Communication Options for Persons with Severe and Profound Disabilities: State of the Art and Future Directions

This article reviews the literature related to issues of communication augmentation for individuals with severe and profound intellectual disabilities within the framework of the “Participation Model” (Rosenberg & Beukelman, 1987). This model consists of a communication opportunity strand and a communication access strand. The opportunity strand is discussed briefly in terms of the knowledge and attitudinal barriers that may limit communication, with suggestions for remediation of these problems. The access strand is discussed in detail, beginning with a review of current methods of assessing capability in relevant domains. The relevant literature related to the learning characteristics of both unaided and aided communication techniques is reviewed next, followed by a discussion of potential external constraints that may affect the range of options for consideration. This information facilitates the next step of selecting communication options with a view to the current and future needs and capabilities of the individual. Following this, a review is presented of vocabulary selection and effective instructional techniques in augmentative communication interventions. Finally, evaluation issues are discussed in relation to level of disability.