Enhancing Everyday Communication for Children with Disabilities - Softcover

Copyright © 2006 by Paul H. Brookes Publishing Co. All rights reserved.

INTRODUCTION

This chapter illustrates the concepts and procedures considered in Chapters 1–6 through a series of five case studies. Each case study was selected to illustrate the different intervention needs that partners are likely to encounter among individuals with developmental and physical disabilities. For each case study, we describe the assessment, intervention pathways, and instructional procedures that were used.

CASE STUDY 1: STRENGTHENING POTENTIAL COMMUNICATIVE ACTS

Liana was an 8–year–old girl who attended a school that included students with severe and multiple disabilities. Due to her very limited motor control and lack of formal expressive language skills, Liana was dependent on those around her for help with her daily needs. Liana's apparently passive role in just about every interaction meant that others believed that she had virtually no influence over her environment or the activities and routines that she experienced both at school and in the home where she lived.

Assessment

School staff were concerned that it would be difficult to find ways to involve Liana in decisions about her daily life, in order to maximize her active participation in the various events that make up a typical day. A few ideas were tested. First, a number of staff members watched routines, such as mealtime, and wrote notes about the communicative interactions occurring between Liana and her partners. These naturalistic observations lasted about 10 minutes and were conducted across a range of daily activities. After taking notes for several days, all of the partners involved with Liana got together and discussed the patterns they could see in the notes.

Based on their knowledge of Liana and these naturalistic observations, the communication partners were able to identify a number of potential communicative acts. For example, a number of partners noted that Liana sometimes made a faint smiling expression. This potential communicative act was interpreted by partners as Liana's way of indicating that she wanted more of an object or activity. These types of acts were considered appropriate forms of communication; however, it was unclear if these potential acts were in fact representative of the perlocutionary or illocutionary stage of communication development.

Intervention Pathway

The decision was, therefore, made to enter these types of acts into the Interpretive Pathway, with the goal of increasing the consistency and frequency with which they occurred during communicative interactions with partners. For example, one goal was to increase Liana's use of the smiling expression as a way of requesting more of a preferred object or activity.

Instructional Procedures

The partners created opportunities for Liana to request more within typically classroom activities by withholding a preferred item or interrupting an activity. Staff verbally acknowledged Liana when she smiled during these opportunities, and they consistently reinforced the response as a request by giving Liana more of the relevant object or activity.

Modifying the Program

Informal notes on progress were made and circulated among staff members to encourage consistency in using the instructional procedures. Liana's communication partners soon found that time was a major consideration in this procedure. Specifically, they got better results by waiting for 25–30 seconds after an opportunity to request more arose.

Outcomes

Eventually, a faint smile became a consistent way for Liana to achieve this particular communicative function, which opened the way for Liana to develop more control of her environment and play a more active part in communication processes. This increased power changed many of the expec– tations previously held by her partners. The partners now began to expect a response from Liana in situations in which they had never attempted to include her input.

Summary

This case study underlines the importance of careful observation and partner skills in changing the communicative lives of individuals with developmental and physical disabilities. By recognizing the influence of factors such as partner wait times and consistency and by systematically using information collected in natural learning environments, Liana's partners helped her develop her potential communicative act into a reliable form of communication.

CASE STUDY 2: INCREASING SOCIAL INTERACTION

Bill was a 7–year–old boy with a severe intellectual disability and cerebral palsy. He attended the neighborhood school and lived at home with his parents and two siblings. He was not able to walk or stand, but he could sit independently. The extent of his visual ability was unknown.

Assessment

Informal interviews with partners revealed that Bill mainly used prelinguistic forms of communication. For example, he appeared to seek continuation of a social interaction by reaching out and touching the adult with whom he was interacting. In addition, at mealtimes, he often kept his eyes shut. Because Bill was able to interact with people at other times (e.g., social games, routines), it was decided that he also needed to interact more with the person assisting him at lunchtime.

Intervention Pathway

Partners agreed that more time needed to be taken to include interactions during mealtimes. The communication objective was that Bill would open his eyes and look at the person assisting him at mealtimes in response to the cue, "Bill, look at me. Do you want some lunch?" In addition, his communication partners agreed that they needed to recognize that mealtime was an appropriate, natural context for promoting social interaction. They, therefore, had to respond consistently to Bill so as to increase potential communicative acts that occurred during mealtimes.

Instructional Procedures

Referencing was the selected strategy with the request for Bill to look, followed by directing him to the person assisting him with his meal and his food.

Outcomes

Bill initially opened his eyes and looked to the side as he moved his head about. He gradually focused his attention toward the person interacting with him so that finally he stopped moving his head and looked directly at the person talking to him and assisting him with his meal. Bill also became more responsive when others outside the classroom interacted with him. If spoken to, he would lift his head and look at the person interacting with him. As a result, more people began to take the time to talk with Bill.

He was also observed to pay more visual attention to things happening in the classroom. For example, he would follow someone moving across the room. The behavior of looking to the person interacting with him transferred to other activities throughout the day.

Summary

This case study illustrates how the partners attempted to use the referencing procedure to increase Bill's social interaction during mealtimes. The establishment of a social connection with the person assisting him with his meal appeared to have a significant impact on Bill's overall quality of life.

Excerpted from Chapter 7 of Enhancing Everyday Communication for Children with Disabilities, by Jeff Sigafoos, Ph.D., Michael Arthur-Kelly, Ph.D., & Nancy Butterfield, M.Ed., with invited contributors