Extended Abstract: First Contact Survey: Profiles of Students with Significant Cognitive
Disabilities and Complex Communication Needs
Introduction
This session will report on findings from the First Contact Survey, a multi-state
survey designed to provide teachers in the United States with a way to report important
information about students with significant cognitive disabilities (SCD) who were eligible
to take the Dynamic Learning Maps™ (DLM®) Alternate Assessment. While previous
studies have increased understanding of the prevalence of CCN, the importance of AAC
and the types of AAC used (Binger & Light, 2006; Matas et al., 1985; Murphy, Marková,
Moodie, Scott, & Boa, 1995; Siu, et al., 2010; Weiss et al., 2005), specifics about the
profiles of students with SCD and CCN with respect to symbolic language, literacy and
access needs are limited. The current analysis of survey results focused on questions
related to students’ abilities to use speech, sign language and/or aided AAC systems to
meet expressive communication needs, as well as questions probing complexity of
language use, and physical, sensory and academic characteristics of the sample of
students. These differences have important implications for practice, policy,
development, and future research.
Results
The majority (75.9%) of students in the sample were reported to use speech to
communicate. An additional 18.93% (n=8,439) were reported to use AAC and 7.70%
(n=3,435) used sign language. Teachers indicated that approximately one-third
(n=2,676) of the students known to use AAC also used speech to meet some portion of
their communication needs. Similarly, 42.7% (n=1,466) of the students reported to use
sign language used it as a supplement to speech. A remaining 4,319 (9.69%) students
were not known to use speech, AAC or sign language to meet their expressive
communication needs, suggesting a lack of symbolic language use. Of the 4,003
surveyed cases of students reported to not use speech, AAC or sign language to
communicate, 1,925 (48.1%) used conventional gestures, 560 (14.0%) used
unconventional gestures, and 1,518 (37.9 %) used reflexive, rather than intentional
behaviors.
AAC systems ranged from simple systems with symbols presented in groups of
one or two, to dynamic display systems with voice output. Respondents were asked to
mark all of the AAC systems that a student used, thus reporting on the use of one or
more systems. On average, students known to use AAC were reported to use 1.87
different types of AAC systems. Approximately half (50.6%; 4,114) of the 8,125 students
reported to use AAC were only able to use symbols offered in groups of 1 or 2; and, for
27.3% (1,124) of these students this was the only way they used AAC. In 33.1% of
student cases, simple voice output devices with 9 or fewer messages were used. In
29.6% of cases, low-tech communication boards with 8 or fewer symbols were used.
Only 23.7% of cases used voice output devices or computer/tablets with dynamic
display software that offered voice output.
Analysis of language complexity revealed that 23,736 (70.7%) students who
used speech typically combined three or more words when speaking to meet a variety
of communicative purposes; 6,698 (19.9%) typically used two-word combinations to
meet a variety of communicative purposes; and 3,141 (9.4%) typically used only one
word at a time to meet a limited number of communicative purposes. For students who
use only AAC, merely 252 (4.5%) were reported to use three or more symbol
combinations, 875 (15.6%) used two-symbol combinations to meet a variety of
communicative purposes, and 4,465 (79.8%) used only one symbol at a time for a
restricted range of communication purposes.
Literacy, specifically the ability to spell, is required for students who cannot use
speech to communicate if they are ever going to be able to independently communicate
whatever they want, to whomever they want. The troublesome report for 4,498 (54.3%)
students known to use AAC, and 1,348 (39.4%) students known to use sign language,
was an inability to read any words when presented in print or Braille (excluding
environmental signs or logos). Similar differences were noted about writing. Teachers
reported that 1,956 (23.3%) students known to use AAC and 1,017 (29.85) students
known to use sign language were able to select symbols to express meaning when
asked to write, compared to 21,440 (63.7%) students known to use speech.
Of the sample of 8,439 students known to use AAC, 568 (6.7%) were known to
be deaf or hard of hearing. Of the sample of 3,435 students known to use sign
language, 658 (19.2%) were known to be deaf or hard of hearing. Of the students
known to use AAC, 5,985 (70.9%) had no known vision loss, 1,263 (15%) had normal
vision with correction, and 1,191 (14.1%) were known to be blind or have low vision that
could not be corrected with glasses or contact lenses. The use of visual aids were
reported for 1,273 students known to use AAC, with 685 (71.7%) requiring or using
tactile graphics/symbols, 565 (59.1%) requiring or using enlarged print, and 23 (2.4%)
requiring or using Braille.
Of the total sample of students known to use AAC, 5,949 (70.5%) were able to
walk unaided, 914 (10.8%) could walk with assistance, and 1,567 (18.7%) were unable
to walk. Of the sample of 2,262 students known to use AAC and require mobility
assistance, 1,960 (86.6%) were reported to use a wheelchair with assistance, 229
(10.1%) a wheelchair independently, 51 (2.3%) a cane, 403 (17.8%) a walker.
Conclusion
The language, learning, sensory and motor profiles of students with SCD in the
sample differed based on primary means of communication. Complexity of symbolic
language use differed significantly, with approximately 70% of students known to use
speech able to combine three or more words when speaking, while nearly 80% of
students known to only use AAC were limited to the use of one symbol at a time for a
restricted range of purposes. These results suggest that expansion of symbolic
communication is an area of instructional need for many students with CCN and SCD.
In the proposed session, these results and their implications will be shared.
References:
Binger and Light (2006), Demographics of preschoolers who require AAC. Language,
Speech and Hearing Services in Schools, 37, 200-208.
Matas, J. A., Mathy-Laikko, P., Beukelman, D. R., & Legresley, K. (1985). Identifying the
nonspeaking population: A demographic study. Augmentative and Alternative
Communication, 1, 17–31.
Murphy, J., Marková, I., Moodie, E., Scott, J., & Boa, S. (1995). Augmentative and
alternative communication systems used by people with cerebral palsy in Scotland:
Demographic survey. Augmentative and Alternative Communication, 11, 26–36.
Siu, E., Tam, E., Sin, D., Ng, C., Lam, E., Chui, M., Fong, A., Lam, L, & Lam, C. (2010).
A survey of augmentative and alternative communication service provision in Hong
Kong. Augmentative and Alternative Communication, 26(4), 289-298.
Weiss, P. L., Seligman-Wine, J., Lebel, T., Arzi, N., & YalonChamovitz, S. (2005). A
demographic survey of children and adolescents with complex communication needs in
Israel. Augmentative and Alternative Communication, 21, 56–66.