Opportunities of Pre-Symbolic Communication in Correcting Maladaptive Behavior in Nonverbal Children with Severe Intellectual Disabilities

Objectives There is a critical shortage of research on the development of communication and adaptive behavior in nonverbal children with profound intellectual disabilities and severe multiple developmental disorders (SMDD). Of particular interest is a subgroup of children for whom not only verbal speech but also the acquisition of alternative and augmentative communication (AAC) systems is inaccessible. This study explores the potential of using pre-symbolic communication to address maladaptive behavior in children with moderate, severe, and profound intellectual disabilities.

Methods. The study employed the Communication Matrix tool, observation, and outcome recording. A theoretical analysis and synthesis of existing concepts of pre-symbolic communication was conducted, accompanied by illustrations of non-verbal behavior topographies and the development of an algorithm for correcting maladaptive behavior in non-verbal children with profound intellectual impairments using pre-symbolic communication. The intervention was considered effective when the behavior was formed and served the intended function.

Results. The study describes examples of the topography of pre-symbolic communicative behavior in non-verbal children with severe intellectual disabilities — such as facial expressions, gaze, vocalizations, body movements, and natural gestures — used in correcting maladaptive behavior. A version of a behavior correction algorithm based on pre-symbolic communication is presented. It includes: analysis of the function of the undesired behavior, linking it to a communicative motive, assessment of the child’s communicative level, identification of target skills and desired communicative behaviors, formation of socially acceptable replacement behaviors, and evaluation of intervention effectiveness.

Conclusions. The study highlights the importance of thoroughly assessing the child’s current level of communication and available non-verbal, pre-symbolic means of interaction when planning corrective interventions and identifying alternative behaviors to replace maladaptive ones.

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