Communication by People with Profound Multiple Impairments

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Project I: Communication by People with Profound Multiple Impairments Individuals with profound multiple impairments (PMI) are those who have cognitive, sensory, and motor disorders leading to severe deficits in communication. Generally, individuals with PMI are nonverbal and rarely exhibit intentional nonsymbolic communicative behavior. In our recent research, we developed ways for many individuals with PMI to control sources of stimulation with adaptive switches and to indicate preferences about types of stimulation (e.g., music versus vibration). Some individuals also have learned how to choose between two concurrently available sources by refraining from closing the switch for one source and closing the switch for an alternative. These skills represent acquisition of a developmental cusp we refer to as contingency discrimination. We propose to demonstrate that individuals who acquire this cusp can learn another pair of contingencies: (a) refraining from closing the switch maintains contact with a highly preferred source of stimulation and (b) closing the switch brings assistance when the highly preferred source is momentarily unavailable. With single-subject behavior-analytic methods, we propose to find the individualized combinations of switch-closure requirements and calling modes (e.g., voice output communication aide, buzzer) that lead to reliable, contextually controlled signaling. Signal users will be tested for generalization to opportunities to signal for session initiation and to request that a low-preference source of stimulation be replaced with a high-preference source. The proposed research will merge innovative and traditional teaching methods to reveal a communication potential not previously thought possible with this population. With logistic regression analyses we will test several hypotheses regarding possible relations between participant variables and outcome success. The significance of the research is that it has the potential to demonstrate how even the most significantly impaired individuals can advance along the continuum of communication development as well as reveal who among them is most likely to succeed.