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Objectives: The present study evaluated a new smartphone-based program to help 12 participants with intellectual disability plus visual and motor impairments to self-regulate their stimulation input (thus avoiding their dependence on staff) through simple non-verbal responses. Method: Nonconcurrent multiple baseline designs across participants were used to assess the effects of the program. The technology used for the program involved a Samsung J4 Plus smartphone with Android 9.0 operating system, two voice recording devices, smart-plugs, and a mini speaker. The smartphone was provided with a Google account and Internet connection, which allowed the participants to access Google Assistant and Google Play Music. The participants could make requests for two different types of stimulation (e.g. songs and familiar voices or noises) by activating via hand pressure the two voice recording devices. The verbal request messages emitted by the devices were recognized by the Google Assistant, which led the smartphone to deliver the related stimulation. Results: During the baseline sessions (without the support of the voice recording devices), the participants failed to access any stimulation. During the intervention and post-intervention phases (with the support of the voice recording devices), all participants managed to access the types of stimulation available independently. The mean frequency of responses (i.e. activations of both voice recording devices) per session ranged between about 8 and 14. Conclusion: The new smartphone-based program can be viewed as a useful resource to enable individuals like the participants of this study to access preferred stimulation independently.

Implementation science deals with the translation of evidence-based knowledge into practice in the real world. Mindfulness-based programs for people with intellectual and developmental disabilities (IDD) emerged about 20 years ago. Efficacy and effectiveness studies provide the evidence-base for these programs and the field of IDD is moving towards large scale implementation of these programs. This article presents a model for implementing mindfulness-based programs in community settings, including family and group homes, schools, vocational settings, and congregate care facilities. The model is based on the 3-tier positive behavior support (PBS) system commonly used in school, family, and agency settings. Specific mindfulness-based programs can be linked to each of the three tiers to improve the quality of life of people with IDD.

Objectives: This study assessed a new technology-aided program to support independent leisure and communication engagement with people with intellectual and motor or sensory-motor disabilities. Methods: Six adults participated. The program relied on the use of a Samsung Galaxy Tab S2 LTE tablet with Android 6.0 Operating System, a NANO SIM card, and the WhatsApp Messenger and MacroDroid applications. The participants were presented with leisure and communication (i.e. text messaging) alternatives, and, based on their choices, with series of steps allowing them to access leisure events or send messages. Results: During baseline, the participants were unable to access leisure events or send messages. During intervention and post-intervention phases, they used the program successfully and spent large percentages of the session time independently engaged in leisure and messaging. Conclusions: A program based on readily available technology may be functional to support leisure and communication in people like the participants of this study.

Objectives: Caring for individuals with intellectual disabilities (ID) or autism spectrum disorder (ASD) can be gratifying as well as stressful. Professional staff employed as caregivers often report compromised mental and physical wellbeing due to the stressful nature of working with clients who exhibit aggressive and destructive behaviors. Prolonged work-related stress results in diminished quality of life for the caregivers. The aim of the present study was to evaluate the comparative effects of three programs--mindfulness program, psychoeducational program, and inservice training-as-usual--on the quality of life of professional caregivers who provide services to adolescent and adult clients with ID and ASD. Methods: Professional caregivers (N = 216) were randomized into three experimental conditions, and trained in mindfulness, psychoeducation, and inservice training-as-usual. The effects of the training on the caregivers' quality of life were assessed in terms of perceived stress, compassion satisfaction, compassion fatigue (i.e. burnout, secondary traumatic stress), and symptoms of depression at the end of 32 weeks of implementation. Results: Perceived stress, burnout, and secondary traumatic stress decreased significantly in the mindfulness condition, followed by psychoeducation, but not in the inservice training-as-usual condition. Compassion satisfaction increased significantly in the mindfulness condition, followed by psychoeducation, but not in the inservice training-as-usual condition. Symptoms of depression, which were rated in the borderline clinical range prior to intervention, decreased significantly to within normal levels in the mindfulness condition, decreased minimally in the psychoeducation condition, and showed no change in the training-as usual condition. Conclusions: A 3-day training in mindfulness meditations and associated contemplative practices provides a better basis for enhancing caregivers' quality of life than psychoeducation or inservice training-as-usual.

