Early Communication and Microtechnology: Instructional Sequence and Case Studies of Children with Severe Multiple Disabilities

Teachers and speech-language pathologists serving children who have dual sensory impairments combined with severe orthopedic impairments are often at a loss as to how to provide effective communication instruction. No systematic approach has been available to guide teachers through the intricacies of what is necessarily a difficult process. This paper describes the results of a 3-year investigation of the use of microtechnology to enable children with dual sensory impairments and severe orthopedic impairments to communicate. We present here an instructional sequence that applies across the wide variety of children who participated in the investigation. Some of these children initially appeared to have no voluntary behavior at all: others were able to produce some intentional motor behaviors, but these were not under any clear stimulus control; while others had some primitive but unreliable means of signalling, such as gross vocalizations. By the end of the project, all of these children had shown an ability to learn and had acquired new communication skills, ranging from signalling for attention to indicating a choice. Three case studies are provided to illustrate the use of the instructional sequence.