Improvisation and Communicative Agency: Contribution of an Improvisational Model to the Analysis of Communicative Agency

Introduction: Persons with congenital deafblindness mainly communicate using the bodily tactile modality. Their expressive communication is often formulated by an authentic language that gives the persons with congenital deafblindness low readability towards the rest of the world. This can be an obstacle for the development of their communicative agency. In the present study it is investigated whether a theoretical approach to improvisation can contribute to the development of communicative agency in a person with congenital deafblindness with low readability and authentic language in a dialogical perspective. Method: The study employs a qualitative design conducted as a dialogical single case study. Even though this research is based only on one recording of a communicative encounter between a person with deafblindness and her communication partner, it is assumed that the study can be used as a representative case study for people with low readability and authentic language. A video of communication between a person with CDB and a sighted/hearing communication partner is transcribed and the transcription is analysed in three stages through 1) Conversational analysis (CA), 2) Improvisation analysis and 3) Subjectivity/intersubjectivity analysis. Results: The Conversation analysis proved useful to identify complex turn-taking patterns in the communication. Through the improvisation model it was possible to define the degree of subjectivity/intersubjectivity in every utterance by each participant, as well as how each act was met by the other. With the improvisation model discriminations could be made between the different modalities, as vocal speech and bodily tactile acts. Regarding communicative agency, the model was useful to analyze degrees of self-expression as well as the balance of subjectivity and intersubjectivity between the participants. Conclusion and discussion: The model of improvisation contributed to specify subjectivity/intersubjectivity and multimodality in communication, though it did not contribute to the analysis of turn-taking. The model contributed to the development of communicative agency by pointing to the open-ended outcome for each utterance as the most important factor for developing and sustaining communicative agency. Limitations: The main limitation of this study was that the analyses were performed on only one video-clip with one dyad. Due to time constraints, a consensus check could not be carried out. Recommendations for future research is that, since this is a very innovative method in the deafblind field, replications of the study should be performed on more dyads, different dialogues and more video clips. Recommendation for practice: The combination of conversation analysis and improvisation analyses can very well be used with focus groups of care professionals in clinical practice under supervision of a trained expert in this method of communication analyses.

Analysis of the Relationship Between the Content and Effectiveness of an Intervention based on the Layered Communication Model to Improve Communication

The Layered Communication Model (LCM) describes intersubjective development based on eight different communicative behaviors in three consecutive layers. Earlier studies showed that when the model is used in an intervention, the presence of many LCM behaviors increases from before to after the intervention. The present study aims to relate the content of the intervention to its effectiveness to learn whether and how the LCM can be used to improve communication. 15-minute videos of four student-teacher dyads were coded in ten-second intervals for the presence and absence of the eight LCM behaviors before, during and after the intervention. The intervention was divided into two phases: self-assessment and video feedback coaching. Intervention content was described based on the behaviors that were targeted for improvement during the two phases. Effectiveness was measured by calculating the percentage increase in presence between phases and by calculating effect sizes using a nonoverlap of all pairs method. Results showed that the second intervention phase (video feedback coaching) was most effective in terms of increasing the presence of LCM behaviors and creating larger effect sizes. Effectiveness measures decreased during the follow-up phase but were still higher than at baseline. Furthermore, effectiveness was higher for targeted behaviors than for untargeted behaviors. In conclusion, the LCM can be used as a tool to improve communication, especially when specific behaviors are clearly targeted and video feedback coaching is used to clarify how to work on improving the presence of those behaviors. The self-assessment phase needs adjustments to increase its effectiveness.

The Social Construction of Congenital Deafblindness in relation to Education: Analysis of focus groups in East and Central Africa

This study investigated the importance of social construction of congenital deafblindness (CDB) when planning special needs education services. The study was conducted in Uganda and the Democratic Republic of the Congo (DRC). The research was based on a literature review and a focus group study. In the focus groups a dialogical perspective was used for acquiring knowledge through communicative interactions. The focus was on two main topics: social construction of Congenital Deafblindness (CDB) and knowledge about education services for people with CDB. Fourteen participants were selected, with seven from each country. Participants were familiar with deafblind persons and/or with communities where they lived. The grounded theory approach and thematic analysis method were used to determine the correct coding and themes and identify patterns of meaning of different opinions. The results of the data analyses showed that participants attributed the causes of CDB in Uganda and the DRC to cultural and religious beliefs. The medical stance on CDB was less understood. In addition, culture and religion were identified as dominant factors in the social construction of the position of people with CDB in the community, leading to misunderstanding and inappropriate services for them. This community misunderstanding indicates that people at the local level are likely to stick to traditional and religious practices. Therefore, changing attitudes and educational opportunities for people with CDB requires more understanding of third-party voices and the underlying barriers in these communities.

