People with advanced dementia who have lost the ability to speak are typically thought to have no communicative abilities or desire to interact and, as such, are excluded from the social world. This is likely to be detrimental to the wellbeing of those with dementia, difficult for interactions with carers and upsetting for family. 

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Ellis & Astell found that, despite a lack of speech, people with advanced dementia retain both the urge to interact and individual repertoires of non-verbal communicative capacities including sounds, movements, facial expressions. These actions can be used by caregivers to re-engage individuals with advanced dementia in social interaction - an approach known as 'Adaptive Interaction'.