Speech and language therapists' approaches to communication intervention with children and adults with profound and multiple learning disability

Juliet Goldbart, Darren Chadwick, Susan Buell

Research output: Contribution to journalArticle

10 Citations (Scopus)
49 Downloads (Pure)

Abstract

Background People with profound intellectual and multiple disabilities (PMLD) have communication impairments as one defining characteristic. Aims To explore speech and language therapists' (SLTs) decision making in communication interventions for people with PMLD, in terms of the intervention approaches used, the factors informing the decisions to use specific interventions and the extent to which the rationales underpinning these decisions related to the components of evidence based practice (EBP), namely empirical evidence, clinical experience and client/carer views and values. Methods & Procedures A questionnaire on communication assessment and intervention for people with PMLD was sent to SLTs in the UK to elicit information on: the communication intervention approaches they used; their rationales for their intervention choices; their use of published evidence to inform decision making. Outcomes & Results Intensive interaction and objects of reference were the communication interventions most often used with people with PMLD, with some differences between children and adults evident. Rationales provided conformed somewhat to the EBP framework though extension of the existing framework and addition of practical and organizational considerations led to a revised typology of rationale for decision making. Rationales most frequently related to the empowerment, development and behavioural preferences of the person with PMLD. Conclusions & Implications Empirical research evidence was seldom mentioned by SLTs as informing intervention decision making leading to very diverse practice. There is a need for further research on the effectiveness of commonly used but under-evaluated interventions. There is also a need to alert SLTs to the evidence base supporting other approaches, particularly switch-based, cause and effect approaches.

Original languageEnglish
Pages (from-to)687-701
Number of pages15
JournalInternational Journal of Language and Communication Disorders
Volume49
Issue number6
DOIs
Publication statusPublished - Nov 2014

Fingerprint

multiple disabilities
Learning Disorders
learning disability
Intellectual Disability
therapist
Language
Communication
Decision Making
communication
language
Evidence-Based Practice
evidence
decision making
Empirical Research
Caregivers
Learning Disability
Research
empirical research
empowerment
typology

Keywords

  • communication
  • decision-making
  • intervention
  • PMLD
  • profound disability
  • speech and language therapy

Cite this

@article{6ab96159dd5040049f6f02ba5c90eb9a,
title = "Speech and language therapists' approaches to communication intervention with children and adults with profound and multiple learning disability",
abstract = "Background People with profound intellectual and multiple disabilities (PMLD) have communication impairments as one defining characteristic. Aims To explore speech and language therapists' (SLTs) decision making in communication interventions for people with PMLD, in terms of the intervention approaches used, the factors informing the decisions to use specific interventions and the extent to which the rationales underpinning these decisions related to the components of evidence based practice (EBP), namely empirical evidence, clinical experience and client/carer views and values. Methods & Procedures A questionnaire on communication assessment and intervention for people with PMLD was sent to SLTs in the UK to elicit information on: the communication intervention approaches they used; their rationales for their intervention choices; their use of published evidence to inform decision making. Outcomes & Results Intensive interaction and objects of reference were the communication interventions most often used with people with PMLD, with some differences between children and adults evident. Rationales provided conformed somewhat to the EBP framework though extension of the existing framework and addition of practical and organizational considerations led to a revised typology of rationale for decision making. Rationales most frequently related to the empowerment, development and behavioural preferences of the person with PMLD. Conclusions & Implications Empirical research evidence was seldom mentioned by SLTs as informing intervention decision making leading to very diverse practice. There is a need for further research on the effectiveness of commonly used but under-evaluated interventions. There is also a need to alert SLTs to the evidence base supporting other approaches, particularly switch-based, cause and effect approaches.",
keywords = "communication, decision-making, intervention, PMLD, profound disability, speech and language therapy",
author = "Juliet Goldbart and Darren Chadwick and Susan Buell",
year = "2014",
month = "11",
doi = "10.1111/1460-6984.12098",
language = "English",
volume = "49",
pages = "687--701",
journal = "International Journal of Language and Communication Disorders",
issn = "1368-2822",
publisher = "Wiley",
number = "6",

}

TY - JOUR

T1 - Speech and language therapists' approaches to communication intervention with children and adults with profound and multiple learning disability

AU - Goldbart, Juliet

AU - Chadwick, Darren

AU - Buell, Susan

PY - 2014/11

Y1 - 2014/11

N2 - Background People with profound intellectual and multiple disabilities (PMLD) have communication impairments as one defining characteristic. Aims To explore speech and language therapists' (SLTs) decision making in communication interventions for people with PMLD, in terms of the intervention approaches used, the factors informing the decisions to use specific interventions and the extent to which the rationales underpinning these decisions related to the components of evidence based practice (EBP), namely empirical evidence, clinical experience and client/carer views and values. Methods & Procedures A questionnaire on communication assessment and intervention for people with PMLD was sent to SLTs in the UK to elicit information on: the communication intervention approaches they used; their rationales for their intervention choices; their use of published evidence to inform decision making. Outcomes & Results Intensive interaction and objects of reference were the communication interventions most often used with people with PMLD, with some differences between children and adults evident. Rationales provided conformed somewhat to the EBP framework though extension of the existing framework and addition of practical and organizational considerations led to a revised typology of rationale for decision making. Rationales most frequently related to the empowerment, development and behavioural preferences of the person with PMLD. Conclusions & Implications Empirical research evidence was seldom mentioned by SLTs as informing intervention decision making leading to very diverse practice. There is a need for further research on the effectiveness of commonly used but under-evaluated interventions. There is also a need to alert SLTs to the evidence base supporting other approaches, particularly switch-based, cause and effect approaches.

AB - Background People with profound intellectual and multiple disabilities (PMLD) have communication impairments as one defining characteristic. Aims To explore speech and language therapists' (SLTs) decision making in communication interventions for people with PMLD, in terms of the intervention approaches used, the factors informing the decisions to use specific interventions and the extent to which the rationales underpinning these decisions related to the components of evidence based practice (EBP), namely empirical evidence, clinical experience and client/carer views and values. Methods & Procedures A questionnaire on communication assessment and intervention for people with PMLD was sent to SLTs in the UK to elicit information on: the communication intervention approaches they used; their rationales for their intervention choices; their use of published evidence to inform decision making. Outcomes & Results Intensive interaction and objects of reference were the communication interventions most often used with people with PMLD, with some differences between children and adults evident. Rationales provided conformed somewhat to the EBP framework though extension of the existing framework and addition of practical and organizational considerations led to a revised typology of rationale for decision making. Rationales most frequently related to the empowerment, development and behavioural preferences of the person with PMLD. Conclusions & Implications Empirical research evidence was seldom mentioned by SLTs as informing intervention decision making leading to very diverse practice. There is a need for further research on the effectiveness of commonly used but under-evaluated interventions. There is also a need to alert SLTs to the evidence base supporting other approaches, particularly switch-based, cause and effect approaches.

KW - communication

KW - decision-making

KW - intervention

KW - PMLD

KW - profound disability

KW - speech and language therapy

UR - http://www.scopus.com/inward/record.url?scp=84912534467&partnerID=8YFLogxK

U2 - 10.1111/1460-6984.12098

DO - 10.1111/1460-6984.12098

M3 - Article

VL - 49

SP - 687

EP - 701

JO - International Journal of Language and Communication Disorders

JF - International Journal of Language and Communication Disorders

SN - 1368-2822

IS - 6

ER -