ACQ Vol 10 No 3 2008

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ACQuiring knowledge in speech , language and hearing, Volume 10, Number 3 2008 89
INTERVENTION: WHY DOES IT WORK AND HOW DO WE KNOW?
research addressing its utility is still emerging (Blackstone,
Hunt Berg, Thunstand, & Wilkins, 2004).
The aim of this pilot study was to examine the usefulness of
the Social Networks inventory to explore (a) the modalities
used by three adults with severe intellectual disability during
interactions as determined by different communication
partners, and (b) the potential usefulness of the inventory to
document change before and after a communication
intervention as determined by independent raters (hence a
preliminary indication of the reliability of the tool).
Methodology
Participants
Adults with intellectual disability. Three adult males participated
in the study: James (29 years), Craig (26 years) and Mark (22
Keywords:
AAC,
communication partners,
intervention,
outcomes,
severe intellectual disability
People with severe intellectual disability (ID)
and complex communication needs lack
speech skills to meet their daily needs. They often
rely on informal modes of communication, such as gestures,
facial expression and idiosyncratic behaviours (Iacono, Carter,
& Hook, 1998), and sometimes simple forms of augmentative
and alternative communication AAC; (Beukelman & Mirenda,
2005; Mirenda, Iacono, & Williams, 1990). The success of any
communication interaction with an individual with severe ID
will depend, at least to some extent, on the skills of
communication partners in reading their signals (Light,
Binger, Agate, & Ramsay, 1999). There is a danger, however,
that partners of people with severe ID will fail to recognise or
value non-symbolic forms of communication, such as facial
expressions, vocalisations and gestures, as communicative
(Mirenda et al., 1990).
Until recently, there has been a lack of assessment tools to
document the use of different forms of communication across
partners. To address this need, Blackstone and Hunt Berg
(2003) provided a systematic strategy for describing the com­
munication of people with complex communication needs
during interactions with different types of communication
partners. Using an inventory format, Blackstone and Hunt
Berg extended the concept of “circles of friendships” to include
the use of various modalities across different communication
partners. Use of their Social Networks inventory facilitates
the identification of current and potential communication
partners within each of five Circles of Communication
Partners (CCP) (ranging from close family to acquaintances),
and the communication modalities that are used within each
(see appendix). Included in the inventory is information
about strategies used by partners to support interaction. This
information is useful in helping partners be explicit about
existing strategies in addition to exploring potential strategies.
Because the inventory has only recently been developed,
Adults with Severe Intellectual Disability:
Communication Partners and Modes
Sheridan Forster, Teresa Iacono, Karen Bloomberg, and Ruth Bryce
Communication for people with severe intellectual dis­
abilities (ID) varies according to their communication
partners and the modalities used. Until recently, there has
been no systematic way of documenting that variation as
part of the assessment process. In this small-scale study
we aimed to explore communication modalities and
strategies used by three adults with ID according to
family and paid support worker informants, using the
Social Networks inventory, before and after an inter­
vention. This inventory offers promise as a means of
understanding differences in communication across
partners and situations, and in documenting change.
This article has been peer-reviewed
Teresa Iacono Sheridan Forster Karen Bloomberg Ruth Bryce
years). They all had ID. James had Down syndrome, and
Craig and Mark had autism spectrum disorder. At the
beginning of the study, they had recently moved into the
same supported accommodation within the community.
Informants. According to the Social Networks guidelines
(Blackstone & Hunt Berg, 2003), information is obtained from
at least two informants and, in this study, on two separate
occasions. Each adult’s mother was an informant from the
first circle for both interviews; Mark’s father was also an
informant at the second interview. Interviewees from the
fourth CCP were two support workers for each adult.
Speech pathologists. Five speech pathologists were recruited to
provide judgements of differences evident in inventories
taken on two occasions (Times 1 and 2). They all had at least
12-months experience in working with adults with intellectual
disabilities and complex communication needs.
Procedures
Social Networks inventory
Description. The Social Networks inventory (Blackstone &
Hunt Berg, 2003) comprises sections addressing the
composition of CCPs, communication modalities and their
effectiveness (i.e., results in the desired effect) and efficiency
(i.e., is recognisable), and partner strategies that support
communication (see the appendix). Information collected
across informants is collated onto a summary sheet.
Administration. Two inventories were completed for each
adult with disability from interviews with parents and
support workers, respectively. Interviews were conducted at
the beginning and end of a 12-month period (Times 1 and 2)
by the first and fourth authors.