what is the state of the evidence.pdf
Communication Interventions for Individuals with Severe Disabilities
Exploring Research Challenges and Opportunities
by Rose A. Sevcik, Ph.D. and MaryAnn Romski, Ph.D.
Contents
- Communication Interventions for Individuals with Severe Disabilities: What Is the Evidence?
- What Is the State of the Evidence?
- Prelinguistic Communication Intervention for Young Children with Intellectual Disabilities: A Focus on Treatment Intensity
- Challenging Behavior and Communicative Alternatives
- Research on Communication Intervention for Children Who Are Deafblind
- Are We There Yet? Targeted and Phenotypic Communication Interventions for Children with Down Syndrome or Autism Spectrum Disorder
- Augmented Language Interventions for Children with Severe Disabilities
- Parents as Partners in Effective Communication Intervention
- Putting It Together: Discussion Synthesis of Communication Interventions for Individuals with Severe Disabilities
What Is the State of the Evidence?
Research is urgently needed to promote identification and implementation of effective communication interventions for individuals with severe intellectual and developmental disabilities (IDD). This chapter summarizes events leading up to this conference and the current state of the evidence regarding communication practices for individuals with severe IDD.
BACKGROUND
In 1984, the Council of Language, Speech, and Hearing Consultants in State Education Agencies initiated efforts to develop national guidelines for developing and implementing educational programs to meet the needs of children and youth with severe communication disabilities. These efforts culminated in a national symposium, Children and Youth with Severe Handicaps: Effective Communication held August 19–21, 1985, in Washington, D.C.
The purpose of the NJC is to advocate for individuals with significant communication support needs resulting from intellectual disability and often coexisting with autism and sensory and/or motor limitations. The committee consists of representatives from various associations, reflecting the pervasive importance of communication in all spheres of human functioning.
Box 1.1. Communication Bill of Rights
All people with a disability of any extent or severity have a basic right to affect, through communication, the conditions of their existence. Specific communication rights include:
- Request desired objects, actions, events, and people
- Refuse undesired objects, actions, or events
- Express personal preferences and feelings
- Be offered choices and alternatives
- Reject offered choices
- Request and receive another person’s attention and interaction
- Receive a response to any communication, whether or not the responder can fulfill the request
- Have access to augmentative and alternative communication (AAC) and other assistive technology (AT) services and devices
- Be in environments that promote one’s communication as a full partner with other people, including peers
EVIDENCE SUPPORTING INTERVENTIONS FOR PEOPLE
The NJC developed a research evaluation instrument consisting of four sections—reviewer and article information, criteria for including a study, description of study, and evaluation of the quality of evidence. A qualifying database of 116 studies contained a total of 460 individuals with severe IDD, with various disabilities identified: intellectual disability, autism, multiple disabilities, and sensory impairment.
The database was assessed for intervention characteristics, including context for the intervention, instructional methods, and the nature and quality of the evidence. The studies reported positive outcomes in various communication outcomes while highlighting areas needing more research.
Implications for Future Research
The state of the evidence base in severe disabilities highlights the need for consistency in how intervention research is conducted, focusing on reliability, treatment fidelity, generalization, and maintenance data. Providing evidence-based practices will assist practitioners in identifying effective communication interventions for individuals with severe disabilities.
Conclusion
The suggestions presented for improving the evidence base in severe IDD signify a call for better research methods and a range of suggested improvements to enhance communication interventions in natural environments.