Quality of communication support for people with severe or profound intellectual disability and complex needs

This paper describes the differences in communication strategies between good and poor services for people with severe or profound intellectual disability and complex needs.

As part of a wider research project into skilled support (Beadle-Brown et al, in submission), information about communication was collected using a range of measures. This included observations of alternative and augmentative communication, reviews of written information, and interviews with managers.

Most staff did not use appropriate and effective ways of communicating with people they supported. Despite staff rating 60% of people they supported as non-verbal, less than 20% of observed staff communication involved the use of AAC. A third of people were being supported in a team where communication was rated as good and appropriate most/all of the time. Services providing good support in terms of providing choice, assistance and higher levels of activity were also better at communicating with people.

Communication partnerships were significantly better in services which are providing skilled support in other areas. Person-Centred Active Support is one way in which staff can acquire these skills. This type of intervention, which aims to give staff the core skills necessary, may be necessary to ensure the success of communication interventions.