Análisis de la Comunicación y de la Discapacidad desde un enfoque multidisciplinar

by Marina Calleja Reina (Volume editor)
©2019 Edited Collection 224 Pages


Este libro analiza los procesos comunicativos en personas con discapacidad en un sentido amplio. Aborda algunas estrategias de intervención para personas con Discapacidad Intelectual severa, Enfermedad de Alzheimer, Trastorno del Lenguaje, Discapacidad Sensorial Visual. Propone herramientas TIC para mejorar los intercambios comunicativos y la intervención con población con Discapacidad. Analiza la importancia de la Iconicidad de los símbolos empleados en los Sistemas de Comunicación Aumentativa y Alternativa (CAA). Incluso recoge un glosario para intérpretes cuyo desempeño profesional se realiza en el ámbito médico-sanitario.

Table Of Contents

  • Cover
  • Titel
  • Copyright
  • Autorenangaben
  • Über das Buch
  • Zitierfähigkeit des eBooks
  • Análisis de la Comunicación y de la Discapacidad Intelectual desde un enfoque multidisciplinar
  • Tabla de Contenidos
  • Communication and Related Strategies for Fostering the Inclusion of Individuals with Severe Disabilities in Their Communities
  • La Importancia de la Iconicidad en un Sistema de Comunicación Alternativa y Aumentativa con Símbolos Multimodales Destinados a Personas con Discapacidad Intelectual Profunda
  • Aplicaciones TIC del Proyecto EC+ para Profesionales a Cargo de Personas con Discapacidades Severas y Necesidades Especiales de Comunicación
  • Tecnologías Móviles en el Ámbito de la Salud
  • EC+: una propuesta para la Interacción Comunicativa en las Personas Adultas con Discapacidad Múltiple y Profunda (DAMP-a)
  • Current State of Education for Students with Disabilities in Azerbaijan
  • Creación de un Glosario a través de un Corpus para la Interpretación en los Servicios Sanitarios. Caso Práctico: Entrevista Médico-Paciente
  • Dificultades de Comunicación en la Enfermedad de Alzheimer: Datos de un Caso. Estudio Piloto en AFA.
  • El Síndrome SYNGAP1: Análisis Casos y Estrategias de Intervención.
  • Mejora de la Comunicación en la Atención a Población Inmigrante sin Permiso de Residencia en la Comunidad Andaluza: la Necesidad de un Nuevo Enfoque en Salud Mental.
  • Audio Description: Seeing With Your Ears
  • Acquired Dysgraphia and its Correlation with English as a Foreign Language Learning
  • La Terminología en la Comunicación sobre Trastornos del Lenguaje. Terminografía Aplicada a la Interpretación (ES-DE-EN)

←10 | 11→

Communication and Related Strategies for
Fostering the Inclusion of Individuals with
Severe Disabilities in Their Communities

((Communication and related strategies))

Abstract Individuals with severe disabilities require a variety of instructional practices in order to foster their inclusion in schools and other settings. This paper focuses on the role of communication, or, augmentative and alternative comunication, in this regard. Numerous evidence-based practices are discussed along with corresponding examples illustrating their use in natural settings. Educators and others are encouraged to adopt practices that foster functional, highly valued skills that enhance the likelihood that individuals will be fully included in their communities.

Resumen Las personas con discapacidades severas requieren una variedad de prácticas de instrucción para fomentar su inclusión en las escuelas y otros entornos. Este documento se centra en el papel de la comunicación, o la Comunicación Aumentativa y Alternativa, a este respecto. Se analizan numerosas prácticas basadas en la evidencia junto con ejemplos correspondientes que ilustran su uso en entornos naturales. Se alienta a los educadores y otros profesionales a adoptar prácticas que fomenten habilidades funcionales y altamente valoradas que aumenten la probabilidad de que los individuos se incluyan plenamente en sus comunidades.

Keywords: Augmentative and Alternative Communication, severe disabilities, inclusion, integrated programs, instructional priorities

Palabras claves: Comunicación Aumentativa y Alternativa, discapacidades severas, inclusión, programas integrados, prioridades de instrucción

1. Introduction

Why won't that mom let her little girl eat? Several years ago, the Angelman Syndrome Foundation (USA) asked the author to review raw video footage provided by professionals as well as families in response to a request for examples of model strategies for fostering communication skills. Once this content was extracted, ←11 | 12→the author’s task would then be to integrate the various clips into a master tape that would be broadly disseminated for instructional purposes. Not long into this process, the author came across a video of a young girl, Whitney, and her mother eating lunch at a McDonalds restaurant.