Helping people with intellectual and visual disabilities engage in activity and mobility is considered crucially important to promote constructive occupation and a basic form of physical exercise (i.e., objectives that are essential for the individuals' wellbeing and in line with their rights). This study assessed two new programs aimed at helping eight participants with intellectual and visual disabilities (four in each program) to independently move through specific indoor destinations, collect and transport objects, and access stimulation events (e.g., music) with the support of technology systems involving a smartphone linked to mini cameras and speakers. The second program was more advanced than the first and (a) required the participants to discriminate the objects used and transport two (rather than one) of them before any stimulation event, and (b) included telephone calls to and stories from preferred communication partners among the stimulation events. Each program was implemented using a single-case research design (i.e., a non-concurrent multiple baseline design across participants). The results showed that both programs were effective in enabling the participants to collect, transport, and put away objects and access stimulation independently during 20-min sessions. Based on the results, both programs might be considered useful tools to help people with intellectual and visual disabilities manage independent activity and mobility. [ABSTRACT FROM AUTHOR]

This study assessed a technology-aided program (monitoring responding, and ensuring preferred stimulation and encouragements) for promoting physical activity with 11 participants with severe/profound intellectual and multiple disabilities. Each participant was provided with an exercise device (e.g. a static bicycle and a stepper) and exposed to the program according to an ABAB design, in which A and B represented baseline and intervention phases, respectively. Data recording concerned (a) the participants' responses with the exercise device (e.g. pedaling) during baseline and intervention phases and (b) their heart rates during the last intervention phase. The results showed that all participants had significant increases in responding with the exercise devices during the intervention phases. Heart-rate values during the intervention sessions indicated that the participants' responding during those sessions mostly amounted to moderate-intensity physical activity, with potential benefits for their overall physical condition. Implications of the findings and questions for future research in the area were discussed.

We evaluated an upgraded version of a microswitch-cluster program used for promoting adaptive foot and head responses and reducing finger mouthing with a boy with multiple disabilities. The boy had been exposed to an early version of the program, which ensured that positive stimulation followed only adaptive responses occurring free from finger mouthing. The first extra feature of the new version was that the stimulation lasted for the scheduled time only if finger mouthing was absent all that time. Another feature of the new version consisted of extra stimulation arrangements. The boy showed significant performance improvement with the new version of the program. The improvement was maintained over a 7-month follow-up. (Contains 1 figure.)

Students with multiple disabilities, such as severe to profound mental retardation combined with motor and visual impairment, are usually unable to engage in constructive activity or play a positive role in their daily context. Microswitches are technical tools that may help them improve their status by allowing them to control environmental events with small and simple responses suitable to their condition. Recently, a pilot study was conducted to assess such a program with a boy who had multiple disabilities, including total blindness and minimal motor behavior. The results were encouraging, in that the boy became quite active and chose stimuli he was expected to prefer and bypassed those he was not, thus exhibiting purposeful choice behavior. The present study reported in this paper served as a replication and extension of the pilot study, with two new students who had multiple disabilities. These students relied on a vocalization response to activate the microswitch as opposed to the eyebrow movements used in the pilot study. A computer system was used to handle sets of expected preferred and nonpreferred stimuli: it presented brief samples of the stimuli and eventually turned them on for longer periods of time if students selected them. The results of this study found encouraging evidence for the possibility of using specifically developed microswitch programs to enable individuals with minimal residual vision, limited motor behavior, and circumscribed intellectual ability to choose among environmental stimuli. Further research may help determine the generalizability of these results and assess ways of integrating different microswitch programs into the daily educational schedule of such individuals.

