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A Communication Independence Model: For People With Severe Communication Disabilities

A Communication Independence Model: For People With Severe Communication Disabilities
Yvonne Gillette
January 31, 2005


The more functional skills an individual possesses, the more independently that person can function in their daily life. Brown, Branston, Hamre-Nietupski, Pumpian, Certo, & Gruenewald (1979) indicated that functional skills were those required to function independently in the natural environment. If someone cannot perform functional skills independently, someone else (a communication partner, or significant other etc.) must assist to accomplish these goals and tasks. Examples of functional skills would include; making meals, taking a shower, washing clothes or calling a doctor to make an appointment. Functional skill development is the foundation of best practices in the field of disabilities.

Communication is a major functional skill. When an individual cannot communicate, often their communication partners assist with prompts and interpretations. When this occurs, the individual with the disability is not communicating independently. Additionally, given this situation, it is not possible to determine if the message source is truly the disabled individual or the significant other.

The notion of "communication independence" is based on the observation that individuals with severe disabilities often depend upon significant others to send messages. In some cases, significant others play "20 questions" to determine wants, needs, and desires. Examples include;

"Do you want to play outside or inside?"
"Do you need to use the bathroom?"
"Who do you want me to call?"

Other times, partners prompt the individual to say certain things. For example;

"Tell the lady you want a short haircut."
"Say please!"

Significant others translate information to third parties, and also to themselves. For example;

"When he makes that face, I know he wants to go home."

These communication exchanges reveal the need for a model of communication independence for individuals with severe disabilities. To be effective, intervention to foster and promote independent communication must include partners, and partners may need to change their expectations and strategies. In fact, partners often have no expectation for independent communication.

Partners often over-use questions, prompts, and interpretations because they believe they need these props to bolster communication with the individual. However, the Communication Independence Model (Gillette, 2003) suggests strategies such as commenting, waiting, and modeling should occur more frequently than questioning, prompting, and interpreting. Many individuals with severe disabilities can participate more fully -- once their partners alter their communication strategies and expectations.

The Communication Independence Model provides a strategy for assessing communication opportunities and skills, then planning for opportunity and skill growth. In this way, independent communication can evolve within everyday communication opportunities. When clients have severe communication disabilities, speech-language pathologists (SLPs) should consider a contextual, interactive approach to developing communication relationships with existing partners, and the SLP should assess existing communication opportunities and client skills within everyday contexts.

Yvonne Gillette

Related Courses

Textbook: Achieving Communication Competence
Presented by Yvonne Gillette, PhD, ASHA Fellow
Course: #10517Level: Advanced15 Hours
Based on the textbook, Achieving Communication Competence, this course describes a three-step process to create an effective intervention plan for people with severe communication disabilities. Assessment of environmental factors and communication skills, implementation and modification of intervention plans, and progress reporting are discussed.

Textbook: AAC in the Schools - Best Practices for Intervention
Presented by Gloria Soto, PhD, Nancy B. Robinson, PhD, CCC-SLP, Professor Emerita
Course: #10519Level: Intermediate8 Hours
Based on the textbook AAC in the Schools: Best Practices for Intervention, this course is a comprehensive guide for systematically overcoming barriers in the school for students who use AAC. Curriculum-based assessment tools are discussed, along with methods for aligning intervention goals with general education standards, developing lesson plans, and adapting curricula for students with AAC needs.

Home Sweet Home: Transitioning AAC to the Home Environment
Presented by Trina Becker, MS, CCC-SLP
Course: #9760Level: Intermediate1 Hour
This course discusses ways to transition augmentative/alternative communication (AAC) from the speech therapy room to the home environment, for children who use AAC. Strategies for planning and implementing carryover of skills from the educational setting are shared.

Inpatient Management of Speech and Swallowing After Total Glossectomy
Presented by Jodi Knott, MS, CCC-SLP, BCS-S
Course: #9768Level: Introductory1 Hour
This is Part 1 of a two-part series. This course introduces participants to a “road map” for rehabilitation and restoration of speech and swallowing, following a total glossectomy. It discusses postoperative anatomy and physiology and the importance of preoperative counseling, along with approaches to inpatient management and the SLP’s role across the continuum of care.

AAC: Taking the ‘OMG’ out of Report Writing and Treatment Planning
Presented by Kim Winter, MA, CCC-SLP
Course: #10536Level: Intermediate1.5 Hours
This course describes how to document augmentative/alternative communication (AAC) assessment outcomes and treatment planning for adult clients, in order to obtain funding of a speech-generating device (SGD) via Medicare or other third-party payers. Medicare SGD coverage, access methods to assess, required evaluation report elements, and client competencies to target in goals and treatment are discussed.

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