Search

This study assessed a new technology system to help six participants with intellectual and visual disabilities manage leisure engagement and communication with distant partners in an independent manner. A nonconcurrent multiple baseline design across participants was used to assess the effects of the new technology system. This included a Samsung Galaxy J4 Plus smartphone with Android 9.0 operating system, mini voice recording devices, and a Bluetooth speaker. The smartphone was provided with a Google account and Internet connection. The participants could activate the smartphone's Google Assistant and thus access leisure events, start telephone calls or send messages by triggering mini voice recording devices. Each device, when triggered, uttered a specific verbal request (i.e., a request for a leisure option or for a communication partner to call or to reach by messages). Messages received from those partners were read automatically by the smartphone. During baseline (when the voice recording devices were not available), the participants did not manage to activate the smartphone's Google Assistant and thus did not access leisure events and did not make telephone calls or send messages independently. During the post-intervention phase (when the voice recording devices were available), all participants accessed leisure events and made telephone calls or sent and received messages independently, remaining positively engaged throughout the 10-min sessions. Staff rated the new technology system positively. The new technology system may be a useful resource to help people like the participants of this study access basic leisure and communication independently. A technology system relying on commercial devices may be practical and acceptable in daily programs for persons with intellectual and other disabilities. Such system may be used for supporting the persons' independent leisure engagement and communication with distant partners. A system may be accessible to persons with significant disabilities if the responses needed to operate it are simple. Simple hand-pressure responses may be sufficient to operate a system that relies on the input of mini voice recording devices [ABSTRACT FROM AUTHOR]

BACKGROUND: People with severe/profound intellectual and multiple disabilities often need support for their occupational engagement. OBJECTIVE: This study assessed a smartphone-based intervention program to strengthen a functional object manipulation response (i.e., collecting and putting away objects) and possibly improve the mood of five adult participants with severe/profound intellectual disability and visual-motor impairment. METHODS: The intervention program, which relied on a smartphone linked to a motion sensor, was implemented according to a nonconcurrent multiple baseline across participants design. During the program phase, every object manipulation response (detected by the motion sensor) caused the smartphone to provide the participants with 9 or 10 s of preferred stimulation. Failure to respond for a preset period of time caused the smartphone to present a verbal encouragement/prompt. RESULTS: Data showed that during baseline (prior to the intervention program), the participants' mean frequency of object manipulation responses per 5-min session was always below three. During the intervention phase, the mean frequency of object manipulation responses varied between about 14.5 and 20.5 per session. Moreover, participants showed mood improvement. CONCLUSIONS: These results suggest that a smartphone-based intervention program may promote functional responding and improve mood in people with severe/profound intellectual and multiple disabilities. [ABSTRACT FROM AUTHOR]

People with mild to moderate intellectual or multiple disabilities may have serious difficulties in accessing leisure events, managing communication exchanges with distant partners, and performing functional daily activities. Recently, efforts were made to develop and assess technology-aided programs aimed at supporting people in all three areas (i.e., leisure, communication, and daily activities). This study assessed a new technology-aided program aimed at helping four participants with intellectual and multiple disabilities in the aforementioned areas. The program, which was implemented following a non-concurrent multiple baseline across participants design, relied on the use of a smartphone or tablet connected via Bluetooth to a two-switch device. This device served to select leisure and communication events and to control the smartphone or tablet's delivery of step instructions for the activities scheduled. Data showed that during the baseline phase (with only the smartphone or tablet available), three participants failed in each of the areas (i.e., leisure, communication and functional activities) while one participant managed to access a few leisure events. During the intervention phase (with the support of the technology-aided program), all participants managed to independently access leisure events, make telephone calls, and carry out activities. These results suggest that the program might be a useful tool for helping people with intellectual and multiple disabilities improve their condition in basic areas of daily life. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This study assessed everyday technology to help eight participants with intellectual and sensory-motor disabilities access stimulation via functional arm/hand responses and improved body posture. An ABABB1BB1 design was used for each participant, with A representing baseline phases, B intervention phases in which arm/hand responses led to a 12-s stimulation, and B1 intervention phases in which the stimulation for arm/hand responses was conditional on an improved/correct torso and head posture. The technology involved a Samsung Galaxy A10 smartphone fitted with Google Assistant and MacroDroid, a mini voice-recording device, and a portable mini voice amplifier. All participants had a large increase in arm/hand responses from the baseline periods to the B and B1 phases. They also had a large increase in correct posture from the B phases to the B1 phases. This technology-aided approach may be a helpful resource for people similar to the participants of this study. [ABSTRACT FROM AUTHOR]

