The Trifocus Framework and Interprofessional Collaborative Practice in Severe Disabilities.

PURPOSE: Individuals with severe disabilities are a diverse group of learners with complex communication needs. This article presents a synthesis of the literature addressing the five strategies of the trifocus framework, with its triadic structure of learner with disability, communication partner, and environment. The application of interprofessional collaborative practice (IPCP) to the implementation of trifocus framework communication strategies is emphasized. METHOD: A literature search was conducted using Google Scholar and EBSCO to identify literature and research studies on IPCP and communication intervention for learners with severe disabilities, published 1994-2015, and then organized within the trifocus framework. The trifocus strategies are enhancing sensitivity, utilizing routines, increasing communication opportunities, modifying the communication environment, and augmenting input. Studies that included at least one participant with severe disabilities and their communication partners were considered. A secondary search was then conducted by reviewing the articles referenced in the original articles. CONCLUSION: Effective IPCP in communication intervention considers the learner's characteristics, the knowledge and skills required of communication partners, and effective environmental arrangements to support communication. Future research should include clear participant descriptions, documentation of fidelity measures, and evidence of generalization to support professionals to know when findings are relevant to the individuals they serve.

Critical Issues in the Lives of Children and Youth Who Are Deafblind.

The coeditors of an American Annals of the Deaf special issue on deaf-blindness introduce readers to critical issues surrounding children and youth who are deafblind. These issues-early identification, communication, social-emotional needs, family and multicultural issues, universal design and assistive technology, transition planning, and personnel preparation-are explored further in the articles that follow. By way of introduction, the present article provides definitions of deafblindness and a discussion of the heterogeneous nature of the population. The history of the field of deafblindness is then explored in terms of three distinct population shifts, from (a) individuals of the 18th and 19th centuries who became deafblind due to illness, to (b) the influx of individuals with congenital rubella syndrome in the 1960s who had disabilities besides deafblindness, and

The State of Research on Communication and Literacy in Deafblindness.

In a synthesis of the research, the authors present findings from communication and literacy studies conducted with children and youth with deafblindness, ages 0-22 years, and published in peer-reviewed journals, 1990-2015. Findings are organized within the structure of the four aspects of communication: form, function, content, context. The studies implemented child-guided and systematic instructional approaches. Studies on form addressed tangible representations, gestures, pictures, and technologies to increase expressive communication rates, and included research focusing on specific functions. Most of the research on context addressed the coaching of adult communication partners to improve responsiveness. Research on communication by children who are deafblind has focused almost exclusively on improving expressive communication. Therefore, there is a need for research on receptive communication and comprehension. In the area of literacy, studies are needed on emergent literacy and reading and writing interventions for children who are deafblind.

Communication and Language in Learners Who Are Deaf and Hard of Hearing With Disabilities: Theories, Research, and Practice.

Findings are presented from communication intervention research in three areas related to deafness with disability (DWD): D/deaf and hard of hearing (DHH) with (a) intellectual disability, (b) autism spectrum disorders, (c) deafblindness. Early identification, prevalence, theoretical perspectives, and evidence-based practices are discussed. Developmental theory, behavioral theory, and social-interactionism theory undergird many assessment and intervention practices in communication. The tri-focus framework and the four aspects of communication are useful frameworks. While communication research is a relative strength in the deafblindness field, a dire need exists for research in the other two DWD areas. Across all DWD areas there is a need for interventions addressing receptive language. Effective communication and language intervention can only occur when children who are DWD are identified early, placed in individually suitable classrooms with appropriately prepared professionals, and provided with services that build on their strengths and meet their needs.

Young deafblind adults in action: becoming self-determined change agents through advocacy.

Six young deafblind adults took a 1-week course on civic engagement and advocacy, which provided the focus for a participatory action research study with a collective case study design. They selected advocacy topics, were briefed on these policy issues, and were paired with experienced mentors for meetings with legislators in Washington, DC. Eight themes were identified from constant comparative and in vivo analysis of classroom discussion notes, interviews, and journals: (a) defining advocacy and advocate, (b) rights and equality, (c) expectations, (d) role of education in change, (e) deafblind expertise, (f) characteristics of effective change agents, (g) advocacy is teamwork, (h) future advocacy. In the classroom, the participants learned about policy issues, communication considerations, and leadership, then applied this knowledge in the legislative arena. Through the advocacy process, they learned to apply their personal strengths as advocates and experienced the importance of teamwork in advocacy.

Teachers' and speech-language pathologists' perceptions about a tangible symbols intervention: efficacy, generalization, and recommendations.

Twenty-nine special education teachers (n=21) and speech-language pathologists (n=8) were interviewed about a tangible symbols intervention conducted with 51 children (3-21 years) with multiple disabilities and visual impairment. The intervention, which took place over a 7-month period, addressed the use of tangible symbols in the context of a structured protocol for implementing the daily schedule. These educators reported that students learned the meaning of symbols, exhibited improved behavior, and learned part or all of the daily routine, among other benefits. Supports and barriers to student learning (later coded as student characteristics or intervention characteristics) were discussed. Interviewees suggested improvements to the intervention and for generalization to the home setting, including labeling in the family's first language.

Intentional communication acts expressed by children with severe disabilities in high-rate contexts.

The purpose of this study was to identify the rates of communication expressed by 17 children with severe disabilities in high-rate school contexts while piloting a new coding system for intentional communication acts (ICAs). The following nine characteristics were used when coding ICAs expressed in both child initiated and adult initiated communicative interactions: joint attention, form of communication, use of pause, persistence, repetition, repair, expression of pleasure or displeasure when understood or misunderstood, expression of pleasure or displeasure to communication partner's message, and evidence of comprehension. Children communicated 1.7 - 8.0 ICAs per minute in the highest rate contexts. Nine of the 34 high-rate contexts were speech clinical sessions, six were activities that included eating, 30 were familiar activities, and four were novel activities.

Perceptions of teachers and parents on the cognitive functioning of children with severe mental disability and children with congenital deafblindness.

This article reports Phase I results of a questionnaire study on the perceptions of US teachers and parents on the cognitive functioning of children with severe mental disability and children with congenital deafblindness, ages 4-12 years. Teachers were more likely than parents to report emerging skills and to provide examples of how the skill was being taught. Teachers and parents of children with severe mental disability had different perceptions about how children demonstrated understanding of cause-effect, object permanence, memory, incidental cues, reasoning and creativity. Teachers and parents of children with congenital deafblindness differed in their perceptions of how children demonstrate understanding of incidental cues and exhibit reasoning. Both teachers and parents expressed concern about whether choice making was meaningful. Novelty was reported to be a motivating factor for children with severe mental disability, while familiarity was cited as motivating for children with congenital deafblindness. Teachers and parents of all children cited consistency, routine and repetition as important to learning.