Unformatted Attachment Preview
Use your own words and try to summarize the text using easy words and the text should not have the
same words and then use other simple words with the same meaning
One-to-one communication
When you start a conversation with someone you
don’t know well, you should always try to create the
right kind of feeling. It is important to create a positive
emotional atmosphere before you go on to discuss
complicated issues or give people information. The
other person needs to feel relaxed and happy to talk to
you. Very often people will start with a greeting such as
‘Good morning’. You can help other people to relax by
showing that you are friendly and relaxed.
Informal communication
We often use informal communication when we know
people well – for example, with friends and family.
Some friends or family members may use terms that
other people would not understand. Local groups
from particular places might also have their own ways
of speaking. For example, some people in southern
England might say things like ‘Hiya, mate. How’s it
goin’?’ If you belong to this group, you will appreciate
this as a warm, friendly greeting. But different groups
of people use different informal language so it can
sometimes be hard to understand the informal
communication of people from different social groups.
Formal communication
Health and social care work often involves formal
communication. For example, if you went to a local
authority social services reception desk you might
expect to be greeted with the phrase ‘Good morning.
How can I help you?’ This formal communication
is understood by a wide range of people. Formal
communication also shows respect for others.
The degree of formality or informality is called the
language ‘register’.
Imagine going to the reception desk and being
greeted with the phrase ‘What you after then?’ Some
people might actually prefer such an informal greeting.
It might put them at ease, making them feel that the
other person is like them. But in many situations, such
informal language could make people feel that they
are not being respected. Being ‘after something’ could
be a ‘put down’; you might assume that you are being
seen as a scrounger. So it is often risky to use informal
language unless you are sure that other people expect
you to do so. If you are treated informally, you may
interpret this as not being treated seriously, or ‘not
being respected’.
So is there a correct way to speak to people when
you fi rst introduce yourself? After all, if you are too
formal you may come across as pretentious or ‘posh’.
Usually care workers will adjust the way they speak in
order to communicate respect for different ‘speech
communities’.
Communication between colleagues
Family and friends know you well and will usually
understand you, even if you communicate poorly or
very informally. Communicating with people at work is
different because:
• It is important that care workers communicate
respect for each other. Colleagues who do not show
respect for each other may fail to show respect to
the people who use care services.
•You may often have to greet colleagues by asking
if they are well and spend time on ‘warm-up talk’ in
order to show that you value them.
• You will need to demonstrate that you are a good
listener and can remember details of conversations
with your colleagues.
• Colleagues have to develop trust in each other. It
is important to demonstrate that you respect the
confi dentiality of conversation with colleagues.
• Work settings may have their own social
expectations about the correct way to communicate
thoughts and feelings. These may differ from social
expectations when communicating with your friends
and family.
Although communication between colleagues may
often be informal it is important that care workers use
skilled communication in order to develop respect and
trust
Communication with professionals
When people who use services communicate with
professionals there is always a risk of misunderstanding
between people from different language communities.
It is important that people check that they are being
understood correctly. Professional health and social
care staff need to check their understanding of issues
with people who are communicating with them.
Multi-agency working
Health and social care professionals often have to
communicate with colleagues who work for different
organisations. For example, a home care organiser
might have to communicate not only with people who
use services and care workers but also with community
nurses, GPs’ surgeries, hospital services, occupational
therapists, voluntary groups, day care groups and
many other organisations. It is important not to assume
that people from different agencies will understand the same terminology. Formal communication may
help to convey respect and avoid misunderstandings
when interacting with unfamiliar professionals in other
agencies.
Communication between professional people and people using services
Professional people, such as doctors and nurses, often
work within their own specialised language community.
A language community is a community of people that
has developed its own special words, phrases, social
expectations and ways of interacting that set it apart
from other groups of people. Professionals are usually
well aware of the need to translate technical language
into everyday language when they work with people
from other professions or people who use services.
It is important that professionals check that they are
not being misunderstood (see section 2 on the role of
feedback).
Multi-professional working
Professionals from different backgrounds often have
to work together in order to assess and meet the
needs of people who use services. Multi-professional
working happens when many different professionals
work together. Communication will often need to be
formal and carefully planned in order to avoid barriers
to understanding.
Speech
Different localities, ethnic groups, professions and work
cultures all have their own special words, phrases and
speech patterns. These localities and groups may be
referred to as different speech communities. Some
people may feel threatened or excluded by the kind of
language they encounter in these speech communities.
However, just using formal language will not solve
this problem. The technical terminology used by care
workers (often called jargon) can also create barriers for
people who are not a part of that ‘speech community’.
When people from different geographical areas use
different words and pronounce words differently they
are often using a different dialect. Some social groups
use slang – non-standard words that are understood
by other members of a speech community but which
cannot usually be found in a dictionary.
Jargon – Words used by a particular profession or group that
are hard for others to understand.
Dialect – Words and their pronunciation, which are specific to
a geographical community. For example, people who live in
the north west of England might use a different dialect from
Londoners.
Slang – Informal words and phrases that are not usually found
in standard dictionaries but which are used within specific
social groups and communities
Posture
The way you sit or stand can send messages. Sitting
with crossed arms can mean ‘I’m not taking any notice’.
Leaning back can send the message that you are
relaxed or bored. Leaning forward can show interest or
intense involvement.
First language
The author and psychologist Steven Pinker (1994)
estimated that there may be about 600 languages
in the world that are spoken by more than 100,000
people. There are many more minority languages.
Some people grow up in multilingual communities,
where they learn several languages from birth. But
many people in the UK have grown up using only one
language to think and communicate. People who learn
a second language later in life often fi nd that they
cannot communicate their thoughts as effectively as
they might have done using their fi rst language. The
fi rst language that people have learned to think in
usually becomes their preferred language.
