Abstract
We extended the use of microswitch-cluster technology to six children with severe to profound developmental disabilities and autism spectrum disorders. The primary aim of the intervention was to improve the adaptive behavior (ie, insert three objects in three different containers within 3 s) and simultaneously decrease the challenging behavior of hand/objects mouthing. The second aim was to assess the effects of the intervention on the indices of happiness. An ABCAC experimental sequence was adopted for each participant. Thus, subsequent to a baseline condition, a first intervention phase was implemented for increasing the adaptive responding irrespective of the challenging behavior, followed by a cluster phase in which positive stimulation was provided contingent on an adaptive response, only if the challenging behavior was absent. A 3 month follow-up occurred. Results showed a performance improvement for all participants involved. Additionally, they all consolidated the adaptive responding during the follow-up. Sixty external raters favorably endorsed the use of such technology. Implications of the findings were discussed.
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References
Anderson, G. M. (2012). Twin studies in autism: what might they say about genetic and environmental influences. Journal of Autism and Developmental Disorders, 42, 1526–1527.
Baker, B. L., & Blacher, J. (2015). Disruptive behavior disorders in adolescents with ASD: comparisons to youth with intellectual disability or typical cognitive development. Journal of Mental Health Research in Intellectual Disabilities, 8, 98–116.
Barlow, D., Nock, M. K., & Hersen, M. (2009). Single case experimental designs: strategies for studying behavior change (3rd ed.). Boston: Allyn and Bacon.
Bölte, S., Westerwald, E., Holtmann, M., Freitag, C., & Poustka, F. (2011). Autistic traits and autism spectrum disorders: the clinical validity of two measures presuming a continuum of social communication skills. Journal of Autism and Developmental Disorders, 41, 66–72.
Borg, J., Larson, S., & Ostegren, P. O. (2011). The right to assistive technology: for whom, for what, and by whom? Disability and Society, 26, 151–167.
Brown, R. I., Schalock, R., & Brown, L. (2009). Quality of life: its application to persons with intellectual disabilities and their families - introduction and overview. Journal of Policy and Practice in Intellectual Disabilities, 6, 2–6.
Caffò, A. O., Hoogeveen, F., Groenendaal, M., Perilli, V., Damen, M., Stasolla, F., et al. (2014). Comparing two different orientation strategies for promoting indoor traveling in persons with Alzheimer’s disease. Research in Developmental Disabilities, 35, 572–580.
Callahan, K., Henson, R. H., & Cowan, A. K. (2008). Social validation of evidence-based practices in autism by parents, teachers, and administrators. Journal of Autism and Developmental Disorders, 38, 678–692.
Cannella-Malone, H. I., Wheaton, J. E., Wu, P., Tullis, C. A., & Park, J. H. (2012). Comparing the effects of video prompting with and without error correction on skill acquisition for students with intellectual disability. Education and Training in Autism and Developmental Disabilities, 47, 332–344.
Case-Smith, J., Weaver, L. L., & Fristad, M. A. (2015). A systematic review of sensory processing interventions for children with autism spectrum disorders. Autism, 19, 133–148.
Catania, A. C. (2007). Learning (4th ed.). New York: Sloan Publishing.
Cervantes, P. E., & Matson, J. L. (2015). The relationship between comorbid psychopathologies, autism, and social skill deficits in young children. Research in Autism Spectrum Disorders, 10, 101–108.
Cervantes, P. E., Matson, J. L., Adams, H. L., & Konst, M. J. (2014). The relationship between cognitive development and conduct problems in young children with autism spectrum disorder. Research in Autism Spectrum Disorders, 8, 1287–1294.
Chantry, J., & Dunford, C. (2010). How do computer assistive technologies enhance participation in childhood occupations for children with multiple and complex disabilities? A review of the current literature. British Journal of Occupational Therapy, 73, 351–365.
Chiapparino, C., Stasolla, F., De Pace, C., & Lancioni, G. E. (2011). A touch pad and a scanning keyboard emulator to facilitate writing by a woman with extensive motor disability. Life Span and Disability, 14, 45–54.
Crawford, M. R., & Schuster, J. W. (1993). Using microswitches to teach toy use. Journal of Developmental and Physical Disabilities, 5, 349–368.
Dickson, C. A., MacDonald, R. P., Mansfield, R., Guilhardi, P., Johnson, C., & Aheam, W. H. (2014). Social validation of the new england center for children -core skills assessment. Journal of Autism and Developmental Disorders, 44, 65–74.
