Thinking Out Loud

Visual Markers

Jacob has a neurological disorder that makes sustained attention difficult for him. He often leaves a conversation that is obviously not finished, which can be disconcerting and confusing to others. His roommate, Bill, has tried to give Jacob verbal clues and direction to keep him better focused, but this didn’t always work. Although Bill understands what’s going on, it’s frustrating for him. At times, he feels like Jacob’s parent, or worse it seems to him that Jacob is self-centered and uncaring, which Bill knows is not the case.

Words are important and we rely on them to achieve meaning and structure to our experience. Words, however, are only one form of structure to help give us direction. When Bill, Jacob, and I talked about the problems they were experiencing in their communication patterns, we decided to take a different approach to structure.

Rather than Bill only giving Jacob verbal cues, we decided to add practical visual, kinesthetic, and logical cues. For example, when they need to talk about something important, they sit at the kitchen table in designated chairs.  Prior to sitting, they put a blue table cloth (only used for this purpose) on the table, construct an agenda attached to a clip board, and make tea. They use the same routine each time they have these talks.

By literally setting the table with the same items (visual and kinesthetic reminders) and creating an agenda (logical) where they can check off items, they create patterns and structures to give Jacob multiple clues to help anchor his attention. Oh, and it is Jacob’s job to cross off items on the clip board as the conversation progresses, so he knows where they are in the process of discussion. This also gives him something tangible to do.

This type of structure has helped Jacob and Bill have extended conversations that are more satisfying to both of them. It does not fully compensate for Jacob’s attention difficulties, but it does give them both more structure and opportunity to collaborate on the process and content of their conversations, which helps them feel more connected.

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