Fostering High Quality Communication in People with Congenital Deafblindness

Daily communication between clients with congenital deafblindness and their caregivers (parents, teachers and professional caregivers) is extremely important for clients’ wellbeing and social functioning. However in practice clients and caregivers experience serious difficulties in expressing their intentions and creating mutual understanding. Caregivers put much effort into responding to the meaning of client’s utterances in such a way that the clients feel understood. Often this is a challenging task due to the nature of deafblindness in combination with other disabilities, the complexity of communication processes in general, and a lack of natural skills in the caregivers. As a consequence, deafblind clients do not develop communicative skills according their potential and get stuck communicating in an instrumental way only. This means that clients are unable to use a full variety of communicative intentions; they are forced to limit communication to expressing their personal needs, rather than sharing ideas and thoughts with others about topics relevant within and outside the direct context. In previous studies we developed and successfully tested the Contact program. This program improved interaction in such a way that caregivers were able to attune their behaviors and emotions better to those of the clients. Clients improved on interaction categories such as initiatives, turn-taking and affective involvement. However this intervention did not improve communication enough with regard to creating mutual understanding and expressing communicative intentions. For this reason we developed the Communication program. Its aim is to support caregivers of clients with congenital deafblindness in enhancing communication after establishing harmonious interactions. This project tests the efficacy of the Communication program on quality of interaction (mutual attuning to behaviors and emotions) and on quality of communication (mutual attuning to understand and express the meaning of utterances). The ultimate goal for the clients is that they are able to use more spontaneous utterances, use more varied communicative intentions and share their ideas with more caregivers within and outside the direct context. It is important for caregivers to feel supported when they are experiencing problems in communication with their clients. With this in mind, we investigate how caregivers evaluate social validity (practicality) of the Communication Program and the effect on clients’ participation and communication. For further fine tuning and transferability of the Communication program assessments are made on how caregivers value important components of the program in terms of caregiver competencies and aspects of client communication. This project yields a substantial gain in knowledge about the efficacy of an intervention that takes into consideration the importance of developing harmonious interactions as a basis for developing high quality communication. This knowledge will lead to practical applications increasing effectiveness of interventions from which many clients and caregivers may benefit.