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Effective Practices for Counselling People With Developmental and Learning Disorders

Effective counsellors adjust their methods and approaches to meet the needs of individual clients. This article presents some strategies and practices to consider when working with people who have developmental and learning disorders.

Before you begin, you may want to learn more about disabilities that fall into the following broad categories:

Counselling clients with developmental disabilities

What do I wish I’d known when I started working with persons with developmental disabilities?—“In general, in my education and experience, I was led to believe that the hopes, dreams, and aspirations of persons with developmental disabilities were different from everyone else… and that’s not true. We all want to have family involvement, to have loved ones in our lives, to have jobs and careers. I had to really look and think about things differently to ‘get’ this.”

Communicating with clients

Families and other supporters

Clients who struggle with traditional communication methods often rely on family members and other supporters to facilitate discussions. However, the client’s wishes, opinions, and voice should remain primary. Always secure clients’ permission before sharing information about them with others or allowing others to share information on their behalf.

Autism spectrum disorders

When working with clients on the autism spectrum, pictures may work more effectively than words. Consider using gestures, sign language, computer-aided visual communication tools, or established methods such as the Picture Exchange Communication System (PECS).

Fetal alcohol spectrum disorder

When working with clients with fetal alcohol spectrum disorder (FASD):

  • Use a directive, action-oriented approach grounded in the client’s current needs and situation.
  • Model the behaviours you expect the client to demonstrate, such as being calm and focused.
  • Provide structure, such as by dividing each counselling session into clear steps. These might include check-in, progress update, feedback, planning next steps, and final questions or concerns. Communicate these steps clearly to the client.
  • Contact your municipal, regional, provincial, or territorial substance abuse office for information on local FASD support organizations.

Career counselling approaches for clients with developmental disabilities

Many people assume this client group lacks the capacity for self-determination. However, intellectual ability plays a lesser role in self-determination and autonomous functioning than simply having the opportunity to make choices.

Use the following counselling approaches with this client group:

  • Establish a warm, supportive, trusting environment.
  • Avoid anxiety-producing situations, such as testing conditions.
  • Provide encouragement, positive reinforcement, patience, and support.
  • Build recognition, praise, progress charts, and special rewards into activities.
  • Work frequently with clients over a period of time.
  • Provide group experiences and use them as occasions to practise verbal expression, explore employment interests, and discuss personal concerns.
  • Show pictures and visit businesses and industries to expose clients to job and workplace information and other life roles.
  • Adapt or modify material as necessary. Use a range of resources.
  • Be creative. Don’t be afraid to experiment.
  • Consider a person-centred planning (PCP) approach to increase decision-making autonomy.

Begin by gathering information about the client’s strengths, hopes for the future, likes, dislikes, and needs. Family, support workers, and former teachers can often provide this information, particularly for clients who do not communicate in a conventional way. At this point, details about required disability-related supports and financial support are important.

Referrals for assessment

To qualify for funding or training, the client may need to undergo assessments to confirm the nature of their disability.

Some clients will already have a professional assessment or diagnosis on file. Check on this before seeking further testing that may intimidate or cause discomfort for the client. If you feel further assessment would help, refer the client to the appropriate agency.

Family members tend to be very involved in the lives of loved ones with disabilities. Although this is often helpful, their presence during assessment can skew responses. Seek the client’s permission for a non-family support person, such as a friend, peer, co-worker, or neighbour, to contribute observations to inform the assessment.

Inclusive post-secondary education

Inclusive schooling now extends to the post-secondary level. Many adults with severe, profound, or multiple disabilities take part in these programs successfully.

Inclusive post-secondary education for people with developmental disabilities lays the foundation for transition into the community and the competitive workforce.

The programs provide the following advantages:

  • The means and experiences to develop career-related skills and aptitudes
  • Life-enriching experiences that help clients transition to adulthood and community life
  • Pathways to accessing experts and optimized learning environments
  • Practicum experiences that can lead to employment opportunities
  • Increased self-confidence and social skills
  • Decreased need for paid support workers

Counselling clients with learning disorders

Communicating with clients who have non-verbal learning disorders

When working with clients with non-verbal learning disorders:

  • Clearly state your expectations.
  • Use computers as a tool when appropriate.
  • Follow consistent scheduling.
  • Arrange facilitated group activity.
  • Encourage or introduce mentorship opportunities.
  • Provide clients with logical explanations for change.
  • Have clients consider coaching to learn organizational skills.
  • Suggest that clients undertake training in social skills.
  • Provide verbal explanations along with visual materials.

What do I wish I’d known when I started working with persons with learning disorders?—“I wish that I had known about the issue of diverse presentations. Sometimes we get ‘pigeonholed’ thinking that all people with learning disabilities are the same. And they’re not, not at all. Everyone is so different. The issue of behavioural presentation can be very confusing. I learned about learning disabilities through working with people.”

