Nursing Care Plan for Impaired Verbal Communication

Impaired verbal communication is defined as decreased, delayed, or absent ability to receive, process, transmit, and use a system of symbols.

Related to :

• Physiologic conditions
• Alteration of central nervous system
• Impaired neurologic development or dysfunction
• Disturbance in attachment/bonding with the parent/caregiver

Characterized by :

• Language delay or total absence of language
• Immature grammatic structure; pronoun reversal; inability to name objects
• Stereotyped or repetitive use of language (echolalia, idiosyncratic words, inappropriate high-pitched squealing/giggling, repetitive phrases, sing-song speech quality)
• Lack of response to communication attempts by others

Outcome :

• Communicate in words/gestures that are understood by others

Interventions and Rationales

1. Use one-on-one interactions to engage the client in nonverbal play.
   R/: The nurse enters the client’s world in a nonthreatening interaction to form a trusting relationship.


2. Recognize subtle cues indicating the client is paying attention or attempting to communicate.
   R/: Cues are often difficult to recognize (glancing out of the corner of the eye).


3. Describe for the client what is happening, and put into words what the client might be experiencing.
   R/: Naming objects and describing actions, thoughts, and feelings helps the client to use symbolic language.


4. Encourage vocalizations with sound games and songs.
   R/: Children learn through play and enjoyable activities.


5. Identify desired behaviors and reward them (e.g., hugs,treats,tokens,points,or food).
   R/: Behaviors that are rewarded will increase in frequency. Desire for food is a powerful incentive in modifying behavior.


6. Use names frequently, and encourage the use of correct pronouns (e.g., I,me,he). R: Problems with self-identification and pronoun reversal are common.


7. Encourage verbal communication with peers during play activities using role modeling, feedback, and reinforcement.
   R/: Play is the normal medium for learning in a child’s development.


8. Increase verbal interaction with parents and siblings by teaching them how to facilitate language development.
   R/: Play is the normal medium for learning in a child’s development.