Over 3 years, the committee developed this much needed staff training curriculum to assure that transitions between programs, such as from school age to adult services, meant consistency and continuation of the development of communicative competence in the individuals served. The curriculum is applicable to all staff, all individuals served and to all programs, day and residential.
After agreeing on guiding treatment philosophy, some guiding principles were identified. The process for developing our decisions and consensus will be explained so that other programs can assure the training program is consistent with their mission and values. Guiding principles we identified include:
- All programs provide communication services that are applicable to the individual’s next setting.
- The programs work together for the benefit of individuals served.
- Family input is encouraged
- Practices must be evidence based
- All staff work on developing, maintaining and generalizing communication skills with individuals served.
The guidelines include concepts such as the relationship between communicative competence and problem behavior. It has been well established that there exists an inverse relation between competence with communication and problem behavior (Baker, Cantwell, & Mattison, 1980; Talkington, Hall, & Altman, 1971). That is, lower levels of communicative competence tend to be associated with higher rates of problem behavior, and vice versa. This covariance has been demonstrated with children diagnosed with language delay and individuals with various degrees of developmental disabilities (Carr et al, 1994). As a result, a Communication Hypothesis of Problem Behavior has emerged (Carr et al., 1997; Carr & Durand, 1985; Durand, 1990) which suggests that individuals with poor or ineffective communication skills are more likely to use problem behavior as a way to get needs and wants met because problem behavior frequently results in reinforcement. It is not surprising then that an extensive body of literature exists which involves teaching individuals effective methods to communicate needs and wants as a replacement for problem behavior. These are communicative behaviors which are functionally equivalent and equally or more efficient and effective for the individual as the problem behavior. Verbal behaviors (Carr & Durand, 1985; Mace & Lalli, 1991), sign language (Bird, Dores, Moniz, & Robinson, 1989; Durand & Kishi, 1987, Horner & Budd, 1985), assistive devices (Durand, 1993; 1999) and picture communication books (Hunt, Alwell, & Goetz, 1988; Mirenda, 1985) have all been taught to replace the use of problem behavior. These procedures have been termed Functional Communication Training (FCT), and are now considered a best practice for supporting people with poor communicative competence and problem behavior. Two training modules develop this concept with practical application to assure communicative competence is a significant component of the proactive strategies of the behavior support plan.
Transition is an important consideration and requires comprehensive planning and coordination. Concepts such as those listed below are discussed in the training curriculum:
- Each program transitions knowledge of how each individual communicates to the next setting.
- Programs and staff must work together both as a sender and as a receiver of the transitioned individual. A list of transition activities is discussed.
- When selecting an Assessment tool, consider what Assessments would be expected or beneficial to the individual’s next setting.
- There should be follow up contacts between programs a few weeks after the individual has transitioned.
- The DDI Communication Information Form should be used to share information about how an individual communicates to the next setting. This can also be used within programs. I.e. transition from one class or staff to another. There is a training presentation for the Communication Information Form
Staff training concepts and the role of the Speech Language Pathologist (SLP) are designed to assure that the SLP is closely involved and that through a transdisciplinary model, all staff are actively aware of how they can build communicative competence throughout the day. The following is a list of the training modules included in the communication guidelines for DDI:
- Module 1: Philosophy, guiding principles, relationship between problem behavior and communicative competence, Transition, staff training
- Module 2A: Assessment, Role of SLP, service delivery
- Module 2B: Communication Information Form
- Module 3A: Intro to Modes of Communication
- Module 3B: Modes of Communication + Handouts
- Module 3C: Modes of Communication, Continued
- Module 3D: Considerations for Alternative or Augmentative Modes of Communication form/procedure
- Module 4: Behavior and Communication + Handout
- Module 5: Helpful Tips for Behavior Support and Teaching
- Module 6: Strategies for Successful Communication – Rapport and Dignity and Respect reminders
- Module 7: Strategies for successful communication – communicative intents/pragmatics
- Module 8: Some things to remember when encouraging communication attempts, some ways to encourage expressive communications/ Some ways to encourage greater comprehension or understanding
- Module 9: Social Communication
- Module 10: Echolalia + Handout/spoken script
The participant will gain tools to apply concepts and structure from this presentation to their own setting.
A complete list of references will be provided as well.
Mary E. Hoffman, LSP, CCC
Director of the Children's Day Program
Developmental Disabilities Institute
Mary Hoffman is the Director of the Children's Day Program at the Developmental Disabilities Institute. She is a licensed speech-language pathologist and school district administrator, having attained her MA and post masters in education through Hofstra University. She has 30 years' experience assuring outstanding coordinated services for students with developmental disabilities.
Leslie J. Popko, CCC-SLP
Developmental Disabilities Institute
Leslie J. Popko, Supervisor of the Children’s Day Program Speech Department, has served children with developmental disabilities since 1979, and in collaboration with many universities has supervised numerous graduate interns. Having 32 years' experience, she has also worked in private practice, taught at a local college and developed staff trainings.