Key Concepts

Communication Disabilities Access Canada believes that: 

  • Communication is the foundation for exercising legal capacity, autonomy, expressing preferences, communicating and making decisions.
  • Disabilities that may affect one or more areas of how a person understands, problem solves and/or expresses what they want to communicate include cerebral palsy, cognitive, intellectual or developmental disability, learning disability, fetal alcohol syndrome, Down Syndrome, autism spectrum disorder, multiple sclerosis, Amyotrophic Lateral Sclerosis, aphasia, dementia, Alzheimer’s disease, acquired or traumatic brain injury, head and neck cancer, Parkinson’s disease, Huntington’s disease and other disabilities. 
  • Communication supports aim to maximize an individual’s participation in making and/or communicating about matters that are important to them regardless of whether they make decisions independently, with support from trusted people or if they rely on others to make decisions on their behalf.
  • Communication supports include practices, tools and assistance that an individual may require in one or more areas of understanding information, problem-solving, expressing opinions, preferences and in making or communicating decisions.
  • Assistance or support to make a decision may or may not be required and must be addressed within a broader communication support context.
  • Communication supports must be in place before a person’s capacity is determined and throughout the process of decision making to ensure their opinions and preferences are heard and acknowledged.
  • Communication supports differ in type and amount depending on how the individual communicates, their personal support needs, the decision to be made and the skills of the person with whom they are communicating.
  • An understanding of the distinct roles and responsibilities of support person(s) is critical in recognizing authentic communication.
  • Communication assistance occurs when a support person facilitates communication that is generated or approved by the person with the disability. Proxy communication or advocacy is not generated by the individual and occurs when a support person says what they think an individual would communicate in a situation based on current or past knowledge of the individual, and interpretive communication occurs when a support person assigns meaning or intent to an individual’s non-symbolic behaviours. All roles are important but different.
  • Organizations require policies, procedures, safeguards and documentation regarding the duty to accommodate the identification and provision of communication needs of people using their services.
  • A Speech Language Pathologist is required in critical situations where:
    • the capacity assessor is not experienced or qualified to provide communication support
    • a person has a complex communication disability or no obvious way of communicating
    • a person’s capacity to provide informed consent is questionable
    • if there is evidence of a conflict of interest, undue persuasion or coercion from support person(s)
    • in critical communication contexts such as medical assistance in dying and justice settings. 

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