Communication breakdown

Also called Breakdown, Miscommunication, Failed communication

Knowing when a conversation has failed, and deciding who carries the work of fixing it. Hint: it shouldn't always be the person with the least speech.

What it is

A communication breakdown is the moment a message doesn't get through and both people know it, or, worse, only one of them does. The AAC user has said it three times; the partner has nodded three times and understood nothing. Or the partner has asked a question, the person has answered by looking at the window, and the partner has read that as "no answer".

Naming it matters because breakdowns are usually blamed on the person with the impairment. In fact a conversation is a joint job, and most breakdowns come from the partner's side: too fast, too much, too little time, no system in reach, not looking. Once you see it that way, most of the fixes are yours to make.

Who it can help

Everyone involved in a conversation where one person uses AAC, signs, has unclear speech, or communicates through behaviour and expression. It's particularly worth understanding for staff in care homes, wards and classrooms, where breakdowns are frequent, unnoticed and lead directly to a person being described as "challenging" or "withdrawn".

The idea isn't for the person alone; they already know what breakdown feels like. It's for partners, who often don't realise it has happened.

How it works

Breakdowns have signs. The person repeats the same thing, louder or harder. They give up mid-message and look away. They agree with whatever's suggested, which is often surrender rather than agreement. They become distressed, or angry, or very quiet. The partner, meanwhile, is nodding and saying "yes, yes" and changing the subject.

Who repairs it depends on who has the resources. A fluent partner can slow down, wait, check, offer choices and narrow things down at almost no cost. A person scanning through a device to produce one word at a time is paying a far higher price for every repair attempt. So the load should sit mostly with the partner, and a good partner takes it: "I'm not getting this and it's my fault. Let's try it a different way."

When repair fails, the honest ending is to say so, and to come back to it: "I still haven't got it. Can we try again after lunch, with your board?" A repair strategy agreed in advance, and a communication passport that says what to do, both shorten the failure.

Getting started

Notice the next time you say "yes" to something you didn't understand. Stop, and say instead: "I didn't get that. Say it again for me."

Check your side first. Is the system in reach and charged? Have you waited ten seconds? Is the room quiet enough? Are you looking at them?

Keep a note for a week of when breakdowns happen: the time, the place, the topic, who was there. Patterns show up fast, and they're usually about the environment, not the person.

Where to get help

Partner training from your speech and language therapy service is the direct fix. Communication Matters and the ACE Centre both cover breakdown and repair in partner courses. For dementia, Alzheimer's Society and Dementia UK have guidance on when a conversation isn't working. For adults in care, the Care Quality Commission expects communication needs to be met, and a pattern of unrepaired breakdown is a care quality issue.