People with severe/profound and multiple disabilities may receive insufficient stimulation and correspondingly show low levels of happiness (satisfaction). Various stimulation strategies have been proposed to address this situation. This study aimed to extend the assessment of two of those strategies (i.e., self-regulated and staff-regulated stimulation strategies) with 12 participants who were exposed to each strategy. During intervention sessions with self-regulated stimulation, the participants sat at a desk and received stimulation if they pushed a panel in front of them thus activating a smartphone's proximity sensor. During intervention sessions with staff-regulated stimulation, they sat at a desk and received stimulation independent of any response. All participants showed increases in indices of satisfaction with self-regulated stimulation. Nine of them also showed such increases with staff-regulated stimulation. The participants' level of satisfaction during self-regulated stimulation sessions was frequently higher than that observed during staff-regulated stimulation sessions. Staff personnel interviewed about the two strategies provided higher scores for self-regulated stimulation. The self-regulated stimulation strategy may be considered preferable to the staff-regulated stimulation strategy because of its impact on participants' satisfaction and active responding. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated a tablet-based program to help eight participants with moderate intellectual disability, sensory and/or motor impairments, and lack of expressive or expressive and receptive verbal skills to select and access leisure activities and video calls independently. Methods: The program relied on the use of a tablet (i.e., Samsung Galaxy Tab S2 LTE) with 8-inch screen, Android 6.0 Operating System, front camera, proximity sensor and multimedia player. The tablet was fitted with a SIM card and two specific applications, that is, WhatsApp Messenger for making video calls and MacroDroid for automating the tablet's functioning in accordance with the program conditions. The tablet presented pictures concerning leisure activities and preferred partners for video calls. The participant could select any activity or partner by touching (or nearing his or her hand to) the tablet's proximity sensor. Results: During the baseline (i.e., without the program), the participants failed to access leisure activities or video calls. During the post-intervention phase (i.e., with the program), they selected and accessed those activities and calls independently and spent between about 75% and 90% of the session time engaging with them. Conclusion: The tablet-based program can be highly beneficial for people like the participants of this study. A technology-aided program may enable persons with intellectual and other disabilities to independently access leisure activities and communication with distant partners. The program may involve the use of video calls to allow communication to participants with limited or no verbal skills. The program may be realized using a tablet (a) including Android 6.0 Operating System, proximity sensor, and multimedia player, and (b) fitted with a SIM card and applications such as WhatsApp Messenger and MacroDroid. The program may be easily adapted to the participants' characteristics in terms of activities available and partners to reach. [ABSTRACT FROM AUTHOR]

This paper presents an overview of recent technology-aided programs (i. e., technology-aided support tools) designed to help people with significant disabilities (a) engage in adaptive responses, functional activities, and leisure and communication, and thus (b) interact with their physical and social environment and improve their performance/achievement. In order to illustrate the support tools, the paper provides an overview of recent studies aimed at developing and assessing those tools. The paper also examines the tools' accessibility and usability, and comments on possible ways of modifying and advancing them to improve their impact. The tools taken into consideration concern, among others, (a) microswitches linked to computer systems, and aimed at promoting (i.e., through positive stimulation) minimal responses or functional body movements in individuals with intellectual disabilities and motor impairments; (b) computer systems, tablets, or smartphones aimed at supporting functional activity engagement of individuals with intellectual disabilities or Alzheimer's disease; and (c) microswitches with computer-aided systems, elaborate communication devices, and specifically arranged smartphones or tablets, directed at promoting leisure, communication, or both. [ABSTRACT FROM AUTHOR]

This study extended the research on technology-aided programs for promoting the independent performance (practice) of functional motor responses (e.g., arm or leg-foot movements) in people with intellectual disabilities and extensive motor impairments. Specifically, the study assessed (a) the suitability of simple commercial technology (i.e., a smartphone) to monitor the responses targeted and provide stimulation contingent on them, and (b) the impact of response performance on the participants' level of physical exertion (heart rates) and mood. The results showed that the simple commercial technology was effective in helping the participants independently practice the two target responses selected for them. All participants had a significant increase in their heart rates during the intervention sessions, thus suggesting that the performance of the target responses represented a mild form of physical activity. Moreover, all participants displayed mood improvement (i.e., an increase in indices of happiness) during the intervention sessions. The implications of these results are discussed in terms of (a) new technology solutions for intervention programs with people with intellectual disabilities and extensive motor impairments, and (b) potential benefits of those programs. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the impact of a technology-aided program providing sequence/space cues and contingent stimulation on object assembling and mobility for eight participants with multiple disabilities. Method: The technology-aided program was introduced according to a non-concurrent multiple baseline design across participants. Pipe components were distributed over different desks. The program served to (a) guide the participants to collect and assemble those components in the right sequence via verbal or light cues automatically emitted by electronic boxes, and (b) deliver preferred stimulation as the participantsput away a completed pipe. Results: The participants increased the mean frequencies of pipes assembled and put away accurately and independently from (virtually) zero during the baseline to between about 6 and 14 per 15-min session during the technology-aided program. This performance was maintained at a follow-up check. Twenty-four staff members surveyed about the program provided favorable ratings of it. Conclusions: These data indicate that the program may be an effective tool for supporting people like the participants of this study. [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. [ABSTRACT FROM AUTHOR]

