Paid Carer Communication Partner Intervention in Adult Intellectual Disability Services: Developing and Testing a Speech and Language Therapy Intervention

Background
Adults with intellectual disabilities (ID) frequently have social care and health staff as their primary communication partners. Effective communication within this partnership is fundamental to quality of life, yet achieving this for people with complex communication needs, within an under resourced care system, is challenging. One approach Speech and Language Therapists (SLTs) utilise involves detailing an individual with ID’s communication skills and support needs in a Communication Profile and then upskilling the carers to adjust their communication to meet the individual’s needs. There is minimal evidence available to guide this type of SLT intervention.

Methods
Phase one sought to establish a professional consensus around terminology to accurately describe the approach of interest. Phase two involved interviewing paid carers and SLTs working in ID services across the UK (n=13) to identify barriers to communication strategy use. This informed the development of an intervention, guided by behaviour change theory, to increase paid carers use of SLT recommended communication strategies documented in an individual’s Communication Profile. Phase three tested the resultant Communication Profile Implementation (CPI) intervention in a multiple probe across subject design study with paid carer participants (n=6) and three adults with intellectual disabilities.

Results
The SLT led CPI intervention was feasible and acceptable to participants. There were statistically significant differences in paid carers’ use of the targeted communication strategies, their knowledge and skills, and self-efficacy to manage communication challenges. Suggestive improvements were made to the individuals with ID’s participation and wellbeing.

Conclusions
This study used a transparent, systematic and theory driven approach to develop a communication partner SLT intervention for paid carers in adult intellectual disability services which addressed identified barriers to achieving communication behaviour change. The intervention, trialled in a real world context, offers clinicians new insights into optimising individual outcomes when working indirectly with paid carer communication partners.