Ine Hostyn

Describing dialogue between persons with profound intellectual and multiple disabilities and direct support staff using the scale for dialogical meaning making

BACKGROUND The dialogical approach of meaning making forms a rich and renewing theoretical perspective to study communication between presymbolic communicators and their interaction partners. The aim of this study is to investigate whether an observation scale based on the dialogical theory, the Scale for Dialogical Meaning Making (S-DMM), has potential to describe these communicative interactions. METHODS Eighteen videotaped observations of persons with profound intellectual and multiple disabilities and their support staff were coded using the S-DMM and a consensus-rating procedure. RESULTS Sufficient inter-rater agreement and an acceptable range in scores confirm the usefulness of the S-DMM. Strong sub-scale intercorrelations were identified. The quantitative scores and the qualitative arguments supporting the ratings, demonstrate how the S-DMM aids to significantly describe staff-client dialogue. CONCLUSIONS Using the S-DMM to describe dialogue with persons with profound intellectual and multiple disabilities appears to be promising. The value of the S-DMM and its consensus-rating procedure are reflected upon and discussed with regard to implications for research and practice.

Interaction with a person with profound intellectual and multiple disabilities: A case study in dialogue with an experienced staff member

Abstract Background The aim of this descriptive single case study was to describe a unique interaction with a person with profound intellectual and multiple disabilities (PIMD) in a holistic way—focusing on the client, the staff member, and the interacting dyad—and to include the experiential knowledge of the interaction partner. Method A videotaped interaction of the staff–client dyad was analysed by triangulating data from video analysis, documents, observational rating scales, and an interview with the staff member. Results The interactional pattern revealed in this study is that of a staff member who offers an activity that is considered to be stimulating for the client, by using a variety of initiatives and structuring strategies, and a client who is alert and responsive, but has limited chances to take own initiatives. Rather low scores were obtained on observations from a dialogical perspective. Conclusions This study highlights the value of video analysis for practitioners, demonstrates the usefulness of describing an interaction episode supported by an integrative theoretical framework, and confirms the importance of combining observations by an independent researcher with experiential staff knowledge.