The article discusses research which investigated the possibility of teaching three participants with blindness and motor disabilities to manage independent leisure engagement and communication with distant partners via a smartphone. Topics discussed include review of related literatures, description of the studyy participants, data sources and analysis, and the suggestion of further research into additional arrangement conditions to make smartphones suit the needs of people of blind people.

Motor impairments such as lack of standing and/or independent ambulation are common among persons with multiple disabilities. These two studies assessed technology-aided programs for persons with those impairments. Specifically, Study I assessed a program to teach two non-ambulatory adults to hand reach a stimulation-linked object by standing up. Study II assessed a program to teach a child and a man to ambulate while holding a rail or following a corridor wall. Standing increased from below 15% to about or over 80% of the session duration in Study I. The participants of Study II managed to complete brief ambulation trials independent of guidance. These performance achievements were discussed in relation to the technology-aided programs employed in the studies and the programs' applicability in daily contexts. [ABSTRACT FROM AUTHOR]

Intervention programs for people with acquired brain injury and extensive motor and communication impairment need to be diversified according to their characteristics and environment. These two studies assessed two technology-aided programs for supporting leisure (i.e., access to songs and videos) and communication (i.e., expressing needs and feelings and making requests) in six of those people. The three people participating in Study 1 did not possess speech but were able to understand spoken and written sentences. Their program presented leisure and communication options through written phrases appearing on the computer screen. The three people participating in Study 2 did not possess any speech and were unable to understand spoken or written language. Their program presented leisure and communication options through pictorial images. All participants relied on a simple microswitch response to enter the options and activate songs, videos, and communication messages. The data showed that the participants of both studies learned to use the program available to them and to engage in leisure and communication independently. The importance of using programs adapted to the participants and their environment was discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Eye-tracking communication devices and brain-computer interfaces are the two resources available to help people with advanced amyotrophic lateral sclerosis (ALS) avoid isolation and passivity. OBJECTIVE: This study was aimed at assessing a technology-aided program (i.e., a third possible resource) for five patients with advanced ALS who needed support for communication and leisure activities. METHODS: The participants were exposed to baseline and intervention conditions. The technology-aided program, which was used during the intervention, (a) included the communication and leisure options that each participant considered important for him or her (e.g., music, videos, statements/requests, and text messaging) and (b) allowed the participant to access those options with minimal responses (e.g., finger movement or eyelid closure) monitored via microswitches. RESULTS: The participants started leisure and communication engagement independently only during the intervention (i.e., when the program was used). The mean percentages of session time spent in those forms of engagement were between about 60 and 80. Preference checks and brief interviews indicated that participants and families liked the program. CONCLUSIONS: The program might be viewed as an additional approach/resource for patients with advanced ALS. [ABSTRACT FROM AUTHOR]

Purpose: These two studies extended technology-aided programs to promote leisure and communication opportunities to a man with cervical spinal cord injury and a post-coma man with multiple disabilities. Method: The studies involved the use of ABAB designs, in which A and B represented baseline and intervention phases, respectively. The programs focused on enabling the participants to activate songs, videos, requests, text messages, and telephone calls. These options were presented on a computer screen and activated through a small pressure microswitch by the man with spinal cord injury and a special touch screen by the post-coma man. To help the latter participant, who had no verbal skills, with requests and telephone calls, series of words and phrases were made available that he could activate in those situations. Results: Data showed that both participants were successful in managing the programs arranged for them. The man with spinal cord injury activated mean frequencies of above five options per 10-min session. The post-coma man activated mean frequencies of about 12 options per 20-min session. Conclusions: Technology-aided programs for promoting leisure and communication opportunities might be successfully tailored to persons with spinal cord injury and persons with post-coma multiple disabilities. [ABSTRACT FROM AUTHOR]