Dillon, C. M., & Carr, J. E. (2007). Assessing indices of happiness and unhappiness in individuals with developmental disabilities: A review. Behavioral Interventions, 22, 229–344.
Dutt, A. S., Berg, W. K., Wacker, D. P., Ringdahl, J. E., Yang, L., Vinquist, K. M., & Zaman, M. (2014). The effects of skill training on preference for children with severe intellectual and physical disabilities. Journal of Developmental and Physical Disabilities, 26, 585–601.
Fava, L., & Strauss, K. (2014). Response to early intensive behavioral intervention for autism-an umbrella approach to issues critical to treatment individualization. International Journal of Developmental Neuroscience, 39, 49–58.
Felce, D., & Perry, J. (1995). Quality of life: Its definition and measurement. Research in Developmental Disabilities, 16, 51–74.
Foxx, R. M. (2013). The maintenance of behavioral change: the case for long-term follow-ups. American Psychologist, 68, 728–736.
Furniss, F., & Biswas, A. B. (2012). Recent research on etiology, development and phenomenology of self-injurious behavior in people with intellectual disabilities: a systematic review and implications for treatment. Journal of Intellectual Disability Research, 56, 453–475.
Gardner, S. J., & Wolfe, P. S. (2015). Teaching students with developmental disabilities daily living skills using point-of-view modeling plus video prompting with error correction. Focus on Autism and Other Developmental Disabilities, 30, 195–207.
Genereaux, D., Van Karnebeek, C. D. M., & Birch, P. H. (2015). Costs of caring for children with an intellectual developmental disorder. Disability and Health Journal, 8, 646–651.
Gould, E., Tarbox, J., O’hora, D., Noone, S., & Bergstrom, R. (2011). Teaching children with autism a basic component skill of perspective-taking. Behavioral Interventions, 26, 50–66.
Gutowski, S. J. (1996). Response acquisition for music or beverages in adults with profound multiple handicaps. Journal of Developmental and Physical Disabilities, 8, 221–231.
Hastie, T., Tibshirani, R., & Friedman, J. (2009). The elements of statistical learning (2nd ed.). New York: Springer.
Joosten, A. V., Bundy, A. C., & Einfeld, S. L. (2009). Intrinsic and extrinsic motivation for stereotypic and repetitive behavior. Journal of Autism and Developmental Disorders, 39, 521–531.
Kane, M. J., Angoa-Peréz, M., Briggs, D. I., Sykes, C. E., Francescutti, D. M., Rosenberg, D. R., et al. (2012). Mice genetically depleted of brain serotonin display social impairments, communication deficits and repetitive behaviors: possible relevance to autism. PloS One, 7, 11.
Kazdin, A. E. (2001). Behavior modification in applied settings (6th ed.). Belmont: Wadsworth.
Kennedy, C. H. (2005). Single-case designs for educational research. Boston: Allyn and Bacon.
Klintwall, L., & Eikeseth, S. (2012). Number and controllability of reinforcers as predictors of individual outcome for children with autism receiving early and intensive behavioral intervention: a preliminary study. Research in Autism Spectrum Disorders, 6, 493–499.
Kuppens, S., & Onghena, P. (2012). Sequential meta-analysis to determine the sufficiency of cumulative knowledge: the case of early intensive behavioral intervention for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 168–176.
Lancioni, G. E., & Singh, N. N. (2014). Assistive technologies for people with diverse abilities. New York: Springer.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Stasolla, F., Manfredi, F., & Oliva, D. (2004). Adapting a grid into a microswitch to suit simple hand movements of a child with profound multiple disabilities. Perceptual and Motor Skills, 99, 724–728.
Lancioni, G. E., Comes, M. L., Stasolla, F., Manfredi, F., O’Reilly, M. F., & Singh, N. N. (2005a). A microswitch cluster to enhance arm-lifting responses without dystonic head tilting by a child with multiple disabilities. Perceptual and Motor Skills, 100, 892–894.
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., & Oliva, D. (2005b). Microswitch programs for persons with multiple disabilities: an overview of the responses adopted for microswitch activation. Cognitive Processing, 6, 177–188.
