Evaluation of language and communication skills in adult key word signing users with intellectual disability: Advantages of a narrative task (summary)



Narrative skills are those skills needed to tell stories or recount things that have happened. The ability to use narrative depends on a wide range of language, communication and cognitive skills. The use of narrative can be a way of gathering information about language content and form in a short period of time but in the main this type of task has not been used with adults with intellectual disability (ID), particularly those who use augmentative and alternative communication (AAC). Many adults with ID who use AAC use key word signing (KWS), meaning they use spoken language with the most important words being supported by manual signs. This group have generally been excluded from research into narrative tasks.

The use of narrative tasks with adults who use KWS might have advantages over more traditional language assessments as it can take a shorter time and is more like natural communication and everyday use of language.

The authors noted that people who scored poorly on standard language tests often managed to express themselves at a higher level than expected when using AAC, so a narrative task might give a better indication of functional use of language with KWS than standard tests.

What did they do?

A narrative task for adults with ID who used KWS was developed to gather information about language content and form, including the use of KWS.

The task, which involved retelling a story with picture support, was used with 40 adult KWS users who were also assessed on a range of language tests and in conversation with a speech and language therapist. The narrative task and conversation were recorded and transcribed, looking at both spoken language and manual signs.

What did they find?

They found a strong link between the results of the formal language assessments and the verbal elements of the narrative task and conversation, but the opposite was true of the manual signing elements of both assessments.

However the manual signing element of the narrative task did not match with the formal test scores, indicating that the formal assessments, even when non-verbal subtests were included, did not reflect the level of KWS supported communication skills.


The use of a narrative task was found to be useful and valid with adults with ID and could help to evaluate both verbal language and manual signing. It could identify communication strengths and weaknesses and could be expanded to other forms of AAC and to predict the ability of people to learn to use KWS for functional communication.

The authors believe that narrative tasks should be used when evaluating the language and communication abilities of KWS users.


This study did not look into things such as test-retest consistency and inter-rater reliability when using the narrative task.

Things you may want to look into:

Narrative Therapy

Added to site Dec 2015