Caregivers in residential care facilities’ perspectives on the communication needs of children with complex communication and their role in supporting communication

Abstract

Many children with complex communication needs (CCN) are unable to meet their communication needs owing to various challenges like their family circumstances, additional disabilities, and severity of their disabilities as well as barriers within the environment (Finke et al., 2008). Opportunities for meaningful social interactions and participation in the society is significantly limited. Children with CCN in residential care facilities are usually faced with additional challenges that restrict them from participating and contributing in the society when compared to their peers who live with their families. Caregivers working in residential care facilities have a crucial role in supporting the communication of the children as they are usually the most frequent and sometimes the only communication partners for the children (Beukelman et al., 2012). With factors like overcrowding, short staffing and the severe disabilities of the children, caregivers often struggle to fulfil their role in supporting communication of the children. Owing to the hurdles that children with CCN in residential care facilities are faced with, their communication needs remain unmet. The aim of this study is to understand the perspectives of caregivers in a residential care facility regarding the communication needs and skills of children with complex communication needs as well as the role that caregivers in the facility play to support their communication. Seven caregivers from one residential care facility in Tshwane agreed to be interviewed. The interview schedule was developed based on a range of previous studies and aimed to obtain information on (1) biographical information of the caregivers, (2) caregivers’ understanding of communication, (3) caregivers’ knowledge of the children’s communication needs and skills as well as (4) the views of caregivers regarding their roles in supporting communication. The qualitative data were transcribed and analysed using the thematic analysis method. The results obtained indicated that caregivers described the children at the residential facility as having severe to profound intellectually disability with a range of communication impairments. Dominant themes in the description of the children’s communication skills were emergent communicators, non-verbal communication with subthemes such as informal unaided communication. Caregivers reported that they used self self made unaided AAC strategies to communicate with children with CCN. However, no formal or aided AAC communication support strategies were mentioned despite the availability of some unused AAC laptops in the facility. Challenges and factors contributing to the limited communication support were identified, namely short staffing, the additional teaching role, the need for training to improve the knowledge and skills of caregivers in supporting communication, and the need for speech therapists knowledgeable of AAC.