Facial expression
Your face often indicates your emotional state. When a
person is sad they may signal this emotion by looking
down – there may be tension in their face and their
mouth will be closed. The muscles in the person’s
shoulders are likely to be relaxed but their face and
neck may show tension. A happy person will have
‘wide eyes’ that make contact with you – and they will
probably smile. When people are excited they move
their arms and hands to signal this.
We can guess another person’s feelings and thoughts
by looking at their eyes, using eye-to-eye contact. Our
eyes get wider when we are excited, attracted to, or
interested in someone else. A fixed stare may send the
message that someone is angry. In European culture,
looking away is often interpreted as being bored or
not interested. Most people can recognise emotions in the non-verbal
behaviour of others. You will also need to understand
how your own non-verbal behaviour may infl uence
other people.
Touch
Touch is another way of communicating without words.
Touching another person can send messages of care,
affection, power over them or sexual interest. The
social setting and a person’s body language will usually
help you to understand what their touch might mean.
But touch can easily be misinterpreted. You might try
to comfort someone by holding their hand but they
may interpret this touch as an attempt to dominate.
Sometimes it can be a good idea to ask if you may touch, or gesture in a way that allows another person
to refuse your touch, before proceeding.
People may also look at, or feel, the degree of muscle
tension that you show when you communicate with
them. The tension in your feet, hands and fi ngers can
tell others how relaxed or tense you are. If someone
is very tense their shoulders might stiffen, their face
muscles might tighten and they might sit or stand
rigidly. A tense person may have a fi rmly closed mouth,
with lips and jaws clenched tight, and they might
breathe quickly
Silence
One defi nition of friends is ‘people who can sit
together and feel comfortable in silence’. Sometimes
a pause in conversation can make people feel
embarrassed – it looks as if you weren’t listening or
you weren’t interested. Sometimes a silent pause can
mean ‘let’s think’ or ‘I need time to think’. Silent pauses
can be OK, as long as non-verbal messages that show
respect and interest are given. Silence doesn’t always
stop the conversation.
Proximity
The space between people can sometimes show how
friendly or ‘intimate’ the conversation is. Different
cultures have different customs regarding the space
between people when they are talking.
In Britain there are expectations or ‘norms’ as to how
close you should be when you talk to others. When
talking to strangers we usually keep ‘an arm’s length’
apart. The ritual of shaking hands indicates that you
have been introduced – you may come closer. When
you are friendly with someone you may accept them
being closer to you. Relatives and partners might not
be restricted at all in how close they can come.
Proximity is a very important issue in health and care
work. Many people have a sense of personal space.
A care worker who assumes it is fi ne to enter the
personal space of a person who uses services, without
asking or explaining why, may be seen as dominating
or aggressive
Reflective listening
We can often understand other people’s emotions just
by watching their non-verbal communication. However,
we can’t always understand someone’s thoughts
without good listening skills.
Listening skills involve hearing another person’s
words, then thinking about what their words mean,
then thinking about how to reply to the other person.
Sometimes this process is called ‘active listening’ and
sometimes ‘reflective listening.’ The word ‘reflective’
is used because the person’s conversation is reflected
back (like the reflection in a mirror) in order to check
understanding. As well as remembering what a person
says, good listeners will make sure that their non-verbal
behaviour shows interest.
Skilled listening involves:
•looking interested and communicating that you are
ready to listen
• hearing what is said to you
•remembering what was said to you, together with
non-verbal messages
British Sign Language
British Sign Language is a language in its own right
– not simply a signed version of spoken English. The
British Deaf Association explains that British Sign
Language is the first or preferred language of many
Deaf people in the United Kingdom. The British Deaf
Association also explains that BSL was recognised as
an official British language in 2003 and the Association
campaigns for the right of Deaf people to be educated
in BSL and to access information and services
through BSL. Many Deaf people argue that the Deaf
community should be identifi ed as ‘culturally Deaf’ by
using a capital ‘D’ for Deaf. This emphasises that ‘Deaf’
people use another language system, as opposed to
‘Deaf’ people who are perceived to be impaired.
Makaton
Makaton is a system for developing language that
uses speech, signs and symbols to help people with
learning diffi culties to communicate and to develop
their language skills. People who communicate using
Makaton may speak a word and perform a sign using
hands and body language. There is a large range of
symbols to help people with learning diffi culties to
recognise an idea or to communicate with others.
Written communication
There is a Chinese saying that ‘the faintest ink is
stronger than the strongest memory’! Written records
are essential for communicating formal information
that needs to be reviewed at a future date. When
people remember conversations they have had, they
will probably miss out or change some details. Written
statements are much more permanent and, if they are
accurate when they are written, they may be useful
later on.
Braille
Braille (a system of raised marks that can be felt
with the fingers) provides a means of written
communication, based on the sense of touch, for
people who have limited vision. The communication
system known as Braille was first published by Louis
Braille, a blind 20-year-old, in 1829. This system is now
widely used, for reading and writing, by people who
cannot see written script.
Modern computer software can translate written
material into Braille, which can be printed out using
special printers.
Use of signs and symbols
Gestures made with hands or arms, written symbols
or diagrams (such as traffic signs) all communicate
messages to people.
Objects can sometimes be used to communicate
with people who do not use much signed or spoken
language. A child or adult with a learning disability
might understand that a cup stands for ‘would you like
a drink’. An object like a spoon tied to a card might
communicate that it is time for dinner when the spoon
is presented. A person without language might use
a patch of cloth to communicate that they wish to
sit in a favourite chair covered in that type of cloth.
Sometimes a person might learn a symbol, perhaps
a symbol like a horseshoe that can be used to label
possessions or identify his or her room.
