23 Communicative Competence in a Group of Visually Impaired Children Michelle Simpson, BA (Speech and Hearing Therapy) (Witwatersrand) Glenda Shapiro, BA (Log) (Witwatersrand) Department of Speech Pathology and Audiology, University of the Witwatersrand, Johannesburg ABSTRACT Aspects ofverbal and non-verbal communicative competence offive visually-impaired six and seven year old children were investigated. The Profile of Communicative Appropriateness (Penn, 1983) was used to assess communicative competence in one discourse interaction with a known interlocutor (mother). The results indicated that the subjects were predominantly appropriate in terms ofverbal communication, and predominantly inappropriate in terms ofnon-verbal communication. Severity ofvisual impairment influenced performance in terms of non- verbal communication. Research and therapeutic implications are discussed. OPSOMMING Aspekte van die verbale en nie-verbale "kommunikasievermoens van vyf visueelgestremde kinders tussen die ouderdomme ses en sewejaar is ondersoek. Die "Profile of Communicative Appropriateness "(Penn, 1983) is gebruik om kommunikasievermoens in een interaksiesituasie met 'n bekende persoon (die moeder) te evalueer. Die proefpersone se verbale kommunikasie is as hoofiaaklik toepaslik beoordeel terwyl nie- verbale kommunikasie as hoofiaaklik nie toepaslik beoordeel is nie. Diegraad van gesigsgestremdheid het nie-verbale kommunikasie betn- vloed. Implikasies vir navorsing en behandeling word bespreek. At birth, humans are the most helpless of living creatures, whereas, as adults, they are social and communicative indivi- duals at high levels of creativity. This transformation occurs through acquisition, learning and development, which evolves as a result of continuous interaction between the environment and the individual (Affolter & Sticker, 1980). Full sensory integrity is essential for establishing fundamental cognitive and emotional stability (Affolter & Strieker, 1980; Wills 1965). Early sensory deficits interfere with perceptual infor- / mation processing, and a child lacking a major sense such as vision understands and structures his world differently to a child with vision. j Fraiberg (1977) describes the blind child's world as one in which objects, persons and things emerge from a void as tran- sient tactile auditory experiences, and disappear to become meanihgless experiences.'it is a conceptual problem for the blind infant, who must infer the identity and substantiality of an object. As language development is closely linked to stages of cognitive development, and vision plays an important role in theories of cognitive development, the significance of visual impairment in relation to language acquisition needs to be examined. Vision is the "synthesizer" of sense experience, and a visual deficit therefore imposes significant cognitive con- straints on the visually-impaired baby, particularly during the sensori-motor period (Fraiberg, 1977). ' McGurk (1983) reviewed some of the more recent literature on the language acquisition of visually-impaired children, and felt that visual impairment, rather than having specific deter- minate effects, seems to have general moderating, or modulat- ing influences upon the development of communicative compe- tence. Fraiberg (1977), although noting that without vision the child faces an arduous task in acquiring language, con- cludes that ultimately the blind child has equivalent language to the sighted child. Other researchers (Anderson et al. 1984; McGinnis, 1981), show that visually-impaired children's use of action words is self-directed, rather than directed to exter- nal objects, and suggest that blind children's language reflects the experience-specific conceptualisations of objects that they are able to obtain via non-visual senses. Overall, it seems that the word meaning and usage of visually-impaired children may reflect specific, experiential deficits. Interactive experience and exchange of messages in all com- municative modalities are at the basis of language develop- ment (Bullowa, 1979; Bloom, 1973), and communicative be- haviours develop in early infancy arising from the matrix of adult-infant interaction (Rogow, 1982). The sighted child literature predicts significant constraints on the visually-impaired child's learning to communicate. Bate- son (1975) called the first mother-infant interchanges "proto- conversations", i.e., constant or nearly constant communica- tion in one modality (visual) and intermittent alternating com- munication in another, and emphasizes the importance of pre- verbal conversational skills in relation to later communicative development. Bullowa (1979) states that she has observed mother-infant pairs engaging in face-to-face conversations from as early as a few hours old. Overall, therefore, the path to communicative competency begins in early infancy, where babies first converse with their eyes, then their bodies (mainly hands), and finally add spoken language (Bullowa, 1979). Rowland (1983) examined the pragmatic perspective of pre- verbal blind infant development