Using intervention mapping to develop an intervention for multiparty communication with people with congenital deafblindness.

BACKGROUND: Due to their dual sensory impairment, people with congenital deafblindness (CDB) are rarely naturally involved in other people's conversations. Their communication partners find it challenging to include them in group conversations. However, overhearing others communicate is important for developing social and communication skills. Hence, we developed an intervention program to guide communication partners in offering multiparty communication to people with CDB. This article describes how the program was developed through an intervention mapping approach. METHOD: Intervention mapping is a six-step process: logic model, model of change, program design, program production, program implementation plan, and evaluation plan. These six steps were applied to systematically develop a program to foster multiparty communication in people with CDB. Representatives of the involved groups participated in the project group and the working group to ensure feasibility and acceptability. RESULTS: Following the intervention mapping steps resulted in creation of a program for communication partners that consists of an education session, practicals, and four video-feedback sessions. Information sessions for practitioners and managers were also developed. The program was implemented incrementally with program implementers in each organization. A subjective evaluation and an impact evaluation were done after each implementation phase. DISCUSSION: Intervention mapping was used to develop a program that connects theory to practice. The program appeared to meet the communication partners' needs and be feasible in terms of time investment. This article offers suggestions for broadening the scope of the program to other settings and for further investigating the effects of the program on the social and communication skills of people with CDB.

Communication development from an intersubjective perspective: Exploring the use of a layered communication model to describe communication development in students with congenital deafblindness.

This exploratory study conducts a quantitative investigation on the communication development of students with congenital deafblindness (CDB). First, a layered communication model (LCM) is introduced, describing communicative behaviors based on three layers of intersubjective development for typically developing children (Bråten & Trevarthen, 2007). Subsequently, an analysis is made of how applicable the LCM is for children with CDB. Video recordings of four dyads of students with CDB with varying developmental ages and their teachers are coded using ten-second partial interval coding. The presence of LCM behaviors, the student and teacher contributions to communication, and the development over a half-year period are described and compared between dyads. The results reflected the developmental differences between dyads. At the primary layer, all behaviors occurred a comparable number of times between dyads, which confirms that this is a basic communication layer. Quantitative differences between dyads were encountered between and within the secondary and tertiary layers. Teacher contribution was higher for students with lower developmental ages compared to students with higher developmental ages. Also, teacher contribution was higher for the secondary and tertiary layer behaviors of the LCM compared to the primary layer behaviors. No increase was found in the behaviors over the half-year period. Results suggest that the LCM can be used to gain insight into the communication level of a dyad, hereby paving the way for intervention studies to improve communication development.

Scaffolding the Communication of People With Congenital Deafblindness: An Analysis of Sequential Interaction Patterns.

The High Quality Communication intervention aims to stimulate interpersonal communication between individuals with congenital deaf-blindness (CDB) and their social partners. Found effective in multiple-case experiments, the intervention is based on Trevarthen's theory of inter-subjective development (Bråten & Trevarthen, 2007), which describes children's innate and developing ability to share subjective states in interpersonal communication and social partners' mediating role in this development. One implication of this theory is that social partners can support the emergence of higher-complexity communication behaviors in individuals who are still developing these behaviors. To test this proposition, communication patterns between individuals with CDB and their parents, teachers, and professional caregivers were analyzed. Analysis of two-event sequences of communicative behaviors showed a highly significant correspondence between the behavior of the social partner and the subsequent behavior of the individual with CDB, confirming that social partners can scaffold higher-complexity communication within interpersonal communication.

Fostering Emotion Expression and Affective Involvement with Communication Partners in People with Congenital Deafblindness and Intellectual Disabilities.

BACKGROUND: Recent studies have shown that it is possible to foster affective involvement between people with congenital deafblindness and their communication partners. Affective involvement is crucial for well-being, and it is important to know whether it can also be fostered with people who have congenital deafblindness and intellectual disabilities. METHODS: This study used a multiple-baseline design to examine whether an intervention based on the Intervention Model for Affective Involvement would (i) increase affective involvement between four participants with congenital deafblindness and intellectual disabilities and their 13 communication partners and (ii) increase the participants' positive emotions and decrease their negative emotions. RESULTS: In all cases, dyadic affective involvement increased, the participants' very positive emotions also increased and the participants' negative emotions decreased. CONCLUSION: The results indicate that communication partners of persons with congenital deafblindness and intellectual disabilities can be successfully trained to foster affective involvement.

Stimulating intersubjective communication in an adult with deafblindness: a single-case experiment.

Sensory disabilities may limit a person's development of intersubjectivity, that is, the awareness of self and other, which develops in conjunction with interpersonal communication. This study used intersubjectivity theory to test a new intervention called the High-Quality Communication (HQC) intervention for its effects on a young adult with congenital deafblindness and a developmental age of between 1.5 and 4 years. Three of his social partners were trained to support attunement and meaning making with him through education and video feedback. This study measured seven observation categories at three layers of intersubjective development during a baseline and two intervention phases: dyadic interaction, shared emotion, referential communication, meaning negotiation, shared meaning, declarative communication, and shared past experience. The participant's use of conventional communication was included as an additional category. Effects were observed in all observation categories from the baseline to the intervention phases. Further study of the effectiveness of the HQC intervention is recommended to test whether effects generalize across people and settings.