One major objective of programs for persons with severe or profound intellectual and multiple disabilities is to teach these persons occupational and vocational tasks and to enable them to carry out these tasks independently (Davis, Brady, Williams, & Burta, 1992; Lancioni et al., 1991; Steed & Lutzker, 1997). The performance of such tasks has traditionally been conceived as a form of individual engagement (Siperstein & Leffert, 1997). However, recent research has shown that it is possible to enable persons with multiple disabilities, including visual impairment, to work together with peers and to share familiar tasks (that is, to engage cooperatively in task--hereafter "cooperative task engagement") (Lancioni, O'Reilly, Cognini, & Serenelli, 2001; Lancioni, O'Reilly, & Oliva, 2002). The purpose of this pilot study was to conduct a preliminary social validation assessment of cooperative versus individual task engagement of persons with multiple disabilities. Toward this end, videotapes showing the two task conditions for five adults with multiple disabilities, including visual impairment, were presented to rehabilitation personnel (teachers, physiotherapists, and occupational therapists), who were asked to rate the two conditions on a six-item, Likert-type questionnaire.

Microswitches are critical tools that can help people with multiple disabilities control aspects of their environment, including their favorite environmental stimuli through simple responses (Crawford & Schuster, 1993; Gutowski, 1996). One such response may be vocalization (that is, any brief sound emission) (Lancioni, O?Reilly, Oliva, & Coppa, 2001). Such a response can be present in children who have little motor behavior and seems to be highly valued by staff and parents, probably because it is closely linked to verbalization or speech (McCathren, Yoder, & Warren, 1999).

Persons with multiple disabilities often have limited functioning of their lower limbs and tend to spend large amounts of time sitting in a wheelchair. Efforts to enable some of these persons (that is, those who are in better overall physical condition) to make some use of their legs may involve the use of support walkers. The risk may be even greater if the disabilities include blindness, which may increase a person's level of difficulty or insecurity in taking steps and thus reduce his or her motivation to try to do so. Recently, a study was conducted in which a walker was used in conjunction with the automatic delivery of contingent stimuli with two participants. As a result of this intervention, both participants increased the frequency of their steps, and their moods improved. The aim of the study reported in this article was to extend the previous research with a new participant with multiple disabilities, including blindness. This blind participant also used a walker and received a brief period of favorite stimulation at each step that he performed. A positive outcome with this participant was thought to be important to support the generality of the previous findings and the overall suitability of the intervention strategy.

The use of microswitches has been considered a crucial strategy to help individuals with extensive multiple disabilities overcome passivity and achieve control of environmental stimulation (Crawford & Schuster, 1993; Gutowski, 1996; Ko, McConachie, & Jolleff, 1998). In recent years, considerable efforts have been made to extend the evaluation of microswitches and to make their role more relevant. For example, studies have investigated new, convenient responses and the matching microswitches that are likely to facilitate learning and performance with low-functioning persons and the possibility of using multiple microswitches for multiple responses to extend motor activity and sensory input (Lancioni et al., 2002). Responses to the environment by people with extensive multiple disabilities have almost exclusively involved simple motor acts, such as hand and head movements. However, vocal utterances may occasionally be present in a person's repertoire and could become crucial means of exerting control over environmental events (Lancioni, Singh, O'Reilly, & Oliva, 2003; Romski, Sevcik, & Adamson, 1999). To enable persons with severe multiple disabilities to reach the goal of using vocal utterances to control their environment, one would need microswitches that could discriminate between various utterances. Such microswitches do not exist. However, two computer systems were recently set up to substitute for such microswitches with one-syllable or wordlike utterances (Lancioni et al., in press). This study evaluated the system's setup for wordlike utterances (ones that could have a wider application in daily contexts) with two participants with multiple disabilities. The system combines a new control software program with a commercially available speech-recognition program (Dragon Naturally Speaking, V6.0 Standard, manufactured by Scansoft, 2002).

Background: Microswitch-aided programs for persons with multiple disabilities (a) have been rarely used with participants possessing only minimal (e.g., eyelid) responses and (b) have generally targeted simple head or hand responses with higher functioning participants. This study extended the assessment of those programs with both types of participants. Method: Four participants with minimal responses were exposed to programs entailing eyelid and lip movements and optic or camera-based microswitches to control environmental stimulation. Six participants with head, arm, and leg-foot responses were exposed to programs entailing demanding forms of those responses and matching microswitches to achieve control of environmental stimulation and physical exercise. Results: The results showed that all 10 participants increased their response frequencies, reaching a clear level of stimulation control. For the last 6 participants, the response increases also afforded basic physical exercise. Conclusions: Microswitch-aided programs can be adapted to the participants' condition to help them achieve relevant goals.