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Adaptive Interaction and Nonverbal Communication in

Alzheimer's dementia communication cognitive non verbal

Adaptive Interaction is a term that describes a method of communication that can help carers connect with people living with dementia who have lost the ability to communicate verbally. It is not difficult to learn and it can help to provide contact and engagement, even as the dementia advances. A common effect of advancing dementia is that the ability to speak can be gradually diminished, until people retain little or no capacity for verbal communication, relying instead on sounds or movements. Despite this, research has shown that people living with advanced dementia do still retain the desire to communicate. (Ellis & Astell,

This is important, as often people who have lost the capacity for speech are regarded as being withdrawn and consequently shut off from the world around them. Being able to communicate without speech can reduce social isolation, improve quality of life and allow more opportunities for caregivers to engage with people living with advanced dementia.

Everyone is born with an instinctive desire to connect with other people. We see this instinct in the way a baby will attempt to communicate, perhaps by smiling, crying, opening and closing their tiny hands, or making eye contact and, as adults, we recognize, enjoy and respond to these actions, often encouraging them by imitating the sounds and gestures that the baby is making. By mirroring these actions we enable and encourage the baby to engage in social interaction, even before they are able to speak. This is something that we take for granted but research indicates that it could also be a key skill that could help us to engage with people as they age and lose the ability to communicate verbally. The way we interact with babies may in fact hold the key to how we might communicate with people living with advanced dementia who have lost the capacity to speak.

Viewed through the lens of Adaptive Interaction, seemingly random actions by people living with advanced dementia, such as tapping, crying out, or repetitive bodily movements can be interpreted as potentially communicative, as opposed to random, or even problematic. It may be in fact that by copying, or mirroring the actions, and by paying attention to the mood of the person involved, the carer might find a way to communicate with someone unable to speak. Perhaps more importantly, those individuals with dementia can, once again, experience human connection and engagement with their loved ones.

The key principle of Adaptive Interaction is to view all behavior, such as sounds, movements and facial expressions as a potentially intentional attempt to communicate. This approach is based primarily on carefully looking for and observing such actions, such as sounds, movements, eye contact, gestures, etc, made by the nonverbal partner, and to use these observations to try to develop an understanding of the ways in which the individual may be attempting to communicate.

As these potential attempts to communicate are observed, the observer can then experiment with reflecting back, or imitating (mirroring) these actions, which can then potentially develop into nonverbal conversations. The actions in question can and will vary enormously from person to person. As mentioned above, examples may include tapping on a surface, touching hands, facial expressions, clapping, movement of feet, other bodily movements, smiling, or even crying out..

It is important to understand that Adaptive Interaction is not a panacea that will fit every person and every circumstance. Equally, for it to be beneficial, the carer must genuinely want to connect with the person involved, otherwise it could degenerate into simple mimicry, which would be harmful. There is a lot of research and a lot of literature available on the subject of Adaptive Interaction and, for any carers struggling to communicate with someone who has lost the capacity to speak, it is potentially a valuable skill to investigate and learn. If you need any assistance in connecting with additional information on the subject of Adaptive Interaction, contact us at and we will endeavor to connect you with material that will be helpful.