As you saw in the Communicative Independence Model the emerging communicator is an individual who:
1) does not have any RELIABLE method of symbolic
communication [G]; and
Remember, the fact that an individual does not have more sophisticated communication is not necessarily an indication of a cognitive impairment or developmental delay. The limited communication could be due to many other factors:
In fact, if an emerging communicator has severe motor impairments, I would argue that you cannot know the underlying cognitive abilities until he/she has a way to communicate. There is no way to test cognition without good motor control and/or reliable communication. We simply cannot know until we finally establish expressive symbolic communication [G].
What is the purpose of vocabulary selection for the Emerging Communicator? The goal should be only one thing:
But that goal does not mean that we have to make the interaction a dull, stimulus-response activity to prove that symbolic communication has been established. In fact, that would be the worst way to proceed because it may make the individual unwilling to participate in your attempts. Instead, with emerging communicators (or "re-emerging" adults), you must select the vocabulary that will empower the individual through communication. You want vocabulary that will:
Identifying those truly POWERFUL concepts is no easy task. This is particularly true with emerging communicators who cannot, by definition, tell you what they want to be able to say. Here are some strategies that you may find helpful in your work with these individuals.
This technique is used to determine what the child or adult really likes and really dislikes so communication can focus on those things. Here is a form that can be used to keep track of likes and dislikes in a variety of modalities (e.g. sounds, sights, touch, etc.) for some individuals: Likes and Dislikes Checklist.
You can see that this method is best at identifying objects or actions that the individual wants to request or to reject. Typically, I use this list to interview family members and caregivers who usually already know this information. In some cases, we use it in planning actual trials with the individual to determine likes and dislikes. If I were to use this with an adult in intensive care, I would modify it to requests that can be made in that context (e.g. ice chips, fan, etc.)
Here are some other resources for preference inventories:
Another technique is to observe the non-speaking individual in order to see what interests him. For example, if you observe a child during snack, you may find that he never eats his snacks and that he is more interested in something to drink. But you may also notice that he needs help getting the milk carton open. If you give him a symbol for the pretzels or chips, he may not use them. But if you give him a way to ask for "milk" and "help open" he may show successful (and more complex!) communication in that context.
Here is an observation form that I use during this type of observation: Observing Communication in Context
If setting aside time to observe is impossible, we then recommend that
team members keep notes only when communication is problematic. For this
we use a "Breakdown Diary" like the one shown here:
When you analyze this type of diary, don't look just for the specific vocabulary that would have prevented that breakdown; look instead for a class of words. For example, let's say an individual wanted to hear a particular song on tape and it took 5 minutes of yes/no questions to identify it. You wouldn't want to just put that song title on a communication board; you'd put all the favorite songs, leaving room for new songs as they are identified.
Some individuals have problem behaviors, such as tantrums, kicking, scratching, damaging property or self-injurious behaviors. There is considerable evidence that some of this behavior can be replaced with functionally equivalent alternative communication. Studies have identified specific communicative functions that are crucial for many individuals with problem behaviors. According to Lloyd et al (1997), these are:
Here are some excellent resources on this topic:
When you select the initial vocabulary for an emerging communicator, be sure to concentrate first on