Talk to Handicapped Children and Adults- They Won’t Bite
First of all, none of my hubs on Disabilities are about what the current, politically correct designation is for people with disabilities or handicaps. The designations “Children with Special Needs”, “Differently Abled”, and “Handi-capable” are preferred by some. The designation is not my point, and to share my point, readers must find me. I chose “handicapped” because people are searching for this term, but the returns in Google search are in the one to three million range, not 40 to 55 million range as for “special needs”. If I get lost in the returns and never get read, I have no point, right?
So on to my point, which is about communicating with handicapped children and adults. Having been assigned twice to Wilford Hall Medical Center, the U.S. Air Force’s largest hospital, and being a rehab therapist, I have encountered countless handicapped people. I’ve also witnessed thousands of interactions between handicapped individuals and the rest of us. It seems that many people are reluctant, or too uncomfortable to talk to handicapped people.
As an occupational therapist, I am quite comfortable talking to people with disabilities. I have been on many pediatric interdisciplinary teams, for clinics such as Spina Bifida, Spasticity and Premie Follow-up. Parents have occasionally commented, “We can always tell which of you are the therapists, because you always greet our child.” I guess the docs tend to come in and get straight to business, asking parents questions.
Of course, when I am walking down the halls of my facility, I don’t have a sign that says “OT- I’m one of the good guys”. I tend to make eye contact and greet someone in a wheelchair the same way I would anyone else I encounter in the halls. They however often seem oblivious. From my perspective, I think that handicapped adults are accustomed to being ignored, or carefully avoided.
People with Disabilities are Used to Being Ignored
When I was in OT school, we had to spend a half day in a wheelchair. This sort of project is common for occupational therapy students. We worked in pairs. Some of our classmates decided to just stay at school. My partner and I decided to go to a restaurant for lunch. I was in the chair. I went to the restroom, and there were other women in there. I was at the sink counter, and a woman came out of a stall. She saw me, immediately looked away, then turned around and left the restroom without washing her hands! It’s not like I was blocking the only sink. There was more than one sink in the restroom.
We also went to the Medical University Library. Just a routine “need to go to the library”, only difference being that it happened to be on our wheelchair day. The library is filled with medical, dental, nursing, pharmacy, PT, OT and other health care students. No one would make eye contact here either! It was surprising in the restaurant. It was shocking in an environment of future health care professionals! So this experience is my basis for saying that handicapped people are used to being ignored.
I encourage you to attempt to make eye contact, and greet people with disabilities when you encounter them. If you are meeting them, going different directions, this is nothing more than “Hello.” or “Good morning.” If they aren’t making eye contact as you approach, so what. Greet them anyway. It may give them encouragement that not everyone is a bozo, and that they are not totally invisible.
If you’re in a dentist waiting room, at the grocery store, or some other public place, you may strike up a pleasant conversation. Not that you will know what a person’s disability is, but if the person is alone without a caregiver, they are mentally capable to do so. If you encounter someone with a spinal cord injury for example, most likely nothing is wrong with their brain. They can carry on a normal conversation.
It’s Not About You- Try Not to be Anxious
When I was in my early 20s, one of my cousins who I will call Sonya, made a rare appearance at a family dinner, with her teenage daughter who I will call Penny. Penny had suffered a head injury in a car accident. I remember being anxious about talking to her. What if I can’t understand her? It will be awkward for me, and will likely make Penny feel bad. Ultimately I realized that she spoke slowly and with low volume, but otherwise her articulation and language skills were normal. This was a lesson for me later: Don’t make it about me. Don’t let my own anxiety get in the way of communicating with someone. I extended this to talking to people who spoke English as a second language too. Don’t psych yourself out, and assume that you won’t be able to understand.
During my first assignment to Wilford Hall 10 years ago, I got a referral on a woman my age, who had athetoid cerebral palsy. This is a relatively rare condition. It is common for those with athetoid CP to have severe impairment to motor function, almost always unable to walk, and often unable to coordinate speech. They also usually have normal or higher intelligence. My client, whom I’ll call Renata, could speak, but it would be considered by most to be very difficult to understand. Using my approach to set my own anxiety aside, I found that I had no difficulty whatsoever understanding her conversational speech. It was only when I had to ask about her medical history that her father had to answer and clarify.
