“How adults with a profound intellectual disability engage others in interaction” – a powerful, provocative article

Just wanting to share my favourite reading at the moment. The article is simultaneously complex and straightforward. They use a complex method of conversational analysis to look at natural interactions occurring between some staff and people with profound intellectual disabilities. Their findings are straightforward: staff are in a dilemma. They are use “typical” communication patterns with people whose communication needs are far from typical. Successful interaction is not happening.

It is a wonderful challenge handed to us to explore, use, and share a different way of communicating. It is a challenge to anyone who “trains”, “teachers”, “mentors” staff who engage everyday with people with profound intellectual disability to learn the optimal individual language that may defy neurotypical rules. It challenges us to change the rules of engagement.


Antaki, C. , Crompton, R. J., Walton, C. and Finlay, W. (2017), How adults with a profound intellectual disability engage others in interaction. Sociol Health Illn, 39: 581-598. doi:10.1111/1467-9566.12500


Using video records of everyday life in a residential home, we report on what interactional practices are used by people with severe and profound intellectual disabilities to initiate encounters. There were very few initiations, and all presented difficulties to the interlocutor (support staff; the recording researcher); one (which we call ‘blank recipiency’) gave the interlocutor virtually no information at all on which to base a response. Only when the initiation was of a new phase in an interaction already under way (for example, the initiation of an alternative trajectory of a proposed physical move) was it likely to be successfully sustained. We show how interlocutors responded to initiations verbally, as if to neuro?typical speakers – but inappropriately for people unable to comprehend, or to produce well?fitted next turns. This mis?reliance on ordinary speakers’ conversational practices was one factor that contributed to residents abandoning the interaction in almost all cases. We discuss the dilemma confronting care workers.

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