and found that many schemes associated with competent language development (e.g., sym- bolic play) were absent. A delay in symbolic play may be Die Suid-Afrikaanse Tydskrif vir Kommunikasieafykings, Vol. 36, 1989 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2) 24 attributed to the "self/other" confusion typical of visually- impaired children (Fraiberg & Adelson, 1976). Giving and showing, which normally form the basis of the early games and turn-taking rituals that Bruner (1983) considers precur- sors to the joint regulation of verbal exchanges, were virtually absent. Pointing, an especially good predictor of language development (Bates et al. 1977), and reaching-as-a-request, both of which are visually-guided behaviours, were also ab- sent. The absence of these, visually-mediated deictic beha- viours from tjie blind child's repertoire, severely constrains the opportunities for contingent interaction over shared refer- ents, and to. that extent the child's competence-enhancing experiences are restricted (Mulford, 1983). Various researchers (Urwin, 1978; Anderson et al. 1984; McGinnis, 1981), have examined the nature of the interactive language patterns between a blind child and an adult speaker, and have discovered usage problems in relation to the effec- tiveness of the children's contributions to the conversations. These include sudden topic shifts and minimal use of com- municative gesture. Controversy exists regarding blind child- ren's use of expressive bodily action (Apple, 1972; Brieland, 1950). Many studies in the language acquisition of visually- impaired children may be criticised methodologically. Ander- son et al. (1984) attempted to overcome some of the methodo- logical shortcomings of previous studies, and found that at a purely structural level, the language of blind children resem- bles that of their sighted peers, whereas, when examined in its discourse context, there are consistent discrepancies. This, to- gether with the fact that McGinnis (1981) feels that more research is needed on the communication of blind children, particularly in the area of gestural communication, compelled the writer to examine more specifically the communicative competence of a group of visually-impaired children. Com- municative competence is: "... the mastery of an underlying set of appropriateness rules - which are determined by culture and situation - that affect the verbal and non-verbal choices in com- munication events." (Wood, 1981, p. 238.) Furthermore, since McGinnis (1981), states that the inclusion of both blind and partially-sighted subjects in a study would assist a fuller understanding of whether partial vision results in the development and use of communicative gestures, both blind and partially-sighted subjects were included in this study, which examined the communicative competence of five visually-impaired six and seven year old children in one dis- course interaction each with their mothers. METHODOLOGY The study aimed to examine the communicative competence of five visually-impaired six to seven year old children, with the ultimate purpose of examining trends regarding the relation- ship between visual impairment"' early preverbal develop- ment, and the cumulative implications for later communca- tive competence. Subject selection Five subjects were used in a descriptive research design. All children had a visual impairment which precluded normal educational mainstreaming, and attended Prinshof School for the Partially Sighted as day scholars. The subjects were Eng- Michelle Simpson and Glenda Shapiro lish-speaking with a normal IQ, and a preverbal onset of visual impairment. Two subjects were bilaterally blind, and three subjects were visually-impaired. Description of the subjects Subjects were chosen according to the above-mentioned crite- ria. -Relevant biographical and clinical data are provided in table 1. Table 1: Description of the five subjects ( 1 - 5 ) Age Sex Aetiology Age of onset Degree of 1 impairment 1 6 Μ Hereditary Absent corneas bilaterally Congenital Bilateral blind- ness (minimal light perception) 2 : ' 6 F ' Bilateral cataracts Congenital Unilateral· blind- ness (left) Adequate vision in right* 3 % Μ •Birth*· anoxia Congenital Unilateral blind- ness (right). 30% vision in left* 4 6 F Unknown Congenital Bilateral blind- ness - minimal light perception 5 T F Albinism (with nystagmus) Congenital 30% vision bilaterally Procedure Test environment Only one discourse interaction (subject 1) was conducted in the one-way observation room at the University Speech and Hearing Clinic. The other four discourse interactions-.were conducted in the.subjects' homes using a portable video came- ra. According to Umiker-Sebqpk (1979), conversations in more intimate surroundings, such as the child's own home, where he is more familiar and at ease, are significatitiy more developed, ι i Interaction time A time-based sampling of free conversational interaction ; (Crystal, Garmen &.Fletcher, 1976) was employed. As Perin (1983) recommends, the interaction lasted for 15 minutes'. i Method ' ι A free-play