Clinical Material

Background

Corrie is a 13-year-old boy with complex learning needs, global developmental delay, and physical disabilities, which leave him unable to walk, eat or drink orally, or do anything for himself. However, he makes very slight movements with a single finger and moves his head a little. He is fed through a tube directly into his stomach and this is administered through a machine, which beeps from time to time. He has no speech or language, but makes some non-verbal sounds and has some facial expression. He is of course totally non-ambulant, doubly incontinent, epileptic, and prone to breaks and fractures of his bones, despite his inability to move voluntarily. It is not really known what he sees, but people are asked to approach him at his right side, as vision in his right eye may be better. He lives at home with two sisters and his parents, and attends school each day. The school is for 20 pupils with complex learning needs (formerly profound learning disabilities/profound mental handicap). In school, he is a very popular boy. Anyone speaking to him, or interacting with him, is rewarded with great big smiles from time to time, and he makes very big efforts to communicate, despite all the difficulties. In this way, he is more able than his physical disabilities would suggest. This wish to communicate endears him to the staff. I have been seeing Corrie for individual sessions for three years. The session lasts for half an hour.

At the session time, I collect Corrie from his classroom. He is usually seated or lying in whatever position the staff have deemed most comfortable for him to be taken for the session. On entering the class I normally hear the staff tell him that I am here to take him for his session, and they build a little excitement into their voices, in the hope that in time, he might respond similarly, by smiling when he hears my voice or by turning his head a little as if looking for me. I say that I am here, and that it's time for us to go along f