Keys to Communicating With Someone Who Has a Brain Injury

Communication

By BIRF

Last Updated:

A traumatic brain injury causes damage to the brain in several ways: through the force of the impact, the swelling of the injured brain, and the collection of increased amounts of blood in confined spaces. The greater the interference with circulation of blood, the greater the brain damage. Depending on the extent and location of the brain injury, persons' responses vary. Impairment generally involves physical, psychological, and cognitive difficulties. It is a myth that a person with memory impairment lacks intelligence. A brain injury is often termed an invisible disability because there is no outward manifestation of injury.

Reduce noise and distractions that may impede the person's thought processes .
Allow the person to write information down and then sort it into a logical order due to sequencing difficulties.
Allow the person to tape the interview or take notes for better recall.
Be patient as the person may present information in a tangential or roundabout manner.
Be aware of conceptual or language difficulties, particularly those surrounding time or distances. Ask about what the person may have been doing before the incident occurred to gage time factors.
Make sure that you establish the time and place of further appointments and that the person writes this information down, because he or she may have initiation and recall difficulties.
Ensure that the person gets an opportunity to rehearse any court room procedures thoroughly.

Communicating with Someone who has a Hearing Impairment

A person's hearing loss may range from mild to profound. It may be congenital or acquired.

Secure a sign language interpreter.
Install a TTY/TDD telephone to make yourself more accessible outside of the initial interview.
Speak directly to the person with a hearing impairment and not the interpreter, who should sit next to you for ease of conversation; do not cover your mouth with your hand or chew gum while speaking.
Speak slowly and distinctly but naturally; if the person has difficulty comprehending, rephrase rather than repeat the question.
Avoid having bright light or glaring light behind you when addressing a speech reader, because the shadows render your lips invisible.
Reduce background noises and do not shout.
If you are having difficulties communicating, use notes.
Avoid the term "deaf and dumb": the ability to speak and/or communicate effectively is unrelated to an individual's ability to hear.
Make sure that interpreters or assistive listening devices are in place for this and future appointments.

Communicating with Someone who has a Visual Impairment

There are many different types of visual impairments, and only a small fraction of these individuals is totally blind; even if a person is determined as legally blind, forms and shapes may still be distinguished. A person who is visually impaired may need the assistance of a guide dog, a cane, a magnifying glass, or a sighted escort.

Interview the person with a visual impairment in familiar surroundings to reduce stress. If this is not possible, make sure that accommodations, such as transportation or escorts are in place to allow the person with a visual impairment access to the police station.
Ensure that the person receives Braille or large print copies or tapes of transcripts or statements well in advance to prepare for court room procedures.
Find out if the person has adaptive computer technology, such as a Braille computer display, speech synthesizer, or enlarged text software that enable them to read previous testimony for future courtroom proceedings.
Immediately indicate your presence, both verbally through speech and by approaching the person as he or she enters your office; do not stop speaking because he or she relies on the sound of your voice for direction.
Use a normal tone of voice when speaking; it is not necessary to speak louder.
Remember to introduce other people present for interviews.
Never speak to an assistant or escort rather than the person.
Never interact with a guide dog when it is working.
Offer your arm to guide the person who is unfamiliar with his or her surroundings; allow the person to hold your arm not vice versa.
Remember that a person with a visual impairment can describe an attacker in non-visual terms. Make note of pitch of voice, accent, smell on clothing, or hair texture.

Communicating with Someone who has a Mobility Impairment

Numerous conditions may result in mobility impairment. These include congenital or acquired injuries such as muscular dystrophy, spina bifida, spinal cord injury, amputation due to trauma or disease, and so on . . . There are generally two types of barriers that are particular (but not exclusive) to persons with mobility impairment: architectural and attitudinal. Examples of the former include stairways, doors that are too narrow to accommodate wheelchairs, sidewalk curbs, and an insufficient number of handicapped parking spaces. Attitudinal barriers are usually more subtle. Examples include (but are not limited to) reactions of disgust or pity, discomfort, all expressed verbally and nonverbally.

• Do not assume that a person with mobility impairment needs your assistance. Provide assistance only if you are asked. Of course, common courtesies like holding a door open for the person who exits behind you is perfectly acceptable.
• Be aware that a person's wheelchair is a part of his or her body space, so do not grab or push the wheelchair without permission, and do not stand too close to the wheelchair in case you block the movement of the chair.
• Do not talk down to or crouch awkwardly in front of the person who uses a wheelchair. This can be demeaning and make the person feel like he or she is not worth your time. Sit down and converse at eye level.
• Make sure that adequate transportation to and from the police department or courtroom is set up way in advance.
• Be patient and understand that persons with mobility impairment may need extra time or special equipment to converse or give statements.

Communicating with Someone who has a Speech Impairment

Do not assume that a person with a speech impairment is intellectually impaired; there is no inherent connection between the two.
Do not interrupt or try to finish off the sentence of a person who is speaking: be patient.
Do not shout or mouth your words at the person in a jesticulatory fashion.
Ask the person to repeat something you cannot understand; if difficulties in comprehension persist, try asking him or her to write the words down to ensue you do not miss valuable information.
Limited communication not only supports victimization, but also impedes effective disclosures. It is, therefore, extremely important to have someone accompany the person with limited communication to the interview. This family member or friend can then interpret idiosyncratic gestures or methods of communication.

Communicating with Someone who has a History of Mental Illness

Any person—with or without a disability—is likely to be in a state of anxiety or shock following an incident of crime. A person with a history of mental illness, such as schizophrenia or bipolar disorder, may present with an exacerbation of inappropriate/ unconventional behavior. It is important not to judge the individual but try to establish a sense of trust. The person will easily pick up on your anxiety so keep calm.

Make sure that a community advocate, relative, or someone that the person trusts are present for the interview.
Avoid noise, observers, and distractions that might increase the person's anxiety.
Be calm, patient, firm but reassuring.
Talk slowly and confidently. Avoid rapid, pressured speech or long sentences due to distractability.
Try to take statements when the person has had some time to recoup.
Do not deny a person's delusional or hallucinatory behavior; inform them that you understand his or her fear and want to help.
Persons who live on the street may not be able to recall the specifics of time, so do not assume that all information is as murky.

Communicating with Someone Who Has a Developmental Disability

Developmental disabilities (often termed intellectual disabilities) occur early in life and have a lifelong effect on development, adaptive behavior, and learning. They include Down's Syndrome, learning disabilities, and other neurological conditions. Historically, persons with developmental disabilities were institutionalized and isolated from their families and society. Fortunately, advocates have successfully deinstitutionalized these individuals into mainstream society. Many persons with developmental disabilities have been socialized to be compliant and have grown accustomed to satisfying the demands of authority figures. Some "victims may add details to the story to make it sound what the investigator wants to hear." Sorting out what actually happened in the incident and what is extraneous to the incident is a major investigative challenge and takes time and patience.

Understand that the terms developmental disability and intellectual disability are often interchangeable.
Make sure that someone the person knows and trusts is present.
Try to interview the person in familiar surroundings to reduce stress.
Be patient: give the person time to respond.
Avoid rapid or intense questioning and misleading statements.
Talk slowly and calmly in short, simple rather than complex sentences.
Use concise, concrete terms.
Work with the third party to interpret gestures or any idiosyncracies specific to that person.

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