Interactional patterns between staff and clients with borderline to mild intellectual disabilities.
Staff subtly steer talks with mildly disabled clients—use fewer direct questions and acknowledge every turn to even the balance.
01Research in Context
What this study did
Robertson et al. (2013) watched everyday chats between support staff and adults with mild intellectual disability.
They counted who spoke first, who asked questions, and how often each person followed the other’s idea.
No one got training; the team just mapped what normally happens.
What they found
Staff did most of the steering. They asked more direct questions and sometimes skipped acknowledging the client’s last comment.
Clients gave longer answers but often failed to link their turn back to the staff’s point.
The talk flowed, yet staff held the reins.
How this fits with other research
Cameron et al. (1996) tried a short class to fix a similar imbalance with severely disabled residents. The class helped a little, but gains faded fast.
Lambrechts et al. (2010) saw the same one-sided style when staff reacted to challenging behavior: lots of quick words, few open questions.
Tsai (2013) looked at AAC users and found that even familiar partners did not boost turn sharing. Together these studies say the imbalance is stubborn across settings, severity levels, and speaking modes.
Why it matters
If you support adults with mild ID, notice your own questions. Swap some direct probes for open ones like “What do you think?” and always echo the client’s last line before you move on. These tiny shifts hand the conversation back and build true collaboration.
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02At a glance
03Original abstract
BACKGROUND: Client-centred models of care imply that clients should have a collaborative relationship with staff providing support. This study investigates whether dialogues between staff and clients in naturally occurring contexts reflect this collaborative ideal. METHODS: Nineteen staff members video recorded a social interaction with one of their clients. The topic of the interaction concerned an aspect of their support needs. The recordings were transcribed and analysed using the Initiative Response Analysis designed by Linell et al. RESULTS: Staff were more dominant than clients, albeit the level of asymmetry in the dialogues was relatively small. However, a different pattern of turns was used by staff and clients. Staff asked more direct questions and sometimes neglected meaningful client contributions. Clients, on the other hand, provided more extended turns in response to staff members' questions, thereby helping to maintain the dialogue. However, in a notable minority of communicative turns, the clients failed to link with the staff member's contribution. CONCLUSIONS: The interactional patterns found in this study suggest that staff and clients can face difficulties establishing collaborative dialogues on shared topics. Future research should take account of what staff and clients want to achieve in dialogues, along with the nature of their non-verbal communication.
Journal of intellectual disability research : JIDR, 2013 · doi:10.1111/j.1365-2788.2011.01515.x