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Brookes Publishing
Teaching Communication Skills to Students with Severe Disabilities / Edition 2

Teaching Communication Skills to Students with Severe Disabilities / Edition 2

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How can educators and therapists best teach students with severe and multiple disabilities to communicate effectively? Developed by a highly respected expert, this practical guide has the comprehensive, research-based information professionals need to support students from preschool to high school as they learn and use communication skills. With a strong emphasis on students' need and right to communicate, this book shows readers how to analyze environments for their communicative value, assess students' communication skills, teach specific skills such as gaining attention and requesting, make informed choices about AAC, and guide peers and adults in supporting students with disabilities. In this expanded second edition, readers will also find timely new material on

  • the connection between literacy skills and general communication skills
  • students with disabilities learning side by side with students without disabilities
  • the critical role of communication in strengthening social relationships
  • national policies about the communicative rights of individuals with severe disabilities
  • a new tool that helps connect intervention with assessment

This book is accessible for both preservice and in-service professionals — it gives readers strategies they can use throughout a typical school day, real-life case studies of students of different ages, thoughtful answers to commonly asked questions, and tables that illustrate key points and summarize the strategies in simple steps. With the new edition of this popular resource, educators and therapists will help students with disabilities realize the benefits of effective communication: less frustration, more control over their lives, and stronger bonds with friends and family.

Product Details

ISBN-13: 9781557667557
Publisher: Brookes Publishing
Publication date: 06/01/2005
Edition description: Older Edition
Pages: 252
Product dimensions: 6.80(w) x 9.80(h) x 0.70(d)

About the Author

June E. Downing, Ph.D., was a national leader in the field of special education who focused her expertise, time, and energy researching best practices and advocating for individuals with severe and multiple disabilities. She was a steadfast promoter of inclusive education, viewing access to the general education program and peers without disabilities as best practice, as well as an issue of social equality and civil rights. Dr. Downing was an exceptionally productive scholar who published numerous articles, chapters, monographs, and textbooks focusing on the education and inclusion of students with severe and multiple disabilities. Her publications are used by many educators and parents to learn how to provide quality education in inclusive classrooms to students with severe and multiple disabilities. Dr. Downing provided numerous professional development trainings in many regions of the world and served as the keynote speaker at several national and international conferences. She was known for her practical, invigorating, and humorous presentations and workshops. Dr. Downing's career in the field of special education began as a teacher of students with visual impairments and multiple disabilities including deafblindness. She was Associate Professor at the University of Arizona in Tucson and Professor at California State University, Northridge (CSUN). She directed or codirected several federally funded personnel preparation, research-to-practice, and technical assistance projects and was committed to preparing exceptional, highly qualified teachers, whose role she saw as change agents for the future. Through Dr. Downing's teaching and hands-on guidance, her students developed a passion for teaching and a strong commitment to supporting quality lives for students with disabilities and their families. While at CSUN, Dr. Downing contributed to the development of the CHIME Institute's Charter School and was instrumental in its high-quality inclusive educational practices. Dr. Downing served on the National TASH Board of Directors for six years and was Past President of Cal-TASH and AZ-TASH (the California and Arizona state chapters of TASH). She also served as an associate editor of Research and Practices for Persons with Severe Disabilities. Dr. Downing retired from CSUN in 2007 and returned to Tucson, where she lived until her death in July 2011. Her indomitable spirit, passion, and determination have been a driving force in our field, and her work continues to inspire and create positive and successful learning outcomes for students.

Read an Excerpt

Copyright©2005 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Communication is the key to learning because a lot of what we learn depends on interactions with others. Every time at least two people come together, communication can occur. Although all human beings communicate, some individuals, due to the severity of their disabilities, may have limited communication skills. Individuals with severe and multiple disabilities may not have full access to or full control of the multiple means by which most individuals communicate (e.g., speech, facial expressions, body language, print). This inability to express themselves as others would does not mean that these individuals have nothing to say, nor does it diminish their need and right to communicate. Teachers and other service providers must respect this desire to communicate, using their expertise, experience, and commitment to make communication possible. Taking the stance that everyone has something to say is the least dangerous assumption and demonstrates the greatest level of respect (Cardinal, 2002). This chapter highlights the importance of supporting all communicative efforts of individuals who do not use speech as their primary mode of communication.


