Effective and accessible communication is considered by many as a human right. Organizations supporting this include: the American Speech, Language and Hearing Association; the International Society for Augmentative and Alternative Communication; and the North American Alliance for Communication Access. [1] [2]

As Care Managers and others who serve and support persons with disabilities strive to improve the health care and mental health care of those they serve, one consideration that may be overlooked in this effort is the communication and social-emotional needs of those with limited speaking ability, or more commonly referred to as “non-verbal.” I prefer the term “limited speaking ability” because language or verbal expression can include vocalizations, body language, gestures, signs, symbols, or other forms of Augmentative and Alternative Communication (AAC).

Consider the current ability of a person with limited or no speech to communicate their needs, feelings, location and level of physical pain or discomfort, or the fact that they’re struggling.

One solution is to employ the services of a Speech-Language Pathologist or a collegiate speech clinic that has faculty and graduate students who have experience with Augmentative and Alternative Communication and are able to do assessments and help people learn how to use, or increase their effectiveness in using, AAC. Also consider providing access to communication boards or devices when taking people to medical appointments. If a hospital stay is necessary, consider requesting the assistance of an on-staff Speech-Language Pathologist, just as one might request an interpreter for someone who uses American Sign Language or speaks a language other than English.

For mental health care, seek out counselors, psychologists or psychiatrists who have experience in communicating with and counseling people have limited speech or use AAC. This may prove to be quite challenging. If one cannot be found, search out a provider who is willing to consult with a Speech Language Pathologist who has experience in working with people with complex communication needs. Those who work daily with people who have limited speech provide an important service. They need to know how to be effective communication partners and understand the technological supports their clients utilize. To assist staff in learning how to be effective communication partners, agencies could provide person-specific training for their direct support professionals and other staff. Family members often can provide this training for those that work with their particular individual. But for those who don’t have family involved or perhaps have new guardians who have limited or no experience with how the person communicates, then the need is even greater to provide this support.

The consideration of communication needs, access to AAC and ongoing training for proficiency continues to be an important consideration for young adults as they transition out of school and to the next stage of life, whether it be work, day programs, or community integration – especially for those with the concurrent diagnosis of intellectual or developmental disability – as they face new challenges with new or reduced supports, along with the social-emotional changes that are a natural part of this season of life. Care Managers can work with the young adult, parents, and the circle of care team, including a Speech-Language Pathologist, to ensure that the communication needs of the young adult continue to be met in all aspects of life.

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[1]About the American Speech-Language-Hearing Association (ASHA), ASHA, accessed February 3, 2025, https://www.asha.org/about/

[2] ISAAC – Communication Access, International Society for Augmentative and Alternative Communication, accessed February 3, 2025, https://isaac-online.org/english/communication-access/

This article (without these images) first appeared in the April 2025 issue of EP Magazine, and can be accessed in the archive at https://epmagazine.com