Support Staff-client Interactions With Augmentative and Alternative Communication

Study Overview
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Brief Summary
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This exploratory and observational study focuses on adults with an intellectual disability (ID) and their support workers. Two groups of clients are observed: clients using Key Word Signing, and clients using aided Augmentative and Alternative Communication (AAC). Approximately half of adults with ID is estimated to experience communication difficulties. AAC supports them in their daily communication aiming at optimal participation in society. Current communication models, such as Participation Model (Beukelman & Mirenda, 2005) and International Classification of Functioning, Disability and Health (WHO, 2001), regard both client-related and environmental factors as important elements of communication. A substantial part of the environmental factors is made up of the communication partners' characteristics. In daycare and residential services for adults with ID the support worker is an important communication partner .

Detailed Description
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This study aims to: with regard to teaching Key Word Signing (KWS), a specific form of AAC, to support workers: Analyse the relation between training method, support workers' attitude, and short and long term sign knowledge. with regard to the use of manual signs in everyday communication between support workers and adults with ID: Identity the support workers' characteristics that may influence the quality/quantity of the communication between adults with ID who use manual signs and their support worker. Analyse the nature of this influence as well as any possible interaction effects with the clients' characteristics. Assess whether an existing instrument, designed for measuring interactions between parents and children with cerebral palsy using AAC, may be used with adults client and support workers.

Official Title
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Support Staff's Interactions With Adults With Intellectual Disability Who Use Augmentative and Alternative Communication

Conditions
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Intellectual Disability

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: uses AAC with client client has congenital intellectual disability supports client for at least 6 months Exclusion Criteria: client has dementia symptoms client has severe, non-corrected visual impairment client has diagnosed autism
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| support workers & AAC users<br>Support workers who use KeyWordSigning in the communication with their client who has an intellectual disability | |
| support workers & KWS users<br>Support workers who use aided AAC in the communication with their client who has an intellectual disability | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Signing rate of support workers and individuals with intellectual disabilities | Proportion: number of signed utterances divided by total number (spoken + exclusively spoken) of utterances | Three observation sessions over period of 2 weeks per participant, 2 years for all participants | 
| Sign imitation rate support workers and individuals with intellectual disabilities | Proportion: number of manual sign imitations divided by total number manual signs produced | Three observation sessions over period of 2 weeks per participant, 2 years for all participants | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Explicit Attitude of direct care staff towards manual signs | Self-developed survey with subscales (Likert response): scaled score | One testing per participant, over period of 6 months for all participants | 
| Implicit Attitude of direct care staff working in towards manual signs | Single-Category Implicit Association Test scores | One testing per participant, over period of 6 months for all participants | 
| Communicative functions of individuals with intellectual disabilities | Proportion of responses/acknowledgement versus all communicative functions (responses/acknowledgements as well as initiations) | Three observation sessions over period of 2 weeks per participant, 2 years for all participants | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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AAC, support worker, direct care staff, intellectual disability, learning disability, communication, adults