Stimulating Intersubjective Communication in an Adult with Deafblindness: A Single-Case Experiment

Abstract

Sensory disabilities may limit a person's development of intersubjectivity, that is, the awareness of self and other, which develops in conjunction with interpersonal communication. This study used intersubjectivity theory to test a new intervention called the High-Quality Communication (HQC) intervention for its effects on a young adult with congenital deafblindness and a developmental age of between 1.5 and 4 years. Three of his social partners were trained to support attunement and meaning making with him through education and video feedback. This study measured seven observation categories at three layers of intersubjective development during a baseline and two intervention phases: dyadic interaction, shared emotion, referential communication, meaning negotiation, shared meaning, declarative communication, and shared past experience. The participant's use of conventional communication was included as an additional category. Effects were observed in all observation categories from the baseline to the intervention phases. Further study of the effectiveness of the HQC intervention is recommended to test whether effects generalize across people and settings.

Intersubjectivity Effects of the High-Quality Communication Intervention in People With Deafblindness

“…The intervention was applied by a coach together with the social partners, following a 14-step protocol (see Damen et al, 2014). Four coaches were involved in the study.…”

“…This system was developed by the authors to analyze the observations and had been tested in a single-case experiment (Damen et al, 2014). An overview of the coding categories is presented in Table 3.…”

“…This scale had been used in a previous single case-study of the HQC intervention as well (Damen et al, 2014). In this study, we used the subscale "subjective effectiveness" (16 items).…”

“…Delays in the development of interpersonal communication in children with sensory disabilities such as deafblindness may be understood and treated using theories of intersubjective development (Damen, Janssen, Huisman, Ruijssenaars, & Schuengel, 2014). The term "intersubjectivity" is used for the ability to share subjective states between two or more individuals, but also refers to a variety of behaviors that show this ability in interpersonal communication and to the interpersonal communication itself.…”

“…However, it provides additional support of partners' meaning making strategies (Damen et al, 2014), such as for example, hand-under-hand exploration of objects to develop joint attention. In a single-case experiment, effects of the HQC intervention were found for attunement strategies on both the first and second layers of intersubjective development.…”