Communication Assessment Strategies for Individuals with Severe Disabilities

Western Carolina University, March 22, 2006

Nancy Brady, University of Kansas [email protected]

Assessment Purposes

 Describe current level of functioning to qualify an individual for services  Identify promising intervention practices  How are they currently communicating?

 When and where are they currently communicating?

 Communication environment?

 Supportive contexts available?

Sample videos

Assessing current communication

   How are individuals communicating in real contexts?

Use questionnaires and forms supplemented with direct observation e.g., Inventory of Potential Communicative Acts by Sigafoos, and Woodyatt.   “Please describe how the individual (greets, gets your attention, seeks comfort, let’s you know they are happy…..)” Summarize responses in a behavior x function grid

IPCA: Examples of Potential Communicative Acts

Vocalization Body movement Face/eye movement Sounds Yells Grunt Laugh Moves closer Moves away Tenses Cry/whine Wiggles Repositions body Purses lips Stares Opens eyes Closes eyes Shifts eye Gazes away Reaches/touches Gazes toward Breathing Challenging behavior Stereotypic movements Rapid Slow Hold Swallow Sigh Blow Symbolic forms Aggression Tantrum Self-injury Arm flapping Hand wringing Speech Manual signs Gestures Destruction of items Body rocking Head weaving Head nod Eye point Picture board Pushes/pulls Points

IPCA continued

 Organized by communication function           Social convention Attention to self Reject/protest Request an object Request an action Request information Comment Choice making Answer Imitation

IPCA continued

 Open-ended interview questions  Reject/Protest:  What does person do if …  1. their routine is disrupted?

 2. they are required to do something they don’t want to do?

 3. they don’t like something?

 4. a favourite toy/food is taken away?

Summary Grid Layout

Behavior Soc Conv Att to self Rej/Pro Requests Hands out pinch smile

IPCA summary grids

Assessing current communication

 Communication Matrix by Charity Rowland http://www.communicationmatrix.org/en/  (designs to learn website) Organized by communication function  List of behaviors  Not used, emerging or mastered

Communication matrix

      C1. Refuses or Rejects Something whole body movements (twist, turn away) Mastered scream, whine frown, grimace pushes away object or person gives unwanted item to you Emerging Emerging Emerging Mastered

Communication Matrix

 Matrix summary grid  Presented by level and function  Color coded according to not used, emerging or mastered

Direct Observations

 How do individuals communicate in specific contexts?  Described as the Verification stage by Sigafoos, Butterfield and Arthur-Kelley (in press)

Verification Phase

 Set up opportunities to observe some of the behaviors that were reported in interviews.

 Reaching to request?

 Clapping to request food?  Individualized

Standard Protocol

 Present opportunities for individuals to communicate  e.g., CSBS (Wetheryby & Prizant, 2003), ECBS (Seibert and Hogan, 1981), (McLean, McLean, Brady & Etter, 1991, Brady, McLean, McLean and Johnston, 1995)  Examples

 For example, do they comment?

Do they repair communication breakdowns?

Specific Adaptations: sensory and motor



Examples of adaptations

Does he comment?

Advantages/disadvantages to standard protocol

   Chance to see how different individuals perform under similar circumstances  Sometimes they will surprise you!

 May see behaviors that were not reported by informants More efficient in terms of time But, less individualized = less likely to accommodate individual strengths or probe unique interests

Task

Summary of Protocol Results Marlee

Function Communicative Behavior trampoline Container of toys Fan Bag of novel objects Request activity Smile; arms to midline (more approximation?) Request help Joint attention Joint attention Eye gaze shift; Signed finish Signed finish; pushed away Gaze shift; smile; show

Task Bumble ball Tastes Wind ups Bubbles Function Request help Communicative Behavior Push away; sign finish Joint attention Request help Request more Vocalizes; sign finish Signed finish; pushed away Signed finish; cry

Task Goo Function Joint attention Communicative Behavior Signed Finish Adapted Books Joint attention Eye gaze shift; signed finish

IPCA summary grids

 Requests: point, moves toward, claps, signs more  Rejects: sign stop, sign finish, bites self and others  Comment: smiles  Social conventions: pinch, wave, look at

Assessment thus far

 Inventory of potential communication acts  Data regarding the extent to which communication used during direct observation  Need to use this information to establish instructional priorities  Which of the many gaps in their communication profiles need to be addressed first?

Assessing communication environments

 Does the individual’s environment provide opportunities for the child to communicate?

 Ecological assessment  Design to Learn Inventory evolved from ACE, by Rowland and Schwiegert (1993)  Communication Supports Checklist  Social Networks by Sarah Blackstone and Mary Hunt Berg  PCO Checklist by Houghton et al.

Design To Learn

 Teacher observes an activity, beginning at the time the child makes the transition to the activity and ending with the completion of the activity  Each observed behavior is marked  70 different statements  Transitions; activity; adult’s interaction; students communication system; peer interaction; opportunities to communicate; opportunities to use objects; materials

View

Profile.

Sample Page: Profile Design to Learn

Communication Supports Checklist

    Written by members of the NJC, published by Brookes Covers philosophy, protection of communication rights, environmental support, goal setting practices, program implementation, team competencies 97 items Environmental support,  Expecting communication, providing interesting and age-appropriate materials, including communication partners who know how to use AAC systems and devices used by individual…..

Social Networks

 Interview format  Information about individual’s communication with different social partners  Summarized according to Circles of Communication Partners

Promoting Communication Outcomes for Children with Deaf Blindness: Environmental Checklist

  

Physical and Environmental Characteristics

 The lighting and/or illumination is adapted for child’s visual condition (e.g., shades, glare, focused lighting, contrast, dim, etc.). Specify

Communication

 Communication is accessible to child (e.g., access to communication that is matched to sensory processing disabilities.)

Instructional Arrangements and Programming

 Anticipatory information for every activity is provided



Dignity and Respect



The child is addressed by name by staff

 Total of 24 items

Assessment to Intervention

Interventions based on assessments

 Build New Skills  Teaching new forms  Increasing use of existing forms  Teaching new functions

Examples of teaching new forms

Interventions to improve the communicative environment

 Increasing the responsiveness of the environment  Partner interaction training (e.g., Hanen)  Partner “coaching.”  Engineering the environment to provide more opportunities for communication

Resources

     Blackstone, S. & Hunt Berg, M. (2003). Social Networks. Available from www.caugcomminic.com

Brady, N. and Halle, J. (1997). Functional analysis of communicative behaviors. Focus on Autism and Other Developmental Disabilities, 12, 95-104.

McCarthy et al. (1998). Communication supports network.

Rowland, C. and Schweigert, P. (1999). Time to Learn, available from www.designtolearn.com

Sigafoos, J., Arthur-Kelly, M., & Butterfield, N. (in press). Enhancing everyday communication for children with disabilities. Baltimore: Paul H. Brookes.