ACQ Vol 10 No 3 2008

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

complex communication needs (3rd ed.). Baltimore: Paul H. Brookes. Blackstone, S., & Hunt Berg, M. (2003). Social networks: A communication inventory for individuals with complex communication needs and their communication partners: Manual . Monterey, CA: Augmentative Communication Inc. Blackstone, S., Hunt Berg, M., Thunstand, L. I., & Wilkins, D. (2004). Measuring the impact of augmentative and alternative communication across disability types and ages using social networks as a component of measurement . International Society for Augmentative and Alternative Communication: Research Seminar, Brazil. Iacono, T., Carter, M., & Hook, J. (1998). Identification of intentional communication in students with severe and multiple disabilities. Augmentative & Alternative Communi­ cation , 14 , 102–114. Light, J., Binger, C., Agate, T. L., & Ramsay, K. N. (1999). Teaching partner-focused questions to individuals who use augmentative and alternative communication to enhance their communicative competence. Journal of Speech, Language & Hearing Research , 42 , 241–255. Mirenda, P., Iacono, T., & Williams, R. (1990). Augmentative and alternative communication for individuals with severe intellectual handicaps: State-of-the-art. Journal of the Association for Persons with Severe Handicaps , 15 , 3–21. Murphy, J., Markova, I., Collins, S., & Moodie, E. (1996). AAC systems: Obstacles to effective use. European Journal of Disorders of Communication , 31 , 31–44. Appendix. Sections of the Social Networks inventory I Identifying information II Skills and abilities of the individual (e.g., receptive/ expressive language, reading) III Circles of communication partners 1 Close family 2 Close friends 3 Neighbours, acquaintances 4 Paid to interact 5 Unfamiliar partners IV Modes of expression (e.g., facial expression, signs) V Representational strategies (e.g., objects, written words) VI Selection techniques VII Strategies that support interaction (e.g., gesture dictionaries, prompting) VIII Topics of conversation IX Type of communicator (e.g., emergent, independent) X Summary Associate Professor Teresa Iacono is Director of Research at the Centre for Developmental Disability Health Victoria, and has a seconded position as Senior Researcher to the Communication Resource Centre, Scope. Sheridan Forster is currently completing her PhD at the Centre for Developmental Disability Health, Monash University. Her work aims to describe interactions between adults with profound intellectual and multiple disabilities. Karen Bloomberg is a speech pathologist with over 25 years experience. She co-ordinates the Education and Training Portfolio and is a speech pathology consultant at the Communication Resource Centre. Ruth Bryce is currently in Cambodia working with children with disabilities. She will be returning to Aus­ tralia in the not too distant future.

aware of his use of request cards in the community. People with complex communication needs may use informal communication modes with people with whom they are closest, and who know them well, but more formal modes, such as a communication book, with people who are less familiar with their informal modes (e.g., Light et al., 1999). In terms of the effectiveness and efficiency of communication modes, different reports across informants are likely to be indicative of using different criteria: James’ mother, for example, unlike the staff, judged his signs and communication board use to be ineffective and inefficient because he had not mastered them. Given the descriptive nature of the information provided, we chose to use consensus in speech pathologists’ judgements to determine changes over time. Craig and Mark were noted to have demonstrated improvements in aspects of their com­ munication, such as using more formal modes of communi­ cation. Also, over time, it was evident that the support workers used more strategies to support their own communication, possibly reflecting the communication input received. It was evident that although formal AAC systems were being used more frequently within fourth and fifth CCPs, the informants reported that their use was somewhat limited because of their own failure to develop and use them. Increasing use of AAC systems in everyday environments presents an ongoing challenge (e.g., Murphy, Markova, Collins, & Moodie, 1996). Informants in the present study did not directly question the value of AAC, but further probing may have revealed less overt forms of resistance. In contrast to the limited use of formal communication (AAC), it was evident that both parent and support worker informants recognised non-symbolic modes of communication at both Times 1 and 2. They also felt that for each adult with ID, two or more non-symbolic modes were effective and efficient across different CCPs. Hence, it was apparent that the support workers, as well as parents, had become more aware of and familiar with each person’s behaviours that had communicative potential (Mirenda et al., 1990). Implications The Social Networks inventory was found to be a useful tool for exploring the communication of three adults with complex communication needs. Informants with different relationships with the adults with ID contributed to an understanding of their communication modes and strategies used across communication partners. Such differences are indicative of the potential benefit of locating interventions within the contexts that include people who are in positions to support the person’s communication through frequent and meaningful interactions. Furthermore, the consensus judgements provided a means of quantifying changes across a number of dimensions. The findings suggest that the tool may be useful for documenting changes in communication. However, given the small scale and descriptive nature of this study and the lack of a control group, any observed changes cannot be attributable to the communication supports provided, nor was a direct evaluation of such supports a focus of the study. Further larger scale research examining the use of this tool for documenting change is warranted. Note Ethics approval for this study was obtained from the Scope Ethics Committee. References Beukelman, D., & Mirenda, P. (2005). Augmentative and alternative communication: Supporting children and adults with

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