When I was re-assigned to Wilford Hall 5 years ago, I ran into Renata at the mall. She had an augmentative communication device, but we didn’t need it. Because of her motor control difficulty, it is very slow using the device, and we didn’t need it because I could understand her. Only once or twice did I have to say, “I didn’t quite get that. Say it again.”
I encourage you to take a chance and start a conversation with a handicapped child or adult. You may find them to be no different than anyone else you might casually converse with in a dentist office, the mall, or other public place. If their speech or intellect is impaired, try to hear past your anxiousness. If you can’t understand them, maybe a caregiver will “translate”. If they do, then make your next comment back to the person, not the caregiver. If no one interprets for you, and you can’t understand the handicapped person, you could say, “I’m sorry I couldn’t understand you, but you have a good day. Good evening.”
Talk to the Age Level of the Person with Disabilities, No Baby Talk
There was another client who dropped by my clinic from time to time with her mother. I’ll call them Amelia and Cathy. Amelia was about 12 years old, and had spastic quadriplegic cerebral palsy. This means that she had brain damage that caused her muscle tone to be very tight in her arms and legs, and she could not walk.
Because the abnormalities in muscle tone are also present internally, she could not easily eat in a way that was energy efficient. Because of her brain damage, she also did not protect her airway for swallowing safely. Therefore she was fed through a feeding tube.
Amelia was not verbal, meaning she did not communicate with words, but she was vocal, and could laugh and make other noises. She had been assessed to be severely, profoundly mentally retarded. I asked Cathy what her personal assessment was for Amelia’s mental level. She stated she thought Amelia responded like a 9 to 12 month old.
Over the course of time, I had many visits from Amelia and Cathy. One day when Cathy and I were talking, Amelia laughed. Many handicapped children laugh randomly. It’s their way of being social, maybe saying ‘I enjoy your attention. Keep it coming.’ This was different though. In that moment, I knew Amelia was laughing appropriately at a funny remark I had made. And that it had happened before. Stunned and excited, I said to Cathy, “She laughed at my joke! She understood that humor!” Cathy agreed, and said, “Oh yeah, she does that all the time. She thinks Dad is a riot.” Still excited, I said “Cathy, that is not 9 to 12 month old sense of humor! That was a much higher level!”
I had already arranged for Amelia to have an augmentative communication evaluation. Fortunately military Tricare didn’t bat a lash at paying for the evaluation, and luckily we had a very experienced provider in San Antonio to see Amelia. I felt at the time that Amelia was very low functioning, and may not be able to communicate, even with the help of technology, but after all, that was not my specialty. I also felt that since she had never been evaluated for this before, she should be given the chance to see. Some devices are very simple, merely selecting between two choices, or indicating yes or no. Cathy said, “I know when she’s feeling bad. I just wish I knew what hurt.”
The therapist determined that Amelia would be able to use one of several devices. This was great news. The bad news was that Tricare would not pay for the device. Several years later, Amelia got her device. There is a very good benefits program in Texas, but unfortunately the waiting list is years. Once you’re in the program, it opens up a whole new world. Unfortunately, I never got to see Amelia use her device before I moved on to my next duty station. Cathy related that the therapist said Amelia had advanced beyond the level of her initial evaluation, and would need a more sophisticated augmentative communication device. In the therapy clinic she used a programmed device and had a “conversation” with the therapist. She was asked what she was doing after therapy, and she said “go to WalMart”. The therapist asked what she would do at WalMart, and Amelia responded “greet the people.”
So if you meet a child like Amelia, who cannot speak in words and sentences, in a wheelchair accompanied by a parent, obviously you wouldn’t try to talk to them about sports. And they may be mentally like a baby. But they may be mentally like a young child, or the tween of their chronological age. You could make polite conversation, like “How are you today? Are you enjoying the nice weather?”
Don’t Be Afraid-- Talk to Handicapped Children and Adults
So the next time you encounter a handicapped child or handicapped adult, try to treat them like you would treat anyone else. Don’t be patronizing. Don’t talk baby talk. Try not to be anxious. If you pass them in a hall, or on a sidewalk, attempt to make eye contact and just say “hello”. If you are both in the same public place, like waiting in the grocery line, or waiting in a waiting room, try to make normal conversation, like you would with any other person that age.
I dedicate this hub to the many handicapped and handicapable children and adults that I have known over the years. Also I honor Cari Jean and her beautiful daughter Faith.