Exploring spontaneous interactions between people with profound intellectual and multiple disabilities and their peers

Figures & data

Table 1. Participant characteristics.

Participant	Sex (f = female, m = male)	Chronological age (in years)	Visual	Able to reach	Observed at
A	F	8	No reported problems	Yes	Special Education Centre 1
B	F	6	Partially sighted	Yes	Special Education Centre 1
C	M	4	Partially sighted	Yes	Special Education Centre 2
D	M	18	No reported problems	Yes	Special Education Centre 2
E	F	16	No reported problems	Yes	Special Education Centre 3
F	F	14	No reported problems	No	Special Education Centre 3
G	F	57	No reported problems	Yes	Day-care Adults 1
H	M	47	No reported problems	Yes	Day-care Adults 1
I	M	33	Blind	No	Group Home 2
J	F	30	No reported problems	Yes	Day-care Adults 2
K	F	53	No reported problems	Yes	Day-care Adults 3
L	M	26	Blind	No	Group Home 1
M	M	46	Partially sighted	No	Group Home 3
N	M	41	No reported problems	No	Group Home 3

Table 2. Coding scheme.

Timeframe

Was there a change in position for this person?  0. No  1. Yes (see map)

Was there interaction?  0. No  1. Yes  2. Not in room

Who was the interaction partner?  1. Peer with PIMD  2. Direct support person  3. Peer without PIMD  4. Observer  5. Other

Interactive expressions of the interaction partner  1. Vocalisation  2. Gestures  3. Touching  4. Facial expressions  5. Making sounds  6. Looking at the interaction partner  7. Moving  8. Object related

Interactive expressions of the person with PIMD  1. Vocalisation  2. Gestures  3. Touching  4. Facial expressions  5. Making sounds  6. Looking at the interaction partner  7. Moving  8. Object related

Details

Table 3. Number of interactive expressions of people with PIMD and their interaction partners.

	People with PIMD		Interaction partners
			DSPs		Peer		Observer		Other		Total interaction partners
	n	%	n	%	n	%	n	%	n	%	n	%
Vocalising	55	15.1	136	33.1	6	37.5	0	0.0	14	22.6	156	29.6
Gestures	2	0.5	10	2.4	0	0.0	0	0.0	4	6.5	14	2.8
Touching	11	3.0	85	20.7	3	18.7	0	0.0	8	12.9	96	18.0
Facial expressions	85	23.4	36	8.8	2	12.5	4	9.5	5	8.1	47	8.8
Sounds	8	2.2	4	1.0	1	6.3	1	2.4	3	4.8	9	1.7
Looking at	97	26.6	75	18.2	1	6.3	32	76.2	14	22.6	122	22.8
Movement	75	20.6	27	6.6	2	12.5	4	9.5	8	12.9	41	7.7
Object related	31	8.5	38	9.2	1	6.3	1	2.4	6	9.7	46	8.6
Total	364	100.0	411	100.0	16	100.0	42	100.0	62	100.0	531	100.0

Note: The sum of the percentages does not always equal 100 due to rounding off.

Table 4. Interactions between peers and contextual factors.

Participant	Sex	Age	Setting	Total interactions with peers	Peer	Timeframe	Interaction PIMD	Interaction peer
B	F	6.8	Special education centre 1	1	PIMD	15	Vocalising	Vocalising
D	M	18.5	Special education centre 2	3	Peer without PIMD	1	Looking Movement	Movement Facial expression Touching
					Peer without PIMD	2	Movement	Movement Touching
					Peer without PIMD	3	Movement Facial expression	Touching
E	F	16.5	Special education centre 3	2	Peer without PIMD	22	Looking Vocalising Sounds	Vocalising Sounds Object related
					Peer without PIMD	24	Looking	Looking Facial expression
M^a	M	41.1	Group home 3	2	PIMD	15	Vocalising	Vocalising
					PIMD	34	Vocalising	Vocalising
N^a	M	46.9	Group home 3	2	PIMD	15	Vocalising	Vocalising
					PIMD	34	Vocalising	Vocalising

^aParticipant M and participant N were interacting with each other.

Table 5. Case descriptions: context of interactions with peers.

