I watch as Joey studies his screen. He keeps selecting the same incorrect button, but after knowing Joey awhile, I know he’s doing this because he’s determined to somehow get to the correct word. When I watch his errors, I realize he’s often selecting the word directly under the word he is trying to select.
For me, as an adult, this would be ridiculously frustrating. For Joey, it’s just a part of expressing himself.
Every time I watch Joey struggle to select the right word, I’m doing a fast checklist of everything that could be interfering with his communication. Is he positioned right? Is his neck brace supporting him enough? Is the screen positioned correctly? Is it calibrated correctly? Is Joey keeping his eyes on the screen long enough, or does he move his head too quickly? And the truth is, I’m fully aware that these questions might not even be the right ones to ask.
For all of us, communication is about cognition (knowing what we are going to say), ideation (understanding that we can come up with our own ideas and communicate them with our world), and motor planning (the physical movements we need to make in order to speak or gesture.) And while motor planning is important for all of us – we have to physically be able to get our listener’s attention by using our body proximity and holding our heads up so our voice isn’t muffled – for Joey’s it is so much more than that.
Yet, we often forget about the motor planning that is incorporated with communication. For those of us who can type or speak with automatic motor movements, motor planning is barely a consideration as we advocate for our needs, share our ideas, and connect with our loved ones.
Communication for Joey, and other people with complex communication needs, involves so much more than simply the ideation and cognition aspect.
With a background in special education, teaching, and developmental learning, my physical therapy knowledge is weak. Watching Joey struggle to find the right word, over and over again, is a reminder of how important Joey’s whole team is. In order for him to communicate effectively, his body positioning, and motor planning are essential.
As Joey moves towards kindergarten, I’m looking forward to how the school team can help bring the physical therapy, occupational therapy, speech, and special education specialists together. With everyone working together to present a whole picture of Joey’s needs, I hope they will be better able to witness his strengths and everything he can do.
