Applying the Tactile Working Memory Scale (TWMS) in the Assessment of Persons with Sensory and Multiple Disabilities: A Case Study

This case study presents observations and findings of the newly published Tactile working memory scale (TWMS; Nicholas et al., 2019), a method to gather knowledge and understand the cognitive functioning of individuals who are using primarily tactile modality in communication and information gathering. TWMS scoring was conducted with video material of two adolescents with sensory and multiple disabilities. This article presents and discusses the differences in scoring between two raters, at two time points (before and after the formal training for TWMS method), and between and inside scoring of participants. The results show difficulties in reaching inter-rater agreement between two assessors, although the agreement was better after training. There is also variation in scoring between the videos of the same participant, highlighting the situational factors of the physical and interactional elements of the assessment. This was expected, being a well-known fact from clinical experience and previous research in assessing persons with disabilities. Especially with the items assessing higher cognitive functions (manipulating) there were difficulties decoding the observations consistently. We will also offer recommendations for further use of the TWMS based on our findings. Despite the restrictions of the method, we conclude that the TWMS, with its detailed structure for observing cognitive functioning of persons who are outside traditional cognitive testing, is an important method for making visible and understandable the variety and complexity of expressing cognition in interaction.