Cognition in Interaction: Challenges in Assessing Persons with Sensory and Multiple disabilities

This article reports a qualitative study of cognitive assessments of three teenagers with sensory and multiple disabilities, including moderate to profound developmental disability. The aim was to evaluate the possibilities for adapting standardized tests and the implementation of interactional partnership in assessment. Cognitive assessments were made with an individually-adapted psychological assessment tool, the Bayley Scales of Infant and Toddler Development. The assessment situations were video-recorded and analyzed based on sociocultural theories of early interaction, dynamic assessment, and the bodily-tactile modality of cognition. The results showed that the requirements for assessment are complex and highly individualized, extending beyond universal guidelines on test adaptations. The assessments were built on developmental steps within the standardized test, but required a special emphasis on individuality and interaction. We conclude that the study provides novel insights into an under-researched area of cognitive assessment, confirming earlier findings that cognitive skills become observable in unique moments of intensive interaction. The assessor must follow the principles of dynamic assessment, applying competent partner strategies such as providing safety, supporting attention, activity, and alertness, and scaffolding the target skills in the zone of proximal development. Conducted thus, the cognitive assessment process can enable the assessor to recognize, support and authenticate the agency of persons with complex disabilities.

Improving Competences of Newly Qualified Professionals

Introduction: Very little research has been done on the transition of newly qualified professionals onto the working field. They often feel vulnerable, due to the differences between them and the experienced professionals. With present study the researcher wanted to investigate whether introducing newly qualified professionals to a specific theoretical model, can help improve their competence in the field of deafblindness and reduce the gap between newly qualified professionals at the start of their careers and expert professionals. The study was specifically aimed at an intervention in applying the Real Space Blend Model to improve competences in the interpretations of gestures of persons with CDB in both groups of professionals. Method: The study used a qualitative design based on individual video-analyses and focus groups. Results: In two of the newly qualified professionals a considerable increase in the number of gestures was seen. Such an increase was also found for one of the expert professionals. Two other expert professionals showed a little change in the overall number of gestures. From the thematic analysis, different themes came forward for each focus group. Newly qualified professionals seemed overall more confident after the intervention, while experienced professionals seemed to have more difficulties grasping the model of Real Space Blends. The expert professionals felt more aware about their identification of gestures in practice. Conclusion and discussion: The training did improve competences in newly qualified professionals. The main effect was an increase in confidence in their abilities. Experienced professionals, on the other hand, experienced more difficulties in learning how to use the model of the Real Space Blends, but found the model very useful in practice to add on the Diagnostic Intervention Model. Some limitations of this study were the small amount of participants and that there were more experienced professionals than newly qualified professionals. More extensive research on the transition of newly qualified professionals is recommended.

Bua-mi: Learning through Meaningful Outdoor Activities

This paper reflects on a long term and on-going project that used the Scandinavian “friluftsliv” (nature living) concept and meaningful work in the outdoors as a medium for language development with young adults who are congenitally deafblind. The physical nature of the project was key to both participants developing their tactile language.

Getting to What Matters: A Model of Perceptual Guidance

This article outlines a model of perceptual guidance that aims at giving a child with congenital deafblindness perceptual access to the world, and in particular to the social world. It argues that we can closely interact with, and partially direct, a child’s exploration without instructing the child into culturally similar ways of exploring. Perceptual guidance has two facets. The first is a bodily dimension where child and partner interact so that they create a joint bodily orientation to the world. The second is that partner and child show each other ways of organizing their overlapping perceptual field with arms and hands. This showing bears close resemblance to how we judge and discuss aesthetic matters. As in aesthetics, there is not a given correct procedure for exploring and judging, but an effort at creating community through showing each other how we experience the world. This gives the child access to the social world without purporting that this is the only correct way of exploring. The article ends with two practice examples of perceptual guidance, which additionally shows two ways of spatially organizing the perceptual field.

Video-feedback Interventions for Improving Interactions with Individuals with Congenital Deaf blindness: a Systematic Review

Video-feedback interventions have been demonstrated to improve communication between typically developing children and their communication partners. Video-feedback approaches are also applied in interventions that aim to improve interactions and communication of people with congenital deafblindness. However, an analysis of the various applications and effectiveness of video-feedback approaches for this target group is required to guide future practice and research. This study reports on a systematic review of studies on video-feedback interventions aimed at improving social interactions with people with congenital deafblindness. The literature was analysed in terms of intervention landscape and procedure, research methodology and outcome. Results show that a variety of video-feedback interventions are being used with all age groups of people with congenital deafblindness in varied settings and with varied communication partners. The data reveal positive outcomes including increased affective involvement, more sustained interaction and shared understanding. Issues including sustainability of approaches and their effects were identified, as well as lack of detail on the video-feedback sessions. While the review revealed positive outcomes, the lack of explicit information on the video-feedback sessions and the co-occurrence of video-feedback with other interventions make it difficult to determine what factors contributed to the positive outcomes. Recommendations are made for future practice and research.

Are We Getting to All That Matters? The Need for Perceptual Guidance

Congenital deafblindness (CDB) profoundly affects perception of the environment. CDB can affect both which objects are perceived, and which features of the objects are experienced. In order to gain better access to the environment and the social world, it could therefore potentially be beneficial if a child with CDB was perceptually directed by a seeing and hearing person. However, such a form of intervention is not unproblematic. This article argues that such a perceptual guidance is only acceptable if the leading in perception is agency sensitive and contains three features: that of joint perception; a culturally sensitive organization of perceptual fields, and a dynamic back-and-forth mode of leading and exploring.