Finger spelling
People who use a signed language, such as British
Sign Language, also use finger spelling. Finger spelling
enables signers to spell out words that do not have
a general sign, or words that may be misunderstood
such as the names of people and places.
Communication passports
Communication passports are usually small personalised
books containing straightforward practical information
about a person and their style of communication.
The passport may help health and care workers to
understand the needs of a person with communication
diffi culties. Communication passports often include
photographs or drawings that may help care workers
to gain a better understanding of the person who owns
the passport. They are put together by working with
the person with communication diffi culties and his or
her carers; the person tells their own story of their likes,
dislikes and communication styles.
Technological aids to communication
Information technology offers a wide range of facilities
to help with communication. It is possible to provide
enlarged visual displays or voice description for
people with visual impairment. Electronic aids – such
as the minicom for people with a hearing disability
or voice typing for people with dyslexia – can turn
speech into writing. Some electronic communication
systems can be activated by air pressure, so that a
person can communicate via an oral tube connected
to computerised equipment. At a simpler level, aids
such as fl ash cards or picture books can also improve
communication with people who do not use a spoken
or signed language. Text messaging, using a mobile
phone, provides an effective way of staying in touch for
many people. For people with a hearing disability, text
messaging may provide a major form of communication.
When you send text messages to friends, do you
use symbols and shortened words that would not be
acceptable in more formal academic work? If you send
emails, do you use abbreviations, symbols and special
terms or do you only use formal English? Do you think
it should be acceptable to use ‘texting’ symbols and
abbreviations for academic work? How formal should
English be?
Human aids to communication
Many people have specifi c communication needs. It
may be important to employ an interpreter if a person
uses a different language such as BSL. Some carers
learn to use communication systems, such as Makaton,
in order to help them communicate with people.
If you are communicating with a person with a hearing
impairment you should make sure that the person
can see your face clearly so that they can see your
expressions and the way your lips move. Sometimes
people use clues from facial expression and lip
movement to interpret what you might be saying. It
is also important to speak in a clear, normal voice. If
you raise your voice, your face and lips will become
distorted. A person with a hearing impairment may
realise that you are shouting and may assume that you
are angry! It is also important to try and speak in an
environment with little background noise.
If people have limited vision, it may be important
to use language to describe issues that a sighted
person might take for granted, such as non-verbal
communication or the context of certain comments.
Touch may be an important aspect of communication.
For instance, some registered blind people can work
out what you look like if they can touch your face in
order to build an understanding of your features.
It is always important to choose the right style of
language in order to communicate with people from
different language communities.
Variation between cultures
Skilled carers use a range of conversational techniques
when working with others. These include being
sensitive to variations in culture.
Culture means the history, customs and ways of
behaving that people learn as they grow up. People
from different regions of Britain use different
expressions. Non-verbal signs vary from culture to
culture. White middle-class people often expect
people to ‘look them in the eye’ while talking. If a
person looks down or away a lot, they think it is a sign
that the person may be dishonest, or perhaps sad
or depressed. In some other cultures – for example,
among some black communities – looking down or
away when talking is a sign of respect.
No one can learn every possible system of cultural
variation in non-verbal behaviour but it is possible
to learn about the ones that are used by the people
you are with! You can do this by first noticing and
remembering what others do – in other words, what
non-verbal messages they are sending. The next step
is to make a guess as to what messages the person is
trying to give you. Finally, check your understanding
(your guesses) with the person. This involves reflective
listening and thinking carefully about the person’s
responses
Care workers must be careful not to assume that
statements and signs always have the same meaning.
Cultural differences and different settings can alter
what things mean. A vast range of meanings can be
given to any type of eye contact, facial expression,
posture or gesture. Every culture, and even small
groups of people, can develop their own system of
meanings. Care workers have to respect differences
but it is impossible to learn all the possible meanings
that phrases, words and signs may have.
Use your own words and try to summarize the text using easy words and the text should not have the
same words and then use other simple words with the same meaning
One-to-one communication
When you start a conversation with someone you
don’t know well, you should always try to create the
right kind of feeling. It is important to create a positive
emotional atmosphere before you go on to discuss
complicated issues or give people information. The
other person needs to feel relaxed and happy to talk to
you. Very often people will start with a greeting such as
‘Good morning’. You can help other people to relax by
showing that you are friendly and relaxed.
Informal communication
We often use informal communication when we know
people well – for example, with friends and family.
Some friends or family members may use terms that
other people would not understand. Local groups
from particular places might also have their own ways
of speaking. For example, some people in southern
England might say things like ‘Hiya, mate. How’s it
goin’?’ If you belong to this group, you will appreciate
this as a warm, friendly greeting. But different groups
of people use different informal language so it can
sometimes be hard to understand the informal
communication of people from different social groups.
Formal communication
Health and social care work often involves formal
communication. For example, if you went to a local
authority social services reception desk you might
expect to be greeted with the phrase ‘Good morning.
How can I help you?’ This formal communication
is understood by a wide range of people. Formal
communication also shows respect for others.
The degree of formality or informality is called the
language ‘register’.
Imagine going to the reception desk and being
greeted with the phrase ‘What you after then?’ Some
people might actually prefer such an informal greeting.
It might put them at ease, making them feel that the
other person is like them. But in many situations, such
informal language could make people feel that they
are not being respected. Being ‘after something’ could
be a ‘put down’; you might assume that you are being
seen as a scrounger. So it is often risky to use informal
language unless you are sure that other people expect
you to do so. If you are treated informally, you may
interpret this as not being treated seriously, or ‘not
being respected’.
So is there a correct way to speak to people when
you fi rst introduce yourself? After all, if you are too
formal you may come across as pretentious or ‘posh’.
