COMMUNICATION

Introduction
 

Communication is key to understanding and being understood, and is a lifelong skill. It allows us to express our needs, thoughts and emotions, to understand others, and to engage socially with our family, friends, peers, and community members. What we learn, we learn by interacting with others, and when we have limited communication skills the ability to learn can become very difficult.  

Having limited communication skills does not equate to not having anything to say or to share with others, “nor does it diminish [a person’s] need and right to communicate
. Furthermore, if [a] student [has an intellectual disability] coupled with communication challenges, then he or she may be perceived as someone who will not or cannot benefit from communication interventions.

The [focus] should not be whether students with significant disabilities will benefit from communication intervention, but rather how best to provide [support] and intervention.” Downing & Falvey, 2015.

 

Why we communicate


Communication allows individuals to exercise control over their physical and social environment, gives them the means to learn and to access literacy, “is a means of emotional catharsis,” (Downing & Falvey, 2015) and is a way to engage with others and build meaningful relationships.

Control
Communication is essential in order to control certain aspects of our lives. Students with significant disabilities will need support in attaining control and asserting themselves as much as possible. Ensuring that a student can communicate effectively allows them to take on a greater role when planning for their education or future.

 

When it comes to having control over one’s environment communicating with others becomes an essential life skill. Students with significant disabilities need to be taught this skill during their early years. “Teaching children to learn how to make choices in order to gain greater control over their lives demands professional attention (Lohrmann-O’Rourke, Browder, & Brown, 2000). Early intervention to teach this critical communication skill can lay the foundation for more complex decision making that will be expected as the child develops (Cook, Klein, & Chen, 2012).” Downing & Falvey, 2015.

Learning and literacy
We learn by interacting with others who have knowledge and particular skills. Teachers guide students so they may gain the necessary skills by practicing these in a variety of settings. Success “depends on their ability to effectively communicate [with each other].

 

A strong correlation exists between literacy and communication skills development [...] especially for children learning to communicate via augmentative and alternative means (Beukelman & Mirenda, 2013; Fossett, Smith, & Mirenda, 2003). Learning about the world is much more accessible when students understand that information can be represented in a symbolic manner in the form of written material (e.g., book, magazines).  Ensuring that print (braille, if needed) is written on all aided communication symbols provides a critical bridge from communication to literacy learning (Downing, 2005).” Downing & Falvey, 2015.

Catharsis
Students with significant disabilities just like students without disabilities need to learn how to express their anger and frustrations in a socially acceptable manner. The challenge for many students with significant disabilities is they may not have the capacity to do so verbally and often are left with limited ways of expressing their anger or frustration. “Without conventional speech, these students may have much higher levels of frustration and should have more leeway in expressing themselves. Not only do they have limited control over their environment and are highly controlled by others (Brown, Gothelf, Guess, & Lehr, 1998), but they may also face extreme challenges when trying to undertake even simple tasks. Moreover, while educators are trying to teach these students to use words to express themselves, they must also recognize that much of these students’ frustration comes from the effort it takes to do just that. Students with significant disabilities need help in developing appropriate ways to express all of their feelings in order for them to abstain from physical violence. The inverse relationship between functional communication and non-desired behaviour has been well substantiated (Clarke, Worchester, Dunlap, Murray, & Bradley-Klug, 2002; Horner, Albin, Todd, Newton, & Sprague, 2013).” Downing & Falvey, 2015.

Students benefit from being in an inclusive setting because of the consistent and ongoing interactions they have with non-disabled peers on a daily basis. “They are surrounded by competent communicative partners who serve as role models, and can learn to interact with [non-disabled] students on a daily basis (Carter et al, 2009). Downing & Falvey, 2015

Building meaningful relationships
 

Downing & Falvey explain that building meaningful relationships can reduce the sense of isolation and loneliness, help build positive self-esteem, and create a valuable support system that students with significant disabilities can rely on. Communicative interactions can facilitate building and maintaining relationships and reduce dependency, social isolation, regardless of the fact they may have other disabilities. Students with significant disabilities will require specific instructional support to facilitate positive interactions with peers without disabilities.

 

 

Do’s and don’ts
 

Do’s

√       determine how best to meet the student’s communication needs;

√       offer multiple ways of communicating;

       teach as many conventional ways to communicate so students don’t resort 

          to using unconventional or undesirable behaviour;

√       have a multi-disciplinary team contribute to teaching communication skills

          (student, parents, family members, friends, peers, teachers, occupational

          therapists, speech and language therapists, specialists, nurses, physical

          therapists, other professionals, paraprofessionals).

Don’ts


ø       assume that students with significant and multiple disabilities have nothing to say;
ø       assume that students with significant disabilities don’t benefit from communication intervention;
ø    waiting for children to demonstrate cognitive skills before teaching them to communicate;
ø       have to prove that students are eligible to receive communication training or intervention;
ø      have students rely on one mode of communication;
ø      cater to a student’s every need before he or she attempts to communicate a recognized need;
ø     delegate the responsibility of teaching communication skills to one sole person.

