PIP Activity 7: Communicating Verbally - Complete Scoring Guide

Activity 7 covers expressing and understanding verbal information. This is PIP2 Question 9. This activity can score up to 12 points - the highest of any daily living activity. It applies to anyone with speech difficulties, hearing loss, cognitive processing problems or social communication differences.

The Descriptors and Points

a. Can express and understand verbal information unaided - 0 points.

b. Needs to use an aid or appliance to be able to speak or hear - 2 points. Hearing aids, an electro larynx or a speech-generating device that produces understandable speech for you. If the aid does not bring your speech or hearing up to an acceptable standard, a higher descriptor applies instead.

c. Needs communication support to be able to express or understand complex verbal information - 4 points. Someone explains complex things in simpler terms, or repeats/rephrases information for you. Very common with learning disabilities, autism, ADHD and brain injuries.

d. Needs communication support to be able to express or understand basic verbal information - 8 points. Someone helps you understand even simple conversations or express basic needs.

e. Cannot express or understand verbal information at all even with communication support - 12 points.

It's Not Just About Speech

This activity covers BOTH expressing (speaking, making yourself understood) AND understanding (processing what others say to you). You can score here even if you can physically speak, if you cannot process or understand what others say. Brain fog from fibromyalgia, ME/CFS or medication can mean you cannot follow a conversation reliably.

Conditions That Score Here

Hearing loss, stroke (aphasia), autism (processing spoken information), learning disabilities, dementia, brain injury, Parkinson's (quiet/slurred speech), motor neurone disease, Tourette's (speech interrupted by tics), selective mutism. Anxiety that makes you avoid or freeze around people is scored under Activity 9 (engaging with other people face to face), not here, because this activity is about whether you can speak, hear and understand spoken words.

Beyond Speech Problems

This activity covers ALL verbal communication difficulties, not just speech impediments. If anxiety stops you talking to strangers, that is normally scored under Activity 9 (engaging with other people face to face) rather than here, because Activity 7 asks whether you can speak, hear and understand spoken words. If depression leaves you unable to form sentences or express yourself, that counts. If medication makes you slur or lose words, that counts. If hearing loss means you can't follow conversations, that's communication too.

Communication Aids

Descriptor b covers a device that lets you speak or hear: hearing aids, an electro larynx, a speech generating device or a text-to-speech app that produces understandable speech. This scores at least 2 points, and if the device still does not bring your speech or hearing up to an acceptable standard you should be scored on the higher descriptors instead. Sign language is a language, not an aid: if you rely on BSL, the help that scores is an interpreter, which is communication support (descriptor c or d). Communication cards and written notes are not verbal communication, so having to fall back on them is a sign that you are not speaking to an acceptable standard rather than a reason to stop at 2 points. If you need another person to interpret or relay what is said (at appointments, on the phone or with officials), that is communication support and scores higher.

"Basic" vs "Complex" Verbal Information

The regulations separate "basic" and "complex" verbal information, and both are measured in your native language. The distinction matters because basic information needing support scores twice as much (8 points) as complex needing support (4 points):

• Basic information: information conveyed in a simple sentence. "What's the time?" "Two coffees, please." "Where is the toilet?" "Yes I am here for my 2pm appointment."
• Complex information: information conveyed in more than one sentence, or in one complicated sentence. Medical consultations, legal advice, financial decisions, longer conversations with multiple topics, telephone calls about benefits or bills.

If you need someone to interpret or rephrase only complex things (medical, legal, official), you score descriptor c (4 points). If you cannot follow even basic everyday exchanges without help, you score descriptor d (8 points).

What Counts as Communication Support

The regulations define "communication support" as support from a person trained or experienced in communicating with people with specific communication needs, including interpreting verbal information into a non-verbal form and vice versa. The assessment guide confirms this includes a family member or carer with direct experience of communicating with you, and that you should still score if you need this support but do not currently have it. Examples that count:

• British Sign Language (BSL) interpreter for Deaf claimants
• Lip-speakers and Speech-to-Text Reporters for hard of hearing claimants
• Translators for claimants whose first language is not English AND who also have a disability affecting communication (translation alone does not score)
• Speech and Language Therapy-trained support workers
• Family members who routinely interpret for medical appointments because of aphasia, hearing loss, autism or learning disability
• Advocates from disability charities who attend appointments and phone calls to help you follow and answer what is said
• Carers who relay phone calls for you because you cannot hear or follow what is said on the telephone

Telephone Communication - Often Overlooked

Many people who can communicate fine face-to-face cannot manage telephone calls because of:

• Hearing loss - cannot hear clearly without visual lip-reading cues
• Autism - cannot process verbal-only communication without face-to-face cues, struggle with turn-taking on phone
• Anxiety - panic attacks at the thought of phone calls, unable to use phones at all
• Cognitive impairment - cannot follow conversations without writing things down
• Speech impediments - speech is less clear without visual support, particularly with strangers

Phone problems do not score on their own: the descriptors ask whether you need communication support to express or understand spoken information generally, on more than half of your days, not just on the telephone. But if the reason is hearing loss, a speech difficulty or trouble processing speech, the same difficulty usually affects conversation face to face as well, and phone problems are strong evidence for descriptor c or d. Panic about phone calls by itself is not a speaking or hearing difficulty, so it does not score here. The PIP assessment itself is usually by phone - if you cannot follow the assessment without someone repeating or explaining, that is evidence of need.

