Does my client
have an intellectual disability?
An intellectual disability
affects the way a person learns. It can affect them in a
variety of ways and to different degrees. There are many
causes of intellectual disability, including genetic
factors, physical injury, illness in childhood, pregnancy
or childbirth.
Like everyone else, people with an
intellectual disability have a variety of life
experiences. Some work in open employment settings;
others work in supported employment (previously sheltered
workshops) or attend day programs. Some receive
Centrelink benefits or other sources of
income.
Some live in supported
accommodation, such as group homes or residential
centres. Others live independently in the community or
with family members. Some are in relationships and are
parents. Some are aged.
Intellectual
disability is not the same as mental
illness.
Intellectual disability is
sometimes confused with mental illness but they are very
different. A mental illness often arises in early
adulthood and affects a person's perception and mood. It
is often episodic.
Some examples of mental illness
are: schizophrenia, depression, bipolar affective
disorder (previously manic depression)
An intellectual disability arises
either at birth or when the person is a child or young
person. It is fairly constant throughout the person's
life, although the effect of the disability will depend
on what support and opportunities for development the
person has.
It impacts on various skill areas
such as communication, self-care and social
skills.
Depending on the person, a person
with a intellectual disability might:
- take longer to absorb
information
- have difficulty understanding
questions, abstract concepts or
instructions
- have difficulty with reading
and writing and money skills
- have a short attention span and
might be easily distracted
- find it difficult to maintain
eye contact
- find it difficult to adapt to
new situations or to plan ahead or solve
problems
- find communication over the
phone difficult
- have difficulty expressing
their needs
You cannot tell whether a person
has an intellectual disability by their appearance. You
will need to observe the client for yourself.
If you suspect that your client
might have an intellectual disability you could ask them.
If they do not know, are not sure, or do not identify as
having an intellectual disability you could
ask:
- Did they go to a special school
or were they in a special class?
- Do they receive services from
the Department of Ageing, Disability and Home Care
(DADHC)?
- Do they live in a group home or
residential centre?
- Do they have a case or key
worker?
- Do they receive the Disability
Support Pension?
- Do they work in a sheltered
workshop?
The answers to these questions may
not necessarily indicate intellectual
disability.
Working with
clients with an intellectual disability
Adjusting your communication
style to suit the client can make a difference to the
capacity of the client to understand their case, provide
instruction and understand and participate in the
proceedings.
Be aware that the client may have a
short attention span and have difficulty staying on the
same subject.
Remember, they may not have
absorbed the information you discussed at your last
appointment.
- It is preferable to interview
the client in person.
- Tell the person you want them
to let you know if they don't understand
- Treat the person with respect
and build their confidence - don't
criticise
- Allow additional time for the
interview
- Hold the interview in a quite,
private area free from distractions and
interruptions
- Allow the person to tell their
story - save your questions for the end
Some tips for
interviews and speaking on the phone
- Don't interrupt or finish the
person's sentences
- Use open rather than leading
questions
- Use simple words and sentences -
one idea at a time
- Avoid abstract concepts and don't
use jargon. Check whether they understand - get the
person to repeat back the information in their own words
or ask follow up questions
- Be aware that the client may need
more breaks than other clients
- You may need to spell out any
phone numbers slowly for the client to write
down
Hiding their
disability
People with an intellectual
disability may not want you to know that they have an
intellectual disability or wish to hide the effect of
their disability from you. This is often because of the
stigma associated with having an intellectual
disability.
Your client may give a false
appearance that they understand what is being said to
them. This is referred to as a 'cloak of competence'. The
person may be responding in this way to hide that they do
not understand or they may be eager to please you and be
giving answers they think you want them to
give.
This might lead to inappropriate or
inconsistent answers to questions. It is important to
refrain from using leading questions when speaking with
your client.
Allow
Time
Allow extra time or more
interviews when working with a client with an
intellectual disability. Explaining information will take
longer and you will need to take more breaks. You may
find that you ask a question and the client does not
respond within the time period you expect. Avoid jumping
in to clarify or ask another question. If you wait you
may find that the client's response will come.
Non-verbal
communication
Be aware of the client's
non-verbal communication and behaviour. This may provide
more information about how they are responding to a
situation and what they really think about what is
happening.
Find out about your client's skill
level in reading and writing. Where the client has
difficulty reading, make sure you communicate the
information contained in any letter to the client in
person or on the phone.
When writing to your client
consider the following:
- Use at least 14 or 16 point
font
- Use at least 1.5
spacing
- Use a clear and easy to read
font like Arial
- Do not make the wording
dense
- Use short sentences and
paragraphs
- Use headings
- Write in point form
- Use plain English
- Include only necessary
information in the letter
- Consider changing any pro forma
client agreement to a format that assists the client
to understand it.
Reports
Assessments of an
intellectual disability are best made by a psychologist.
The assessment measures both IQ level and functional
skill levels. Both are important. Assessments can suggest
an age range within which the person functions, but this
information should be used with caution as the person is
an adult with their years of experience and they will
have strengths and weaknesses in different areas.
If the client has other
disabilities such as a mental illness or epilepsy, then
an additional assessment by a psychiatrist or neurologist
would be useful.
Working with a
support person
A client may bring a support
person with them to an interview or court appearance.
This person might be a CJSN support person, family
member, friend, worker or advocate.
You should:
- Establish what the role of the
support person will be. For example, assisting the
client to communicate with others, including the
solicitor.
- Talk directly to the client not
through the support person.
- Ensure the support person is
appropriate and has a helpful attitude towards the
client.
- Check conflict of
interest.
- Seek to avoid any situation
where the client makes any admissions in the presence
of the support person.
- You may wish to consider asking
the support person to sign a confidentiality
agreement.
For further
information
Legal Advice available between 2pm
- 5pm weekdays
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