 

Difficulties that teachers will encounter
 

Waiting to teach communication skills until a student has acquired certain skills risks having a student resort to using undesirable and unconventional ways of communicating. Everyone has a need to communicate and the sooner conventional ways are taught the less the chances of a student resorting to “unconventional or undesirable behaviour” (Downing & Falvey, 2015) to communicate with others.

Challenging Behaviour
“The relationship between the lack of effective and conventional communication skills and challenging behaviours has been well documented (Chiang, 2008; Mancil, 2006; Sigafoos, 2000). Individuals often will resort to physically displaying their anger and frustration when they are unable to adequately communicate their needs or desires. [They] may lash out by biting, screaming, spitting, hitting, destroying materials, or engaging in self-injurious behaviour. Although the behaviour may seem quite abnormal [...], the sensitive and responsive communication partner should be able to see it as the individual’s most effective means of expressing frustration, anger, pain, or intense boredom. There is nothing abnormal about such emotions [and] these unconventional behaviours should be seen as a cry for [help]. Punishing the behaviour would be inappropriate and could lead to even more serious forms of expression (Sigafoos, O’Reilly, Drasgow, & Reichle, 2002).” Downing & Falvey, 2015.

Passivity
If an individual doesn’t feel supported, he or she may decide that it’s not worth the effort to try and communicate and completely give up. The behaviour is known as learned helplessness. “Learned helplessness, a term coined by Seligman (1975), occurs when individuals can do something but choose not to because they perceive the situation to be beyond their control.
Once students with significant disabilities have given up trying to communicate, they lose control over their physical and social environments and sometimes become extremely passive, waiting instead for the environment to act on them (Beukelman &Mirenda, 2013; Iacono, 2003). Avenues to learning become blocked because teaching students who seem disinterested and resigned is extremely difficult” (Downing & Falvey, 2015).

 

 

Effective team work


Downing & Ryndak discuss key concepts and their relationships to evidence-based practices for integrating team expertise. They include having:

  • Shared vision

    • have an overall vision of the student’s preferred life outcomes and use of communication;

    • have an understanding of how the team will work together to integrate their expertise;

  • Shared responsibility of

    • planning interventions;

    • implementing interventions;

    • evaluating interventions;

  • Natural contexts

    • identify the most critical or meaningful times for student to receive interventions;

  • Role release

    • instruct other team members about specialized expertise so they may have a better understanding of how to intervene and ensure consistency of interventions;

  • Common times for planning, providing and evaluating impact of interventions

    • determine set times during the week for all team members to meet and discuss issues (in-person or virtual meetings);

    • ensure that team members use their various sets of expertise to maximize the student’s time in interventions;

  • Collaborative teaming

    • each team member shares information and expertise so everyone can have a better understanding of the student’s strengths and needs and how best to meet his or her needs and reach set goals;

    • integrate therapies the student needs into the instructional and non-instructional activities planned for the entire general class or into activities that occur in the student’s natural contexts;

When professionals stay within strictly defined expertise boundaries and work independently, without knowledge of how other team members view the student’s abilities and needs and what other team members are doing with the student, the focus is on remediating weaknesses and may not have any direct relation to what is being learned in the student’s general education class. Downing & Ryndak, 2015

 

Assessment


Assessing a student with significant disabilities can be challenging because his/her disability could have an impact on his/her ability to communicate clearly and intentionally.  Assessment  tools, strategies and the person assessing must be sensitive enough to determine the communication skills and strengths of the student (Downing, Peckham-Hardin & Hanreddy, 2015).
Assessment should be done by various individuals, including family members. This allows for a more complete portrait of the student’s abilities, strengths and needs.

Purpose
We assess students to determine how the student communicates,  what communication support is needed, how well the student is progressing, and what goals need to be set next.

Standardized Assessment vs Alternative Assessment

 

Benifits

Components of Assessment


“Communication is complicated. Unraveling the different components of communication can help guide the assessment process by ensuring that the different features that make up communication are considered. It is important to note the form, function, and content of the communication exchanges. Finally, gathering information about the student’s social communication skills, including to what degree the student responds, initiates, repairs, and/or maintains an interaction, is important,” (Downing, Peckman-Hardin & Hanreddy, 2015).

Pre-intentional and Intentional Behaviour
An initial reaction to a student’s attempt to communication might be dismissed as pre-intentional or non-intentional communication. To a trained or sensitive communication partner, these attempts from the student could be seen as an opportunity to help a student realize that these behaviours can “gain someone’s attention and convey a message. Non-intentional or pre-intentional behaviour can become intentional in this manner” (Downing, Hanreddy, Peckman-Hardin, 2015).    

Receptive Communication
Assessing how the student responds when asked to do something is part of receptive communication. When assessing, it is important to note the most effective method in helping a student understand what is being asked or said. The following question are taken from Teaching Communication Skills to Students with Severe Disabilities by Downing, Hanreddy, Peckhm-Hardin, 2015.
What does the student do to demonstrate that the message has been received and understood?
What forms of communication seem to be best understood? i.e. Did the student respond to the verbal direction to go line up for recess or to the gesture (pointing toward the door)?
When asked what he or she wants to do, does the student respond more quickly when the options are signed along with oral language or when presented with picture choices alone?
Does the student understand the direction to raise his or her hand when his or her name is called, or is this clearer when  touch is given to his or her elbow?    
How well does the student perform an activity? Does the student complete all the task or part of the task?
How long does it take the student to respond to what is being asked? (Period of latency)
In what context was the student observed?

