The kaleidoscope of communication : Different perspectives on communication involving children with severe multiple disabilities

Sammanfattning: This thesis consists of six publications presenting a theoretical framework, a methodological proposal and three empirical studies. The aim of the work is; to gain knowledge on how children with severe multiple disabilities communicate with their caregivers, to analyse how different research strategies can add knowledge from different perspectives on communication, and to develop models for analysing and describing the dyadic interaction.The theoretical framework addresses the impact of multiple disabilities on the child’s communicative development, as well as the role of the communication partner, and implications for interventions. In the methodological framework, different research approaches are discussed and a system theory-based approach is proposed. The empirical studies are focused on pre-school children with intellectual disabilities in combination with vision disability and/or motor disability. When relationships between use of communication and child characteristics and setting conditions were investigated, the results showed relationships between disability and the use of communication but also that children with similar disability profiles could display quite different communicative patterns. When the communicative process was investigated with the proposed system theory-based approach, it was found that the child and caregiver continuously co-regulated their actions and together created consensual frames and that the process went through phases of instability and stability. Models for a system theory-based analysis of dyadic interaction are presented.The discussion is concentrated around how the results from the studies along with the theoretical aspects can contribute to evidence-based practice. The main conclusions are that, in communication involving a person with severe multiple disabilities, meaning is something that is co-constructed and communication cannot be regarded as a personal competence, the competence is within the dyad.