interactive situation was utilised in the testing procedure. Prior to initiating recording, all participants were provided with the same instructions. The mothers were instructed to interact in a natural manner with their children, and the children were told that they were allowed to play freely in the room. / y Recording of the data Video and audio recordings were made of the conversational interactions, to allow for a detailed verbal and non-verbal analysis of the data obtained. According to Muma (1978), videotaping is the best recording method, as it not only allows The South African Journal of Communication Disorders, Vol. 36, 1989 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2) Communicative Competence i n a Group of Visually Impaired Children 25 a way of rechecking what was said, but it also provides a way of noting reference and communicative intent. Additionally, one of the scales of the PCA required analysis of non-verbal beha- viour, and therefore, necessitated video-recording. Analysis firmation that the data reflect a true change in subject beha- viour rather than variability in observer recording (McRey- nolds & Kearns, 1983). The formula advocated by them w a s employed to analyse inter-rater reliability. RESULTS AND DISCUSSION Materials Profile of communicative appropriateness The conversational sample was analysed according to the Pro- file of Communicative Appropriateness, (PCA; Penn, 1983). The PCA was selected as it evaluates the appropriateness of language usage along various parameters which were relevant for the study. Furthermore, the PCA includes a verbal and a non-verbal analysis, and the importance of assessing both ver- bal and non-verbal behaviours in visually-impaired children has been stressed (McGinnis, 1981; Apple, 1972). Transcription The data was transcribed using traditional English ortho- graphy. The unit of analysis employed was one-minute "chunks" of data known as the conversational unit (Penn, 1983). Ten minutes of each interaction served as the basis for analysis. Two judges, both experienced in language pathology, were employed. Conversational partner According to Penn (1983) the degree of familiarity with the interlocutor determines, to some extent, both the style and topic of a subject's output. Fielding and Fraser (1978) define familiarity behaviourally, in terms of the extent of previous, interaction, and cognitively, in terms of the participants' knowledge of each other, and state that it is an important aspect of the speaker-listener relationship. Therefore, the wri- ter acknowledges the limitations of the use of only one familiar conversational partner, i.e., the child's mother. Method of analysis The judges were given a blank PCA sheet which was com- pleted for each interaction, a written instruction sheet and a 'table exemplifying and defining each component of the profile. Judges were additionally provided with a typed transcription of the interaction (as described above). This is in accordance with Penn (1983). The judges were required to indicate the position on a five point rating scale which they felt best de- scribed the appropriateness of the communicative behaviour of each subject on the dimension under consideration during each C.U. of one minute. The five-point rating scale delineated on the PCA was employed: Mostly inappropriate; Mostly appropriate and Appropriate. Inappropriate; Some appropriate; Penn (1983) also includes a category for 'Could not Evaluate' which she requests her judges to use as little as possible. Included in the PCA analysis were the dimensions of Re- sponse to Interlocutor; Control of Semantic Content; Cohe- sion; Fluency; Sociolinguistic Sensitivity and Non-Verbal Communication. The specific quantitative data obtained for each subject were tabulated on the PCA. Inter-rater reliability Measures of inter-rater reliability provide independent con- Inter-rater reliability of discourse interaction Inter-rater reliability was calculated by employing the for- mula provided by McReynolds and Kearns (1983). For the conversation involving subject 1 inter-rater reliability fell bet- ween 88% and 100% on all scales of the PCA, for subject 2 86% to 100%, for subject 3 88% to 98%, for subject 4 86% to 100%, and for subject 5 85% to 95%. According to the criteria pro- vided by Kazdin (1977; cited by McReynolds & Kearns, 1983), these findings may be considered as acceptable levels of inter-rater agreement. This degree of interrater reliability implies that the observations were reliable, as well as accurate (Dollagham & Miller, 1986). Results of the PCA Appropriate Mostly appropriate Some appropriate Mostly inappropriate Inappropriate Β D F I F J Scales of the PCA (Penn, 1983) Figure 1: Performance of the five subjects on all scales of the PCA Scales of the PCA : Key A = Response to Interlocutor Β = Control of Semantic Content C = Cohesion D — Fluency Ε = Sociolinguistic Sensitivity Fi = Non-verbal Communication: Vocal Aspects Fj = Non-verbal Communication: Non-verbal Aspects Subjects: Key 51 52 = X 53 = Δ 54 = α 55 = - All subjects Scale A. Response to Interlocutor