title: Examination of the communication interface between students with severe to profound and multiple intellectual disability and educational staff during structured teaching sessions.
abstract: BACKGROUND
  Individuals with severe to profound and multiple intellectual disability (S-PMID) tend to function at the earlier stages of communication development. Variable and highly individual means of communicating may present challenges to the adults providing support in everyday life. The current study aimed to examine the communication interface between students with S-PMID and educational staff.
  
  
  METHODS
  An in-depth, observational study of dyadic interaction in a class within the secondary part of a special school was conducted. The designated educational level was Key Stage 3 under the National Curriculum of England, which is typically for children from age 11 to 14 years attending a state school. There were four student-teacher dyads in the class. The students had multiple impairments with severely limited communication skills. Video capture of dyadic interaction was conducted during five English lessons and sampled to 2.5 min per dyad per lesson. The video footage was transcribed into standard orthography, detailing the vocal and non-vocal aspects. A coding framework guided by the principles of structural-functional linguistics was used to determine the nature of dyadic interaction, comprising linguistic moves, functions and communicative modalities. The relative contributions of student and teacher to the interaction were examined.
  
  
  RESULTS
  Significant differences were found between the students and educational staff on the majority of the measures. The teachers dominated the interaction, occupying significantly more turns than the students. Teacher turns contained significantly more initiations and follow-up moves than the students, who used more response moves. Teacher communication mainly served the functions of requesting and information giving. Feedback and scripted functions were also significantly greater among teacher turns, with only limited occurrence among the students. Self- or shared-expression was greatest among the students. The modalities of speech, touch, singing and objects were used by the teachers for the purpose of communication, whereas vocalisation and gesture were used by the students.
  
  
  CONCLUSIONS
  Despite differences in the availability of communication skills, both student and teacher were able to make their respective contributions to the interaction during classroom activity. Features of the student-teacher interface retained critical features seen in studies of more able individuals with intellectual disability. Scaffolding provided by teachers appears to be relevant to the communicative contributions of individuals functioning at the earliest stages of communication. The coding framework based on structural-functional linguistics provides some new potential for examining and enhancing the communication interface between individuals with S-PMID and the people who support them.
authors.affiliation: School of Allied Health Professions, University of East Anglia, Norwich, UK. k.bunning@uea.ac.uk
authors.forename: K
authors.initials: K
authors.lastname: Bunning
authors.forename: C
authors.initials: C
authors.lastname: Smith
authors.forename: P
authors.initials: P
authors.lastname: Kennedy
authors.forename: C
authors.initials: C
authors.lastname: Greenham
mesh_terms: D000293:Adolescent; D002648:Child; D003142:Communication; D003143:Communication Devices for People with Disabilities; D019988:Children with Disabilities; D004495:Education of Persons with Intellectual Disabilities; D004519:Education, Special / Q000379:methods; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000534:rehabilitation*; D007398:Interpersonal Relations; D008297:Male; D015397:Program Evaluation; D012720:Severity of Illness Index