Staff members' understandings about communication with individuals who have multiple learning disabilities: a case of Finnish OIVA communication training.
ABSTRACT Often communication training has been directed at the communication practices of staff members working with people with multiple learning disabilities. To date, the thinking habits of staff members, which also influence interactions, have not been addressed. We identified the issues staff members perceived as important for their development as communication partners after participating in a communication training program.
Six key staff members participated in semistructured interviews that explored the insights they had gained during participation in the Finnish communication training program OIVA.
Participating staff members identified issues relating to the communication practices and thinking habits they had acquired during the training. Both communication practices and thinking habits were important for the staff members' development as communication partners.
The findings of this study suggest that it is important to give staff members the opportunity to learn new practices and to explore the thinking that underpins the actions they perform during communication training.
[Show abstract] [Hide abstract]
ABSTRACT: Background People with profound intellectual and multiple disabilities (PMLD) have communication impairments as one defining characteristic. AimsTo 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 & ProceduresA 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 & ResultsIntensive 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 & ImplicationsEmpirical 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.International Journal of Language & Communication Disorders 06/2014; 49(6). DOI:10.1111/1460-6984.12098 · 1.39 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Background The provision of skilled support is dependent on staff knowledge and understanding (Beadle-Brown J., Beecham J., Mansell J., Baumker T., Leigh J., Whelton R. & Richardson L, unpublished data). Influencing staff knowledge and understanding is an important component of interventions. Materials and Methods Fourteen individual semi-structured interviews elicited staff views and experiences of knowledge development. These were analysed using a thematic network analysis (Attride-Stirling 2001, Qualitative Research 1, 385–405). ResultsThree global themes were identified; skills are developed from experience, service aims influence service delivery and practice is more important than theory. This article focuses on the first of these themes. Relationships between staff and service users played a central role in enabling development of knowledge. Although some skills were seen as transferrable, experience of a particular service user was described as being essential. Conclusions Support staff may not see the relevance of research findings, professional knowledge or training, unless these have involved direct work with the service user in question.Journal of Applied Research in Intellectual Disabilities 07/2013; 26(4). DOI:10.1111/jar.12020 · 1.38 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Background: Speech and language therapists (SLTs) working with adults who have multiple learning disabilities and complex communication needs often deliver their care via indirect therapy where SLTs train carers to communicate with their clients. Yet, very little is known about how SLTs assess the carers' communication skills prior to the training even though the assessment should be the basis of this indirect therapy. Aims: To explore the level of agreement between Finnish SLTs' assessments of carers as skilful communication partners for adults who have multiple learning disabilities and complex communication needs. To investigate which interaction strategies affect the SLTs' assessments. Methods & Procedures: Six SLTs with more than 15 years of experience in working with individuals with complex communication needs saw together ten video clips of interaction situations between a carer and an adult who had multiple learning disabilities (aged 17-50 years). The SLTs assessed the carers on a scale from one to ten. The SLTs discussed their selections before giving their final ratings. The data were analysed both quantitatively and qualitatively. The unanimity of SLTs' assessment was analysed with a test of Kendall's W. Furthermore, the frequencies of the carers' different communication acts were counted and these counts were compared with the mean of the carers' assessments. These results were further explored with the SLTs' justifications about their assessments. Outcomes & Results: SLTs did not fully agree on which of the carers were the most skilful interaction partners. Furthermore, the six SLTs were not unanimous about which carers' interaction strategies resulted in skilful communication. However, SLTs assessed those carers higher who used facilitative verbal acts. The carers used these verbal acts to involve themselves in the interests of the client. Conclusions & Implications: This case study showed that Finnish SLTs seem to have different criteria about what is considered skilful communication between carers and clients who have multiple learning disabilities. Even though there might not be a single way of being a skilful interaction partner, this variable can be confusing to carers if they work with several SLTs and each of them offers different professional advice. Therefore, the results suggest a need for an assessment tool for evaluating the carers' interaction skills. In addition to this tool, it appears that SLTs also need further training to be able to perform this multifaceted task.International Journal of Language & Communication Disorders 11/2012; 47(6):685-95. DOI:10.1111/j.1460-6984.2012.00175.x · 1.39 Impact Factor