Abstract
This study IS concerned with communication assessment and intervention with people with severe intellectual disabilities. It proposes that since communication arises as a result of people interacting in social contexts then that is where it should be assessed. To this end, a number of observational methods were designed to assess the communication skills of four people with severe intellectual disabilities as observed in their interactions with others.
On the basis of the assessments completed, interventions comprising staff training and the introduction of augmentative communication strategies took place.
Four people with severe intellectual disabilities and all of the staff who worked with them participated in this study. Observations were taken over three phases. During the first 12 week phase approximately 17 hours of observations were undertaken. Each observation was time tabled to cover 10 minutes of each half hour of an individual's day. The data gathered formed the basis of
communication profiles written on each of the disabled participants. At the end of this phase, staff training took place in one setting and four weeks later, in the second setting. In the second phase, a further three hours of observation was completed at regular intervals throughout an individual's day over 12 weeks. In the final phase, after the introduction of individual communication strategies, another two hours of observation was completed over eight weeks.
All of the staff working with the disabled participants were interviewed during phase one. The staff in one setting were interviewed as a group again after staff training and the staff in the other setting participated in facilitated discussions that were fed back to the researcher by the Manager of that service.
The results supported the thesis that the communication partner has a substantial effect on the communication behaviour of individuals with severe disabilities. In this study, the disabled participants attempted to establish communication on a regular basis but staff were unprepared for that communication and consequently did not respond to communication opportunities when they arose. Distinct differences also emerged in the communication that occurred in each of the settings studied. These differences further highlighted the power of staff behaviour to encourage communication.
Subsequent to staff training, the staff changed their own behaviour to become more receptive to the communication opportunities created by their clients. The resulting change to the quality and quantity of communication between staff and the disabled participants was essential to the successful introduction of individually tailored augmentative communication strategies at the beginning of the final phase.
These results question the usefulness of the behavioural analyses of communication that are generally completed with people with severe disabilities. It is argued that by focusing assessment on
the individual experiencing communication difficulties, the effect of the partner and the environment on communication is ignored. In addition, the use of the pre-determined codes of behaviour commonly used in these assessments restricts the gaze of the observer to the extent that they can fail to see the extent to which individuals with severe disabilities attempt communication with others.
The implications ansmg from this study include: the development of assessment strategies that are capable of capturing the depth of communication that exists between people with and without severe disabilities and the extent to which the communication partner enhances that communication; the need for staff training and on-going support and mentoring; quality leadership; and research to better understand the experiences and lives of people with severe intellectual disabilities.