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Communications Skills Notes Za Wizara Cmt Nta 4 Clinical Medicine First Year

Example of Communications Skills & Counselling notes za wizara of cmt nta level 4 clinical medicine first year as below shown, after this example of notes of wizara below there is directly download link to download Communications Skills & Counselling notes za wizara.

Skills of effective communication in interacting with a child and adolescents

Objectives: By the end of this session, students will be able to:

a. Definition of terms

b. Describe the concept of child and adolescent health and rights

c. Explain the importance of involving adolescents in the process of their own health

d. Identify social determinants and risk factors that affect child and adolescents

e. Use techniques of communicating with child and adolescents to provide health services



Definition of terms:

       Child. This comes from the Latin language (infant) means the one who does not speak.

      Or is any human being below the age of 18 years  but writers say is below 16 years unless under     

       the law applicable to the child. So the child is a human being with rights and dignity.

      Adolescent. Is the age between 10 to 15 years in male and 10 to 12 years in female



   Concept of a Child:

  Child rights were first recognized after the First World War with adoption of Geneva Declaration in   1924.  It was then recognized for the second time by the United Nations in 1959 that at the age of 16 years is considered to be a child.  Then became legally recognized internationally in November 20th 1989 with all fundamental rights.

Concept of an Adolescent:

Adolescent is a stage characterized by phenomenal (unusual) life events and many challenges. Like living with ought a road map from the society to pursue the ideal social norms due to emotional and physical changes that occur by fluctuations in interests, engaging in peer groups and reduce child parent relationship, expose them to adverse social and psychological hardship. They usual fall in substance abuse and crime.

Adolescent involves in the following changes;

Biological changes.  Increase in body size and proportional.

Development of sexuality in both physical and emotional, sexual organs, and secondary sexual characteristics such as growth of pubic hair and breasts

  Children  rights: -

· The right to life, not to be killed

· The right to be free from discrimination

· The right to dignity, through the protection of physical and mental integrity,

· The right to be protected against slavery, torture and bad treatments.

· Need to grow and develop under favorable conditions.

Rights to have education.   A child needs to have good education, live with his or her parents to benefit from protections

Rights to food. A child needs enough balanced diets necessary for growth and development

Rights to good health. A state of physical, mental and social wellbeing and dose not only mean an absence of care for mothers.

Rights to water.  Essential to survival since water plays major role in daily life and in the environmental  for all people. A clean and safe drinking water must be available, accessible and free of health risks and be reliable.

Rights to Identity. To be identified to Nationality

Rights to Freedom.  Free to live, Freedom to speak,

Right to Protection.  Protection from any harm, to ill health,


Adolescent rights:

· Rights to live, guidance  and  have Freedom

· Rights to get education

· Rights to speak

· Rights to express their views

· Rights to identity and protection

· Rights to have psychological support



· Reduces risk behaviors adolescent may have which may lead them to be infected with HIV and other blood borne diseases like HBV  ( Hepatitis B Virus or Hepatitis C Virus) and other sexual Transmitted Diseases like Syphilis or Gonorrhea eg. Use of drugs which are illegal, drinking alcohol, having multiple partners   and rapping.

· They can be empowered and trained as effective peer educators’ counselors, trainers and advocates.

· Can be viewed as equal partners and stakeholders

· Contributes to make policy, planning, making decisions, involves in implementing of some programs, monitoring and evaluation.

· Have the capacity to identify approaches or solutions to problems.

· Reduces risk behaviors adolescent may have which may lead them to be infected with HIV and other blood borne diseases like HBV  ( Hepatitis B Virus or Hepatitis C Virus) and other sexual Transmitted Diseases like Syphilis or Gonorrhea eg. Use of drugs which are illegal, drinking alcohol, having multiple partners   and rapping.

· Through education may know different ways of preventing themselves against some infectious diseases.




Factors to children:

Environmental risks. Children are more vulnerable than adults to environmental risks because of the   

                                        following factors:

Children are constantly growing.

