Communication intervention for people with profound intellectual and multiple disabilities: implications from a systematic review

Background: Communication is a human right. Children and adults withprofound intellectual and multiple disabilities experience profounddevelopmental delay, and communication, mobility and sensory difficul-ties, restricting their access to this basic right. A range of communica-tion interventions is available to increase interaction and participation,but there is limited high-quality supporting evidence. The aim of thispaper is, through a systematic review, to identify evidence-based com-munication interventions for practitioners and to inform the design offuture research.Methods: A systematic review was undertaken, conforming to PROS-PERO guidelines. Quality appraisal was conducted using Crowe's Criti-cal Appraisal Tool (CCAT). Findings are reported according to PRISMA.Results: Few good-quality evaluations of communication interventionwere found; however, some cautious recommendations can be madefor teaching and therapy. Challenges to research rigour include thediversity of children and adults with profound intellectual and multipledisabilities, small sample sizes and difficult decisions regarding whoshould intervene, assessment consistency, acceptable interventionintensity and the management of fidelity.Conclusions: Whilst further high-quality research is needed, someinterventions with either cognitive or interactive bases can be cau-tiously recommended. Researchers could consider greater use of sin-gle case experimental designs and the involvement of parents,teachers and therapists in delivering interventions