Career planning approaches

In working with clients with learning disorders:

  • Take the time to get to know your clients. Ask them about their whole life, from birth to present. Pay attention to education experiences, medical background, and social experiences.
  • If possible, involve significant people in clients’ lives in the career planning process. This could include partners, family members, employers, and co-workers. Significant others can provide a broader perspective on issues and demonstrate for the client how a collaborative, cooperative approach works.
  • Gather all available documentation on clients. Getting to know a client’s history can help you understand their perspective.
  • Help clients become aware of and acknowledge the ways in which their disorder can have disabling effects. People who understand the typical traits of their disorder are more likely to accept it as part of who they are and plan ways to compensate for the challenges it poses.
  • Help clients recognize the unique strengths that often comprise a significant part of their disorder. Help them identify these strengths and build on them.

Success factors

Successful people with learning disorders seek—and gain—control of their lives. To do this, they must want to succeed and know how to set goals. They must also reframe their disorder in positive terms. The key problem is not the disorder itself, but overcoming the challenges it presents.

Learned creativity is a critical factor in employment success. As career counsellor Jayne Greene-Black puts it, getting through school with a learning disorder can be “a pretty good business boot camp.” It teaches risk taking, problem solving, and resilience.

Part of feeling in control is having self-determination. For people with learning disabilities, self-determination means developing personal approaches to meeting demands in the community and at work. This often means using strengths in one area to bypass difficulties in another. For example, a client might use organizational skills to create checklists that will help them overcome poor memory.

Ultimately, success emerges from the client’s ability to strategize. You can help by promoting their self-awareness and self-understanding.

Assessment

When to refer for assessment—“Trust your intuition. If you think it [a learning disability] is there, it quite likely is. Diagnosis is really important. For many adults, diagnosis is a huge relief.”

A professional assessment often provides an important first step in career planning by clearly defining the problem.

Psychologist John Vavrik writes, “Learning disabilities should be formally diagnosed by a registered psychologist with advanced training in the learning disabilities field.” Based on a comprehensive psychoeducational assessment, the psychologist will determine the nature and extent of academic difficulties. The assessment also aims to identify, as closely as possible, the specific brain mechanism responsible for these difficulties.

Psychoeducational assessment

A valid learning disorder assessment includes:

  • A medical history (including head injuries or exposure to environmental toxins)
  • A developmental history (including onset of developmental milestones, such as walking and talking)
  • An educational history (school grades and type of remedial instruction provided)
  • Performance on measures of specific mental processes (such as auditory discrimination)
  • Performance on measures of academic achievement (such as reading comprehension)

The assessment must account for the fact that most adults have been out of school for many years. In many cases, they never received adequate schooling. This makes it more challenging to assess learning disorders in adults than school-aged children.

Benefits of assessment

There are many benefits of assessing clients with learning disorders:

  • Clients enjoy a sense of relief and reassurance when they finally learn the cause of their difficulties.
  • Clients’ self-esteem grows as they discover strengths and talents that have gone unrecognized or undervalued.
  • The focus shifts from hiding problems to identifying ways to address them.
  • Building a profile of strengths and challenges makes it easier to plan interventions.
  • Counsellors and clients can determine if clients qualify for related funding, programming, training, and testing.

Referrals for assessment

For information on referrals for assessment, consult the learning disabilities/disorders association in your area or the national office of the Learning Disabilities Association of Canada. Ensure that a professional experienced in dealing with the client’s age group completes the assessment. Psychologists who have worked extensively with children with learning disorders may have limited experience working with adults with the same condition.

Education options for clients with learning disabilities

As a result of the diagnostic and remedial services now offered to children with learning disorders during their school years, a growing number of adults with learning disorders have completed, or almost completed, secondary school credentials. Young adults with learning disorders are less likely than their peers to attend post-secondary institutions, but the numbers of those attending are rising.

Post-Secondary Success Stories: Graduate Student and Community Advocate (2:25)

Kim is a graduate student with a learning disability. With the help of assistive technology and access to post-secondary funding, she's becoming a strong advocate for her community.

However, many young adults with learning disorders have not done well in the education system. For example, they may have been passed through the system without adequate learning. Slightly older adults may have left the system before programs were in place to help them deal with their disorders.

These adults tend to be vulnerable in the labour market. Many remain undiagnosed. They know they have difficulties, but they don’t know why. While many find their way into literacy and basic education programs, others don’t know what kind of help they need or where to find it. Some simply feel too embarrassed to seek help.

Yet reports on people with learning disorders who complete post-secondary education show that their employment rates compare well with those of peers without disabling conditions. In fact, they often fare better than these peers in finding and retaining employment as well as in the salaries they earn.

In other words, a better, more satisfying quality of life may be within the reach of many clients with learning disorders. Upgrading, training, and retraining may be available through adult education programs across Alberta. Improving your client’s employment prospects may begin with no more than a professional assessment, accurate diagnosis, and appropriate accommodation in training and on the job.

Post-Secondary Success Stories: BA in Psychology (2:34)

Renee is pursuing a Bachelor of Arts in Psychology. She describes how she learned to open up about her invisible disability and access the funding supports, accommodations, and adaptive technology she needed.

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