Challenges with communication are common for many people with intellectual disability and, while counselling practitioners need a solid theoretical basis to their work, they also need to ensure that their practice is flexible enough to respond effectively to the needs of this broad client group (O’Driscoll, 2009). The communication styles of people with intellectual disability vary, as they do with all people. Some may be very articulate, some very talkative, and others may have very limited or no verbal communication (Gallagher, 2002).

Depending on the individual client’s communication style, needs and limitations, counsellors may need to talk more or talk less, make more statements than usual, give more suggestions, prompt more, rephrase the other person’s words and ideas, or ‘loan them the words’ more than usual (Booth & Booth, in Gallagher, 2002).

IQ is not a useful indicator of a person’s communication capacity. Two people with the same measured IQ can be very different in their practical abilities as well as their verbal fluency. Nor is a person’s vocabulary a good indicator of their level of comprehension or communication ability (Booth & Booth, in Gallagher, 2002). In the same way, a person’s chronological age may not be an adequate measure of their maturity (Dossetor et al., 2005).

Poor communication ability can have a wide impact on a person’s ability to negotiate the systems necessary to live well – for example to access banks, Centrelink, the Public Trustee, medical services and so on. It is important for counselling practitioners to take these challenges into account, to enable clients to take full advantage of the support services available to them, and to assist them in communicating their experiences and needs to others.

In the literature about counselling people with intellectual disability, there is often no distinction between people with ‘milder’ forms of impairment and more ‘severe’ forms of impairment. In addition, people with more ‘severe’ communication difficulties are often deliberately excluded from the research. There is a real absence in the literature about how to offer counselling, treatment and support to people with intellectual disability who have very limited verbal ability or who have more ‘severe’ forms of impairment. More work needs to be done to better understand and respond to the needs of this group.

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