Identification of intentional communication in students with severe and multiple disabilities

Abstract

The use of published criteria to determine the intentionality of communicative behaviors of individuals with severe and multiple disabilities is discussed in light of research with individuals with and without intellectual disability. Data were collected from four young students with severe intellectual and physical disabilities in addition to sensory deficits. Communicative sampling procedures were used to explore how behaviors other than co-ordinated attention may signal emerging intentionality. These behaviors, which included persistence, idiosyncratic behaviors, and modifications to signals, in addition to patterns of differential modality use, are discussed as potential indicators. Implications for the identification and development of intentional communication in children with severe and multiple disabilities are discussed, along with directions for future research.

An ecological method for the sampling of nonverbal signalling behaviours of young children with profound and multiple learning disabilities (PMLD)

“…This is particularly so in the case of young children with PMLD who will be functioning at the very early stages in their acquisition of schema, shared attention and the formation of vehicles of expression. There is therefore an inherent difficulty in determining those behaviours realised by a child affected by PMLD that qualify as being intentionally communicative [15,47]. To make progress with this issue requires an understanding of how the notion of intentionality must change in accord with a child's developmental state [14].…”

“…This population requires a novel approach to social and communicative engagement which can address their inability to produce any clear and consistent verbal or motor signal. It is precisely this absence of transparency in their signalling repertoire that makes the previous functional approaches unviable with the particular population of children with PMLD as defined here [14,15]. The development of our new approach was motivated by the needs of this novel group which could not be served by existing methods.…”

Using dynamic assessment with learners who communicate nonsymbolically

“…Second, adaptations may be needed to enable responses by those with extensive motor involvement. For example, Iacono, Carter, and Hook (1998) modified temptations taken from the CSBSs (Wetherby & Prizant, 1993a) for individuals with cerebral palsy by lengthening the display of an activity so that they could orient and attend to it (e.g., slowly inflate a balloon, direct the air in the individual's direction, and repeat this over sessions) or by adding a switch to make self-activation of a toy or music possible. Third, because temptations may not characterize a partner's usual interactions with the individual being assessed, it is important to coach partners to present the temptation in familiar ways so that learners can participate.…”

“…As an example, information gained from interviews with parents and teachers and observations of their interactions with learners can help to (a) identify learners' idiosyncratic forms and functions as well as the activities, people, and settings associated with communication; (b) establish team goals for the assessment and tailor assessment to suit these goals; (c) obtain rich communication samples of learners' interactions with familiar partners; (d) understand how to assess the repair of communication breakdowns; and (e) individualize scaffolding (Chan & Iacono, 2001;Crais & Calculator, 1998;Iacono et al, 1998;Kublin et al, 1998;Siegel & Wetherby, 2000). Thus, although parental and staff involvement is not a required feature of dynamic assessment, it is a valued addition for learners who are nonsymbolic communicators.…”

“…Although all three function categories have been reported in learners who are nonsymbolic, the frequency of these functions, particularly for children with autism, has been documented in descending order, with behavior regulation being the most prevalent, social interaction occurring less often, and joint attention often being absent (Mundy, Sigman, & Karasi, 1990;Stone, Ousley, Yoder, Hogan, & Hepburn, 1997;Wetherby & Prutting, 1984). Learners with limited movement tend to have restricted forms that often involve subtle movements (Iacono et al, 1998), but their communicative functions may still span the entire range seen in early development.…”