Communication intervention for people with PIMD: Implications from a systematic review

Introduction: Communication is a human right. Children and adults with profound intellectual and multiple disabilities (PIMD) experience profound developmental delay, and communication, mobility and sensory difficulties, restricting access to this basic right. A range of communication interventions is available to increase interaction and participation, but there is limited high quality supporting evidence. The aim of this paper is, through a systematic review, to identify evidence-based communication interventions for practitioners and to inform the design of future research.

Methods: A systematic review was undertaken, conforming to PROSPERO guidelines. Quality appraisal was conducted using Crowe’s Critical Appraisal Tool (CCAT). Findings are reported according to PRISMA.

Results: Few good quality evaluations of communication intervention were found; however, some cautious recommendations can be made for teaching and therapy. Challenges to research rigour include the diversity of children and adults with PIMD, small sample sizes and difficult decisions regarding who should intervene, acceptable intervention intensity and the management of fidelity.

Conclusions: Whilst further high-quality research is needed, some interventions with either cognitive or interactive bases can be cautiously recommended. Researchers could consider greater use of single case experimental designs and the involvement of parents, teachers and therapists in delivering interventions.