Augmentative Communication for Individuals with Autism Spectrum Disorder, Intellectual Disability and Visual Impairment: Development of the ComFor-V

Background:  

Augmentative communication is very important for individuals with autism spectrum disorder, intellectual disability and visual impairment. Most individuals with autism spectrum disorder take in information most readily through visual channels. Consequently, visualization forms the key to many educative programs and communication strategies for individuals with autism. Such approaches are not evidently applicable to individuals with a visual impairment. The ComFor (Forerunners in Communication; Verpoorten, Noens, & van Berckelaer-Onnes; Dutch version: 2004, revised Dutch version: 2007; English version: 2008), an instrument for the indication of augmentative communication, has proven to be a very valuable tool for individuals with autism spectrum disorder and intellectual disability, but visual impairments were not taken into account in the development of the original ComFor. The main objective of the study is to adapt the ComFor to be appropriate for individuals with a co-occurring visual impairment.

Objectives:  

1. To evaluate and refine the pilot version of the ComFor-V;
2. To assess the psychometric properties of the ComFor-V;
3. To study the interpretation and implementation of the ComFor-V-results.

Methods:  

Data were gathered in three phases. First, a semi-structured interview about the pilot version of the ComFor-V was administered from 6 experts in autism spectrum disorders, intellectual disabilities, and/or visual impairments from the Netherlands and Belgium. The pilot version was further explored in a focus group interview with 11 participants. Second, the ComFor-V was tested on a sample of children and adults with visual impairment, autism spectrum disorder and/or intellectual disability (n = 84) with a developmental level between 12 and 60 months on the domain of daily living skills, measured with the Vineland Screener 0-6yrs-NL (Scholte et al., 2008). Third, interpretation and implementation of the ComFor-V results were investigated via 10 case studies (selected from the second phase of the study); this phase is currently running.

Results:  

On the basis of the feedback gathered in phase one, the pilot version of the ComFor-V has been refined. The most important adaptation concerned a revision of the structure of the ComFor-V. In order to adjust to the large heterogeneity within visual impairments, the final instrument provides two tracks with a common start; one track for blind individuals (including deaf blind individuals) and one track for individuals with low vision. Preliminary results indicate good to excellent inter-rater reliability.  Further psychometric properties and preliminary results of the case studies will be available at the IMFAR.

Conclusions:  

The ComFor-V seems a promising tool to explore underlying competence for augmentative communication in individuals with autism spectrum disorder, intellectual disability and low vision or blindness. Areas for future research and clinical relevance will be discussed.