As therapists we want to heal and help. Practicing with an inclusive policy is vital to make sure we welcome all people to our practice; but what does that involve day to day?

Well, we can offer good accessibility for parking cars, wheelchair access, single-floor access for people who may be unsteady. We can write policies and be aware of legislation that affects people we may treat and ensure safe practice in an appropriate environment. We can offer community visits to people who cannot get to our clinics. We can provide many modes of communication via the phone, social media, websites, and emails for people, so they can choose a preferable way to contact us and communicate.

In fact, communication is at the very heart of what we do. We communicate daily through touch, tone of voice, body language and gesture. However, for some people with communication difficulties this may be difficult to interpret or understand. This is where we can engage in a total communication approach.

Becoming aware and trained in different communication methods can be helpful in ensuring you offer all your clients every opportunity to feel understood and therefore begin to work through any issues that may be affecting their health.

Signing is increasingly being championed within our communities to ensure that people who find speech or hearing difficult can be valued and made welcome. More shops, companies charities and individuals are being trained to sign. Whether it be Makaton, British Sign Language or another blend of basic key signing this can make a huge difference to communicating.

If a client has learning difficulties, you can use sign to say hello in a way that makes them feel comfortable. You can establish if and where any pain might be. You can build rapport more quickly and encourage someone to trust you and enable them to receive a treatment where previously they may have refused. 

Signing helps both communicators slow down and focus. People of all ages who are on the autistic spectrum can feel that you have entered their world on their terms and help them open up to you and trust you. Once you have established that trust, new possibilities about helping them slow down, focus and connection with the world around them can occur.

Even people who do not know signing, can follow conversations better especially if they have some sort of cognitive impairment which requires more visual prompts. Try signing along as well as verbalising your message to someone who lives with dementia if it is appropriate. You might be surprised at how much better they follow what you are saying as many signs are based on natural gesture.

Signing is designed to be used alongside the spoken word, this allows the other person every opportunity to use all their communication skills to understand and speak with you. We lip read more than we realise, and people with hearing impairments even more so. So it creates a clearer, more holistic form of communication.

Signing can reduce the frustration associated with being misunderstood. In turn this can reduce behaviour we find challenging, and therefore pre-empt aggressive episodes and even reduce the need for medication used to calm people down.

It also helps with improving good eye contact, and this in turn can forge good communication habits, and help people connect better. However, for some people who may have learning difficulties or be on the autistic spectrum, eye contact may be seen as a threat. However, signing can still be used without eye contact and can be used sidelong with people. The point is to be clear and consistent with your signing.

“Baby signing” has helped parents and babies build a close bond with each other during their 1st months and establish their babies’ needs more quickly resulting in a more content little one, and parent. Many schools now teach signing as part of their curriculum, especially in foundation, pre-school and primary schools. This encourages a more inclusive school community and enables all children to communicate with each other better. In fact, signing is fun, and signing and singing is a playful way to express yourself. There are some myths around signing preventing children from developing their language healthily, however, research shows that it actually encourages speech and language development, mental capacity and creates a larger expressive and receptive spoken language vocabulary (Acredolo et al., 1999; Goodwyn et al., 2000; Moore et al., 2001).

On a personal note, I saw the immense value of children so young being taught signing. Back in December 2013, my nephew was diagnosed with a brain tumour, which was immediately removed. After the trauma of surgery, he temporarily lost his speech and used signing to express his needs, wants and feelings. This helped everyone around him ease his pain, provide him with the medical attention he needed, or simply give him space when he needed to rest. His frustration though was that he was the best signer out of all of us, and we could not always get it right, but that was a huge incentive to go and learn some more signs to muddle through. You tube was a great resource at that time, but there are plenty of free apps you can now download to help you if you need to check a sign.

Thankfully, my nephew is a very bright spark who is now well on the way to recovery and he no longer needs to sign. However, my practice has been enhanced radically since learning basic signing. I have been able to establish if a client is in pain; I have been able to open up my speciality and welcome people with varied special needs into my clinic; I have enjoyed singing and signing with a client who has dementia during a treatment, and helped chase his gloominess away.

Ultimately, good therapy is about using as many tools in our kit to be creative, inventive and welcoming, so we can create a space to connect, express, nurture and heal. Using signing has opened doors for me on many levels; the doors of my clinic to more people within my community, doors of opportunity, and doors to people’s hearts.

Nicolle runs courses on massage for dementia patients and has one running in Brighton on 18th July.

Visit www.fht.org.uk/events for more information and to book.

About Nicolle

Nicolle Mitchell has run a general practice offering holistic massage since 1998 and is a support worker in The Adult Speech and Language Therapy Department for The Peninsula Community Health Trust, who provide therapy and rehabilitation on behalf of the NHS in Cornwall.

Nicolle is passionate about her specialist field, dementia, delivering her award winning course: ‘How to Massage People with Dementia’ countrywide. She visits a nursing home weekly, offering people with dementia integrated massage, aromatherapy, validation therapy and reminiscence. 

Image: Dollar Photo Club