The video involved Whitney’s mother presenting two choices, french fries or soda, and then encouraging Whitney to make a choice using pictures on a communication device. After each bite or sip, the foods were withdrawn and another trial commenced (i.e. Whitney again had to make a selection). Each time Whitney reached for one of the objects, her mother redirected her to her communication device, a sheet containing four symbols in all. Her goal was to have Whitney use her device to make choices, even though she fully understood Whitney was already communicating this content through purposeful reaching.

2. Mistaken focus

Over the course of reviewing this video, the author’s 4-year-old daughter Kaity entered the room. A few minutes into the session, Kaity exclaimed, “Why is that lady being so mean to that little girl?” When asked to elaborate, Kaity remarked, “Why won’t she let her little girl eat?” Kaity had picked up an example of what constituted a ‘mistaken focus.’ This refers to situations in which interventions are misguided in that they target skills that miss the big picture. In the case of Whitney, a preferred goal would be to teach Whitney to eat more independently. If a communication goal was to be addressed, it could have included things such as encouraging her to greet workers and other customers, order her meal, or even exchange small talk with her mother while eating. Any of these goals would shift the focus away from having Whitney make a series of choices, for no reason other than the making of these choices, in a situation in which a typical individual would instead be expected to eat with as little dependence on another person as possible.

2.1 A suitable alternative

If choice making was identified as a necessary and relevant skill to teach Whitney, it may have been preferable to teach this behavior in the context of an integrated activity. For example, opportunities for making choices throughout the day might be identified and different adults might foster this skill in the context of the ongoing activity. For example, Whitney might be encouraged to select one of two crayons in art class. She might indicate to a school cafeteria worker her ←12 | 13→preference for a particular lunch item, or she might communicate to her teaching assistant the child she wished to be positioned next to for a given activity.

The emphasis on integrated, rather than isolated, teaching is especially relevant with respect to interventions directed toward individuals with severe disabilities. Many of these individuals experience difficulty acquiring and then generalizing skills, making it all the more important that skills are taught in the contexts in which they will most likely be used. This is the case regardless of whether students are in segregated or inclusive educational settings (Calculator, 1988; Calculator & Black, 2010).

2.2 Communication challenges of persons with severe disabilities

For purposes of this paper, the term ‘individuals with severe disabilities’ refers to children and adults with severe to profound intellectual disabilities and accompanying challenges in other areas that may include vision, hearing, movement, behavior, and communication. Regarding the latter, all three expressive modes may be impacted.

Vocally, a large percentage of these individuals have little or no understandable speech. They may instead rely heavily on unintelligible vocalizations and a limited number of word approximations.

Additional problems are often observed in the gestural mode. For example, due to cognitive challenges they may have difficulty learning signs for abstract concepts. Even when such signs are attainable, motor difficulties may prevent them from executing these signs accurately. This means their signs may not only be difficult for communication partners with signing background to interpret, but also for those who have such background but are unaware of the modified versions of signs a particular individual uses. In such cases, listeners may need to rely on the child’s parent or another familiar adult to translate the meanings of these signs.

Finally, individuals with severe disabilities experience difficulties in the graphic mode as well. As degrees of intellectual disability increase, there is a tendency for individuals to experience increasing difficulty using abstract symbols. Thus, an individual may communicate best using concrete forms of representation such as objects and photographs, while experiencing difficulties with more abstract symbols such as line drawings and words. That said, the complexity of symbols could vary greatly within the same form of representation. For example, a broad range of pictures, some more abstract than others, can be used to symbolize the same concept (e.g. ‘car’). It is thus common to see individuals with ←13 | 14→severe disabilities using communication devices with a combination Candidacy for Augmentative and Alternative Communication.

Given the nature of their communication difficulties, all individuals with severe disabilities are candidates for augmentative and alternative communication (AAC) systems. These often consist of a combination of aided (e.g. no-tech, low-tech, and high-tech) devices and unaided (e.g. natural gestures and signs) methods. Most often, AAC systems are intended to augment existing communication skills. However, in some cases they replace these methods of communication. The latter situation is most often the case when individuals are using challenging (e.g. socially inappropriate) behaviors as primary means of communication. For example, a child may communicate a desire for attention by screaming. Another might indicate a desire to have an undesirable activity end by hitting their conversational partner. In either case, an AAC intervention might involve replacing these behaviors with a socially appropriate behavior (e.g. a gesture, sign, or symbol on a communication device) that is functionally equivalent. For example, the child is taught to activate a message on a speech generating device (SGD) to request attention, replacing the previous, undesirable means of doing so. Based on an exhaustive review of the literature, Walker and Snell (2013) concluded AAC systems are extremely effective when introduced as alternatives to challenging behavior. In essence, increased uses of AAC correspond with decreasing frequencies of challenging behaviors.