As can be seen in figure 1, all five subjects attained pre- dominantly appropriate ratings for their responses to the in- terlocutor. Some minor inappropriate responses were observ- ed in subject 4, but were felt to be a function of the child's age rather than the visual impairment specifically. Scale B. Control of Semantic Content All of the subjects were rated as appropriate on all of the six Die Suid-Afrikaanse Tydskrif vir Kommunikasieafykings, Vol. 36, 1989 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2) 26 behaviours reflecting Control of Semantic Content. However, two subjects (4 and 5) showed some difficulty with topic initiation and adopted passive positions in the discourse inter- action. These results were felt to possibly be an artifact of the testing situation wherein the mothers used the question form of interaction, thereby reducing the opportunity for spon- taneous interaction. Scale C. Grammatical Discourse Features All subjects were rated as predominantly appropriate in terms of grammatical cohesion. Scale D. Fluency All subjects were judged to be highly appropriate in terms of fluency control. Scale E. Sociolinguistic Sensitivity All subjects were rated as being appropriately sensitive to the demands of the communicative situations. Scale F. Non-verbal Communication This parameter of the PCA is divided into vocal aspects (inten- sity, pitch, rate, intonation and quality) and non-verbal as- pects (facial expression, head movement, body posture, breath- ing, social distance and pantomime). As can be seen in figure 1, all the subjects exhibited pre- dominantly appropriate vocal aspects but were judged to be inappropriate as regards head movement, facial expression and gesture. Subjects 2 , 3 and 4 made more use of gesture and facial expression but even then it was felt that more utilisation of these components of non-verbal behaviour would have improved communication. The two subjects who were severely visually-impaired (1 and 4) exhibited inappropriate non-verbal behaviour, as seen in recurrent head movements, repetitive inutile hand move- ments, no head-turning to localise interlocutors' verbal input / and reduced facial expression. T,he least visually impaired subjects (2 and 3) exhibited mainly reduced facial expression whilst they were able to employ the previously mentioned non-verbal behaviours. The remaining subject (5) who was moderately visually impaired, exhibited predominantly inap- proriate facial expression, head movement and gesture. As seen in table 2, the subjects' abilities to respond to the interlocutor were seen to be predominantly appropriate. This SUMMARY OF T H E RESULTS . Tahle 2: Percentage of appropriateness obtained by all subjects on all scales of the PCA PCA SCALES !. SUBJECTS PCA SCALES 1, 2 3 4 5 , Response to Interlocutor 90 90 100 80 100 Control of Semantic Content 90 80 80 80 80 Cohesion 90 100 100 80 100 Fluency 100 100 100 100 100 Socio-linguistic Sensitivity 90 100 100 100 100 Non-verbal Communication 30 40 40 30 40 Michelle Simpson and Glenda Shapiro is in accordance with evidence provided by Mulford (1983), who concludes that the communicative competence of visually- impaired children, with a familiar interlocutor (e.g., mother), is adequate, as the familiar listener is able to assess the child's focus of attention. Some inappropriate turn-taking skills were seen, but their occurrence was minimal. A further interesting finding of this study was that the mothers of visually-impaired children tended to ask questions requiring a direct answer, or that the children carry out a request. Anderson et al. (1984) also noted this. The mothers in this study also provided fewer descriptions of the surrounding environment, rather provid- ing labels for immediate objects or actions. Topics tended to be centred on the child, rather than the environment. Overall, it is important to note that the severe constraints predicted for visually-impaired children in terms of the early precursor'' development of turn-taking skills (Urwin, 1983), were not observed, i.e., the few inappropriate turn-taking skills obser- ved did not interfere significantly with the communicative competence of the children. In terms of Control of Semantic Content, it was seen that most subjects displayed much reliance on the interlocutor for con- text, particularly topic initiation. Subjects were able to main- tain the flow of conversation, and to convey adequate infor- mation and vocabulary. This conflicts with the findings repor- ted by Anderson et al. (1984), wherein they reported many instances in which the child strayed form the general conver- sation, and made unrelated topic shifts. Some inappropriate topic shifts were observed in subject 2, but it was felt by both judges to be related to the child's age, rather than a function of poor semantic cohesive abilities. All the subjects were judged to have predominantly approp- riate grammatical cohesion features. Two subjects (1 and 4) were noted to have instances of incorrect pronoun usage wherein they replaced "I" (when referring to themselves), with "you". Incorrect pronoun usage has been discussed ex- tensively by various researchers (Fraiberg & Adelson, 1976; McGinnis, 1981), who noted that blind children make signifi- cantly more personal reference errors than their sighted peers. This has been linked to poor development of body image and selfconcept (Fraiberg, 1977; Burlingham, 1965). It is interest- ing that the incorrect pronoun usage observed in this study occurred in the blind as opposed to the partially sighted sub- jects (see table 2), indicating that the more severe the visual impairment, the more likely the specific experiential deficits will have cumulative implications for later language develop- ment. Mulford (1983) found that the use of situational deictic terms by these children was worse than that of their sighted peers, indicating that blind children are unable to take the relative viewpoint of the listener. In this study, however,; it was noted that the visually-impaired children were able to functionally utilise all deictic terminology correctly. As can be seen in table 2, all subjects were judged to have appropriate fluency control, which suggests that apart from the occurrence of normal non-fluencies, tbe visually-im- paired child does not seem to exhibit non-fluencies which interfere with the coherence or sequence of the intended message. All subjects were judged to be predominantly appropriate in those behaviours which reflected a sensitivity to the demands of the communicative situation. As has already been men- tioned, some instances of lack of sensitivity to the interlocutor were noted, and although this is in accordance with the litera- ture (McGinnis, 1981), it is felt to be not particularly signifi- cant, having only occurred minimally. / The South African Journal of Communication Disorders, Vol. 36, 1989 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2) Communicative Competence in a Group of Visually Impaired Children 27 The most significant findings were in the area of non-verbal behaviour. This can most clearly be seen in table 2 and figure 1. In terms of the vocal aspects, all of the subjects demonstrated approriate pitch and intonation, with some instances of inap- propriate intensity being reported. This was observed in both the blind and visually-impaired subjects and may be linked to the conversational reticence noted. Various non-verbal be- haviours deemed to be inapproriate were observed in all of the subjects. Controversy exists regarding the presence or absence of facial expression in visually-impaired subjects (Brieland, 1950; Apple, 1972). In this study facial expression was judged to be minimal,and not consistent with the verbal message in subjects 1, 4 and 3. This seems to be predicted in much of the literature on the preverbal development of the blind and visual- ly-impaired child (Fraiberg, 1977; Urwin, 1983). Four of the five subjects showed inappropriate head movements. The severity was increased in the two blind subjects as opposed to the two visually-impaired subjects. This seems to indicate that the more severe the visual impairment, the worse the degree of aberrant head movement is. Inappropriate gesture (inutile hand waving), was also noted in subject 1, although in none of the other subjects. It was felt by the raters that the gestural sys- tems of the other four subjects, although not inappropriate, were reduced and inexpressive. This supports the findings of McGinnis (1981), who found that blind subjects used minimal expressive hand gestures to accompany their speech, relying on sometimes ambiguous verbal communication. A further finding, also described by McGinnis (1981), was that the sub- jects did not use head-nodding as a substitute for words. It appears, therefore, that visually-impaired children exhibit predominantly appropriate communicative competence in terms of some of the parameters, measured by the PCA (Penn, 1983). However, various inappropriate behaviours are obser- ved in terms of non-verbal behaviours, specifically facial ex- pression gesture and head movement. CONCLUSION The results of this study revealed that the visually-impaired subjects were on average, appropriate in terms of verbal com- municative competence, and on average, inappropriate in terms of non-verbal communicative competence. Non-verbal skills which appeared to be predominantly inap- propriate were head movement, facial expression and gesture. The inappropriateness of the non-verbal skills tended to in- crease with the severity of the visual impairment, i.e., the blind subjects demonstrated aberrant head movement, whereas the partially sighted subjects showed ineffective communicative head movement. Gesture was found to be minimal, and in some cases aberrant. Instances of incorrect pronoun usage were noted in the blind subjects, and not seen in the partially sighted subjects. The small size of the sample, and the lack of randomness in the selection of subjects, necessitates caution in generalising the results. A further limitation of the study was the use of a single familiar interlocutor, and this may have implications for future