With a cognitive disability, communication is always a problem because the impairment cannot be seen. In addition, the mental impairment is a lack of attention and no one knows what they are not paying attention to. Self- reports are not reliable, but the person does know something and still has rights. Using what they can do tends to get tangled up into knots because different people define the problem from different perspectives. The following suggestions may help avoid the knots and concentrate on activities they can do.