Effective communication intervention depends on reliable tools for identifying communication concerns and tracking changes in skills. Established tools for detecting and tracking skills in early intentional communicators (i.e., directing a behavior such as reaching toward an adult to convey a message) involve communication temptations and assessing a wide variety of child behaviors in response to those dynamic temptations. While these tools have been normed for typically developing children and used for intervention tracking with intentional communicators, they can only be used to detect the absence of such skills in pre-intentional communicators and do not reflect changes in essential skills that support the development of intentional communication. There are no available normed assessments that provide dynamic and comprehensive data on pre-intentional communication and reflect evidence-based procedures to assess skills and track treatment progress in children and adults older than 12 months. If we can assess comprehensive skills that promote intentional communication in children and adults, we can intervene in skills that are essential foundations of all other communication and reduce the likelihood of secondary behavioral or adaptive impairments that affect communication and life skills. The plan for this project is to develop a comprehensive, skill progressive, sensitive, dynamic, and modality-independent assessment to detect and track communication skills in older children and adults who are basic pre-intentional communicators (Basic Social and Communication Behavior Scales; BSCBS). Initial testing showed that the pilot BSCBS (adapted from the PI?s successful development of the ISCBS assessment for infants 2-12 mo.) is an effective tool to measure changes in pre- intentional communication after intervention for children with ASD and/or DD. Consistent assessment of pre- intentional communication in older children and adults could justify focused intervention strategies to address these essential skills for older children and adults. who have an expected prognosis for long-term communication impairment and avoid denial of services to individuals who are presumed to lack supposed prerequisites of communication. We will develop and test proof-of-concept for the BSCBS to assess and track pre-intentional communication in basic communicators of all ages over 12 months for children and adults with severe developmental or acquired disabilities, test reliability and validity for communication assessment, and use pre/post assessments to track treatment progress using the BSCBS to address these specific aims: Develop BSCBS to assess pre-intentional communication skills for children and adults beyond 12 months of age; develop BSCBS components, clusters, and a composite of domains that show skill progression by developmental age in children and adults with disabilities comparable to ISCBS score patterns; establish the efficacy of the BSCBS at tracking changes in pre-intentional communication skills following intervention.
If children and adults with severe communication disabilities can be assessed for basic communication skills using comprehensive normed assessments, then we can plan and track basic communication intervention for pre-intentional communicators of all ages using evidence-based tools targeted at the skills that are most needed and indicative of functional improvement in communication in daily living environments. There is currently no normed and dynamic assessment tool focused on detecting and tracking comprehensive communication skills for children and adults who are basic communicators at developmental ages above 12 months, and the development of such a measure would meet a critical health need for children, adults, and families, and the doctors, clinicians, and service providers who seek this clinically essential information. If we can intervene specifically enough in the skills that are associated with improvement toward intentional communication development at any age, we can mitigate effects of primary impairments and reduce the likelihood of denial of services to children and adults who are still basic communicators because they are presumed to lack prerequisite skills necessary for successful acquisition or rehabilitation of critical intentional communication behaviors that affect communication and other life skills.
