​10 Tips for Interacting and Building Rapport

We asked Tom Hall, M.A., CBIST, assistant vice president for clinical services at Riverside Community Care, to share some of his wisdom after working in the acquired brain injury field for more than 30 years. Below is a snapshot of what Tom shared with us. 

Each individual you meet in this field is unique and has their own personality and preferences and remember, “Once you’ve met ONE person with a brain injury, you’ve met ONE person with a brain injury.” One area which warrants special attention is within the area of communication. Impairments following a brain injury can result in the person having a diminished capacity to process the complexities of receptive and expressive communication. Before their injury, the person may have been able to reconcile and process both the verbal and non-verbal content of a conversation, but since injury onset, they may have a harder time processing the flow of verbal behavior. Therefore, it is important that care providers attend to those elements of non-verbal communication such as speed or cadence, tone or inflection, volume and body language. Below are the “Ten Commandments of Communication” from the North Dakota Center for Persons with Disabilities (2004).

1. Speak directly to the person, rather than through a companion or sign language interpreter who may be present.
2. Offer to shake hands when introduced. People with limited hand use or an artificial limb can usually shake hands and offering the left hand is an acceptable greeting.
3. Always identify yourself, and others who may be with you, when meeting someone with a visual disability. When conversing in a group, remember to identify the person to whom you are speaking. When dining with a friend who has a visual disability, ask if you can describe what is on his or her plate.
4. If you offer assistance, wait until the offer is accepted. Then listen or ask for instructions.
5. Treat adults as adults. Address people with disabilities by their first names only when extending that same familiarity to all others. Never patronize people in wheelchairs by patting them on the head or shoulder.
6. Do not lean against or hang on someone’s wheelchair or pet a service animal. Bear in mind that people with disabilities treat their chairs as extensions of their bodies. And so do people with guide dogs and help dogs. Never distract a service animal from its job without the owner’s permission.
7. Listen attentively when talking with people who have difficulty speaking and wait for them to finish. If necessary, ask short questions that require short answers, or a nod of the head. Never pretend to understand; instead, repeat what you have understood and allow the person to respond.
8. Place yourself at eye level when speaking with someone in a wheelchair or on crutches.
9. Tap a person who has a hearing disability on the shoulder or wave your hand to get his or her attention. Look directly at the person and speak clearly, slowly, and expressively to establish if the person can read your lips. If a person is wearing a hearing aid, don’t assume that they have the ability to discriminate your speaking voice. Never shout at a person. Just speak in a normal tone of voice.
10. Relax. Don’t be embarrassed if you happen to use common expressions, such as “See you later” or “Did you hear about this?” that seem to relate to a person’s disability.

This article was contributed by:

Tom Hall, M.A., CBIST

Tom works in Boston, Massachusetts, as the assistant vice president for clinical services at Riverside Community Care, a non-profit agency providing community-based services for people with acquired brain injury. Tom has worked in the ABI field for more than 30 years and has served as past ACBIS vice chair of governance and chaired the International Committee for 14 years. Tom has presented at numerous regional and national conferences and recently co-authored an article in Brain Injury Professional. You can contact Tom at Thall@riversidecc.org.