Increasing Communication in Children With Concurrent Vision and Hearing Loss

Interventions for children with deafblindness-An integrative review

BACKGROUND

Deafblindness is a rare condition, and its prevalence has been reported to be approximately 1 in 27 000 new-borns worldwide. For individuals with deafblindness, lifelong interventions and support are needed to be able to develop communication, be active and preserve a good quality of life. Because little is known about what kind of support and interventions can be offered to children with deafblindness, the aim was to summarize and disseminate research findings regarding this topic.

METHODS

Integrative review principles were employed. Systematic searches in eight databases and additional manual searches were conducted. The inclusion criteria were as follows: original studies published between 2000 and 2021 examining either interventions for children between 0 and 18 years of age with deafblindness or interventions aimed at children with deafblindness but offered to their relatives or professionals working with them. Studies on support for family members were also sought. Study characteristics were described, and key findings were synthesized into categories based on their similarities.

RESULTS

Of the 6268 identified original studies, 32 were included. The key outcomes from the included studies were synthesized into three categories, with two categories illustrating the goal/intention of the intervention (social interaction and communication, motivation and participation) and one focusing on or identifying the action taken to benefit the child (adaptation of the educational environment). Social interaction and communication was the dominant category, covering 24 of the 32 included studies.

CONCLUSIONS

This review concludes that there are a limited number of evaluated interventions for children with deafblindness. In many cases, the interventions were adapted to the individual child's needs, and most of them were found within the area of social interaction and communication. More research is needed to strengthen the level of evidence for interventions for children with deafblindness.

Successes and Challenges in Treating Severe Communication Disorders

This article summarizes research focusing on communication skills of people with intellectual and developmental disabilities (IDD) who communicate primarily without speech, sign language, or augmentative communication. Importantly, developmental theories were emphasized as useful for interpreting communication in children and adults. These studies led to research aimed at developing improved assessments and interventions for individuals with IDD, who may have a variety of diagnoses. Future research is needed to facilitate more widespread use of these tools by clinicians and researchers.

Communication development from an intersubjective perspective: Exploring the use of a layered communication model to describe communication development in students with congenital deafblindness

This exploratory study conducts a quantitative investigation on the communication development of students with congenital deafblindness (CDB). First, a layered communication model (LCM) is introduced, describing communicative behaviors based on three layers of intersubjective development for typically developing children (Bråten & Trevarthen, 2007). Subsequently, an analysis is made of how applicable the LCM is for children with CDB. Video recordings of four dyads of students with CDB with varying developmental ages and their teachers are coded using ten-second partial interval coding. The presence of LCM behaviors, the student and teacher contributions to communication, and the development over a half-year period are described and compared between dyads. The results reflected the developmental differences between dyads. At the primary layer, all behaviors occurred a comparable number of times between dyads, which confirms that this is a basic communication layer. Quantitative differences between dyads were encountered between and within the secondary and tertiary layers. Teacher contribution was higher for students with lower developmental ages compared to students with higher developmental ages. Also, teacher contribution was higher for the secondary and tertiary layer behaviors of the LCM compared to the primary layer behaviors. No increase was found in the behaviors over the half-year period. Results suggest that the LCM can be used to gain insight into the communication level of a dyad, hereby paving the way for intervention studies to improve communication development.

The Trifocus Framework and Interprofessional Collaborative Practice in Severe Disabilities

PURPOSE

Individuals with severe disabilities are a diverse group of learners with complex communication needs. This article presents a synthesis of the literature addressing the five strategies of the trifocus framework, with its triadic structure of learner with disability, communication partner, and environment. The application of interprofessional collaborative practice (IPCP) to the implementation of trifocus framework communication strategies is emphasized.

METHOD

A literature search was conducted using Google Scholar and EBSCO to identify literature and research studies on IPCP and communication intervention for learners with severe disabilities, published 1994-2015, and then organized within the trifocus framework. The trifocus strategies are enhancing sensitivity, utilizing routines, increasing communication opportunities, modifying the communication environment, and augmenting input. Studies that included at least one participant with severe disabilities and their communication partners were considered. A secondary search was then conducted by reviewing the articles referenced in the original articles.

