=Paper=
{{Paper
|id=Vol-3751/short3
|storemode=property
|title=Intellectual Disabilities: how technologies can improve comminication skills, a review of litterature
|pdfUrl=https://ceur-ws.org/Vol-3751/short3.pdf
|volume=Vol-3751
|authors=Alessandro Aloisio,Clara Esposito,Francesco Cerciello,Rossana Pia Laccone
|dblpUrl=https://dblp.org/rec/conf/dilend/AloisioECL24
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==Intellectual Disabilities: how technologies can improve comminication skills, a review of litterature==
https://ceur-ws.org/Vol-3751/short3.pdf
Intellectual Disabilities: how technologies can improve
comminication skills, a review of litterature.
Alessandro Aloisio1, Clara Esposito1, Francesco Cerciello1, Rossana Pia Laccone1
1
Department of International Humanities and Social Sciences, Rome University of International Studies, Rome (Italy)
Abstract
This article provides an in-depth review of the relationship between Communication Technologies and
Intellectual Disability, with specific attention to Augmentative and Alternative Communication (AAC).
The review delves into recent research exploring how intellectual disability can compromise various areas
of individual development, rendering communicative exchanges vulnerable and contributing to observed
social challenges in individuals with communicative needs. Through a theoretical review, the article
analyzes the role of communication supportive technologies in promoting social inclusion, considering the
often-involved communicative and social challenges. Furthermore, the article discusses the potential
contribution of communication supportive technologies in mediating the relationship between intellectual
disability and communication, offering insights to guide future research and the development of additional
technologies.
Keywords
Intellectual Disabilities, Communication Technologies, Augmentative and Alternative Communication.
1
1. Intellectual Disabilities
Cognitive disabilities are often associated with various forms of developmental disabilities. In cases
of genetic syndromes, such as motor disabilities and autism spectrum disorders, varying degrees of
intellectual disabilities are frequently observed, impacting cognitive and communicative processes
[1].Intellectual disability is a neurodevelopmental disorder that emerges in childhood [2]. Recently,
the criteria for diagnosing intellectual disability have been updated in the fifth edition of the major
international diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
by the American Psychological Association. In this context, intellectual disability is characterized by
a deficit in intellectual functioning (both scholastic and experiential learning, reasoning, problem-
solving, planning future actions, abstract thinking, etc.) and a deficit in adaptive functioning in the
conceptual, social, and practical domains [2,3]. Currently, DSM-V places particular emphasis on the
individual's adaptive functioning, defined as the ability to understand and respond appropriately to
environmental situations, closely linked to developmental and sociocultural standards of personal
independence and social responsibility [4]. In this regard, compromises in adaptive functioning are
crucial for assessing the severity of intellectual disability [2].In educational programs dedicated to
students with intellectual disabilities, the acquisition of communication skills plays a crucial role.
This competence facilitates adaptation to the surrounding environment and positively influences
the cognitive development of the individuals involved [5,6].
Compared to the previous version, DSM-V emphasizes the greater relevance of the Adaptive
Quotient (AQ) over the Intelligence Quotient (IQ). This, in the perspective of an evaluation, less
rigidly emphasizes IQ and underscores the importance of adaptive functioning as an overall
predominant criterion, which can vary based on the presence of barriers/facilitators; these criteria
Proceedings of the Digital Innovations for Learning and Neurodevelopmental Disorders, May 24–25, 2024, Rome, Italy
Alessandro.aloisio@unint.eu (A. Aloisio); clara.esposito@unint.eu (C. Esposito) and francesco.cerciello@unint.eu
(F. Cerciello); rossana.laccone@unint.eu (R.P. Laccone);
0000-0003-3911-4008 (A. Aloisio); 0000-0001-5780-610X (C.Esposito); 0000-0001-8341-2796
(F.Cerciello);0009-0001-6100-3470 (R.P. Laccone);
© 2023 Copyright for this paper by its authors.
Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).
CEUR Workshop Proceedings (CEUR-WS.org)
CEUR
ceur-ws.org
Workshop ISSN 1613-0073
Proceedings
are reiterated within the International Classification of Diseases-11th revision (ICD-11) of the World
Health Organization (WHO) [7,8]. Adaptive functioning defines the degree of assistance needed to
maintain an adequate standard of living; based on this, four severity levels are recognized: mild,
moderate, severe, and profound[2]. What has just been stated converges in the perspective of the
biopsychosocial anthropological framework ICF (International Classification of Functioning,
Disability and Health) by WHO [9, 10]. In this sense, there is a shift from mere identification of the
deficit to a multidimensional and taxonomic definition; to an approach where individual factors
function in relation to factors of intellectual, social, and practical origin, and the degree of support
needed to enable the person to lead an autonomous life [11, 8]. Indeed, an individual's ability to
perform an action depends not only on their physical characteristics but also, and especially, on the
influence of environmental elements, which can either facilitate or hinder activity and social
participation [8]. In intellectual disabilities, communicative deficits are often detectable in the
cognitive profile, particularly in forms characterized by higher levels of impairment, making
individuals vulnerable in communicative exchanges [12, 13, 14,15, 16,17). Since communication
constitutes a fundamental human right, it is essential that each individual acquires autonomy to
actively participate in society and develop adaptive behaviors[18, 19]. Indeed, the redefinition by
manuals does not represent a simple categorical reconfiguration but rather a scientifically
consolidated choice that directs towards the creation of interventions, environments, and services
aimed at supporting paths of orientation and life projects based on self-determination for quality of
life [8].
