Using Wordless Books to Support Clinical Consultations

This paper discusses the use of wordless books to support clinical consultations and shows that minimising the cognitive load by using wordless pictorial narrative reduces anxiety and empowers the patient, and clinicians using such resources describe positive clinical outcomes.
Purpose – Based on a literature and practice review, the purpose of this paper is to examine the theoretical
and clinical basis for using wordless books with patients who have intellectual disabilities (ID) and/or autism.
Design/methodology/approach – A literature review identified seminal peer-reviewed English language
articles relating to the neuroscience of information and emotion processing for adults with ID and/or autism.
In addition to published examples, illustrative case examples were contributed by clinicians regularly using
wordless books.
Findings – Many people, including those with ID, selectively attend to visual information. Minimising the
cognitive load by using wordless pictorial narrative reduces anxiety, and empowers the patient. Clinicians
using such resources describe positive clinical outcomes. Only the Beyond Words wordless books have
been identified in published clinical trials.
Research limitations/implications – Although existing evidence suggests a strong positive impact, further
research into the use of wordless books for people with ID is needed.
Practical implications – Wordless books are reported to help develop staff skills and empathy for
supporting adults with ID. The books facilitate some legally required reasonable adjustments to increase
service access. Staff training is needed for effective use of wordless books.
Originality/value – Wordless books specifically designed with and for adults with word processing
difficulties, ID and/or autism to enhance health literacy and explore their own narratives and emotional
responses around health experiences and personal traumas are a unique approach. This paper may also
offer the first exploration of their neuropsychological underpinnings.