My mother-in-law recently moved into a long-term care home in our neighbourhood, so I am able to walk over to see her. Her present health on account of aging has made it difficult for her to remember names and events well. When we talk together, there are times when she has difficulty recalling. Yet when I pull up pictures to remind her, she shares specific details and suddenly a whole story spills out.
When my daughters Emily and Sophia were young, they would create all kinds of pictures to explain their stories, and many of their first words were initiated with common sign language. Now as a mom of two non-speaking daughters, Rachel and Janneke, I have learned so much about communication and the power of the visual.
Working with choice
A number of years ago, we introduced some pictures with Rachel, as a way to communicate choice. We used simple infographics, presenting two options as a choice. For example, we used a red stop sign for no and a green circle for yes. Facing Rachel, with one graphic in each hand and held at least a shoulder’s width apart, we tried to develop a routine with her eye gaze on the graphic to indicate yes or no.
This worked well enough with her peers supporting her at school, but when our world was turned with the COVID-19 pandemic, we paused the work with infographics. At home, we relied solely on her eye gaze with objects and spaces that were in the room with her. For example, after an activity such as a walk outside, I would ask her if she wanted to watch a show on the T.V. or rest in bed. Due to the proximity of the choices, she was able to show me her choice by looking to the left at her bed or her right at the T.V. Though this was working, we knew this wasn’t sustainable long-term.
When Rachel started high school in September, we began working with an augmentative communication team from the local children’s treatment centre. Together, we discussed common choices Rachel has each day, both at home and at school. I talked about how we take walks at home and sit in the butterfly garden. School staff created their list of common choices for Rachel.
As a result, a book was created with familiar infographics that now travels between home and school each day. The back of the book is covered in a soft material similar to felt. Each graphic is laminated and has velcro on the back. This allows anyone to attach the graphic to the back of her communication book. Our first step is to create a connection between the infographics and what they represent. For example, before working on choices, we are establishing what the infographics “get out of chair” and “listen to book” look like (see photo). So far, we sense Rachel is paying attention. Time will tell us more.
Creating connection through communication is a beautiful thing. The beauty is found in the unique and different ways we share our stories and our preferences. This beauty requires patience in waiting for responses – and, at times, for our memory to recall, but the connection is worth the wait.
Janneke has yet to show consistency in her indication of choices while seated in her wheelchair. Yet when she is in her walker at school, she is determined to make her way to either the gym or the outdoors. We hope one day we will learn her language!