They breathe more air

Consume more food

Drink more water in proportion to their weight because the central nervous system, Immune, reproductive and digestive system are still developing

They behave differently from adults as they have different patterns of exposure   

Young children crawl on the ground where they can be exposed to dust and chemicals.

They have little control over their environment

They are unaware of risks and choices.

· Other health risks include: Exposure to:

· Contaminated water

· Poor sanitation

· Indoor smock

· Rampart disease vectors such as mosquitoes

· Inadequate food supply

· Unsafe use of chemicals

· Unsafe waste disposal.

These disease ranks among the highest environmental burden of disease worldwide.

Children can also be affected by other environmental risks such as- Air pollution, Chemical hazards, Injuries, and Radiations.

Risk factors to Adolescents Health

· Drug abuse

· Alcohol problem

· Diseases like – Diabetes, HIV, and Sexual Transmitted Diseases.

· Traumatic injuries

· Sexual abuse

· Eating disorders

· Engage in risk behaviors

Improving adolescents health worldwide requires improving young people’s daily life with families  peers and in schools. Also to address risk factors and protective factors in the social environment at a population level and focusing on factors that is protective across various health outcomes.

The most affective Interventions are:

Improve access to education

Employment and

Reduce risk of transport- related risks

Techniques of communicating with a child and Adolescents.

To a child. Factors to be considered before communication:

· Physical appearance of a child

· Look for learning ability/ disability

· Sight problem

· Hearing problem

· Difficult with reading and speaking

· Cultural needs of a child, families and care takers

· Take into account on religious beliefs


      Communication should be:

       -Age appropriate child and adolescent friendly.

  How to Communicate

· Discuss and list the skills and behaviors which might be most helpful when consulting with children.

· Lay out of the consulting room, put toys, books and drawing materials.

· Establish how comfortable the child is when she first comes in with a parent and her family.

· Build rapport                                                    

· Listen carefully

· Use clear and appropriate language to child’s age or same language

· Consider the child’s character (tabia au sifa  yake)

· You can stories wile communicating

· Add humors (vichekesho)

· Find out where the child is most comfortable. e.g on the parents knees or on the floor playing with toys particularly during  physical examination.

· Pay attention to proximity (ukaribu) between you and the child- many children like you to be at their level.

· Be gentle

· Offer a clear follow up plan

 To  Adolescents:

        Establish rapport

        Prepare a friendly environment for communication

       Learn adolescent’s terms to communicate effectively

       Do not embarrass the client

       Pay a respect as a human being

       Let her or him be open

       Be attentive when communicating  



Skills of effective communication in interacting with people with  speech and hearing  disability.

By the end of this session students will be able to:

a) Define speech disability

b) Explain the concept of communication in interacting with people with speech and hearing disability

c) Explain challenges of communication in interacting with people with speech and hearing disability

d) Apply techniques of communication in interacting with people with speech and hearing disability


Speech disability.

 Is an impairment of articulation of speech, sound, fluent and or voice.

Articulation disorder- is the atypical production of speech, sound characterized by substitutions, omissions, addition or distortions that may interfere with intellectuality.

Fluent disorder- Is an interruption in the flow of speech characterized by atypical rate, rhythm and repetitions in sound, syllables, words and phrases.  

Voice disorder- Is characterized by abnormal production and/ or absences of vocal quality, pitch, loudness, resonance and / or duration, which is inappropriate for an individual’s age and / or sex.


Hearing Disability 

Deaf is defined as hearing disorder that limits an individual’s aural/ oral communication performance to the extent that the primary sensory input for communication may be other than the auditory channel.

Hard hearing is defined as a hearing disorder whether fluctuating or permanent, with adversely affects an individual’s ability to communication. The hard- of – hearing individual relies on the auditory channel as the primary sensory input for communication.

Hearing disorder is a result of impaired auditory sensitivity of the physiological auditory system.

Hearing disorder is classified according to difficulties in detection, recognition, discrimination, comprehension and perception of auditory information .Individual with hearing disorder is described as deaf or hard hearing. People who are deaf or difficult hearing use sign language.  It is visual interactive language that uses a combination of hand and motion.