CONCLUSION

Effective IPCP in communication intervention considers the learner's characteristics, the knowledge and skills required of communication partners, and effective environmental arrangements to support communication. Future research should include clear participant descriptions, documentation of fidelity measures, and evidence of generalization to support professionals to know when findings are relevant to the individuals they serve.

Measuring Early Communication in Spanish Speaking Children: The Communication Complexity Scale in Peru

BACKGROUND

There is a great need in the United States to develop presymbolic evaluation tools that are widely available and accurate for individuals that come from a bilingual and/or multicultural setting. The Communication Complexity Scale (CCS) is a measure that evaluates expressive presymbolic communication including gestures, vocalizations and eye gaze. Studying the effectiveness of this tool in a Spanish speaking environment was undertaken to determine the applicability of the CCS with Spanish speaking children. Methods & Procedures: In 2011-2012, researchers from the University of Kansas and Centro Ann Sullivan del Perú (CASP) investigated communication in a cohort of 71 young Spanish speaking children with developmental disabilities and a documented history of self-injurious, stereotyped and aggressive behaviors. Communication was assessed first by parental report with translated versions of the Communication and Symbolic Behavior Scales (CSBS), a well-known assessment of early communication, and then eleven months later with the CCS.

HYPOTHESIS

We hypothesized that the CCS and the CSBS measures would be significantly correlated in this population of Spanish speaking children.

OUTCOMES & RESULTS

The CSBS scores from time 1 with a mean participant age of 41 months were determined to have a strong positive relationship to the CCS scores obtained at time 2 with a mean participant age of 52 months.

CONCLUSIONS & IMPLICATIONS

The CCS is strongly correlated to a widely accepted measure of early communication. These findings support the validity of the Spanish version of the CCS and demonstrate its usefulness for children from another culture and for children in a Spanish speaking environment.

Describing Treatment Intensity in Milieu Teaching Interventions for Children With Developmental Disabilities: A Review

Purpose

This investigation aimed to apply the dosage framework proposed by Warren, Fey, and Yoder (2007) to variations of milieu language teaching intervention strategies to explore how each of the dosage parameters (i.e., dose, dose form, dose frequency, total duration, and cumulative intervention intensity) was reported in the located empirically based applications with learners between birth and 23 years of age.

Method

A systematic search located existing studies that implemented a milieu teaching intervention for children with developmental disabilities. Dosage data were then extracted from 42 studies along with study characteristics and participant characteristics.

Results

Only 37.8% of empirical investigations provided a clear definition of treatment intensity and reported the full range of dosage parameters, thus making it difficult to compare the results across investigations. Of the investigations that reported on all dosage parameters, the majority were single-case design as opposed to group design studies.

Conclusions

Given the limited reporting of dosage parameters in existing studies, there is a need for closer attention to reporting this information in early communication intervention protocols. Replication and customization of interventions for learners experiencing developmental disabilities will only be possible with additional empirical examination of dosage parameters.

Promoting Academic Achievement for Early Communicators of All Ages

A review of best practices and recent research efforts provide guidance for serving school-age early communicators with complex communication needs (CCN) and significant cognitive disabilities (SCD). Our aim as SLPs working with students with CCN and SCD is to support the development of intentional and symbolic communication abilities and implement augmentative and alternative communication (AAC) systems that provide the means for interaction with a range of partners for varied purposes on a myriad of topics. Consistent exposure to knowledgeable communication partners who respond in meaningful ways to expressive behaviors leads the way for learning to use symbolic forms of communication. It is through our instruction and aided language input across a range of contexts that our students with SCD learn and assign meaning to the symbolic representations we teach. The Common Core State Standards (CCSS) have heightened expectations about what students with SCD should know and be able to do and offer contexts that emphasize communication as an integral part of learning. Meeting these expectations through active participation and interaction in all learning activities requires reliable access to systems of communication that support ongoing development of abilities as a speaker, listener, reader, and writer.

The effectiveness of psychosocial and vocational training for mentally challenged in a day care centre

BACKGROUND

A growing number of mentally challenged individual are being excluded mainly from the educational process because of a presumed inability to learn.

AIM

The study is aimed at identifying the efficacy of psychosocial and vocational training for mentally challenged in a day care centre.

METHODS

The sample for the study consisted of 30 clinically diagnosed mentally challenged children (N=30, boy=18, girl=12), who are enrolled in Ashadeep day care centre. Methods employed were a semi demographic questionnaire and Vineland Social Maturity Scale to assess the improvement of the child across the various subscales in the pre post test sessions. Correlation coefficient and t-test was used to compare the profile of the children across both the sessions.