Background This study aimed to assess a microswitch-aided program for helping 2 persons with multiple disabilities, who presented with head and shoulder posture problems, to exercise a combination of appropriate head and arm movements. Method The program involved microswitches for monitoring participants' head and arm movements. A computer system recorded those movements and provided brief stimulation contingent on them during intervention. Three intervention phases took place, which focused on head movements, arm movements, and the combination of the 2 movements, respectively. Four weeks after the last intervention phase, a post-intervention check occurred. Results Both participants increased the frequencies of (a) the head and the arm movements during the first 2 intervention phases, respectively, and (b) those movements combined during the third intervention phase. Positive performance was maintained at the post-intervention check. Conclusions Microswitch-aided programs can support exercise of complex response schemes of persons with multiple disabilities. [ABSTRACT FROM AUTHOR]

Highlights: [•] Three microswitch-aided programs were used with three persons with multiple disabilities. [•] The first program was aimed at helping a woman exercise appropriate head and arms movements. [•] The second program was aimed at helping a man enhance ambulation continuity. [•] The third program was aimed at helping a girl increase ambulation with appropriate foot position. [•] Each of the programs produced satisfactory results. [Copyright &y& Elsevier]

BACKGROUND: Interventions for post-coma persons, who have emerged from a minimally conscious state but present with extensive neuro-motor impairment and lack of or minimal verbal skills, need to promote occupation and communication through the use of assistive technology. OBJIECTIVE: These two studies were aimed at assessing two technology-aided programs to promote leisure engagement and communication for three post-coma participants with multiple disabilities. METHODS: Study I assessed a program to allow a woman and a man with extensive neuro-motor impairment and lack of speech to switch on music and videos, make requests to caregivers, and send messages to (communicate with) relevant partners and receive messages from those partners. Study II assessed a program to allow a post-coma woman with extensive motor impairment and reduced verbal behavior to activate music, videos and requests, send and receive messages, and make telephone calls. RESULTS: Data showed that both programs were successful. The participants of Study I managed leisure engagement, requests, as well as text messaging. The participant of Study II showed consistent leisure engagement, text messaging, and telephone calls. CONCLUSIONS: Assistive technology can be profitably used to provide post-coma persons with multiple disabilities relevant leisure and communication opportunities. [ABSTRACT FROM AUTHOR]

Highlights: [•] Programs were developed to allow recreation and communication options to two post-coma men. [•] The men had re-acquired consciousness but showed lack of speech and extensive motor disabilities. [•] The men accessed the programs and related options with the use of microswitches. [•] Both men were successful in managing the recreation and communication options available. [ABSTRACT FROM AUTHOR]

Highlights: [•] Microswitch-aided programs were used with three non-ambulatory adults with multiple disabilities. [•] The programs were to motivate the participants to exercise foot–leg responses. [•] All three participants had high levels of foot–leg responses during intervention and post-intervention sessions. [•] The participants also displayed positive involvement (signs of interest and happiness) during those sessions. [ABSTRACT FROM AUTHOR]

Highlights: [•] Standard technology resources were used to support patients with moderate Alzheimer's disease. [•] A computer with inexpensive video editing software provided pictorial instructions to support activity. [•] A doorbell system provided sound and light cues to support indoor travel. [•] Patients used both technology resources with satisfactory activity and travel results. [ABSTRACT FROM AUTHOR]

Purpose: Assessing two technology-based programs for reducing toe walking and breaks during walking of two men with multiple disabilities, respectively. Method: The men were involved in separate single-case studies, each of which was carried out according to an ABAB design. The technology included a microprocessor with specific software, optic sensors, and visual plus vibrotactile or auditory systems for presenting preferred stimuli. In Study I, the man received 1 s of preferred flickering lights and vibratory input for each step performed with the heel of the left foot touching the ground or coming close to it (i.e. within a 2-mm distance). In Study II, the other man received 10 s of preferred music anytime he crossed one of the small marks present along the travel routes. Results: The B phases showed that (a) the man included in Study I increased the percentages of left- and right-foot steps performed with the heels touching or nearing the ground to above 85% and 70%, respectively, and (b) the man included in Study II walked with very few breaks. Conclusion: Technology-based programs can be highly effective in helping persons with multiple disabilities improve their walking behavior. [ABSTRACT FROM AUTHOR]

Background A camera-based microswitch technology was recently developed to monitor small facial responses of persons with multiple disabilities and allow those responses to control environmental stimulation. This study assessed such a technology with 2 new participants using slight variations of previous responses. Method The technology involved a computer with a CPU using a 2GHz clock, a USB video camera with 16-mm lens, and special software. Small colour spots were used under the lower lip of one participant and on the eyelid of the other participant to aid the camera and computer to detect their mouth and eyelid responses. The study involved an ABAB design and included a 3-week post-intervention check. Results The participants' mouth and eyelid responses increased during the intervention (B) phases and post-intervention check (i.e., when the technology allowed them to control stimulation). Conclusions Camera-based microswitch technology can help persons with multiple disabilities control stimulation with small responses. [ABSTRACT FROM AUTHOR]