Usually care workers will adjust the way they speak in
order to communicate respect for different ‘speech
communities’.
Communication between colleagues
Family and friends know you well and will usually
understand you, even if you communicate poorly or
very informally. Communicating with people at work is
different because:
• It is important that care workers communicate
respect for each other. Colleagues who do not show
respect for each other may fail to show respect to
the people who use care services.
•You may often have to greet colleagues by asking
if they are well and spend time on ‘warm-up talk’ in
order to show that you value them.
• You will need to demonstrate that you are a good
listener and can remember details of conversations
with your colleagues.
• Colleagues have to develop trust in each other. It
is important to demonstrate that you respect the
confi dentiality of conversation with colleagues.
• Work settings may have their own social
expectations about the correct way to communicate
thoughts and feelings. These may differ from social
expectations when communicating with your friends
and family.
Although communication between colleagues may
often be informal it is important that care workers use
skilled communication in order to develop respect and
trust
Communication with professionals
When people who use services communicate with
professionals there is always a risk of misunderstanding
between people from different language communities.
It is important that people check that they are being
understood correctly. Professional health and social
care staff need to check their understanding of issues
with people who are communicating with them.
Multi-agency working
Health and social care professionals often have to
communicate with colleagues who work for different
organisations. For example, a home care organiser
might have to communicate not only with people who
use services and care workers but also with community
nurses, GPs’ surgeries, hospital services, occupational
therapists, voluntary groups, day care groups and
many other organisations. It is important not to assume
that people from different agencies will understand the same terminology. Formal communication may
help to convey respect and avoid misunderstandings
when interacting with unfamiliar professionals in other
agencies.
Communication between professional people and people using services
Professional people, such as doctors and nurses, often
work within their own specialised language community.
A language community is a community of people that
has developed its own special words, phrases, social
expectations and ways of interacting that set it apart
from other groups of people. Professionals are usually
well aware of the need to translate technical language
into everyday language when they work with people
from other professions or people who use services.
It is important that professionals check that they are
not being misunderstood (see section 2 on the role of
feedback).
Multi-professional working
Professionals from different backgrounds often have
to work together in order to assess and meet the
needs of people who use services. Multi-professional
working happens when many different professionals
work together. Communication will often need to be
formal and carefully planned in order to avoid barriers
to understanding.
Speech
Different localities, ethnic groups, professions and work
cultures all have their own special words, phrases and
speech patterns. These localities and groups may be
referred to as different speech communities. Some
people may feel threatened or excluded by the kind of
language they encounter in these speech communities.
However, just using formal language will not solve
this problem. The technical terminology used by care
workers (often called jargon) can also create barriers for
people who are not a part of that ‘speech community’.
When people from different geographical areas use
different words and pronounce words differently they
are often using a different dialect. Some social groups
use slang – non-standard words that are understood
by other members of a speech community but which
cannot usually be found in a dictionary.
Jargon – Words used by a particular profession or group that
are hard for others to understand.
Dialect – Words and their pronunciation, which are specific to
a geographical community. For example, people who live in
the north west of England might use a different dialect from
Londoners.
Slang – Informal words and phrases that are not usually found
in standard dictionaries but which are used within specific
social groups and communities
Posture
The way you sit or stand can send messages. Sitting
with crossed arms can mean ‘I’m not taking any notice’.
Leaning back can send the message that you are
relaxed or bored. Leaning forward can show interest or
intense involvement.
First language
The author and psychologist Steven Pinker (1994)
estimated that there may be about 600 languages
in the world that are spoken by more than 100,000
people. There are many more minority languages.
Some people grow up in multilingual communities,
where they learn several languages from birth. But
many people in the UK have grown up using only one
language to think and communicate. People who learn
a second language later in life often fi nd that they
cannot communicate their thoughts as effectively as
they might have done using their fi rst language. The
fi rst language that people have learned to think in
usually becomes their preferred language.
Facial expression
Your face often indicates your emotional state. When a
person is sad they may signal this emotion by looking
down – there may be tension in their face and their
mouth will be closed. The muscles in the person’s
shoulders are likely to be relaxed but their face and
neck may show tension. A happy person will have
‘wide eyes’ that make contact with you – and they will
probably smile. When people are excited they move
their arms and hands to signal this.
We can guess another person’s feelings and thoughts
by looking at their eyes, using eye-to-eye contact. Our
eyes get wider when we are excited, attracted to, or
interested in someone else. A fixed stare may send the
message that someone is angry. In European culture,
looking away is often interpreted as being bored or
not interested. Most people can recognise emotions in the non-verbal
behaviour of others. You will also need to understand
how your own non-verbal behaviour may infl uence
other people.
Touch
Touch is another way of communicating without words.
Touching another person can send messages of care,
affection, power over them or sexual interest. The
social setting and a person’s body language will usually
help you to understand what their touch might mean.
But touch can easily be misinterpreted. You might try
to comfort someone by holding their hand but they
may interpret this touch as an attempt to dominate.
Sometimes it can be a good idea to ask if you may touch, or gesture in a way that allows another person
to refuse your touch, before proceeding.
People may also look at, or feel, the degree of muscle
tension that you show when you communicate with
them. The tension in your feet, hands and fi ngers can
tell others how relaxed or tense you are. If someone
is very tense their shoulders might stiffen, their face
muscles might tighten and they might sit or stand
rigidly. A tense person may have a fi rmly closed mouth,
with lips and jaws clenched tight, and they might
breathe quickly
Silence
One defi nition of friends is ‘people who can sit
together and feel comfortable in silence’. Sometimes
a pause in conversation can make people feel
embarrassed – it looks as if you weren’t listening or
you weren’t interested. Sometimes a silent pause can
mean ‘let’s think’ or ‘I need time to think’. Silent pauses
can be OK, as long as non-verbal messages that show
respect and interest are given. Silence doesn’t always
stop the conversation.
