ACQ Vol 10 No 3 2008

INTERVENTION: WHY DOES IT WORK AND HOW DO WE KNOW?

A dults with S evere I ntellectual D isability : C ommunication P artners and M odes

Sheridan Forster, Teresa Iacono, Karen Bloomberg, and Ruth Bryce

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

This article has been peer-reviewed

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.

Keywords: AAC,

communication partners, intervention, outcomes, severe intellectual disability

P eople with severe intellectual disability (ID) and complex communication needs lack speech skills to meet their daily needs. They often

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.

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,

89

ACQ uiring knowledge in speech , language and hearing , Volume 10, Number 3 2008