Specific Conditions and Likely Activity 7 Scores

• Profound deafness: Descriptor b only if hearing aids bring your hearing up to an acceptable standard; where they do not, which is usual with profound loss, c or d applies whether or not BSL is your first language, and lip-reading does not count as understanding speech
• Post-stroke aphasia (expressive or receptive): Typically c (4 points) if mild, d (8 points) if severe, e (12 points) if global aphasia
• Autism with significant social communication impairment: Often c (4 points) if needing rephrasing of complex things, sometimes d (8 points) if cannot follow conversations with strangers
• Moderate learning disability: Often d (8 points) - need basic information explained
• Severe learning disability: Often e (12 points) - cannot understand or express even with support
• Selective mutism: Can reach d (8 points) where a known person has to relay what you say and what is said to you (communication support); a known person who is simply present to reassure you is prompting or social support under Activity 9, and severe social anxiety on its own is scored under Activity 9, not here
• Advanced dementia: Typically d or e depending on stage
• Motor neurone disease: Variable from b to e depending on bulbar involvement
• Severe Parkinson's: Often b (speech aids) or c (needing repetition)

Evidence for Activity 7 Claims

• Audiogram showing hearing thresholds
• Speech and language therapy reports
• Hospital letters mentioning aphasia, dysarthria, dysphonia
• Educational psychology assessment for learning disability
• Autism diagnostic assessment report
• Mental health letters describing anxiety affecting communication
• Statement from the person who regularly supports your communication
• Examples of times communication failed (missed appointments, misunderstandings, refused service)

Frequently Asked Questions

I can talk fine with family but freeze with strangers. What do I score?

It depends on why you freeze. Activity 7 is about whether you can speak, hear and understand spoken words, with people generally rather than just family. If you freeze because of anxiety, that is normally scored under Activity 9 (engaging with other people face to face), where needing someone to reassure or support you counts as prompting or social support. It counts here only if the person with you actually relays what you say and what is said to you - that is communication support and scores descriptor c or d.

Do glasses count as an aid for Activity 7?

No - glasses help reading (Activity 8) not communication. Activity 7 aids are devices that let you speak or hear, such as hearing aids, an electro larynx or a speech-generating device, and they score descriptor b (2 points) only where they bring your speech or hearing up to an acceptable standard. BSL is a language, not an aid: if you rely on an interpreter, that is communication support (descriptor c or d). Lip-reading is not treated as an acceptable way of understanding speech, and having to write notes or point at a communication board means you are not communicating verbally to an acceptable standard, so the higher descriptors should be considered instead.

I have a thick regional accent that people sometimes do not understand - is that PIP?

No. Accent is not a disability for PIP purposes. But if you have a speech impediment, voice disorder or post-stroke dysarthria that makes you regularly misunderstood, that is PIP-relevant.

I am a BSL user - what should I claim?

If BSL is your primary language and you need a BSL interpreter to communicate verbally in English, you should score at least descriptor c (4 points) and potentially d (8 points). Many profoundly deaf BSL users qualify for enhanced daily living when Activity 7 is combined with Activities 8 (reading captions) and 9 (engaging with hearing people).

I have to write things down to communicate - does that count as an aid?

Not as descriptor b. That descriptor is for an aid or appliance that lets you speak or hear, such as a hearing aid or an electro larynx. The assessment guide says that if you cannot make yourself understood and have to resort to writing notes or hand gestures, you are not communicating verbally to an acceptable standard, so the assessor should look at the higher descriptors: c or d if another person could help you express or understand what is said (communication support), or e (12 points) if you cannot express or understand verbal information at all even with that support.

What if my partner always speaks for me at appointments?

That is communication support and should score Activity 7 descriptor c (4 points) for complex information or d (8 points) if you cannot manage basic things either. Make this explicit on your form: "My partner attends every medical appointment because I cannot follow conversations with healthcare professionals reliably without her explaining things."

I have ADHD - can I score on Activity 7?

Possibly. ADHD can cause difficulty maintaining attention during long conversations, missing important information, interrupting or zoning out. If these affect your reliable ability to communicate verbally - particularly in formal or complex contexts - you may score descriptor c (4 points). Combine with anxiety or autism if relevant.