Many students with disabilities experience difficulties communicating. Emotional disorders can interfere with effective communication, especially in unfamiliar and stressful situations. Individuals with autism and severe developmental delays, as well as those with severe sensory impairments (vision or hearing or both; Arthur, 2003; Heller, Alberto, & Bowdin, 1995), may also find it difficult to communicate effectively. Certainly, a severe physical disability, especially when it is in addition to an intellectual impairment, can hinder the development of speech and language. The intricate physical movements of the oral musculature required for speech are negatively affected by a severe physical disability, and a severe intellectual impairment makes it very difficult for the individual to associate symbols with their referents. Individuals with severe cognitive disabilities often have difficulty acquiring an abstract means of communication, such as speech or American Sign Language (ASL). Essentially, any child who has a disability that interferes with the normal acquisition and development of language will experience difficulties in communicative exchanges (both receptively and expressively).

Some individuals have acquired a few speech skills that enable them to express basic concepts (e.g., requesting a desired food or activity). Limitations in using complex language patterns, however, hamper more abstract communication (e.g., discussing dreams, concerns, and/or future plans). Even though these individuals may have multiple means of communicating without abstract symbols, the ability to clearly express more complex thoughts and feelings is not possible without the use of some kind of system of representative symbols.

This book addresses the needs of children and youth whose severe disabilities make even the most basic interactions difficult. Many of these children use alternative forms of communication in their efforts to understand and be better understood by others. Because this is a large and extremely heterogeneous group of individuals, information in this book concentrates on those children and youth (ages 3–22) who receive their education in age-appropriate general education classes with the support of teachers, classmates, paraprofessionals, parents, administrators, and related services providers. General education classrooms afford both students and teachers with incredible opportunities for learning (Downing, 2002; Fisher & Meyer, 2002; Renzaglia, Karvonen, Drasgow, & Stoxen, 2003; Soto, Muller, Hunt, & Goetz, 2001) and, therefore, general education will be the premise of this text. Much of the information presented in this text, however, also has applicability to other natural environments such as the home, the workplace, and other community facilities. Thus, communication interventions for students who need them are strongly recommended no matter where the students are educated.


Communication occurs when one individual sends a message to another and that message is received and understood (Butterfield & Arthur, 1995). Competence in a symbolic and abstract language system (e.g., spoken English or Spanish, manual ASL), with formalized rules of word representation, production, and use, is not a prerequisite for communication. In fact, one can be quite adept with a spoken language and not communicate at all if there is no one to talk to, no one present who understands the spoken language used, or no one who is attending to or hearing the message. A request for directions in a foreign country or an interaction with a preoccupied teenager illustrates these points.

Just as the presence of language does not necessarily mean that communication will follow, the absence of language does not always mean that communication cannot occur. In fact, those not using language can communicate quite well at times. For example, graduate students putting away their papers and pens let the professor know that class has ended; rumbling stomachs and glazed eyes let the principal know that the meeting is over (or should be); and the fidgety behavior of young children who need to go to the bathroom is easily recognized. For all of these situations and countless others, the absence of symbolic language behavior is irrelevant. In fact, as much as 90% of any message exchanged between two very verbal people can be attributed to nonverbal behavior (Evans, Hearn, Uhlemann, & Ivey, 2003). In addition, many nonverbal communicative behaviors are universal, recognized, and understood despite cultural and linguistic differences (Ekman, 1980, 2003; Izard, 1994). Recognizing the power of nonsymbolic yet highly communicative behavior (e.g., facial expressions, body movements, gestures) is critical for those interested in facilitating the communication skill development of students who are unable to master symbolic languages. Such behaviors form the foundation for enhanced communicative interactions (Cress, 2002; Dennis, 2002) because, unlike speech, they are easier to shape and, therefore, easier to learn.


