Summer Salad

January/February 2009

FocusSummer Salad

Overcoming communication barriers

Working with patients with intellectual disabilities

Volume 38, No.1, January/February 2009 Pages 10-14

Ka Lip Chew

Teresa Iacono

Jane Tracy


Communication styles and communication difficulties may impact on the ability of general practitioners to provide best possible health care, particularly for patients with intellectual and other developmental disabilities.


To highlight potential difficulties GPs may face in consultations with adult patients with an intellectual disability and to raise awareness among GPs of the different communication methods used by people with intellectual disabilities. Current recommendations for improving communication with this marginalised group and practical issues in implementing these recommendations are also discussed.


People with intellectual disabilities have different communication abilities, using a range of different styles as a group, as well as on an individual basis. They may use speech, augmentative and alternative communication strategies, or visual or behavioural cues to indicate their wants, needs or feelings. Improved collaboration between GPs, patients, and patients' support people, is encouraged to develop an individualised approach to communication with each patient and to promote best possible health outcomes and patient satisfaction.

Some medical practitioners may feel uncomfortable seeing patients with intellectual disabilities. This discomfort often stems from a lack of experience and training in working with people who have communication difficulties. These difficulties may affect interaction in consultations, which then affects the development of rapport and quality of health care provision.1,2 There may also be a reliance on patients' support people in obtaining a medical history.1,3 Although obtaining a medical history from support people may be necessary for patients with limited communication skills, it is critical that patients are not excluded from the communication exchange.4

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