Expressive Communication

Any behaviour being used by a student to express himself or herself  is considered expressive communication. “How the message is conveyed can vary from very clear and obvious to very vague and idiosyncratic. The student’s intent to communicate may be questionable in some cases. Any attempt by the student to start, maintain, or end a communicative exchange should be recognized. Expressive communication is obviously closely linked to receptive communication because understanding what another person says is required prior to responding.How the student communicates (the form) provides important information regarding the student’s skill level. Why the student is communicating (function or intent) provides additional information, with the student likely using different forms of communication for different purposes. What the student talks about (content) gives the assessor information on the breadth of skills and/or accessibility,” (Downing, Hanreddy, Peckman-Hardin, 2015).The following table gives examples of what should be considered when evaluating a student’s expressive communication abilities.

Information gathered from the assessments will help generate appropriate IEP (individualized Education Plan) goals and objectives for the student.
Once goals and objectives have been written, it is important to monitor student’s progress or lack of.

Progress Monitoring
The main purpose of ongoing monitoring is to evaluate if the interventions put in place are effective, “to ensure that interventions remain on the right track and that students acquire targeted skills” (Peckham-Hardin & Downing, 2011).    

 

Strategies Supporting Communication Intervention


“The following factors are based on available research and should be considered in developing communication interventions for students with severe disabilities” (Downing & Chen, 2015).

Importance of a Responsive Communication Partner
Effective communication requires that communication partners interpret and understand the student’s communication behaviours, create and identify opportunities for communication, and facilitate the student’s interactions. “Paraprofessionals require effective training in facilitating communication so that they may serve as a bridge rather than a barrier to the student’s social interactions with others, particularly classmates (Causton-Theoharis & Malmgren, 2005; Feldman & Matos, 2013; Giangreco, Suter & Doyle, 2010).”

“Access to a communication device also includes positioning of the student and the device to ensure usability (Costogan & Light, 2010).”

Selecting an Appropriate Mode or

Form of Expression

 

Students should be able to consistently access modes of communication that are easy and efficient to use so they can communicate at all times. Augmentative and alternative communication ( AAC) can be a speech-generating device, picture exchange system, or manual signs for example. All modes of communication can be adapted to meet the specific needs of the student.

Prompts as an Effective way of Teaching Communication Skills
Using prompts or cues is an effective strategy to encourage students to communicate. Prompts should not inhibit a student’s effort to communicate. One way of preventing this from occurring is to provide sufficient wait time. Students with significant disabilities may need more time to process information and to respond. A 5 to 15 seconds wait time has found that students doubled the number of responses produced by students. “Moreover, research indicates that a student’s communicative response must be elicited not only by prompts but by the natural stimulus for it to be functional and generalized to other situations (Jennett, Harris, & Delmolinok 2008).”

Using Preferences to Motivate Communication
“Motivation is a critical component to intervention, so conducting a preference inventory is a recommended and well used practice" (Moss, 2006; Reid & Green, 2006).


 

Unaided and Aided techniques of Communication
 

There are two types of augmentative and alternative communication (AAC) techniques:

  • Unaided (i.e.: speech/vocalization, gestures, body language, facial expressions, manual signing) and

  • Aided (i.e.: communication board, computer screen, touch screen, online videos, graphic symbols, ).

 

Unaided techniques of communication don’t require external equipment as do aided techniques of communication and are mostly acquired on their own and need very little practice in order to use them, except for sign language. Most students use a combination of unaided and aided techniques which is referred to as their AAC system. This system should continuously be updated to accommodate the changing needs and skills of the student (Mirenda, 2015).

 

References


Downing, June E., Hanreddy, Amy, Peckham-Hardin, Kathryn D. “Teaching Communication Skills to Students with Severe Disabilities.” Third Edition. Paul H. Prookes Publishing Co., 2015

Jazzar, C. “AAC and Special Needs: The Importance of Core Vocabulary.” Centre of Excellence for Speech and Language Development - English Montreal School Board. Retrieved [October 23rd, 2017] from Retrieved [October 15th, 2017] from http://coesld.ca/documents/AAC-Core-Vocabulary.pdf

 

Pruett, M.D. (2011). “Core vocabulary makes communication meaningful.” Innovations and Perspectives. Virginia Department of Educations’s Training & Technical Assistance Center. Retrieved [October 23rd, 2017] from http://www.ttacnews.vcu.edu/2011/05/core-vocabulary-makes-communication-meaningful/
 

Zangari, C. (2013). “Teaching Core Vocabulary.” Retrieved [October 23rd, 2017] from http://praacticalaac.org/strategy/teaching-core-vocabulary/

Centre of Excellence for the Intellectually,

Physically & Multi-Challenged 2017