Objective: To extend the assessment of technology-based programs for promoting stimulus choice and staff/caregiver calls or radio operation and text messaging. Method: In Study I, the program involved a portable computer, commercial software, and a microswitch to allow a man with motor impairment and moderate intellectual disability to choose among preferred stimuli (e.g., songs and film clips) and persons to call. In Study II, the programs involved (a) a radio device and an electronic control unit or (b) a net-book computer and a global system for mobile communication. A woman with blindness and moderate intellectual disability used a microswitch to operate the radio or send and listen to text messages. Results: The participants succeeded in using the technology-aided programs through simple microswitch activations involving partial hand closure (Study I) or hand pressure (Study II). Conclusion: Technology-based programs can provide persons with multiple disabilities relevant leisure and communication opportunities. [ABSTRACT FROM AUTHOR]

Abstract: These two case studies assessed technology-based programs for promoting walking fluency and improving foot-ground contact during walking with a man and a woman with multiple disabilities, respectively. The man showed breaks during walking and the woman presented with toe walking. The technology used in the studies included a microprocessor with specific software, an MP3 with the recordings of preferred stimulus items, and optic sensors. Both studies were carried out according to an ABAB design. In Study I, the optic sensors were activated when the man crossed small marks distributed along the travel routes. At each sensor''s activation, the man received a brief period of preferred stimulation. In Study II, the woman received preferred stimulation when the sensors at the toe and the heel of her shoes were activated in close time proximity. The man walked virtually without breaks and improved his mood (with an increase in indices of happiness) during the intervention phases of the study. The woman largely increased her percentages of steps with adequate foot-ground contact, which reached a mean of about 80 during the second intervention phase. The results were discussed in terms of rehabilitation implications and technology demands. [Copyright &y& Elsevier]

Abstract: In a recent single-case study, we showed that a new verbal-instruction system, ensuring the automatic presentation of step instructions, was beneficial for promoting the task performance of a woman with multiple disabilities (including blindness). The present study was aimed at replicating and extending the aforementioned investigation with three adults with multiple disabilities. During Part I of the study, the new instruction system was compared with a system requiring the participants to seek instructions on their own. Two tasks were used, one per system. During Part II of the study, the new system was applied with two additional tasks. The results of Part I showed that (a) the participants had a better performance (i.e., in terms of correct steps or task execution time) on the task carried out with the new system than on the task carried out with the comparison/control system, and (b) the performance of this latter task improved rapidly when the new system was used with it. The results of Part II showed satisfactory performance with each of the two tasks carried out directly with the new system. The implications of these data were discussed. [Copyright &y& Elsevier]

Objective: To assess whether two women with blindness and additional disabilities could make independent phone calls through a computer-aided telephone system. Method: For each participant, the study involved an ABAB design, in which the A represented baseline phases and the B represented intervention phases with the special telephone system (involving among others a net-book computer with specific software, a global system for mobile communication modem and a microswitch). Results: Both participants learned to use the system and made phone calls independently to a variety of partners such as family members, friends and staff personnel. Conclusion: The system assessed in this study might represent a useful means for enabling persons with blindness and additional disabilities to manage phone calls on their own. [ABSTRACT FROM AUTHOR]

Objective: To assess whether two persons with multiple disabilities could use smile expressions and new camera-based microswitch technology to select environmental stimuli. Method: Within each session, a computer system provided samples/reminders of preferred and non-preferred stimuli. The camera-based microswitch determined whether the participants had smile expressions in relation to those samples. If they did, stimuli matching the specific samples to which they responded were presented for 20 seconds. Results: The smile expression could be profitably used by the participants who managed to select means of ~70% or 75% of the preferred stimulus opportunities made available by the environment while avoiding almost all the non-preferred stimulus opportunities. Conclusion: Smile expressions (a) might be an effective and rapid means for selecting preferred stimulation and (b) might develop into cognitively more elaborate forms of responding through the learning experience (i.e. their consistent association with positive/reinforcing consequences). [ABSTRACT FROM AUTHOR]

Abstract: The present two studies extended research evidence on the use of microswitch technology by post-coma persons with multiple disabilities. Specifically, Study I examined whether three adults with a diagnosis of minimally conscious state and multiple disabilities could use microswitches as tools to access brief, selected stimulus events. Study II assessed whether an adult, who had emerged from a minimally conscious state but was affected by multiple disabilities, could manage the use of a radio device via a microswitch-aided program. Results showed that the participants of Study I had a significant increase of microswitch responding during the intervention phases. The participant of Study II learned to change radio stations and seemed to spend different amounts of session time on the different stations available (suggesting preferences among the programs characterizing them). The importance of microswitch technology for assisting post-coma persons with multiple disabilities to positively engage with their environment was discussed. [Copyright &y& Elsevier]

