Exploring professional knowledge related to the development of communication, for children and young people with Profound and Multiple Learning Disabilities in an educational context.

Abstract

Background Children and young people with Profound and Multiple Learning Disabilities (PMLD) make up 3.2% of all children with identified Special Educational Needs and Disabilities in England (SEND) (Department for Education, 2022). The World Health Organisation (2007) outlines that those in the category of with profound learning disability have an IQ score of 20 or below, that there is usually an organic aetiology underpinning their needs and other physical disabilities. Limitations within communicative abilities are also noted. Goldbart (2014) found that speech and language therapists were highly reliant on experience and practice-based knowledge to inform decision making and ways of working with clients with PMLD to develop communicative skills. Literature review precepting the current study uncovered a dearth of literature regarding the evidence base underpinning commonly used communication approaches for learners with PMLD, and highlighted difficulties faced by teachers who teach children and young people with PMLD in accessing relevant training which supports their practice. There was no research identified that examined the knowledge, practice and decision making of teachers who teach children and young people with PMLD, regarding the development of communication in the educational context. The purpose of the study is to understand how adults around the child know that communication teaching is effective, how communication approaches are selected, any barriers to implementing communication teaching and how teachers come to know how to develop communication for learners with PMLD.

Participants Five teachers with qualified teacher status, currently working in special schools in England with children and young people with PMLD. Five parents of children taught by the participating teachers were recruited to form five case studies. Children and young people acted as co-participants.

Method Multiple exploratory case studies were conducted across the North East, South East and South West of England. Semi-structured interviews and video-stimulated reflections were conducted with teacher participants, and semi structured interviews were conducted with parent participants which completed the data set. Teacher participants engaged with a recruitment questionnaire to support context setting. Interviews and reflections were audio recorded and transcribed.

Analysis All data were analysed using Reflexive Thematic Analysis (Braun & Clarke, 2022) findings are described and presented in thematic maps. Further cross case analysis was then completed.

Findings Teacher participants reported that communication teaching is at the core of their work and is happening at both planned and unplanned times throughout the school day. Both teacher and parent participant’s evaluation of effectiveness lies primarily with the child’s ability to give reliable affirmative or negative responses in preparation for adulthood, to enhance autonomy and independence. Communication for social pleasure, enhanced mental health and wellbeing that enhances quality of life is also cited as a key marker of effectiveness. Teacher and parent participants consistently described person-centred planning practices, not yet connecting these valuable practices to migratable frameworks that would provide a common language. Relevant and applied short courses, lived experience, and learning from knowledgeable others were cited as predominant sources of professional knowledge. Limitations around resourcing, adversarial governance measures, managing support staff, emotional impact of the work, children and young people’s complex and changing medical and developmental profiles and accessing relevant training were amongst the barriers cited.

Conclusion/Implications Implications for teachers include access to specific training and professional networks. Implications for educational psychologists include reflections on role conceptualisation surrounding work with children and young people with PMLD, and the use of video stimulated reflection in practice. Consideration at organisational level include development of initial teacher training and a standardised multidisciplinary offe. Ongoing ethical considerations for research with this group are highlighted.