Effect of a short mobile training of peers in a strategy to structure opportunities to communicate choices for students with multiple disabilities including cortical visual impairment

Open Access
- Author:
- Mc Carty, Tara
- Graduate Program:
- Communication Sciences and Disorders
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- May 23, 2023
- Committee Members:
- Diane Williams, Program Head/Chair
Jessica Caron, Major Field Member
Krista Wilkinson, Major Field Member
David Mcnaughton, Outside Unit & Field Member
Janice Light, Chair & Dissertation Advisor - Keywords:
- multiple disabilities
cortical visual impairment
communicating choices
partner training
peers
augmentative and alternative communication
students - Abstract:
- Students with multiple disabilities (MD) and concomitant impairments in domains such as vision and communication may experience restrictions in social interactions throughout their school days. These restrictions may be due in part to the intrinsic characteristics and skills of the students with MD, as well as potential barriers from communication partners such as peers. Preconceived attitudes or limited knowledge and skills of peers may further hamper potential opportunities for social interactions to occur. Previous communication partner trainings have proven to be effective at teaching peers to recognize the intentional communicative behaviors of students with MD (Holyfield et al., 2018) and teaching adults to offer opportunities for children with CCN to communicate choices (Gormley et al., 2023; McCarty & Light, 2023b). In this study, a pretest-posttest control group design (Creswell, 2013) was used to evaluate the effects of a communication partner training designed to teach peers a strategy to structure opportunities for students with MD to communicate choices. The training was delivered through the INSTRUCT partner mobile training app which was developed by the Rehabilitation Engineering Research Center on Augmentative and Alternative Communication (RERC on AAC; Light et al., 2020). The target strategy included four main steps (i.e., set up, offer choice, wait and watch, respond) to support the communicative, motor, and visual functioning levels of the students with MD. The training reflected the evidence-base regarding instructional content (e.g., target skills or strategies), instructional techniques, and instructional formats. Ultimately, the ‘Offer Choices to a Friend’ training incorporated the following: (a) a previously validated multi-skill strategy for structuring opportunities to communicate choices (“Communicating Choices- CVI”) for students with MD, (b) a checklist to organize strategy steps and sub steps, (c) components of strategy instruction, (d) video models of strategy steps, (e) a partner mobile training app, and (f) role plays using peer collaborative learning groups. Peer interactions with students with MD in their educational settings were video recorded and analyzed to measure the effects of the training. Measures of peer implementation of the strategy as well as the responses of the students with MD to the peers’ implementation of the strategy were evaluated. Additionally, data were collected on the peers’ independent completion of components of the training. After completion of the training, peers in the experimental group demonstrated a mean accuracy of 64% of strategy sub steps implemented in comparison to less than 20% implementation during pretest interactions. Furthermore, peers in the experimental group gained an average of 4.9 steps from a mean of 1.5 steps at pretest to 6.4 steps at posttest in comparison to no gains by the control group from a mean of 1.8 steps at pretest to 1.3 steps at posttest. The peers’ implementation of the strategy led to increased communication by the students with MD who successfully communicated a choice in 77-84% of opportunities provided. The training was both effective and efficient as it only took peers 23 minutes to complete without the need for much prompting or adult supervision. Furthermore, all peers in the experimental group offered more than one choice opportunity when interacting with the students with MD in the posttest interaction (after the training). This study is a promising step towards improving social interactions for peers and students with MD in educational settings by focusing on communication partner skills that might support student skills such as the intentional communication of a choice. This is the first communication partner training study to investigate the impact of the INSTRUCT app and peer collaborative learning groups, along with other evidence-based instructional components (i.e., checklists, strategy instruction model, video models). The development of other trainings focused on peers of students with MD using similar instructional components may prove effective at further encouraging reciprocity, meaningful engagement, and social participation for students with MD in interactions with peers.