Objective: Extending the use of microswitch-based programmes to (a) establish mouth-drying responses and reduce the effects of drooling, (b) assess the possibility of widening inter-response intervals and (c) determine whether different microswitch solutions would impact the accuracy/effectiveness of mouth drying. Method: During the intervention phases of the study, the participant (woman) performed mouth-drying responses via a special napkin. Such napkin contained two pressure sensors/microswitches, a microprocessor and an MP3 serving to monitor responses and ensure stimulation contingent on them. Results: The participant (a) learned to dry her mouth and reduce her chin wetness, (b) stabilized her responding at lower frequencies (i.e. when the stimulation period was extended) and (c) produced more accurate/effective responses when she was required to trigger both sensors of the napkin. Conclusion: Microswitch-based programmes may promote practically sustainable and effective mouth drying to reduce drooling effects in persons with multiple disabilities. [ABSTRACT FROM AUTHOR]

Objective: To assess a computer-aided technology for assisting writing in a man who emerged from a minimally conscious state and presented with extensive motor disabilities. Method: The technology served to present letters, in groups, at the centre of a computer screen and display (write) the letters selected by the man (i.e. through a simplified pointing response) on the upper half of that screen. Results: The results showed that the technology enabled the man to produce clear (readily readable) writing. This writing compared positively with the results obtained using a communication board containing the letters (i.e. a system already available to the man). Conclusion: Computer-aided technology may provide basic writing (communication) opportunities to persons emerged from a minimally conscious state and affected by extensive motor disabilities and lack of speech. [ABSTRACT FROM AUTHOR]

The possibility of enabling two adults with acquired brain injury and profound multiple disabilities to use microswitch-based technology to attain preferred environmental stimuli on their own was assessed. Each of the participants was provided with two microswitches that could be activated by right and left head-turning or head-bending responses. The microswitches were introduced sequentially according to a multiple probe design across microswitches (responses) and allowed access to different sets of auditory or visual stimuli. Eventually, the two microswitches were made available simultaneously. Sessions lasted 5 min. Each participant learned to use the two microswitches successfully and maintained consistent levels of responding when they were simultaneously available. During this phase, both participants showed large within-session variations in their right and left response frequencies, with one of them showing an overall prevalence of the left-side response. The importance of assistive technology within programs for persons with acquired brain injury and multiple disabilities is discussed. [ABSTRACT FROM AUTHOR]

Objective: To enable two persons with acquired brain injury and multiple (e.g. motor and visual) disabilities to communicate with distant partners through a special messaging technology, which served to send out text messages and read (listen to) incoming messages. Method: The study was carried out according to a multiple probe design across participants. Both participants (adults) started with baseline in which the technology was not available and continued with intervention in which the technology was used. The technology involved a net-book computer provided with specific software, a global system for mobile communication (GSM) modem, microswitches and pre-recorded lists of persons and messages. Results: The participants’ mean frequencies of messages sent out and received per 30-minute session were about three and two, respectively, during baseline and seven and four, respectively, during the intervention. All baseline messages were sent and received with guidance. Nearly all intervention messages were sent and received (listened to) independently by the participants. Conclusions: Special messaging technology may help persons with multiple disabilities acquire high levels of independent, basic communication with distant partners. [ABSTRACT FROM AUTHOR]

Abstract: This study assessed whether a program based on microswitch and computer technology would enable three post-coma participants (adults) with motor and communication/consciousness impairments to choose among environmental stimuli and request their repetition whenever they so desired. Within each session, 16 stimuli (12 preferred and 4 non-preferred) were scheduled for the participants. For each stimulus, a computer system provided a sample of a 3-s duration. During the intervention, participants’ responding (e.g., eye blinking and hand closure) in relation to a stimulus sample activated a microswitch and led the computer system to turn on that stimulus for 20s. Participants’ lack of responding led the computer system to pause briefly and then present the next scheduled stimulus sample. When participants responded immediately after (i.e., within 6s from) the end of a stimulus presentation, that stimulus was repeated. Intervention data showed response increases, which were very consistent for two participants and moderate for the third one. All participants asked for the repetition of preferred stimuli and showed minimal responding in relation to non-preferred stimuli. The results were discussed in light of their possible implications for new, person-centered rehabilitation programs for post-coma persons with multiple disabilities. [Copyright &y& Elsevier]