Proximity
The space between people can sometimes show how
friendly or ‘intimate’ the conversation is. Different
cultures have different customs regarding the space
between people when they are talking.
In Britain there are expectations or ‘norms’ as to how
close you should be when you talk to others. When
talking to strangers we usually keep ‘an arm’s length’
apart. The ritual of shaking hands indicates that you
have been introduced – you may come closer. When
you are friendly with someone you may accept them
being closer to you. Relatives and partners might not
be restricted at all in how close they can come.
Proximity is a very important issue in health and care
work. Many people have a sense of personal space.
A care worker who assumes it is fi ne to enter the
personal space of a person who uses services, without
asking or explaining why, may be seen as dominating
or aggressive
Reflective listening
We can often understand other people’s emotions just
by watching their non-verbal communication. However,
we can’t always understand someone’s thoughts
without good listening skills.
Listening skills involve hearing another person’s
words, then thinking about what their words mean,
then thinking about how to reply to the other person.
Sometimes this process is called ‘active listening’ and
sometimes ‘reflective listening.’ The word ‘reflective’
is used because the person’s conversation is reflected
back (like the reflection in a mirror) in order to check
understanding. As well as remembering what a person
says, good listeners will make sure that their non-verbal
behaviour shows interest.
Skilled listening involves:
•looking interested and communicating that you are
ready to listen
• hearing what is said to you
•remembering what was said to you, together with
non-verbal messages
British Sign Language
British Sign Language is a language in its own right
– not simply a signed version of spoken English. The
British Deaf Association explains that British Sign
Language is the first or preferred language of many
Deaf people in the United Kingdom. The British Deaf
Association also explains that BSL was recognised as
an official British language in 2003 and the Association
campaigns for the right of Deaf people to be educated
in BSL and to access information and services
through BSL. Many Deaf people argue that the Deaf
community should be identifi ed as ‘culturally Deaf’ by
using a capital ‘D’ for Deaf. This emphasises that ‘Deaf’
people use another language system, as opposed to
‘Deaf’ people who are perceived to be impaired.
Makaton
Makaton is a system for developing language that
uses speech, signs and symbols to help people with
learning diffi culties to communicate and to develop
their language skills. People who communicate using
Makaton may speak a word and perform a sign using
hands and body language. There is a large range of
symbols to help people with learning diffi culties to
recognise an idea or to communicate with others.
Written communication
There is a Chinese saying that ‘the faintest ink is
stronger than the strongest memory’! Written records
are essential for communicating formal information
that needs to be reviewed at a future date. When
people remember conversations they have had, they
will probably miss out or change some details. Written
statements are much more permanent and, if they are
accurate when they are written, they may be useful
later on.
Braille
Braille (a system of raised marks that can be felt
with the fingers) provides a means of written
communication, based on the sense of touch, for
people who have limited vision. The communication
system known as Braille was first published by Louis
Braille, a blind 20-year-old, in 1829. This system is now
widely used, for reading and writing, by people who
cannot see written script.
Modern computer software can translate written
material into Braille, which can be printed out using
special printers.
Use of signs and symbols
Gestures made with hands or arms, written symbols
or diagrams (such as traffic signs) all communicate
messages to people.
Objects can sometimes be used to communicate
with people who do not use much signed or spoken
language. A child or adult with a learning disability
might understand that a cup stands for ‘would you like
a drink’. An object like a spoon tied to a card might
communicate that it is time for dinner when the spoon
is presented. A person without language might use
a patch of cloth to communicate that they wish to
sit in a favourite chair covered in that type of cloth.
Sometimes a person might learn a symbol, perhaps
a symbol like a horseshoe that can be used to label
possessions or identify his or her room.
Finger spelling
People who use a signed language, such as British
Sign Language, also use finger spelling. Finger spelling
enables signers to spell out words that do not have
a general sign, or words that may be misunderstood
such as the names of people and places.
Communication passports
Communication passports are usually small personalised
books containing straightforward practical information
about a person and their style of communication.
The passport may help health and care workers to
understand the needs of a person with communication
diffi culties. Communication passports often include
photographs or drawings that may help care workers
to gain a better understanding of the person who owns
the passport. They are put together by working with
the person with communication diffi culties and his or
her carers; the person tells their own story of their likes,
dislikes and communication styles.
Technological aids to communication
Information technology offers a wide range of facilities
to help with communication. It is possible to provide
enlarged visual displays or voice description for
people with visual impairment. Electronic aids – such
as the minicom for people with a hearing disability
or voice typing for people with dyslexia – can turn
speech into writing. Some electronic communication
systems can be activated by air pressure, so that a
person can communicate via an oral tube connected
to computerised equipment. At a simpler level, aids
such as fl ash cards or picture books can also improve
communication with people who do not use a spoken
or signed language. Text messaging, using a mobile
phone, provides an effective way of staying in touch for
many people. For people with a hearing disability, text
messaging may provide a major form of communication.
When you send text messages to friends, do you
use symbols and shortened words that would not be
acceptable in more formal academic work? If you send
emails, do you use abbreviations, symbols and special
terms or do you only use formal English? Do you think
it should be acceptable to use ‘texting’ symbols and
abbreviations for academic work? How formal should
English be?
Human aids to communication
Many people have specifi c communication needs. It
may be important to employ an interpreter if a person
uses a different language such as BSL. Some carers
learn to use communication systems, such as Makaton,
in order to help them communicate with people.