research, as Mulford (1983) states that the introduction of an unfamiliar interlocutor will provide further information per- taining to how referentially successful blind speakers are,and whether or not an "unskilled" interpreter would be able to establish the visually-impaired individual's foci of attention. However, it is felt that the significant findings in terms of non- verbal communicative skills have important implications. First- ly, it increases the understanding of the specifically Visual processes which contribute to the development of communica- tive skills (Bruner, 1983; Bates et al. 1977). Secondly, it pro- vides practical and clinical guidelines for the development of necessary intervention procedures directed toward maximis- ing the early communicative environment of the blind and visually-impaired child. According to Prutting: "The communicative system is the indi- vidual's most powerful tool for getting along in this world." (1984), and it is on the basis of this that the authors believe that communication therapy with young blind, and visually- impaired children, will facilitate the blind child in building a model of their world (Urwin, 1983). REFERENCES Affolter, F. and Strieker, E. (Ed). Perceptual processes as prerequisites for complex human behaviour: a theoretical model and its applica- tion to therapy. Vienna: Hans Huber, 1980. Anderson, Dunlea and Kekelin. Blind children's language: resolving some differences. Journal of Child Language. 11, 645-666, 1984. Apple, M.M. Kinesic training for blind persons: a vital means of com- munication. New Outlook for the Blind. 66, 201-208. 1972. Bates, E; Benigni, L; Bretherton, 1; Camaioni, L; Volterra, V. From ges- ture to the first word: on cognitive and social prerequisites. In Lewis, M. and Rosenblum, L (Eds.) 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Psychoanalytic Study of the Child. 20, 194-208, 1965. Crystal, D; Garmen, M. and Fletcher, P. The Grammatical Analysis of Language Disability. London: Edward Arnold, 1976. Dollagham, C. and Miller, J. Observational methods in the study of communicative competence. In Schiefelbusch, R.L. (Ed.) Lan- guage Competence: Assessment and Intervention, College-Hill, 1986. Fielding, C. and Fraser, C. Language and interpersonal relations. In, Markova, J. (Ed.): The Social Context of Language. Toronto: John Wiley and Sons, 1978. Fraiberg, S. Insights from the Blind. Norwich: Fletcher and Son Ltd, 1977. Fraiberg, S. and Adelson, E. Self representation in young blind child- ren. American Foundation for the Blind. 1976. McGinnis, A.R. Functional linguistic strategies of young blind child- ren. Journal ofVisual Impairment and Blindness. 210-214,1981. McGurk, H. Effectance motivation and the development of com- municative competence in blind and sighted children. In Mills (Ed.) Language Acquisition in the Blind Child: Normal and Defi- cient. San Diego: College-Hill Press, 1983. McReynolds and Kearns. Single-subject Experimental Designs in Com- municative Disorders. Baltimore: University Park Press, 1983. Mulford, R. Referential development in blind children. In Mills (Ed.) Language Acquisition in the Blind Child: Normal and Deficient. San Diego: College-Hill Press, 1983. Muma, J.R. Language Handbook: Concepts, Assessment and Interven- tion. Prentice-Hall Inc, Englewood Cliffs, 1978. Penn, M.A.C. Syntactic and Pragmatic aspects of aphasic language. Unpublished Doctoral Thesis, University of the Witwaters- rand, Johannesburg, 1983. Die Suid-Afrikaanse Tydskrif vir Kommunikasieafivykings, Vol. 36, 1989 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2) 28 Michelle Simpson and Glenda Shapiro Prutting, C.A. The pragmatics of language. The South African Journal of Communication Disorders. 31, 3-5, 1984. Rowland, C. Patterns of interaction between three blind infants and their mothers. In Mills (Ed.) Language Acquisition in the Blind Child: Normal and Deficient. San Diego: College-Hill Press, 1983. Rogow, S. Rhythms and Rhymes: Developing communication in very young blind and multi-handicapped children. Child Care, Health and Development. 8, 249-260, 1982. Umiker-Sebeok, D. Pre-school children's intraconversational narra- tives. Journal of Child Language, 1979. Urwin, C. Early language development in blind children. Br. Psychol. Soc. Occasional Papers, 1978. Urwin, C. Dialogue and cognitive functioning in the language deve- lopment of three blind children. In Mills (Ed.) Language Ac- quisition in the Blind Child: Normal and Deficient. San Diego: College-Hill Press, 1983. Wills, D. Some observations on blind nursery-school children's under- standing of their world. Psychoanalytic Study of the Child. 20, 344-364, 1965. Wood, B.S. Children and communication. Englewood-Cliffs: Prentice- Hall, 1981. 4 < > r n e ' TALKING TO PROFESSIONALS THE NEEDLER WESTDENE ORGANISATION Beg. NO.CK87/02503/23 223 D.F. Malan Drive Northcliff 2196 P.O. Box 2739 Northcliff 2195 ®(011) 888-1009/1087 Fax: (011) 888-1186 Telex: 4-2E068 The South African Journal of Communication Disorders, Vol. 36, 1989 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2)