This paper provides an overview of communication-based intervention, which is an alternative method of controlling problem behaviors in individuals with severe disabilities. It is not uncommon for individuals with disabilities to possess problem behaviors. However, it should be noted that communication-based intervention is not a method that can be used exclusively for all problem behaviors. This paper will also provide an overview of functional assessment, designing communication strategies and contexts, and the generalization of the strategies into the everyday environment.
Keywords ABC Assessment; Antecedents; Aversive Actions; Problem Behavior; Communication; Communication-Based Intervention; Consequence; Contexts; Functional Assessment; Functional Equivalence; Observation; Punishment; Self-Injurious Behavior
Communication is a process that defines how organisms share ideas. In humans, the sharing of ideas is a complex multisystem process. Haynes, Moran, and Pindzola (1990) proposed that communication is composed of five interconnected systems:
• Access to a language model,
• Cognitive development,
• Intent to communicate, and
• Social development.
An effective communicator must have an intact auditory-vocal channel as well as access to a language model that provides opportunities for interaction. In terms of cognitive development, the individual must be able to use a symbol system to share concepts and knowledge (Haynes, Moran, & Pindzola, 1990). The use of the symbol system must be paired with intent to communicate with others in the environment to be an effective communicator. Finally, an effective communicator must socially engage and interact with his or her environment to develop communicative competence (Haynes, Moran, & Pindzola, 1990).
In contrast, language is a component of communication. In comparison to communication, language is a complex shared rule-governed symbol system. Bloom and Lahey (1978) described language in terms of form (phonology, syntax, morphology), content (semantics), and use (pragmatics). Each area overlaps the other at some point and therefore is dependent on the others (Bloom & Lahey, 1978). In other words, difficulties in any one area (form, content, use) can have an effect on the use of the other area(s).
The primary purpose of communication is to allow purposeful interaction between an individual and his or her family and community. Communication allows an individual to influence people and events in his or her environment through social interaction. For many children with severe disabilities and/or autism, social interaction is not considered to be appropriate and is often times replaced by inappropriate behaviors (tantrums, biting, yelling, etc).
This paper will address the replacing of problem behaviors with communication using communication-based intervention.
The Beginnings of Communication-Based Intervention
Communication-based intervention is a technique often used to control problem behaviors. The belief is that inappropriate behaviors may serve as a mechanism for communication, as all humans communicate in some way (Carr, Levin, McConnachie, Carlson, Kemp, & Smith, 1997; Wacker, Berg, Harding, Barretto, Rankin, & Ganzer, 2005). Typically, one uses communication-based intervention to replace the long-standing practice of eliminating behaviors (Durand & Carr, 1991). Communication-based intervention is designed for understanding why the problem behavior occurs by determining its function and/or purpose (Carr, et al., 1997; Durand & Carr, 1991).
Carr, Levin, McConnachie, Carlson, Kemp, and Smith (1997) stated that Carr's 1977 seminal article, "The Motivation for Self-Injurious Behavior: A Review of Some Hypotheses" proposed that problem behavior can be a purposeful form of communication by serving a communicative purpose for the individual who initiates the act. This was a thought provoking paper that led to many studies and a refinement of Carr's hypothesis (Carr, et al., 1997; Goldstein, 2002). Carr's continued research in this area proposed that problem behaviors might serve as a form of communication for an individual with limited expressive abilities (Carr, et al., 1997; Goldstein, 2002). This hypothesis has led to research which has investigated the understanding that an inappropriate behavior can serve a purposeful function versus a way in which to decrease social interaction (Beukelman, & Mirenda, 1992; Day, Horner, & O'Neill, 1994; Haynes, Moran, & Pindzola, 1990).
Carr, et al. (1997) defined communication- based intervention as "an approach that reduces or eliminates problem behavior by teaching an individual specific forms of communication" (p.3). There is a distinction between communication training and communication-based intervention (Carr, et al., 1997). Communication training addresses specific speech and/or language deficits. Communication-based intervention replaces problem behaviors with appropriate communication.
Problem Behavior as a Form of Communication
In terms of communication-based intervention, problem behavior includes a variety of verbal and nonverbal behaviors that are considered socially unacceptable. Problem behaviors include acts of aggression (hitting, kicking, biting, etc.); self-injurious behaviors (head banging, self biting, etc.); property destruction (throwing objects, punching walls, etc.); and tantrums (crying, screaming, etc.) (Carr, et al, 1997, p. 3).
By proposing that problem behaviors (i.e., tantrums, aggression, self-injurious behavior) serve as a form of communication, an individual is advancing the thought that language allows one to control his or her environment (Goldstein, 2002). Therefore, this type of intervention is used with individuals who typically have severe behavior disorders or developmental disabilities (Carr, et al., 1997; Day, Horner, & O'Neill, 1994; Goldstein, 2002).
Educational Importance of Communication-Based Intervention
Society views education as an area through which an individual gains the necessary skills and knowledge to become a productive citizen. Learning the basic skills of reading, writing, and arithmetic is the foundation of academic success. However, for individuals with severe developmental disabilities learning to communicate becomes the priority, in many cases. Without simple or basic communication skills, an individual is not able to effectively and appropriately interact in the academic or social environments of everyday life. Thus, for children with developmental disabilities communication is the first basic skill that has to be learned. As a whole, society is not accepting of individuals who do not know how to appropriately interact with others. Thus, exhibiting problem behaviors can lead to isolation for individuals who engage in them.
Premises of Communication-Based Intervention
Regardless of the source, communication-based intervention operates on six distinctive premises. Each will be briefly discussed in the discussion to follow.
• The primary premise of communication-based intervention is that problem behaviors exist because they typically serve a purpose for the individual (Carr, et al, 1997). For example, each time a child throws his or her cup and cries the caregiver fills the cup with milk and returns the cup to the child. Thus, the child learns to request "more milk" by throwing his or her cup and crying.
• A functional assessment must occur to determine what purpose the problem behavior serves. A problem behavior may temporarily be altered through aversive actions such as punishment. However, should the original function of the behavior not be determined then the behavior will continue and possibly become more problematic. For example, over time, the caregiver withholds the drink in an attempt to punish the behavior of throwing the cup. In response, the child adds the problem behavior of biting his or her hand along with throwing the cup and crying.
• In educating children with significant disabilities (i.e., mental retardation, autism), one must keep in mind that the goal is to teach the individual that alternative means (i.e., communication) exist to influence the behavior of others rather than an inappropriate behavior (Carr, et al., 1997). Prior to the idea that the behavior could be a form of communication, intervention primarily focused on immediate elimination of the behavior.
• Carr, Levin, McConnachie, Carlson, Kemp, and Smith (1997) stated that another theme in communication-based intervention is that a problem behavior can exist in different contexts and serve different purposes. Thus, intervention that is successful in one context may not be successful in another.
• To be effective, interventionists must understand the goal is to change the social contexts and not the individual (Durand, & Carr, 1991). For communication to occur a dyad must exist between a speaker and a listener (Bloom, & Lahey, 1978; Haynes, Moran, & Pindzola, 1990). Whether the mode of communication is verbal or nonverbal, a message must be communicated between at least two people. Thus, for an individual with a problem behavior the social context must cause enough of an interest that the individual wants to socially interact.
• For life to have meaning or some type of quality, the reduction of the problem behavior should attempt to increase the social interaction of the individual with his or her environment. The intent of communication-based intervention is to assist the individual with problem behaviors; from a passive participant in society to an active participant.
While the advantages of communication-based intervention are evident, one cannot assume that a behavior can be haphazardly observed and intervention initiated. Therefore,...
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