# Communication Interventions for Individuals with Severe Disabilities ## Exploring Research Challenges and Opportunities by **Rose A. Sevcik, Ph.D.** and **MaryAnn Romski, Ph.D.** --- ## Contents I. Communication Interventions for Individuals with Severe Disabilities: What Is the Evidence? 1. What Is the State of the Evidence? Nancy C. Brady, Martha E. Snell, and Lee K. McLean 2. Prelinguistic Communication Intervention for Young Children with Intellectual Disabilities: A Focus on Treatment Intensity Tiffany G. Woynaroski, Marc E. Fey, Steven F. Warren, and Paul J. Yoder 3. Challenging Behavior and Communicative Alternatives Joe Reichle and Mo Chen 4. Research on Communication Intervention for Children Who Are Deafblind Charity Mary Rowland and Amy T. Parker 5. Are We There Yet? Targeted and Phenotypic Communication Interventions for Children with Down Syndrome or Autism Spectrum Disorder Stephanie Yoshiko Shire and Connie Kasari 6. Augmented Language Interventions for Children with Severe Disabilities Ashlyn L. Smith, R. Michael Barker, Andrea Barton-Hulsey, MaryAnn Romski, and Rose A. Sevcik 7. Parents as Partners in Effective Communication Intervention Ann P. Kaiser, Lauren H. Hampton, and Megan Y. Roberts 8. Putting It Together: Discussion Synthesis of Communication Interventions for Individuals with Severe Disabilities Ellin B. Siegel, Diane Paul, and Lorraine Sylvester --- ## 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 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 that involved professionals from state and local education agencies and universities. The National Joint Committee (NJC) for the Communication Needs of Persons with Severe Disabilities aims to advocate for individuals with significant communication support needs. The committee consists of representatives from various associations, reflecting the importance of communication in all spheres of human functioning. The purpose of the NJC has been to develop guidelines and tools to improve communication supports and services for people with severe disabilities. The Communication Bill of Rights was created as part of these guidelines, highlighting specific communication rights for individuals with disabilities. ### Box 1.1. Communication Bill of Rights All people with a disability have the right to: - Request desired objects, actions, events, and people - Refuse undesired objects, actions, or events - Express personal preferences and feelings - Be offered choices and alternatives - Request and receive attention and interaction - Receive intervention to improve communication skills ### EVIDENCE SUPPORTING INTERVENTIONS FOR PEOPLE The NJC developed a research evaluation instrument to assess the quality of evidence in past studies. It involved coding multiple items related to the characteristics of the research, including intervention focus and categorizing studies based on inclusion criteria that highlighted the necessity for comprehensive communication support. ### Nature and Quality of the Evidence Research in this area continues to show positive effects for numerous communication outcomes, underscoring the need for new research that will strengthen and expand the existing evidence base. While many studies have demonstrated effective interventions, the variability in approaches and participant characteristics presents challenges in drawing comparisons across interventions. ### Implications for Future Research Future studies should aim for greater consistency in methodology and reporting, including reliability, treatment fidelity, social validity, and generalization of communication skills across natural environments. Specific areas identified for improvement include the need for more rigorous evaluation of treatment effectiveness and inclusion of participant perspectives in assessing intervention outcomes.