Abstract: This study was an effort to extend the evaluation of orientation technology for promoting independent indoor traveling in persons with multiple disabilities. Two participants (adults) were included, who were to travel to activity destinations within occupational settings. The orientation system involved (a) cueing sources only at the destinations (i.e., a single sound source per destination), (b) a newly developed electronic control device that allowed the participants to easily manage the activation of the sources at the destinations, and (c) the provision of approval or encouragement messages. Both participants were successful in using the system and performed their travels to the destinations fairly correctly and in relatively short amounts of time within (a) the occupational setting used for the intervention and (b) a similar occupational setting used for checking generalization effects. The findings are discussed in relation to the importance of independent indoor traveling and the impact of the new technology. [Copyright &y& Elsevier]

Abstract: A program relying on microswitch clusters (i.e., combinations of microswitches) and preferred stimuli was recently developed to foster adaptive responses and head control in persons with multiple disabilities. In the last version of this program, preferred stimuli (a) are scheduled for adaptive responses occurring in combination with head control (i.e., head upright) and (b) last through the scheduled time only if head control is maintained for that time. The first of the present two studies was aimed at replicating this program with three new participants with multiple disabilities adding to the three reported by Lancioni et al. [Lancioni, G. E., Singh, N. N., O’Reilly, M. F., Sigafoos, J., Didden, R., Oliva, D., et al. (2007). Fostering adaptive responses and head control in students with multiple disabilities through a microswitch-based program: Follow-up assessment and program revision. Research in Developmental Disabilities, 28, 187–196]. The second of the two studies served to carry out an expert validation of the program''s effects on head control and general physical condition with the three participants of Study I as well as the three participants involved in the Lancioni et al. study mentioned above. The expert raters were 72 new physiotherapists and 72 experienced physiotherapists. The results of Study I supported previous data and indicated that the program was effective in helping the participants increase the frequency of adaptive responses in combination with head control and the length of such control. The results of Study II showed that the raters found the effects of the new program more positive than those of other intervention conditions and also considered such program a useful complement to formal motor rehabilitation programs. [Copyright &y& Elsevier]

The study was an effort to help a girl with multiple disabilities increase object manipulation responses and reduce hand mouthing, carried out according to an ABAB sequence (in which A represented baseline phases; B, treatment phases) and including a 3-month follow-up. During the baseline phases, a microswitch cluster (i.e., a combination of microswitches) was used to monitor the girl's object manipulation responses and hand mouthing. Indices of happiness were also recorded. During the treatment phases and follow-up, the microswitch cluster was combined with the use of preferred stimuli for object manipulation responses. The stimuli lasted an 8-s period at each response if the girl remained free from hand mouthing through that period, but were interrupted if hand mouthing appeared. The results show that the girl increased object manipulation responses, learned to refrain from hand mouthing for most of the session time, maintained this performance over time, and showed an increase in indices of happiness. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted to help three participants with multiple disabilities acquire independent dressing through an upgraded version of assistive technology. The participants, aged 37, 27, and 29 years old, had encephalopathy with a level of functioning estimated to be in the profound range of intellectual disability. The technology that was used involved an optic sensor linked to an electronic control system, which regulated a multicolor light display and a mini-vibrator. Some questions have been raised regarding two aspects of the technology, including the delivery of the prompts at preset intervals.

Persons with multiple disabilities and minimal motor behavior may be unable to use available microswitch technology to control environmental stimuli. For these persons, one may need to rely on small motor expressions (as responses) and new, matching microswitch technology to ensure a successful outcome, in the present study, a small movement of the forehead skin was selected as the response for two participants (ages 6.5 and 14.2 years) with profound multiple disabilities. The microswitch technology included (a) an optic sensor, i.e., barcode reader, (b) a small tag with horizontal bars attached to the participants' forehead, and (c) an electronic control system which activated stimuli in relation to response occurrence. Movement of the forehead skin shifted up or down the tag with bars and this shifting, if greater than a preset limit and therefore recorded as a response, led to the activation of the control system. Each participant received an ABAB sequence, in which A represented baseline and B intervention phases, and a 6-wk. postintervention check. Analysis showed both participants increased their responding during the intervention phases and maintained that responding at the postintervention check. Implications of the findings were discussed. [ABSTRACT FROM AUTHOR]

The present two studies evaluated the effects of automatically delivered stimulation for walker-assisted step responses with four persons with multiple disabilities. In Study I, the participants (two children) wore two optic sensors at their heels, which were activated by the performance of steps. Each sensor activation produced a 2.5-s stimulation during the intervention and post-intervention periods. In Study II, the participants (two adults) wore a single optic sensor at their right leg. Sensor activation produced 5 or 6 s of stimulation during the intervention phases. Data were satisfactory with both technical arrangements (i.e., with one or two sensors); all four participants had significant increases in step responses and indices of happiness during the intervention phases. The two children of Study I retained these effects at a 1-month post-intervention check programmed for them. The effects of the stimulation procedure on aberrant behavior (assessed only in Study I) were mixed. These data support and extend previous findings in the area and suggest that the reported approach could be quite useful for application in daily contexts. [ABSTRACT FROM AUTHOR]

