This study followed 18 children with developmental disabilities, whose chronological ages were between 3 years and 6 years at the start of the study, over a 2-year period. At initial observation, children communicated primarily through prelinguistic gestures, vocalizations, and single-word utterances. Children's language skills were measured every 6 months with the Sequenced Inventory of Communication Development-Revised (D. E. Hedrick, E. M. Prather, and A. R. Tobin, 1984). Prelinguistic communication rate and parental responsiveness were also measured at each observation. Development of language over time differed between participants in accordance with their entry-level communication. Hierarchical linear modeling indicated that children's level of gestural attainment, rate of communication, and parent response contingency were significant predictors of language outcome.
This literature review was conducted to evaluate the current state of evidence supporting communication interventions for individuals with severe disabilities. Authors reviewed 116 articles published between 1987 and 2007 in refereed journals meeting three criteria: (a) described a communication intervention, (b) involved one or more participants with severe disabilities, and (c) addressed one or more areas of communication performance. Many researchers failed to report treatment fidelity or to assess basic aspects of intervention effects including generalization, maintenance, and social validity. The evidence reviewed indicates that 96% of the studies reported positive changes in some aspects of communication. These findings support the provision of 1 We would like to thank both Youngzie Lee, University of Virginia, and R. Michael Barker, Georgia State University, for their help with the analyses. We also thank the National Center on Evidence-Based Practice in Communication Disorders of the American Speech-Language-Hearing Association for their assistance in conducting the systematic literature search.Correspondence concerning this article should be addressed to Martha E. Snell, Curry School of Education, University of Virginia, P. O. Box 400273, Charlottesville, VA, 22904-4273., Snell@virginia.edu. NIH Public AccessAuthor Manuscript Am J Intellect Dev Disabil. Author manuscript; available in PMC 2011 February 8. Published in final edited form as: Am J Intellect Dev Disabil. 2010 September ; 115(5): 364-380. doi:10.1352/1944. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript communication intervention to persons with severe disabilities. Gaps in the research were reported with recommendations for future research. Keywords communication; mental retardation; severe disabilities; intellectual and developmental disabilities; autism; multiple disabilities; literature review; intervention The ability to communicate effectively with others is essential for good quality of life. Individuals who have severe disabilities include those with severe to profound intellectual disability, autism, deaf-blindness, and multiple-disabilities. For these individuals, the ability to communicate can be substantially compromised. The question of whether and how this ability to communicate can be improved through intervention was the focus of a national consensus conference convened by the U.S. Department of Education's Office of Special Education Programs, (OSEP) and its Technical Assistance Development System (TADS) in 1985 (OSEP/TADS, 1985). In addition to producing a number of consensus statements, these 1985 conferees called for the formation of "an interagency task force" to disseminate guidelines for the "development and enhancement of functional communication abilities" in individuals with severe disabilities.This recommendation resulted in the establishment of a "National Joint Committee for the Communicative Needs of Persons with Severe Disabilities" (NJC) in 1986. The present review was con...
This study assessed the communication initiation and repair behaviors of 28 individuals with severe to profound mental retardation in a variety of experimental conditions. All of these individuals communicated through nonsymbolic gestures. The experimental procedures were devised to simulate the conditions that typically evoke two different types of initiations: comments and requests. Each subject initiation was followed by an experimenter response that indicated a communication breakdown to determine if and how these subjects would attempt to repair such breakdowns. Different indicators of communication breakdown were systematically varied in these scripted interactions, including explicit requests for repair (verbal and gestural) and implicit requests for repair (failure to respond or inappropriate response to the subject’s communication act). All subjects initiated at least one communication act, and all but three subjects repaired at least one communication act following a breakdown. Significantly more subjects initiated protoimperative than protodeclarative communication acts, despite equal opportunities for both types of acts. Across all conditions, additions were observed to occur significantly less often than recasts or repetitions. There were no significant differences in the number of subjects repairing communication following the different types of communication breakdown.
A structured communication sampling procedure was used to measure the form and function characteristics of intentional communication acts produced by nonverbal adults with severe mental retardation. Four “contact” subjects (who communicated only with contact gestures) and 4 “distal” subjects (who used distal as well as contact gestures) participated in this study. All subjects produced communication acts that were coded as initiations, and all subjects produced protoimperative-type communication acts. However, contact subjects produced no protodeclarative-type communication acts, whereas all distal subjects produced some protodeclaratives. Distal subjects lso produced significantly more repair/recast acts than did contact subjects. Other findings included a tendency for distal subjects to communicate at a higher rate, to initiate more communication acts, and to produce more accompanying wordlike vocalizations than contact subjects. These results are discussed in light of Werner and Kaplan’s (1984) concept of distancing as central to symbolization. Implications for future research and for clinical practice are also discussed.
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