Not all people who are deaf or hard hearing  are trained in sign language, some are trained in speech language.



Concept of speech and hearing disability.

People with speech and hearing disability  face many challenges in the community during interacting with people who are not disabled in speech and in hearing. They normally being isolated or discriminated due to their condition which is not fair.

Time has come for these disabled people to make them feel as other human being by providing them education in specialized schools and help with hearing devices for those who are disabled in hearing.

In doing so they can participate fully in daily activities in the communities


Challenges- The following are challenges facing people with speech disability.

· Misunderstanding. Due to use of non verbal communication

· Takes time to communicate and understand what the person is talking about

· A person can perceive the information wrongly

· Unable to reach into conclusion

· A person can be neglected

· Discrimination from the community

· Failure to afford hearing devices to people who are disabled in hearing. They are very expensive

· Failure to get education to both speech disabled and hearing disabled

· Inadequate schools for them. Even if they get a one, is very expensive

· Failure to be employed

· They are not respected by the society

Techniques  of communication in interacting with people with speech disabilities

· Create good relationship so that they can share information well without fear

· Learn from family, care takers or individual about the nature of a person’s communication disorder, 

· Respect   a person.

· Do not afraid to ask her or him to repeat a word or sentence you didn’t hear properly

· Do not finish a sentence for him or her

· Look for facial or other responses. Speech is not the only way of communication a non verbal communication can be also used

· Do not argue with a person who stutters to slow down or slow over. This tends to make stuttering worse.

· Show patience when talking to a person with speech disability

· Pay attention when communicating

· Avoid negative response. Support the individual and his or her care takers for spiritual support. Do not call them with bad names or telling them words that can offend them like a disabled person.

· Speak clearly.  Be aware that people with speech disability might feel like you are ‘talking down’ to them if you speak slowly.

· People with speech disability should be treated like other human being

· Strive to understand what the individual is saying by focusing on what is saying rather than how is saying .

The following techniques are used in interacting in communication with hearing disability people:

· Face the hearing disability person directly, on the same level and in good light whenever possible.

· Position yourself so that the light shining on the speakers face, not in the eyes of the listener

· Do not talk from another room

· Speak clearly, slowly, distinctly, but naturally without or exaggeration mouth movements.

Shouting  distorts the sound of the sound of speech and may make speech reading more difficult

· Say the person’s name before beginning a conversation.This gives a listener a chance to focus attention and reduces the chance of missing words at the beginning of the conversation

· Avoid talking too rapidly or using sentences or phrases and wait to make sure you have been understood before going on.

· Keep your hands away from your face while communicating with hearing impaired person.

· If you are eating, chewing, smoking etc, while talking your speech will be more difficult to understand.

· Beads and moustache can interfere with the ability of hearing impaired to speech read.

· If the hearing impaired listener hears better in one ear than the other, try to make a point of remembering which ear is better so that will know to position yourself.

· Be aware of possible distortion of sounds.

They may hear your voice but still may have difficulty to understanding some words.

· Try to minimize extraneous noise when talking

Most hearing impaired people have difficult to understand speech where there is background noise.

· Avoid situation where there will be loud sound when possible.

Some people of hearing loss have very sensitive to sound.

· Try to find a different way of saying something rather than repeating the original word over and over. If has difficult to understand a particular phrase or word.

· Avoid sudden changes of a topic.

If the subject is changed tell the person what you are talking about.

· If you are giving specific information such as time, place, or phone numbers have them repeat the information back to you.

· Pay attention to the listener.

A puzzled look may indicate misunderstanding

· Avoid interrupting other speakers



Skills of effective communication in interacting with people with mental disability.


By the end of this session, students may be able to:

a) Define mental disability

b) Explain the concept of communication in interacting with people with mental disability

c) Explain the challenges of communication in interacting with people with mental disability

d) Apply techniques of communication in interacting with people with mental disability.


a) Mental disability  means change of mood and behavior of a person which is caused by different causes


In our society there is powerful negative stigma attached to mental illness, especially the more serious forms.

Mental disability are no more likely to be dangerous to the general population but because of their bizarre behavior (very strange to look at) they often frighten people.

