People who have limited communication skills may experience restrictions in access to academic, social, and vocational opportunities as well as in participation in self-advocacy and decision-making related to education, health care, and life transitions.
Secondary issues often arise when such individuals experience frustration in communication, commonly expressed in the form of challenging behaviors (Petty, Allen, & Oliver, 2009). These behaviors further compromise all aspects of development when they involve aggression toward others, have significant health implications when they are self-injurious, and increase service costs when extensive behavior management plans are needed.
Effectively designed communication interventions, including augmentative and alternative communication (AAC), can promote optimal functioning by enabling service provision in less restrictive settings, fostering participation in all levels of society, and reducing challenging behavior associated with frustration (Durand, 1993; Worsdell, Iwata, Hanley, Thompson, & Kahng, 2000).
Several intervention approaches have proven to be successful at establishing both spoken and AAC-based communication goals, from direct instructional methods to naturalistic and/or modeling-based approaches (e.g., Fallon, Light, McNaughton, Drager, & Hammer, 2004; Harris & Reichle, 2004; Johnston, Reichle, & Evans, 2004). Research has demonstrated that intervention effectiveness is not diminished when the learner has severe intellectual disability; in fact, during intervention individuals with severe disabilities may progress in their communication skills at a rate equal to or faster than that of people with moderate or mild intellectual limitations (Cole, Coggins, & Vanderstoep, 1999; Snell et al., 2010).
One group dedicated to optimizing services for people with severe disabilities is the National Joint Committee for the Communication Needs of Persons With Severe Disabilities (NJC). This interdisciplinary group of scholars and professionals represents speech-language pathology, special education, assistive technology, augmentative and alternative communication, occupational therapy, physical therapy, psychology, and intellectual disability.
NJC has published a number of resources for services with this population. Perhaps the most popular is the downloadable "Communication Bill of Rights," which states the NJC position that individuals with severe disabilities have the same rights to self-expression and self-advocacy as any other individual. Others include a position statement on access to communication services and supports, a set of practice guidelines, a review of the quality of the research base over the last 20 years, a recently hosted conference on intervention research, and a "Communication Supports Checklist" for clinical use.
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