Initiation and repair of intentional communication acts by adults with severe to profound cognitive disabilities.

This study assessed the communication initiation and repair behaviors of 28 individuals with severe to profound mental retardation in a variety of experimental conditions. All of these individuals communicated through nonsymbolic gestures. The experimental procedures were devised to simulate the conditions that typically evoke two different types of initiations: comments and requests. Each subject initiation was followed by an experimenter response that indicated a communication breakdown to determine if and how these subjects would attempt to repair such breakdowns. Different indicators of communication breakdown were systematically varied in these scripted interactions, including explicit requests for repair (verbal and gestural) and implicit requests for repair (failure to respond or inappropriate response to the subject's communication act). All subjects initiated at least one communication act, and all but three subjects repaired at least one communication act following a breakdown. Significantly more subjects initiated protoimperative than protodeclarative communication acts, despite equal opportunities for both types of acts. Across all conditions, additions were observed to occur significantly less often than recasts or repetitions. There were no significant differences in the number of subjects repairing communication following the different types of communication breakdown.