If you are communicating with a person with a hearing
impairment you should make sure that the person
can see your face clearly so that they can see your
expressions and the way your lips move. Sometimes
people use clues from facial expression and lip
movement to interpret what you might be saying. It
is also important to speak in a clear, normal voice. If
you raise your voice, your face and lips will become
distorted. A person with a hearing impairment may
realise that you are shouting and may assume that you
are angry! It is also important to try and speak in an
environment with little background noise.
If people have limited vision, it may be important
to use language to describe issues that a sighted
person might take for granted, such as non-verbal
communication or the context of certain comments.
Touch may be an important aspect of communication.
For instance, some registered blind people can work
out what you look like if they can touch your face in
order to build an understanding of your features.
It is always important to choose the right style of
language in order to communicate with people from
different language communities.
Variation between cultures
Skilled carers use a range of conversational techniques
when working with others. These include being
sensitive to variations in culture.
Culture means the history, customs and ways of
behaving that people learn as they grow up. People
from different regions of Britain use different
expressions. Non-verbal signs vary from culture to
culture. White middle-class people often expect
people to ‘look them in the eye’ while talking. If a
person looks down or away a lot, they think it is a sign
that the person may be dishonest, or perhaps sad
or depressed. In some other cultures – for example,
among some black communities – looking down or
away when talking is a sign of respect.
No one can learn every possible system of cultural
variation in non-verbal behaviour but it is possible
to learn about the ones that are used by the people
you are with! You can do this by first noticing and
remembering what others do – in other words, what
non-verbal messages they are sending. The next step
is to make a guess as to what messages the person is
trying to give you. Finally, check your understanding
(your guesses) with the person. This involves reflective
listening and thinking carefully about the person’s
responses
Care workers must be careful not to assume that
statements and signs always have the same meaning.
Cultural differences and different settings can alter
what things mean. A vast range of meanings can be
given to any type of eye contact, facial expression,
posture or gesture. Every culture, and even small
groups of people, can develop their own system of
meanings. Care workers have to respect differences
but it is impossible to learn all the possible meanings
that phrases, words and signs may have.
Use your own words and try to summarize the text using easy words and the text should not have the
same words and then use other simple words with the same meaning
One-to-one communication
When you start a conversation with someone you
don’t know well, you should always try to create the
right kind of feeling. It is important to create a positive
emotional atmosphere before you go on to discuss
complicated issues or give people information. The
other person needs to feel relaxed and happy to talk to
you. Very often people will start with a greeting such as
‘Good morning’. You can help other people to relax by
showing that you are friendly and relaxed.
Informal communication
We often use informal communication when we know
people well – for example, with friends and family.
Some friends or family members may use terms that
other people would not understand. Local groups
from particular places might also have their own ways
of speaking. For example, some people in southern
England might say things like ‘Hiya, mate. How’s it
goin’?’ If you belong to this group, you will appreciate
this as a warm, friendly greeting. But different groups
of people use different informal language so it can
sometimes be hard to understand the informal
communication of people from different social groups.
Formal communication
Health and social care work often involves formal
communication. For example, if you went to a local
authority social services reception desk you might
expect to be greeted with the phrase ‘Good morning.
How can I help you?’ This formal communication
is understood by a wide range of people. Formal
communication also shows respect for others.
The degree of formality or informality is called the
language ‘register’.
Imagine going to the reception desk and being
greeted with the phrase ‘What you after then?’ Some
people might actually prefer such an informal greeting.
It might put them at ease, making them feel that the
other person is like them. But in many situations, such
informal language could make people feel that they
are not being respected. Being ‘after something’ could
be a ‘put down’; you might assume that you are being
seen as a scrounger. So it is often risky to use informal
language unless you are sure that other people expect
you to do so. If you are treated informally, you may
interpret this as not being treated seriously, or ‘not
being respected’.
So is there a correct way to speak to people when
you fi rst introduce yourself? After all, if you are too
formal you may come across as pretentious or ‘posh’.
Usually care workers will adjust the way they speak in
order to communicate respect for different ‘speech
communities’.
Communication between colleagues
Family and friends know you well and will usually
understand you, even if you communicate poorly or
very informally. Communicating with people at work is
different because:
• It is important that care workers communicate
respect for each other. Colleagues who do not show
respect for each other may fail to show respect to
the people who use care services.
•You may often have to greet colleagues by asking
if they are well and spend time on ‘warm-up talk’ in
order to show that you value them.
• You will need to demonstrate that you are a good
listener and can remember details of conversations
with your colleagues.
• Colleagues have to develop trust in each other. It
is important to demonstrate that you respect the
confi dentiality of conversation with colleagues.
• Work settings may have their own social
expectations about the correct way to communicate
thoughts and feelings. These may differ from social
expectations when communicating with your friends
and family.
Although communication between colleagues may
often be informal it is important that care workers use
skilled communication in order to develop respect and
trust
Communication with professionals
When people who use services communicate with
professionals there is always a risk of misunderstanding
between people from different language communities.
It is important that people check that they are being
understood correctly. Professional health and social
care staff need to check their understanding of issues
with people who are communicating with them.
Multi-agency working
Health and social care professionals often have to
communicate with colleagues who work for different
organisations. For example, a home care organiser
might have to communicate not only with people who
use services and care workers but also with community
nurses, GPs’ surgeries, hospital services, occupational
therapists, voluntary groups, day care groups and
many other organisations. It is important not to assume
that people from different agencies will understand the same terminology. Formal communication may
help to convey respect and avoid misunderstandings
when interacting with unfamiliar professionals in other
agencies.
Communication between professional people and people using services
Professional people, such as doctors and nurses, often
work within their own specialised language community.
A language community is a community of people that
has developed its own special words, phrases, social
expectations and ways of interacting that set it apart
from other groups of people. Professionals are usually
well aware of the need to translate technical language
into everyday language when they work with people
from other professions or people who use services.