When students demonstrate such minimal communication skills that they are not adequately expressing themselves, others tend to assume that they have nothing to communicate or simply do not care about anything. Unfortunately, such assumptions are dangerous because they dehumanize the student, casting him or her in an extremely dependent and vulnerable position (Biklen, 1993; Cardinal, 2002; Kochmeister, 1997). Following the least dangerous assumption, it is always preferable to perceive all students, regardless of the severity of the disability, as individuals who have something to say but who have extreme difficulty making their thoughts heard and understood by others. With this latter assumption, it is the responsibility of those who communicate with greater ease to do whatever they can to help the student understand what is being said and to find a way to give him or her a voice.

Operating on the assumption that all individuals need to communicate, the tendency to wait until certain prerequisite skills are demonstrated before providing helpful intervention makes little sense. Communication is a defining characteristic of all of us, with breathing as the only real prerequisite (Mirenda, 1993). The question, then, should not be whether students with severe disabilities will benefit from communication intervention but rather how best to provide that support.

Unfortunately, practitioners in several states continue to spend valuable time and energy determining eligibility for communication intervention services. Every day, then, many parents and teachers express their frustration at being unable to gain access to quality speech-language services for their children or students who do not speak. When speech becomes a prerequisite for communication intervention, many students with severe disabilities will be denied important support. Several states adhere to a model of cognitive referencing to determine eligibility for intervention services (Notari, Cole, & Mills, 1992). Cognitive referencing is the practice of identifying a discrepancy between a child's cognitive and language abilities to qualify for services. For children with severe intellectual challenges who are determined to have similarly limited speech-language and cognitive abilities, some may consider communication services to be irrelevant. Presumably, these children would not benefit from intervention. However common this approach may be, the belief that children with equal delays in both language and cognitive development are not able to benefit from language intervention has not been substantiated (Cole & Mills, 1997; Cress & Marvin, 2003). In a report to the National Joint Committee for the Communication Needs of Persons with Severe Disabilities, Snell and colleagues provided a strong rebuttal to the many rationalizations used to avoid serving students with severe disabilities (Snell et al., 2003). Based on a long list of reasons to deny services (e.g., age, discrepancy between cognitive and communicative ability, absence of prerequisite skills), these experts made it quite clear that all individuals with complex communication needs require and benefit from quality services. By their very need to communicate they qualify for services.


As stated previously, communication by definition requires at least two people — a sender of the message and a receiver — who understand each other. Having appropriate communication partners constitutes the essential social aspect of communication. Other critical components of communication include form (i.e., a way to send the message), content (i.e., something to talk about), and a reason or purpose to communicate (Beukelman & Mirenda, 2005). Beyond these basic conditions, no specific skill level is needed. Given such characteristics, it is easy to see how everyone can and does communicate; however, students with severe disabilities may find themselves in situations in which competent social partners are not present (e.g., a self-contained special education classroom), and the behaviors (form) they have to use for communication are not clear to others. In addition, these individuals may have severely limited life experiences, leaving little to talk about (content) and little reason to communicate (when all needs are anticipated in advance). Educational team members, therefore, must ensure that these aspects of communication are addressed.

