An exploration of communication within active support for adults with high and low support needs.
Teresa Iacono, Emma Bould, Julie Beadle-Brown and 1 others
PMID 29947456WHAT IT FOUND
In group homes, good staff communication was linked to better support quality and engagement for adults with high support needs, but the pattern was weaker for adults with lower support needs.
Staff reported using AAC more often than observers saw.
Key findings
01For adults with high support needs, good staff communication was associated with higher active support and more time spent engaged.
02Staff reported more use of gestures, symbols and signs by adults with high support needs than observers saw.
03Only 60% of adults with high support needs received good communication, while 96% of adults with low support needs did.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study measured communication support and engagement at the same time, so it cannot show which came first or that communication support caused better engagement. Staff communication ratings were observer judgements using a 0 to 4 scale, not a direct measure of service user understanding. Staff reported more use of gestures, symbols, signs and objects of reference than observers saw, so questionnaire data may overestimate available or used AAC. Data were available for 182 of 246 service users, and the paper does not report why the rest were not included. Observer agreement for the active support measure was lower than for the engagement measure, with some item agreement low. Field notes were selected examples and were de-identified, with all service users referred to as male, so they may not represent all interactions. No communication intervention or training was tested.
The easy way to misread this
Do not read this as evidence that staff communication training improves engagement. The study measured communication support and engagement at the same time. Do not assume that AAC was available or used just because staff reported it, because observers saw less use of gestures, symbols and signs than staff reported.