It is important that professionals check that they are
not being misunderstood (see section 2 on the role of
feedback).
Multi-professional working
Professionals from different backgrounds often have
to work together in order to assess and meet the
needs of people who use services. Multi-professional
working happens when many different professionals
work together. Communication will often need to be
formal and carefully planned in order to avoid barriers
to understanding.
Speech
Different localities, ethnic groups, professions and work
cultures all have their own special words, phrases and
speech patterns. These localities and groups may be
referred to as different speech communities. Some
people may feel threatened or excluded by the kind of
language they encounter in these speech communities.
However, just using formal language will not solve
this problem. The technical terminology used by care
workers (often called jargon) can also create barriers for
people who are not a part of that ‘speech community’.
When people from different geographical areas use
different words and pronounce words differently they
are often using a different dialect. Some social groups
use slang – non-standard words that are understood
by other members of a speech community but which
cannot usually be found in a dictionary.
Jargon – Words used by a particular profession or group that
are hard for others to understand.
Dialect – Words and their pronunciation, which are specific to
a geographical community. For example, people who live in
the north west of England might use a different dialect from
Londoners.
Slang – Informal words and phrases that are not usually found
in standard dictionaries but which are used within specific
social groups and communities
Posture
The way you sit or stand can send messages. Sitting
with crossed arms can mean ‘I’m not taking any notice’.
Leaning back can send the message that you are
relaxed or bored. Leaning forward can show interest or
intense involvement.
First language
The author and psychologist Steven Pinker (1994)
estimated that there may be about 600 languages
in the world that are spoken by more than 100,000
people. There are many more minority languages.
Some people grow up in multilingual communities,
where they learn several languages from birth. But
many people in the UK have grown up using only one
language to think and communicate. People who learn
a second language later in life often fi nd that they
cannot communicate their thoughts as effectively as
they might have done using their fi rst language. The
fi rst language that people have learned to think in
usually becomes their preferred language.
Facial expression
Your face often indicates your emotional state. When a
person is sad they may signal this emotion by looking
down – there may be tension in their face and their
mouth will be closed. The muscles in the person’s
shoulders are likely to be relaxed but their face and
neck may show tension. A happy person will have
‘wide eyes’ that make contact with you – and they will
probably smile. When people are excited they move
their arms and hands to signal this.
We can guess another person’s feelings and thoughts
by looking at their eyes, using eye-to-eye contact. Our
eyes get wider when we are excited, attracted to, or
interested in someone else. A fixed stare may send the
message that someone is angry. In European culture,
looking away is often interpreted as being bored or
not interested. Most people can recognise emotions in the non-verbal
behaviour of others. You will also need to understand
how your own non-verbal behaviour may infl uence
other people.
Touch
Touch is another way of communicating without words.
Touching another person can send messages of care,
affection, power over them or sexual interest. The
social setting and a person’s body language will usually
help you to understand what their touch might mean.
But touch can easily be misinterpreted. You might try
to comfort someone by holding their hand but they
may interpret this touch as an attempt to dominate.
Sometimes it can be a good idea to ask if you may touch, or gesture in a way that allows another person
to refuse your touch, before proceeding.
People may also look at, or feel, the degree of muscle
tension that you show when you communicate with
them. The tension in your feet, hands and fi ngers can
tell others how relaxed or tense you are. If someone
is very tense their shoulders might stiffen, their face
muscles might tighten and they might sit or stand
rigidly. A tense person may have a fi rmly closed mouth,
with lips and jaws clenched tight, and they might
breathe quickly
Silence
One defi nition of friends is ‘people who can sit
together and feel comfortable in silence’. Sometimes
a pause in conversation can make people feel
embarrassed – it looks as if you weren’t listening or
you weren’t interested. Sometimes a silent pause can
mean ‘let’s think’ or ‘I need time to think’. Silent pauses
can be OK, as long as non-verbal messages that show
respect and interest are given. Silence doesn’t always
stop the conversation.
Proximity
The space between people can sometimes show how
friendly or ‘intimate’ the conversation is. Different
cultures have different customs regarding the space
between people when they are talking.
In Britain there are expectations or ‘norms’ as to how
close you should be when you talk to others. When
talking to strangers we usually keep ‘an arm’s length’
apart. The ritual of shaking hands indicates that you
have been introduced – you may come closer. When
you are friendly with someone you may accept them
being closer to you. Relatives and partners might not
be restricted at all in how close they can come.
Proximity is a very important issue in health and care
work. Many people have a sense of personal space.
A care worker who assumes it is fi ne to enter the
personal space of a person who uses services, without
asking or explaining why, may be seen as dominating
or aggressive
Reflective listening
We can often understand other people’s emotions just
by watching their non-verbal communication. However,
we can’t always understand someone’s thoughts
without good listening skills.
Listening skills involve hearing another person’s
words, then thinking about what their words mean,
then thinking about how to reply to the other person.
Sometimes this process is called ‘active listening’ and
sometimes ‘reflective listening.’ The word ‘reflective’
is used because the person’s conversation is reflected
back (like the reflection in a mirror) in order to check
understanding. As well as remembering what a person
says, good listeners will make sure that their non-verbal
behaviour shows interest.
Skilled listening involves:
•looking interested and communicating that you are
ready to listen
• hearing what is said to you
•remembering what was said to you, together with
non-verbal messages
British Sign Language
British Sign Language is a language in its own right
– not simply a signed version of spoken English. The
British Deaf Association explains that British Sign
Language is the first or preferred language of many
Deaf people in the United Kingdom. The British Deaf
Association also explains that BSL was recognised as
an official British language in 2003 and the Association
campaigns for the right of Deaf people to be educated
in BSL and to access information and services
through BSL. Many Deaf people argue that the Deaf
community should be identifi ed as ‘culturally Deaf’ by
using a capital ‘D’ for Deaf. This emphasises that ‘Deaf’
people use another language system, as opposed to
‘Deaf’ people who are perceived to be impaired.