RESULTS

Age of onset of therapy and the duration does not have significant effect on the outcome, but 'higher the IQ' more positive outcome can be seen. The subscales do not correlate when it comes to affecting each other. Girls showed much poor outcomes than boys in the self0help general subscale.

CONCLUSIONS

The study ascertained the fact that education and training of the mentally subnormal child is also possible, and psychosocial and vocational training lead to improving the social competence of the child.

Predicting language outcomes for children learning augmentative and alternative communication: child and environmental factors

PURPOSE

To investigate a model of language development for nonverbal preschool-age children learning to communicate with augmentative or alternative communication.

METHOD

Ninety-three preschool children with intellectual disabilities were assessed at Time 1, and 82 of these children were assessed 1 year later, at Time 2. The outcome variable was the number of different words the children produced (with speech, sign, or speech-generating devices). Children's intrinsic predictor for language was modeled as a latent variable consisting of cognitive development, comprehension, play, and nonverbal communication complexity. Adult input at school and home, and amount of augmentative or alternative communication instruction, were proposed mediators of vocabulary acquisition.

RESULTS

A confirmatory factor analysis revealed that measures converged as a coherent construct, and a structural equation model indicated that the intrinsic child predictor construct predicted different words children produced. The amount of input received at home, but not at school, was a significant mediator.

CONCLUSIONS

The hypothesized model accurately reflects a latent construct of Intrinsic Symbolic Factor (ISF). Children who evidenced higher initial levels of ISF and more adult input at home produced more words 1 year later. The findings support the need to assess multiple child variables and suggest interventions directed to the indicators of ISF and input.

Increasing social interaction using prelinguistic milieu teaching with nonverbal school-age children with autism

PURPOSE

Children with autism display marked deficits in initiating and maintaining social interaction. Intervention using play routines can create a framework for developing and maintaining social interaction between these children and their communication partners.

METHOD

Six nonverbal 5- to 8-year-olds with autism were taught to engage in social interaction within salient play routines. Prelinguistic milieu teaching (PMT) techniques were used to teach the children to communicate intentionally during these routines. Intervention focused on the children's social interaction with an adult. The effects of intervention were evaluated using a multiple baseline design across participants.

RESULTS

At study onset, the participants demonstrated few consistent interaction with others. With intervention, all of the children improved their ability to sustain social interactions, as evidenced by an increase in the number of communicative interactions during play routines. Participants also increased their overall rate of initiated intentional communication.

CONCLUSION

Development of intentional prelinguistic communication within salient social routines creates opportunities for an adult to teach social and communication skills to young school-age children with autism who function at a nonverbal level.

Development of the communication complexity scale

PURPOSE

Accurate description of an individual's communication status is critical in both research and practice. Describing the communication status of individuals with severe intellectual and developmental disabilities is difficult because these individuals often communicate with presymbolic means that may not be readily recognized. Our goal was to design a communication scale and summary score for interpretation that could be applied across populations of children and adults with limited (often presymbolic) communication forms.

METHOD

The Communication Complexity Scale (CCS) was developed by a team of researchers and tested with 178 participants with varying levels of presymbolic and early symbolic communication skills. Correlations between standardized and informant measures were completed, and expert opinions were obtained regarding the CCS.

RESULTS

CCS scores were within expected ranges for the populations studied, and interrater reliability was high. Comparison across other measures indicated significant correlations with standardized tests of language. Scores on informant report measures tended to place children at higher levels of communication. Expert opinions generally favored the development of the CCS.

CONCLUSIONS

The scale appears to be useful for describing a given individual's level of presymbolic or early symbolic communication. Further research is needed to determine whether it is sensitive to developmental growth in communication.

Supporting Young Children With Multiple Disabilities: What Do We Know and What Do We Still Need To Learn?

Young children with multiple disabilities have unique needs and challenges. Many of these young children struggle to communicate their wants and needs, to freely move their body to access and engage their world, and to learn abstract concepts and ideas. Professionals and families working together must identify the individual supports each child needs to ensure that the young child with multiple disabilities is an active participant in all aspects of their lives and makes meaningful progress toward valued life outcomes.