Karen Bloomberg

A statewide demographic survey of people with severe communication impairments

A two part demographic survey was conducted to establish basic data on the size and characteristics of the nonspeaking population in Victoria, Australia. This paper presents results from the first part of the survey. The results showed that two-thirds of these people lived in the Melbourne metropolitan area. Most people with severe communication impairments lived at home, although a significant proportion of the population lived in residential training centers. A number of disabilities, both congenital and acquired, were associated with a severe communication impairment, and were often accompanied by an intellectual disability. Daily activities for this population included educational programs, hospital programs, and limited employment options. Future surveys are needed to monitor the changing profile of this population with particular emphasis on those people with acquired disabilities in hospital settings.

PICTURE IT: an evaluation of a training program for carers of adults with severe and multiple disabilities

PICTURE IT is a communication training package designed for carers of adults with severe and multiple disabilities. A trial of PICTURE IT was conducted with 16 carers of eight individuals with severe and multiple disabilities. The carers worked in pairs comprising a carer from the individual’s day setting and the other from the individual’s home. They participated in a 6‐month training course that involved attendance at six 1‐day training sessions, homework assignments and regular meetings with course leaders. Results from the administration of a series of assessments indicated limited changes in carers’ knowledge and attitudes about communication of people with significant communication impairment. Improved interactions were demonstrated by increased initiations and more appropriate responses to the individuals’ communication attempts by the carers. The individuals responded more frequently to the increased communication opportunities. The ability to formulate appropriate communication goals and to make some changes to the individual’s social environment were also noted. Changes to the individual’s physical environment were more anecdotal. Implications for the training of people working with individuals with severe intellectual disabilities and the usefulness of measurement tools used to evaluate project outcomes are discussed.

Reliability and Validity of the Revised Triple C: Checklist of Communicative Competencies for Adults with Severe and Multiple Disabilities.

AIMS Few tools are available to assess the communication skills of adults with severe and multiple disabilities functioning at unintentional to early symbolic levels. An exception is the Triple C: Checklist of Communicative Competencies. In this study, aspects of support worker and clinician agreement, internal consistency and construct validity of a revised version of the Triple C were explored. METHOD Triple C checklists were completed for 72 adults with severe intellectual disabilities (ID) by 118 support workers and stages were assigned by the researchers. Two support workers completed checklists for each of 68 adults with ID. Three researchers also conducted direct observations of 20 adults with ID. RESULTS The average support worker agreement for items across the five stages of the Triple C ranged from 81% to 87%; agreement for stage assignment based on first and second support worker checklists was moderate to high (k = 0.63). Internal consistency was high (KR20 = 0.97); the stages were found to tap one factor (accounting for approximately 74% of variance), interpreted to be unintentional to early symbolic communication. Agreements between stages based on researcher observations and support worker-completed checklists were 35% and 71% across first and second support workers. CONCLUSION The revised Triple C provides a reliable means of gathering data on which to determine the communication skills of adults with severe and multiple disabilities. The results support a collaborative use of the Triple C, such that a speech-language pathologist or other communication specialist works with a support worker to ensure understanding of the skills observed and development of appropriate intervention strategies.

Acquisition and generalization of key word signing by three children with autism

Abstract Objective: The aim of this study was to examine the effect of Key Word Sign (KWS) intervention on the acquisition and generalization of manual signing among three children with Autism Spectrum Disorder (ASD), and to measure any changes in their production of spoken words and gestures following intervention. Methods: A multiple baseline single-case experimental design was used to measure changes for each of the three children. Results: All three children began using signs following the introduction of the KWS intervention, and generalized their use of some signs across activities. The introduction of the intervention was associated with either neutral, or statistically significantly positive, changes in the children’s production of spoken words and natural gestures. Conclusion: The results provide preliminary evidence for the effectiveness of KWS for preschool children with ASD, which parents, therapists, and educators can use to inform clinical practice.

A preliminary investigation into the internal consistency and construct validity of the Triple C: Checklist of Communicative Competencies

Abstract Background The Triple C was designed to assess the communication skills of people with severe disabilities and to sensitise support workers to their communicative behaviours. The study aim was to investigate the Triple Cs internal consistency and construct validity. Method Deidentified data from the completed checklists of 172 adults with severe disabilities were collected. Results Overall internal consistency was found to be high. Internal consistency was found to be high also for Stages 2 to 6, and acceptable for Stage 1. A measure of association between item and stage totals indicated a hierarchy of skills. Although the factor analysis revealed two underlying factors, most stages loaded highly onto only one factor, interpreted to be early intentional‐presymbolic communication. Conclusions The results indicated good internal consistency, and promising construct validity. They also pointed to a need to modify the Triple C for both clinical and research purposes.

Student and professional attitudes and interests in working with people with complex communication needs.

Speech-language pathology interest in working with people with complex communication needs was investigated in this study. Participants were third year speech-language pathology undergraduates and recent graduates who had participated in a unit on AAC. Undergraduates (n = 85) completed an Interaction with Disabled Persons attitudinal scale and a questionnaire about interest in various client groups before and after the unit. Some undergraduates (n = 34) repeated the attitudinal scale and completed another questionnaire 2 years after graduation. Recent graduates (n = 56) completed a questionnaire about working with people with complex communication needs and factors influencing work choices; 10 also participated in interviews or focus groups. We found a small but positive attitudinal shift for the undergraduates, but, along with previous disability experience, this was a weak predictor of working with this group. Working in developmental disability ranked low amongst undergraduate preferences. Most graduates were influenced in their job choices by a desire to work on a particular team and previous clinical placements. Questionnaires and interview/focus group data indicated the strong influence of clinical placements on later work choices. Participants who worked in disability appeared passionate about the work involved and offered suggestions for engaging more professionals with this group. Implications for speech-language pathology services in disability are discussed.

Supporting people with complex communication needs through community capacity building: the Communication Access Network

Purpose – The purpose of this paper is to describe specific features of a Victorian (Australia) state-wide hub and spoke model of speech pathology provision established for adults with complex communication needs (CCN). Two case studies highlighting successful examples of services developed to enhance community inclusion will be described and the challenges discussed. Design/methodology/approach – The route to community inclusion is described through a case study illustration of one communication accessible community site and one disability service study. The disability service research involved focus groups, survey and interview data and demonstrated the efficacy and sustainability of a support worker training model. Findings – Sustainable change in the community and in disability services can occur through partnerships, training, and long-term commitment. Support workers who can facilitate interactions for people who have cognitive and communicative disabilities are an essential component of building th...