal speech.
Roia, your posts are so insightful :)

Roia said...

And, again, I thank you for your kind words, Amanda. I absolutely agree with you that music therapists (among other professionals) need to learn how to work with people who don't use speech as their main communication mode. Frankly, if it's possible, it would probably be best taught by folks who don't, in fact, use speech to communicate. I know that's how I've learned. And, boy, even after 22 years, I've still got quite a ways to go! :-)