But What Can They Do? Assessment of Communication Skills in Children With Severe and Multiple Disabilities Children born with severe and multiple disabilities often experience significant communication disorders, and many will be AAC candidates. Meaningful assessment of their communication skills is an essential first step toward appropriate intervention. This article focuses on the challenges of assessing the expressive communication skills of children with severe and multiple ... Article
Article  |   April 01, 2005
But What Can They Do? Assessment of Communication Skills in Children With Severe and Multiple Disabilities
Author Affiliations & Notes
  • Charity Rowland
    Design to Learn Projects, Oregon Health and Science University, Portland, OR
Article Information
Development / Hearing Disorders / Augmentative & Alternative Communication / School-Based Settings / Research Issues, Methods & Evidence-Based Practice / Professional Issues & Training / Attention, Memory & Executive Functions / Articles
Article   |   April 01, 2005
But What Can They Do? Assessment of Communication Skills in Children With Severe and Multiple Disabilities
SIG 12 Perspectives on Augmentative and Alternative Communication, April 2005, Vol. 14, 7-12. doi:10.1044/aac14.1.7
SIG 12 Perspectives on Augmentative and Alternative Communication, April 2005, Vol. 14, 7-12. doi:10.1044/aac14.1.7
Children born with severe and multiple disabilities often experience significant communication disorders, and many will be AAC candidates. Meaningful assessment of their communication skills is an essential first step toward appropriate intervention. This article focuses on the challenges of assessing the expressive communication skills of children with severe and multiple disabilities and presents a selection of instruments that are appropriate for the target population. The emphasis is on assessment procedures that reveal what the child cando, as opposed to what the child cannot do.
The children targeted in this discussion are those who experience the most profound combinations of impairments related to congenital conditions. Advances in medical technology in the United States have increased the survival rate of infants born with established risk conditions and severe and multiple disabilities. Etiologies vary widely among children born with severe and multiple disabilities, including risks associated with prematurity, birth asphyxia, and very low birth weight; and a wide variety of hereditary and chromosomal disorders, including rare syndromes and congenital prenatal complications (such as the consequences of prenatal exposure to various infectious diseases). These infants may experience a number of difficulties, including seizures, feeding problems, hydro-cephalus, cerebral palsy, cardiac and pulmonary disease, behavioral disorganization, seizures, hearing loss, visual impairment, and orthopedic impairment.Visual impairment may compromise the extent to which children learn about events and objects that are beyond their physical reach, while hearing impairment may limit what they learn about the environment from auditory sensations. Orthopedic impairment may limit children’s experience with manipulating and exploring the physical environment. Cognitive impairment, including attention and memory deficits, may impede the integration of sensory experiences and limit their ability to make sense of the environment. Any of these conditions may dull the tools necessary to comprehend the social environment and to interact with it meaningfully. Repeated experiences with failure, frustration, and lack of control—often compounded by a tendency for family members and professionals to provide more help than is necessary— may lead to passivity, disinterest, and even learned helplessness.
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