Social Aspect

One major difficulty for students with severe disabilities who are educated in special education classrooms is that they tend to have extensive interactions with adults but limited interactions with other students (Foreman, Arthur-Kelly, Pascoe, & King, 2004; Simpson, Beukelman, & Sharpe, 2000; White, Garrett, Kearns, & Grisham-Brown, 2003). Not only can this lack of social opportunity make it difficult for students with severe disabilities to learn the skills of communication, but also it can interfere with their ability to make friends (Geisthart, Brotherson, & Cook, 2002; Richardson, 2002). In special education classrooms composed solely of students with similar communication difficulties, the brunt of the responsibility for being a responsive communicative partner falls to the teacher or another adult in the room. Because the adult usually must attend to a number of students, all needing considerable support, opportunities for meaningful communication with individual students are limited. Foreman and his colleagues (2004) compared the social-communicative interactions of students with profound and multiple disabilities in special classrooms with those of similarly matched students in general education classrooms. They found that the students with disabilities in general education were involved in significantly higher levels of communication interactions than were their matched pair in special classrooms. These researchers also found that classmates without disabilities were involved in significantly more interactions with their peers with disabilities in general education than in special education.

When students with disabilities are full-time members of general education classrooms, the other students in the class serve as communicative partners. In fact, these students may have a better perspective given the closeness in age to a classmate with severe disabilities and may therefore be better able to understand what their classmate is trying to say. Certainly, they serve as more effective (more age-appropriate) models for communication skills (Davern, Schnorr, & Black, 2003; Janney & Snell, 1996; Soto & von Tetzchner, 2003). Furthermore, communicating with peers is a more direct way for a student to achieve friendships than learning communication skills first with a teacher and then having to transfer those skills to an interaction with a peer. As an added benefit, students without disabilities acquire a better understanding of diversity and learn ways to interact with those who have disabilities.

Form of Communication

Individuals need some identifiable form of communication to effectively convey a message. Sometimes the form or forms used by the individual is very clear (e.g., spoken language, signs, universally understood gestures). Sometimes forms of communication are more difficult to discern. For individuals with the most severe and complex disabilities, the form used may be more difficult to interpret (e.g., fast breathing to indicate no; smooth, easy breathing to say yes). The forms of communication used by the individual must be understood by his or her recipient or they fail to be communicative. Therefore, highly idiosyncratic forms of communication may require a fair degree of interpretation by the communication partner.

Professionals in the field of communication disorders generally recognize the multimodal nature of communication (Beukelman & Mirenda, 2005; Blackstone & Berg, 2003; Reichle, 1997). No one form of communication will suffice to meet all needs or all social expecttions of a given situation. With multiple ways to convey messages, more options are available for choosing a communicative alternative that fits each individual. For example, some students with severe disabilities may not hear or understand speech because of difficulties processing auditory information. These individuals, however, may benefit from receiving messages visually — for example, through pictures, photographs, or natural gestures (Alberto & Fredrick, 2000; Copeland & Hughes, 2000; Mirenda & Erickson, 2000). Conversely, students with limited or no vision may do well with simple speech and representative objects or parts of objects to feel. For students who cannot rely on speech to convey messages clearly, the use of gestures, facial expressions, objects, pictures, and vocalizations may be an effective alternative. Communication will take place with whatever works. In other words, direct services providers should avoid relying on one mode of communication for either receptive or expressive communication because it is likely that a combination of different modes will be necessary. It is not the form of communication that is important, but rather the effectiveness of the interaction.

Excerpted from Chapter 1 of Teaching Communication Skills to Students with Severe Disabilities, Second Edition, by June E. Downing, Ph.D., with invited contributors.

Copyright©2005 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Table of Contents

About the Author
Mary A. Falvey


  1. The Importance of Teaching Communication Skills
  2. Assessing Communication Skills
  3. Analyzing the Communicative Environment
  4. Augmentative and Alternative Communication Techniques
    Pat Mirenda
  5. Teaching Communication Skills: First Steps
  6. Teaching a Wide Range of Communication Skills
  7. The Role of Communicative Partners
    Eileen M. Merges, V. Mark Durand, and Lise M. Youngblade
  8. Integrating Team Expertise to Support Communication
  9. Commonly Asked Questions: Challenges to Effective Communication Intervention
Augmentative and Alternative Communication Resource List

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