Participant B is a girl of 6 years old and observed in a Special Education Centre, she was partially sighted and able to reach. According to the DSP, participant B was able to make contact with somebody if that person was within reach of one meter, she used throat sounds, smiled, reached towards people or pulled people’s hair or clothes. If she was unhappy or not willing to do something she used her arms to push things away or turned her head away. The observation started when there was a music therapist at the group. All persons were positioned in a circle. Participant B was positioned between the bed box and the waterbed (both beds were occupied) facing away from both beds, having a playing rack on her wheelchair desk. She sat there since timeframe 5. Two persons were outside with one DSP. Another occupied bed box was approximately three meters away. One more child (her brother, the interaction partner) sat in the room, about two meters away, turned half away from the table. When they turned their heads they were able to see each other. There was one DSP in the room. Before starting the interaction with the peer (her brother), the observer noticed an increase in sounds by participant B, a DSP responded to one of the sounds in timeframe 14 by vocalizing. The amount of sounds made by participant B increased. Interaction with brother by both making sounds.

Participant D is a young man of 18 years old and observed in a Special Education Centre. He has no reported problems with seeing or reaching. According to the DSP participant D is able to make contact with others. If he tries to make contact he is smiling and makes cooing sounds. In contact his whole face smiles and he makes laughing sounds. When he really enjoys something his face lights up and he stretches out his whole body. When he does not like something his face looks scared and he cries, his body starts to cramp. There were three interactions with a peer, all right at the beginning of the observation during a group session with a music therapist. The group was set up in a circle and participant D sat in between two peers, almost wheelchair to wheelchair. This was the position when the interactions occurred. All interactions were with one peer without PIMD. The peer always used touching as an interactive expression, with participant D responding with movement. Participant D also looked at his peer, resulting in a facial expression.

Participant E is a girl of 16 years old, observed in a Special Education Centre, with no reported problems with seeing or reaching. According to the DSP she is able to make contact with other people, she does so by making sounds, facial expressions and eye contact. If she likes something she smiles and raises up her body. If she dislikes something she makes unhappy sounds, as crying of moping, she also uses her arms to bang on her wheelchair table or scratches her ears. She had three interactions with a peer. The first one happened two timeframes after she was positioned at the table for lunch. A peer, who was able to walk, pushed her wheelchair, in reaction she looked at this peer. After a while this peer started talking and making sounds. In reaction participant E also made sounds and vocalisations and started banging on her wheelchair table with her hand (indicating that she did not enjoy this). Two timeframes later the same peerlooked at her, participant E responded by vocalizing. After another timeframe the DSP started interacting with her. After this, no more interactions with peers occurred.

Participant M and participant N are both male and living in the same group home. They were observed at the same time. Participant M is a man of 46 years, who is partially sighted and not able to reach. Participant N is 41 years old, with no reported visuals problems and not able to reach. According to the DSP participant M makes contact through action – reaction, if a person makes a sound, he responds to that. If he likes something, his body will relax and he smiles. If he does not like something, his body cramps and his feet will go up in the air. Participant N makes contact by facial expressions and moaning sounds, if he likes something, he smiles and makes “happy” sounds. If he does not like something his lip starts to prowl, he moans or looks away. The first interaction occurred when they were sitting at the table, participant M in a wheelchair with table and participant N in a wheelchair without table. They sat opposite each other at the table. Participant M was sitting at the table for over an hour and the last interaction was with a DSP while he was tube fed over 15 minutes ago. Participant N was sitting the same amount of time at the table and interacted almost every timeframe with the DSP or the observer. Both interactions between participant M and N consisted of vocalisations back and forth. After the first interaction, participant M fell asleep. The second interaction occurred in front of the TV where they were positioned next to each other. This was only seen once for the whole period they were sitting in front of the TV and it happened after over an hour after they have been positioned in front of the TV.

Table 6. Opportunities in relation to positioning and interaction with peers.

	Group general		Interaction with peer
	n	%	n	%	Type of interaction with peer
Touching not possible and looking not possible	280	61.3	3	30.0	Vocalising (3)
Touching not possible and looking possible with head movement	122	26.7	2	20.0	Vocalising (2)
Touching not possible and looking possible without head movement	49	10.7	2	20.0	Vocalising (1) Sounds (1) Looking (2)
Touching with effort and looking possible without head movement	4	0.9	3	30.0	Facial expression (1) Looking (1) Movement (3)
Touching with effort and looking with head movement	2	0.4	0	0.0	–
Total	457	100.0	10	100.0	14