ARBD Communication

My name is Leigh Andrews and I am a Speech and Language Therapist with Change Communication, a registered charity. We work with people experiencing homelessness and the organisations that support them. Over half of the people we support use alcohol and drugs at hazardous levels and they have done so for decades. The impact of their alcohol use may have caused damage to the brain which controls our communication. Unsurprisingly, this leads to communication difficulties amongst this group.

Interestingly people often don’t ‘see’ the communication difficulty. Slurring of speech, word finding difficulties and long tangential stories may be assumed to be caused by drunkenness. Difficulties with taking turns and seeing someone else’s point of view may be put down to not listening. In fact, what we may be observing is the result of organic damage to the brain that has affected communication.

At Change Communication we assess people’s communication as best we when we get the chance. We don’t require a period of abstinence, indeed people may drink alcohol in our appointments, and we rarely have access to a clinic room. This approach makes our appointments accessible and helps reduce stigma. In turn this helps us build a relationship with the person.

It is not uncommon for there to be a window of opportunity during which the person is sober and happy to let us assess them again. When this happens we can compare the two presentations and evidence that communication needs are present both when drinking and not drinking. That means services supporting the person need to make communication adjustments to ensure they are working effectively with the individual. This is the law, both the Equalities Act and the Accessible Information Standard bring duties to bear on services who are supporting such individuals.