There are numerous factors to consider when developing AAC systems for individuals with severe disabilities. Calculator & Black (2009) used a panel of experts to validate a set of best practices in the provision of AAC services to students with severe disabilities in general education classrooms. These same practices were later validated by parents of children with Angelman Syndrome in terms of the favorability with which they viewed each one (Calculator & Black, 2010). Interestingly, parents of children in mostly integrated settings viewed these practices similarly to those whose children were in mostly segregated settings.

Practices cited in the Calculator and Black (2010) investigation fell into eight non-mutually exclusive categories. These follow, along with an example of a corresponding practice for each: (1) Promoting positive values [AAC skills foster our child’s membership in the school community]; (2) Collaboration between general and special educators [Sufficient time is set aside each week for collaboration between general education and special education teachers]; (3) Collaboration between educators and related service providers [Sufficient preparation and ongoing supports are provided to enable teachers to acquire the knowledge and skills they need to foster our child’s functional use of the AAC system in his or her classrooms]; (4) Family involvement [Our input, which includes our family’s ←14 | 15→goals and priorities for our child, is considered strongly when selecting the AAC system]; (5) Choosing and planning what to teach [Our child’s preferences, whether conveyed overtly or more subtly, are considered strongly when selecting an AAC system]; (6) Scheduling, coordinating, and delivering inclusive services [Administrators, teachers, parents, and others recognize and support consultative models of service delivery]; (7) Assessing and reporting student progress [Evaluations of the effectiveness of the AAC program consider its impact on our child’s overall quality of life], and; (8) Instructional strategies [There are opportunities for our child to see his or her AAC mode used by more competent peers and adults who model appropriate uses of the same system].

An earlier investigation discussed priorities to consider when designing instructional programs for children with severe disabilities (Calculator & Jorgensen, 1994). These priorities were consistent with the practices cited above. For example, skills taught should be those which individuals have multiple opportunities and reasons to use and practice on a regular basis. If individuals have little or no opportunities and reasons to communicate, they cannot be expected to do so. Instead, intervention may be directed at modifying their environments to occasion these events.

Individuals as well as their families should also value AAC systems. Parents of children with severe disabilities have stressed the importance of their being involved with the selection and implementation of AAC devices (Calculator & Black, 2010). Similarly, negative outcomes may arise when AAC systems do not take into account users’ preferences (Calculator, 2014).

AAC systems should be acquired with relative ease and have immediate functional implications. Investigators have discussed this in terms of planning for current as well as future needs, based on changes in individuals’ circumstances and capabilities (Beukelman & Mirenda, 2013).

2.3 Age appropriateness

Instructional priorities should also account for what may be chronologically and developmentally appropriate. For example, the communication skills taught to Sam, a 35 year-old whose cognitive skills were assessed to be consistent with those typically observed in 3-year-olds, might include enabling him to request a beer at a local restaurant. Although this would not be aligned with his mental age (i.e. we would certainly not teach a typical 3-year-old to make such a request), it would be appropriate given his chronological age. The symbol Sam used to request a beer might be incorporated into a communication device we might expect to be navigable by a typical 3-year-old. By considering both chronological ←15 | 16→and developmental factors we are in a better position to teach skills that will have functional consequences.

Other principles underlying the process of setting instructional priorities include targeting skills that are likely to enhance the status of individuals as perceived by others, improving abilities to function as independently as possible across multiple settings, and teaching behaviors individuals will continue to find useful as adults.


ISBN (Hardcover)
Publication date
2019 (October)
discapacidad Intelectual sistemas CAA Aplicaciones TIC Iconicidad EC+.
Berlin, Bern, Bruxelles, New York, Oxford, Warszawa, Wien, 2019., 224 p., 29 il. blanco/negro, 14 tablas, 3 gráf.

Biographical notes

Marina Calleja Reina (Volume editor)

Marina Calleja Reina es Profesora Titular en el Departamento de Psicología Básica de la Universidad de Málaga. Sus líneas de investigación son Sistemas Alternativos de la Comunicación, Procesos Psicológicos Básicos y Desarrollo Cognitivo. Cuenta con numerosos artículos en revistas de impacto nacionales e internacionales.


Title: Análisis de la Comunicación y de la Discapacidad desde un enfoque multidisciplinar
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226 pages