APPENDIX II

MODIFICATIONS OF THERAPY TO ACCOMMODATE ADULTS WITH LEARNING DISABILITIES


ORAL LANGUAGE
 
If the client has difficulty with:

Understanding complex words and sentences

The therapist can:

  • Avoid taking comprehension for granted
  • Simplify vocabulary
  • Define words and verify that the client has understood them
  • Decrease complexity and length of sentences
  • Decrease complexity and number of ideas discussed at one time
  • Write out a list of important points
  • Review and highlight key ideas
  • Use visual mapping (concept maps), i.e., drawing charts and diagrams
  • Illustrate points with sketches, visual images, or visual analogies
The rate at which language is understood
  • Slow speech down to the client's pace
  • Repeat frequently
Word finding problems
  • Ask clients if they want help locating the right word
  • Provide word choices
  • Provide the first sound of the word
Oral expression
  • Be ready to ask for clarification
  • Check frequently to verify comprehension of what client says
  • Mirror what the client says
  • Ask client to bring in written or taped notes, questions, and thoughts
Auditory memory
  • Reserve a few minutes at the beginning and end of a session to review previous material
  • Provide continuity by discussing the focus of the next session
  • Allow client to tape-record sessions or take notes
  • Provide a simple list or diagram that you have jotted down during the review of the session
  • Assign "homework" to stimulate the client's memory between sessions. 


ATTENTION AND ORGANIZATION PROBLEMS

If the client has difficulty with:

Attentiveness, restlessness

The therapist can:

  • Shorten sessions
  • Allow for frequent, short breaks
Fidgeting, distractibility
  • Remove distracting objects from office
  • Provide a noiseless, maleable object for client to hold or squeeze
  • Allow client to stand, pace, sit in different chairs
Disorganized or associative thinking, wordy or tangential responses
  • Be more directive overall
  • Play a more active role than usual in determining the structure and focus of therapy
Tendency to stray from the topic
  • Get therapy started by asking a direct question
  • Actively weigh what is heard and consider what to focus on and what to let slide by (see Hallowell & Ratey, 1994)


NONVERBAL PROBLEMS
 
If the client has difficulty with:

Establishing rapport

The therapist can:

  • Avoid assuming that implicit messages are being perceived
  • Describe feelings and attitudes verbally
"Reading" body language
  • Teach body language, describe explicitly
Catching on to practical concepts
  • Use much verbal repetition
  • Act as partner in the search for solutions to practical problems
Inappropriate behaviors
  • Interpret the social world verbally
  • Teach appropriate behaviors and coach clients in their use

 


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