2. Augmentative and Alternative Communication (AAC) and
Intellectual Disabilities
In the literature, there are studies emphasizing the importance of developing tangible technologies
for individuals with communication needs, as they can create new inclusive opportunities to
facilitate alternative modes of communication and connection with others [20,21, 22,23].
Augmentative and Alternative Communication (AAC) represents an integrated system of strategies
and techniques aimed at mitigating communicative challenges and creating real communication
opportunities for individuals who have difficulty communicating effectively [24,15,16]. AAC
comprises both unaided modes, such as manual signs and gestures, and aided modes, including the
Picture Exchange Communication System (PECS)[25]and Speech-Generating Devices (SGD) [26].
Aided AAC systems include high-tech options, such as apps on Apple devices and GoTalk9+ [27],
and low-tech options, such as PECS, boards with eye gaze, symbols on a ring, or in a notebook. In
particular, aided AAC refers to systems that require external or additional supports beyond the
speaker's body. AAC modes refer to the various types of AAC systems: aided or unaided, low or
high-tech, and the various access methods [26]. The synergistic integration of assistive technologies
from AAC systems offers possibilities to develop inclusive educational environments for students
with diverse disabilities. Currently, it plays an innovative role in the development of inclusive
Special Education processes[28,29,30]. From this perspective, AAC systems can also provide
effective support to facilitate interactions between students with disabilities and their peers,
especially in collaborative and cooperative learning groups [21]. AAC systems are based on the use
of stylized symbols, providing individuals with disabilities the ability to communicate requests and
express desires or emotions [1]. Awareness of the potential to influence the surrounding context
through the sharing of simple stylized symbols leads to significant reductions in inconvenience and
disorientation for individuals with disabilities, often caused by difficulties in understanding the
demands of the surrounding environment[31,32,1,30]. Crowe et al.'s (2021) review studies have
identified some evidence-based practices of Augmentative and Alternative Communication (AAC),
including PECS [33], the use of assistive technologies for daily activities [34], the use of high-tech
AAC to teach social communication skills[35], computerized instructions [36], tablet-based video
modeling[37], aided AAC modeling[38], and inclusive education to improve communication skills
[39]. Several studies present a nuanced picture of converging results and variations in AAC use as
assistive technology. Overall, there is progress in both expressive and receptive communication
abilities through the adoption of AAC [40,41,29, 42]. In particular, interventions involving assisted
AAC input have demonstrated a high degree of effectiveness in enhancing participants' language
skills [43]. The frequent use of Speech-Generating Devices (SGD) and the PECS system emerges as a
common practice, with both associated with significant improvements in communication for
children with Down syndrome [44]. It is worth noting that the effectiveness of AAC can vary
depending on usage modes, with particular attention to assisted modeling, which appears to offer
benefits. The use of assisted modeling in AAC is supported by strong scientific evidence, indicating
an effective approach. Similarly, the use of narrative and modeling-based interventions is supported
by robust research, facilitating the learning of graphic symbols and language in AAC [38].
Additionally, AAC interventions with Functional Communication Training (FCT) are effective in
reducing problematic behaviors and promoting the use of AAC systems, assisted or unassisted [45].
While some studies indicate significant positive effects of AAC [46,50], others highlight weaker
effect sizes on specific communicative outcomes through the use of mobile technology [34].
Emerging evidence suggests that AAC can be effective in teaching various communication
functions to children with ASD, in addition to object requests [27]. Assistive technology, including
high-tech AAC, shows a significant impact on independence and participation, contributing to the
improvement of educational opportunities and quality of life [47,35]. Participation and interest in
children significantly improve with the use of AAC in inclusive environments, where children
manifest preferences for materials and books adapted to their needs [48]. However, some critical
issues emerge, such as the limited social network of children using AAC and challenges related to
limited vocabulary on SGDs [49]. In summary, although AAC offers promising benefits, it is crucial
to consider the diversity of practices, participant characteristics, and emerging challenges for a
comprehensive and effective approach [29]. See Table 1 for a general overview of this study.
Table 1
General overview of the study
Keypoint Information
Communication Function in Intellectual Crucial role in adaptive skills - Positive impact
Disabilities on cognitive development
Role of Augmentative and Alternative AAC as an integrated system to mitigate
Communication (AAC) in Intellectual communicative challenges - Unaided and aided
Disabilities modes - Various AAC technologies and their
impact.
Impact of Assistive Technology (High- Significant contribution to independence and
Tech AAC) participation - Improvement in educational
opportunities and quality of life
3. Conclusion
The analyzed studies highlight how AAC, through both assisted and unassisted modes, provides
inclusive opportunities, particularly in educational contexts. Intellectual disabilities, situated within
a multidimensional framework, call for a focus on social adaptation and specific interventions to
promote self-determination. The communicative deficit in severe forms underscores the importance
of specific support strategies. Further exploration of the role of assistive technologies can contribute
to optimizing social inclusion [52]. Interventions based on AAC, supported by scientific evidence,
show progress in communication skills, with various practices including PECS, assistive
technologies, and modeling. However, challenges such as limited social networks require a careful
approach. In conclusion, understanding intellectual disabilities and strategically implementing AAC
are essential for improving the quality of life, independence, and social participation. Ongoing
research is crucial to refine interventions and tailor them to specific needs, contributing to
promoting paths of autonomous and inclusive living.
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