Of course some mentally ill people are dangerous. Our fears of mentally ill people stop from our inability to communicate with them and our lack of knowledge about mental illness.


· Some mental disability people fail to afford medicine

· Discrimination. - Mental disability people are discriminated by the community

· Not access to health facility

· Shortage of health care workers who are knowledgeable on mental illness and management

· Shortage of medicine for mental health illness

· Mental disability people are prone to infectious diseases and road accidents

· Can not be employed

Techniques of communication in interacting with people with mental disability

· Respect.

· Treat the mental illness people like you would like to be treated

· Relax and stay calm

· Start a conversation with the expectation that things will go smoothly

· Minimize distractions. - Ask if you turn off the TV for example.

· Listen actively and make eye contact unless this is threatening.

· Simplify. One topic at a time.

· Use ‘I statement not ‘you statement’

· Acknowledge what the other person says and how they feel, even if you don’t agree

· Engage the person in the process by asking for opinions and suggestions

· Watch out for contradictory messages between verbal and non- verbal messages.

· Don’t take it personally.

Remember that one’s illness can affect their behavior.

· Don’t criticize, accuse or blame

· Don’t assume

Clarify by asking questions

· Don’t raise your voice or discipline the person

· Don’t use general and loaded words such as ‘always’ or ‘never’

· Use specific words instead

· Avoid arguments when communicating with mental disability person

· Do not ask them too many personal questions


 Skills of effective communication in interacting with people with visual  Disability


By the end of this session, students will be able to:

a) Define the term visual disability

b) Explain the concept of communication in interacting with people with visual disability

c) Explain challenges of communication  in interacting   with people with visual disabilities

d) Apply techniques of communication in interacting with people with visual disabilities


a) Definition:

Visual disability means visual impairment.

b) Concept

When you meet people who have vision impairment, always address them by name and introduce yourself by name. Remember that people with vision impairment cannot rely on the same cues as people who do not have a visual impairment.

There are a number of organizations that can help people with visual impairment. Eg. World Vision, Private Health Organizations and other Non Governmental Organizations.

c) Challenges:

· Lack of education to poor people due to high cost of fees.

· The society discriminate people with visual disabilities

· In adequate schools for visual disabilities

· High cost of walking aids

· Some people resist escorting them wherever they want to go as a walking aid

· Dangerous to walk alone as they can be involved in motor accidents


d) Techniques of communicating with visual disability  people

· Introduce yourself by name

· Address them by their names

· Use a common language or the same language in order to understand each other well

· Respect our client

· Avoid talking to third channel communication for effective communication

· Do not change or leave the conversation without saying so.

· Use simple language when communicating with a visual impaired person

· Avoid competition noise during communication

· Use body language, gestures, and postures as these can help to change the tone of your voice and the visual disability person can help to understand the feelings of the person is talking to.

· Always ask first to check if help is needed during communication. This will help the person to express him/herself freely

· Be attentive and an active listener during communication.   



skills of effective communication in interacting with people with drug abusers  and alcoholics.


a) Define the term key population

b) Outline groups in the key populations

c) Explain the concept of communication in interacting with key population

d) Explain the challenges of communication in interacting with  key population

e) Apply techniques of communication in interacting with key populations


Key populations are those people who are at risk and neglected in the society as they engage in behaviors that put them at high risk of acquiring or infected with HIV.

b) Groups in the key population

Drug abusers


Commercial sex workers

Transgender people




Street children


c) Concept of communication in interacting with key population.

Key populations are groups of people that are neglected and discriminated in the community due to their bad behaviors.

Most of these key populations have different causes that put them t have those behaviors.

Strategies should be done to prevent those condition/ behaviors.


d) Challenges.

· Unwilling to express their problems

· They lack information about HIV and services that might help protect them

· Unable to afford treatment for Sexual Transmitted Diseases

· They are discriminated by the society

·  Low knowledge on condom use

· Low knowledge on condom negotiation

· Lack of employment- They have nothing to do that’s why they engage in bad behaviors

· They are chased away from their families

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