Respecting Different Communication Styles

April is Autism Awareness Month, so it feels like a fitting time to address the topic of different communication styles in music therapy. Many people with Autism Spectrum Disorder (ASD), or individuals with a variety of other diagnoses, do not use spoken language as their primary form of communication. This can be challenging at first, especially since for many of us, we rely heavily on speaking to one another as a means of connection and understanding. However, if you have one takeaway from this post, let it be this: Non-verbal ≠ Non-communicating

Whether a person is speaking, moving, vocalizing, or changing their facial expressions, they are communicating. Whether these changes are obvious or subtle, they are valid forms of expression and should be noticed, acknowledged, and respected. 

Presuming Competence

A big pet peeve of mine is when someone speaks about a non-verbal person rather than to them, even while they are standing right there. It is because of this that I practice through a lens of presumed competence. There are many different interpretations of this phrase. In my practice, it means that I operate under the presumption that being non-verbal, or having a diagnosis such as ASD, is not always a determining factor in whether or not a person understands me. I am seeking mutual respect and connection with my clients, and one way I build trust is by openly acknowledging the personhood of everyone I work with. This means not talking down to them, not excluding them from conversations (especially when talking about the client themselves), and not making choices for them when they are capable of doing it themselves. In other words, and here’s another big takeaway: Non-speaking ≠ non-thinking.

Of course, getting to know your clients is still an important step, and presumed competence does not mean that I operate under the assumption that everyone knows everything all the time. As you assess, develop therapeutic rapport, and collaborate with caregivers, you can gain a better understanding of your client’s comprehension, and identify areas where they might need more support. 

Recognition of Communication in all Forms 

We are conditioned to believe that speech is the most effective and most important means of communication, but when working with people who don’t primarily use language, we have to learn to be receptive to all the other ways they might be telling us what they need and how they feel. 

As music therapists, it is our job to be constantly assessing verbal and non-verbal responses from our clients. For example, a client who communicates verbally might feel overstimulated and tell me “the music is too loud” and I can adjust accordingly. But a client who is non-speaking will exhibit other indications that tell me the same thing. For example, changes in facial affect, increased restlessness, and agitation are signs of overstimulation that I am on the lookout for. But these indicators are not the same for everyone. Once again, the better we know our clients, the better we are able to appropriately respond to these changes, and the stronger our therapeutic relationship will be. 

Augmented and Alternative Communication

So far, I’ve focused on all the ways the non-speaking clients might be communicating with us, but if that’s the case, why does music therapy so often focus on increasing communication as a goal area? Isn’t it our responsibility to recognize the communication that’s already happening and go from there? Yes and no. 

Music therapy seeks to give participants skills for expression and independence. Realistically, we live in a society built by and for people who communicate verbally. And not everyone will take the time or energy to learn the highly unique communication styles of each person they interact with. So we develop and utilize tools to make the process easier. 

AAC (augmented and alternative communication) covers a wide spectrum of technological devices and methods that support or replace spoken language. For example, a music therapist might create a board showing pictures related to a client’s favorite songs. During sessions, they are prompted to make a choice (via pointing, extended eye gaze, or other method), thus providing the client the opportunity to non-verbally communicate their preference and desire in the moment. Alternatively, a client might use an AAC device–a computer or tablet with options for words, allowing them an even wider range of expressive language. Oftentimes in these cases, the client also works with a Speech-Language Pathologist (SLP) which could be a great opportunity for co-treating and collaborating on speech or language related goals! 

Language is a powerful thing, but it is not all-encompassing. People who are non-verbal still have preferences, still make choices, and still communicate. It is my hope that every music therapist is able to recognize and respect communication in all its forms, in order to best serve our client populations.