Increasing constructive activity engagement and promoting independent indoor traveling are basic objectives within programs for persons with multiple disabilities. Orientation and traveling may be serious problems for these persons, particularly those with visual impairment. To reduce the impact of these problems, orientation systems have been developed. These systems rely on direction cues or feedback cues. The former systems can be plausibly used with persons with very low levels of functioning as they guide (direct) the persons to the destinations without requiring them to take initiatives or make decisions. The latter systems can be realistically used with persons who have initiative in moving towards the destination and are efficient in correcting their direction in relation to feedback. This paper briefly presents basic orientation systems assessed with persons with multiple disabilities, examines strategies (technical solutions) adopted for promoting a self-managed (independent) use of the systems by these persons, and discusses the systems' overall applicability and practicality. Questions for future research are also examined. [ABSTRACT FROM AUTHOR]

Education and rehabilitation research with persons with developmental disabilities is often based on single-case designs (with small numbers of ordinal data points collected at irregular intervals) and relies upon graphic display and visual inspection of the data. This paper (a) provides a brief account of some statistical tests, which may serve to supplement the visual inspection process and (b) underlines some of their strengths and limitations to help education and rehabilitation personnel make a reasonable choice among them. [ABSTRACT FROM AUTHOR]

Parent-child transactions provide an important social context for the development of adaptive and problem behaviors in young children with autism. Teaching parents to develop alternative transactional pathways often leads to positive behavioral patterns in their children. We taught three parents the philosophy and practice of mindfulness in a 12-week course and assessed the outcome of the training on their children's behavior. In addition, the mothers rated satisfaction with their parenting skills and interactions with their children. Results showed that the mothers' mindful parenting decreased their children's aggression, noncompliance, and self-injury and increased the mothers' satisfaction with their parenting skills and interactions with their children. We speculated on the possible reasons for the efficacy of mindful parenting in decreasing the children's problem behaviors without the application of specific, programmed contingencies for the children's behavior. [ABSTRACT FROM AUTHOR]

This article reports on a study on a preliminary social validation assessment of cooperative versus individual task engagement of individuals with multiple disabilities in 2006. Videotapes showing the two tasks of adults with multiple disabilities were presented to rehabilitation personnel who were asked to rate the conditions on a questionnaire. In the individual- and cooperative-engagement situations, the participants performed identical or comparable tasks consisting of putting objects in related containers. It is suggested that the personnel considered the cooperative-task situation more satisfactory from a social and emotional standpoint, and from a practical and rehabilitation standpoint.

This study assessed whether a boy with profound multiple disabilities and minimal motor behavior would be able to control environmental stimulation using repeated eye blinks with a newly developed microswitch (i.e. an electronically regulated optic sensor mounted on an eyeglasses frame). The study was carried out according to an ABAB design and included a 3 month post-intervention check. Data showed that the boy had a large increase in the target response (repeated eye blinks) to activate the microswitch and produce environmental stimulation during the B (intervention) phases. This performance was maintained at the post-intervention check. Practical and developmental implications of the findings were discussed. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: Favorite stimuli were automatically delivered contingent on the performance of steps by two persons (a boy and a woman) with multiple disabilities during their use of support walker devices. The study lasted about 4 months and was carried out according to a multiple baseline design across participants. Recording concerned the participants’ frequencies of steps and their indices of happiness during baseline and intervention sessions. Data showed that both participants had a significant increase in each of these two measures during the intervention phase. Implications of the findings and new research issues are discussed. [Copyright &y& Elsevier]

This study assessed a rnicroswitch program to Foster simple foot and leg movements in 2 adult wheelchair users with multiple disabilities. The participants mood (indices of happiness) was recorded throughout the study. Data showed that participants rapidly increased the target foot anti leg movements and maintained those movements during the course of the study, which lasted about 4.5 months. With regard to indices of happiness. I participant showed a fairly modest increase during the intervention while the tither participant showed a substantial increase. Implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

This study assessed the impact of automatically delivered stimulation on the activity level and mood (indices of happiness) of two students with multiple disabilities, during their use of a stationary bicycle and a stepper. The stimulation involved a pool of favorite stimulus events which were delivered automatically, through an electronic control system, while the students were active in using the aforementioned exercise tools. Data showed that stimulation had a positive impact on the overall level of activity and indices of happiness of both students. Practical implications and technical aspects of the intervention procedure are discussed. [ABSTRACT FROM AUTHOR]