Makaton
Makaton is a system for developing language that
uses speech, signs and symbols to help people with
learning diffi culties to communicate and to develop
their language skills. People who communicate using
Makaton may speak a word and perform a sign using
hands and body language. There is a large range of
symbols to help people with learning diffi culties to
recognise an idea or to communicate with others.
Written communication
There is a Chinese saying that ‘the faintest ink is
stronger than the strongest memory’! Written records
are essential for communicating formal information
that needs to be reviewed at a future date. When
people remember conversations they have had, they
will probably miss out or change some details. Written
statements are much more permanent and, if they are
accurate when they are written, they may be useful
later on.
Braille
Braille (a system of raised marks that can be felt
with the fingers) provides a means of written
communication, based on the sense of touch, for
people who have limited vision. The communication
system known as Braille was first published by Louis
Braille, a blind 20-year-old, in 1829. This system is now
widely used, for reading and writing, by people who
cannot see written script.
Modern computer software can translate written
material into Braille, which can be printed out using
special printers.
Use of signs and symbols
Gestures made with hands or arms, written symbols
or diagrams (such as traffic signs) all communicate
messages to people.
Objects can sometimes be used to communicate
with people who do not use much signed or spoken
language. A child or adult with a learning disability
might understand that a cup stands for ‘would you like
a drink’. An object like a spoon tied to a card might
communicate that it is time for dinner when the spoon
is presented. A person without language might use
a patch of cloth to communicate that they wish to
sit in a favourite chair covered in that type of cloth.
Sometimes a person might learn a symbol, perhaps
a symbol like a horseshoe that can be used to label
possessions or identify his or her room.
Finger spelling
People who use a signed language, such as British
Sign Language, also use finger spelling. Finger spelling
enables signers to spell out words that do not have
a general sign, or words that may be misunderstood
such as the names of people and places.
Communication passports
Communication passports are usually small personalised
books containing straightforward practical information
about a person and their style of communication.
The passport may help health and care workers to
understand the needs of a person with communication
diffi culties. Communication passports often include
photographs or drawings that may help care workers
to gain a better understanding of the person who owns
the passport. They are put together by working with
the person with communication diffi culties and his or
her carers; the person tells their own story of their likes,
dislikes and communication styles.
Technological aids to communication
Information technology offers a wide range of facilities
to help with communication. It is possible to provide
enlarged visual displays or voice description for
people with visual impairment. Electronic aids – such
as the minicom for people with a hearing disability
or voice typing for people with dyslexia – can turn
speech into writing. Some electronic communication
systems can be activated by air pressure, so that a
person can communicate via an oral tube connected
to computerised equipment. At a simpler level, aids
such as fl ash cards or picture books can also improve
communication with people who do not use a spoken
or signed language. Text messaging, using a mobile
phone, provides an effective way of staying in touch for
many people. For people with a hearing disability, text
messaging may provide a major form of communication.
When you send text messages to friends, do you
use symbols and shortened words that would not be
acceptable in more formal academic work? If you send
emails, do you use abbreviations, symbols and special
terms or do you only use formal English? Do you think
it should be acceptable to use ‘texting’ symbols and
abbreviations for academic work? How formal should
English be?
Human aids to communication
Many people have specifi c communication needs. It
may be important to employ an interpreter if a person
uses a different language such as BSL. Some carers
learn to use communication systems, such as Makaton,
in order to help them communicate with people.
If you are communicating with a person with a hearing
impairment you should make sure that the person
can see your face clearly so that they can see your
expressions and the way your lips move. Sometimes
people use clues from facial expression and lip
movement to interpret what you might be saying. It
is also important to speak in a clear, normal voice. If
you raise your voice, your face and lips will become
distorted. A person with a hearing impairment may
realise that you are shouting and may assume that you
are angry! It is also important to try and speak in an
environment with little background noise.
If people have limited vision, it may be important
to use language to describe issues that a sighted
person might take for granted, such as non-verbal
communication or the context of certain comments.
Touch may be an important aspect of communication.
For instance, some registered blind people can work
out what you look like if they can touch your face in
order to build an understanding of your features.
It is always important to choose the right style of
language in order to communicate with people from
different language communities.
Variation between cultures
Skilled carers use a range of conversational techniques
when working with others. These include being
sensitive to variations in culture.
Culture means the history, customs and ways of
behaving that people learn as they grow up. People
from different regions of Britain use different
expressions. Non-verbal signs vary from culture to
culture. White middle-class people often expect
people to ‘look them in the eye’ while talking. If a
person looks down or away a lot, they think it is a sign
that the person may be dishonest, or perhaps sad
or depressed. In some other cultures – for example,
among some black communities – looking down or
away when talking is a sign of respect.
No one can learn every possible system of cultural
variation in non-verbal behaviour but it is possible
to learn about the ones that are used by the people
you are with! You can do this by first noticing and
remembering what others do – in other words, what
non-verbal messages they are sending. The next step
is to make a guess as to what messages the person is
trying to give you. Finally, check your understanding
(your guesses) with the person. This involves reflective
listening and thinking carefully about the person’s
responses
Care workers must be careful not to assume that
statements and signs always have the same meaning.
Cultural differences and different settings can alter
what things mean. A vast range of meanings can be
given to any type of eye contact, facial expression,
posture or gesture. Every culture, and even small
groups of people, can develop their own system of
meanings. Care workers have to respect differences
but it is impossible to learn all the possible meanings
that phrases, words and signs may have.