Inclusive and Supportive Education Congress International Special Education Conference Inclusion: Celebrating Diversity? 1st - 4th August 2005. Glasgow, Scotland

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Alertness levels and communication involvement in students with the
most severe and multiple disabilities in Australian classrooms: Effects of
short teacher training programs

Professor Phil Foreman and Dr Michael Arthur-Kelly
The University of Newcastle, NSW, Australia
phil.foreman@newcastle.edu.au

Introduction

Behaviour state assessment is a systematic observational approach that allows educators the opportunity to better understand the levels of engagement and responsiveness demonstrated by students with high and complex needs.   These individuals are usually dependent on others for daily needs and may experience combinations of profound intellectual disability, medical, physical and sensory challenges.

Based on the original Neonatal Behavioral Assessment Scale (NBAS) by Brazelton, and developed by Guess and his team in Kansas, teachers and researchers can use codes such as Awake-Active Alert, Dazed and Asleep-Inactive, along with various contextual codes such as communication indicators, physical positioning and social grouping, to describe a nd track patterns in student functioning in school contexts (for example, Arthur, 2003, 2004) and the experiences of young children with high support needs (Roberts, Arthur-Kelly, Foreman, & Pascoe, in press).   This type of data can be helpful at both a macro and micro level in refining best practice for this traditionally hard to teach group.   For example, by recognising personal preferences in learning activities, as indicated by increased levels of awareness, it should be possible to tailor individual education goals to maximise participation and engagement.   At a systems level, having a tool to assist in analysing the impact of setting variations for students who have typically enrolled in segregated schools or classes is another important contribution of the behaviour state assessment protocols.

A recent study

Foreman, Arthur-Kelly, Pascoe, and Smyth King   (2004) recently compared the behaviour states and socio-communicative interactions of students with profound and multiple disabilities (PMD) in either regular class or special school settings in New South Wales, Australia. In the Australian state school system, it is generally possible for students with any degree of disability to be included in a regular class, if that is what the parents wish. Financial support is provided according to need. In the case of a student with PMD, this support would normally be sufficient to employ a full-time teachers’ aide.

In the study by Foreman et al. (2004), we matched eight students with PMD in special classes with eight students with a similar degree of disability who had been included in regular classes. Student behaviour states and several social and communicative indicators were systematically observed and recorded every 20 seconds for five hours over a school day. Two trained observers were used for each student, allowing observers to take a break every 15 minutes. Twenty-five per cent of observations overlapped, providing data to check inter-observer agreement. All inter-observer scores were above 90%.

The comparisons of behaviour states showed that students in regular classes tended to spend more time in awake-active-alert or awake-active-self-stimulatory states and significantly less time in the drowsy state than their matched counterparts in special schools.   The comparisons of communication showed that students in regular classes spent significantly greater amounts of time in communicative interactions than their peers in special classes.   Students in special classes were also significantly more likely to have no communication partner trying to interact with them. When students in special classes had a communication partner it was significantly more likely to be a teacher; in regular classes it was significantly more likely to be a peer.

It is likely that these differences were brought about by the different ecologies of the two settings, rather than by any systemic difference between regular and special settings. In regular settings, it is apparent that students had the opportunity to interact with their teacher, their aide, or any of their 20-25 peers. In a special class, usually consisting of six students, the teacher and aide were frequently engaged in personal care of two of the children, while the other four non-mobile non-verbal students often tended to be left disengaged. This raised the issue of whether greater awareness by the teacher and aide of the need to provide communicative interactions would lead to improvement in the amount of interaction.

The impact of teacher training: One case study

As a follow-along to our recent collaborative study of inclusive and segregated settings (Foreman et al., 2004), we worked with six pairs of educators responsible for educational programs for students with severe and multiple disabilities in special schools. The focus of the program (three mornings of staff training) was on the use of strategies to enhance and maximise communication involvement with students, in light of the evidence for a positive association between aspects of communicative interaction and optimal behaviour states in students (Arthur, 2004).   A case application approach was used, centred on a range of best practices in assessment, planning and intervention strategies in communication support (Butterfield, Arthur, & Sigafoos, 1995).

Each dyad comprised a classroom teacher and teacher’s aide (special), and data was collected using a baseline, baseline probe and post-intervention design, using a series of defined behaviour state and contextual codes, and including inter-observer agreement checks on 25% of scheduled observations.   A partial-interval recording system was used, with one tone in an earpiece indicating that the observer should observe for ten seconds, and a second and a different tone indicating a recording period for ten seconds. Each observation period lasted a total of 1.5 hours. Participating teachers and aides were also asked to complete a pre-post scale that explored their reported skills, knowledge and approaches to communication support for their students.   This data is currently being analyzed, along with the vignettes of students that we asked staff to complete following the training program.

One innovation in this study was the collection of extra information about the judged form and function of student communications. Communication form was simply categorized as symbolic or non symbolic, and a range of perceived functions such as ‘requesting’, ‘greet/farewell’, and ‘expresses feelings’ were included in the coding definitions.

The main data set is currently in the process of entry and analysis. However, one preliminary case study is presented here.   Karina is a thirteen year old girl who is non-mobile and uses a wheelchair for all of her school day, and relies heavily on communication partners to recognize and interpret some idiosyncratic sounds and facial expressions.   Prior to intervention Karina was observed in the Awake-Active-Alert state for 34.9% of observation intervals, compared with 43.6% following the staff training intervention.   However, during the period of the study, the percentage of intervals observed during which Karina was involved in a communicative interaction decreased from a baseline level of   36.3% to a post-intervention figure of 26.2%.   A communicative interaction was defined as an exchange of meanings, with turn-taking , amongst partners.

We also explored the communication functions demonstrated by students in interactions and when cueing for communicative involvement.   As one example, Karina demonstrated requesting for 24.1% of baseline intervals, compared with 43.9% of intervals following the intervention program.

Whether these data are reflected in the other five case studies will become apparent when the full data set is presented at the ISE C Conference. It will be interesting to investigate the entire data collected for the six students , in order to identify the impact of the staff training program on student behaviour states and associated communication and other contextual variables.   Likewise, it will be useful to compare participant reports with actual, observed changes, if any, in the daily milieu of the classroom.

References

Arthur, M.   (2004). Patterns amongst behavior states, socio-communicative and activity variables in educational programs for students with profound and multiple disabilities.   Journal of Developmental and Physical Disabilities, 16, 125-149.

Arthur, M.   (2003).   Socio-communicative variables and behavior states in students with profound and multiple disabilities: Descriptive data from school settings.   Education and Training in Developmental Disabilities, 38, 200-219.

Butterfield, N., Arthur, M., & Sigafoos, J.   (1995).   Partners in everyday communicative exchanges: A guide to promoting interaction involving people with severe intellectual disability.   Sydney/Baltimore: MacLennan and Petty/Paul H. Brookes.

Roberts, S., Arthur-Kelly, M., Foreman, P., & Pascoe, S.   (in press, 2005) Educational approaches for maximising arousal in children with multiple and severe disability: New directions for research and practice in early childhood contexts.   Pediatric Rehabilitation, 8, 2.

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