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Exam Room Etiquette

You may need to provide support to communicate with a patient with developmental disability. Communication may take more thought and planning. Assess whether your patient uses spoken language. If not, they may use other forms of language, such as sign language, written language, or augmentative and alternative communication. People who are non‐verbal may communicate through behavior, facial expressions, and sounds. Listening to your patient may require using more of your senses. Below are some ideas, but ask your patient and caregivers what works best.

  • Order an interpreter if spoken English is not the patient’s primary language. Speak directly to the patient, not the interpreter.
  • Get your patient’s attention before speaking to them.
  • Use person‐first language (person with a disability), or identity‐first language (Autistic person), unless your patient prefers something else.
  • Talk directly to your patient in an adult voice and listen attentively for your patient to respond and to finish. If your patient appears to be thinking, wait quietly.
  • A patient may have better receptive than expressive language. Match the complexity of language to the person’s ability. Be careful not to make assumptions.
  • Treat assistive devices, such as wheelchairs, as personal space. Don’t touch a wheelchair without permission.
  • Before helping, offer assistance and wait for a response and instructions.
  • With patients who do not use spoken language to communicate use non‐verbal communication strategies, such as demonstrations, pictures, touch, gestures, and facial expressions.
  • People with social communication challenges may not be able to interpret facial expressions and gestures and therefore may benefit from concrete, literal explanations.
  • Check for understanding by summarizing and asking your patient to summarize in their own words.
  • If necessary, use short, concrete questions that require yes or no answers.
  • If necessary, ask questions that can be answered non‐verbally. For example, “Show me how you say yes.”
  • Offer to shake hands even if your patient has limited use of hands or an artificial limb.
  • Identify yourself and others to people with visual disabilities and indicate to whom you are speaking. Before leaving a conversation or room, let the person know.
  • It is okay to use common idioms that refer to vision or hearing such as, “Have you heard about…” or “See the light…”.

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