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., Oliva, D., & Basili, G. (2005c). An overview of research on increasing indices of happiness of people with severe/profound intellectual and multiple disabilities. Disability and Rehabilitation, 27, 83–93.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Groeneweg, J., Bosco, A., Tota, A., et al. (2006a). A social validation assessment of microswitch-based programs for persons with multiple disabilities employing teacher trainees and parents as raters. Journal of Developmental and Physical Disabilities, 18, 383–391.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Sigafoos, J., Oliva, D., Baccani, S., et al. (2006b). Microswitch clusters promote adaptive responses and reduce finger mouthing in a boy with multiple disabilities. Behavior Modification, 30, 892–900.
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., Oliva, D., Smaldone, A., Tota, A., et al. (2006c). Assessing the effects of stimulation versus microswitch-based programmes on indices of happiness of students with multiple disabilities. Journal of Intellectual Disability Research, 50, 739–747.
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., Sigafoos, J., Chiapparino, C., Stasolla, F., et al. (2007a). Enabling a young man with minimal motor behavior to manage independently his leisure television engagement. Perceptual and Motor Skills, 105, 47–54.
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., Sigafoos, J., Oliva, D., Pidala, S., et al. (2007b). Promoting adaptive foot movements and reducing hand mouthing and eye poking in a boy with multiple disabilities through microswitch technology. Cognitive Behavior Therapy, 36, 85–90.
Lancioni, G. E., Smaldone, A., O’Reilly, M. F., Singh, N. N., Sigafoos, J., Oliva, D., et al. (2007c). Promoting adaptive hand responding and reducing face hiding in a woman with profound developmental disabilities using microswitch technology. Behavioural and Cognitive Psychotherapy, 35, 225–230.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Sigafoos, J., Oliva, D., Antonucci, M., et al. (2008). Microswitch-based programs for persons with multiple disabilities: an overview of some recent developments. Perceptual and Motor Skills, 106, 355–370.
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., & Sigafoos, J. (2009). An overview of behavioral strategies for reducing hand-related stereotypies of persons with severe to profound intellectual and multiple disabilities: 1995–2007. Research in Developmental Disabilities, 30, 20–43.
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., Sigafoos, J., Oliva, D., Smaldone, A., et al. (2010). Promoting ambulation responses among children with multiple disabilities through walkers and microswitches with contingent stimuli. Research in Developmental Disabilities, 31, 811–816.
Lancioni, G. E., Sigafoos, J., O’Reilly, M. F., & Singh, N. N. (2012). Assistive technology. Interventions for individuals with severe/profound and multiple disabilities. New York: Springer.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Sigafoos, J., Oliva, D., Alberti, G., et al. (2013). Technology-based programs to support adaptive responding and reduce hand mouthing in two persons with multiple disabilities. Journal of Developmental and Physical Disabilities, 25, 65–77.
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., Sigafoos, J., Alberti, G., Perilli, V., et al. (2014). People with multiple disabilities learn to engage in occupation and work activities with the support of technology-aided programs. Research in Developmental Disabilities, 35, 1264–1271.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Sigafoos, J., Boccasini, A., La Martire, M. L., et al. (2016). Technology to support positive occupational engagement and communication in persons with multiple disabilities. International Journal on Disability and Human Development, 15, 111–116.
Lanovaz, M. J., Robertson, K. M., Soerono, K., & Watkins, N. (2013). Effects of reducing stereotypy on other behaviors: a systematic review. Research in Autism Spectrum Disorders, 7, 1234–1243.
Matson, J. L. (2009). Applied behavior analysis for children with autism spectrum disorders. New York: Springer.
Matson, J. L., & Sturmey, P. (2011). International handbook of autism and pervasive developmental disorders. New York: Springer.
Matson, J. L., Hattier, M. A., & Belva, B. (2012a). Treating adaptive living skills of persons with autism using applied behavior analysis: a review. Research in Autism Spectrum Disorders, 6, 271–276.
Matson, J. L., Turygin, N. C., Beighley, J., Rieske, R., Tureck, K., & Matson, M. L. (2012b). Applied behavior analysis in Autism Spectrum Disorders: recent developments, strengths, and pitfalls. Research in Autism Spectrum Disorders, 6, 144–150.
McDougall, J., Evans, J., & Baldwin, P. (2010). The importance of self-determination to perceived quality of life for youth and young adults with chronic conditions and disabilities. Remedial and Special Education, 31, 252–260.
Mechling, L. C. (2006). Comparison of the effects of three approaches on the frequency of stimulus activations, via a single switch, by students with profound intellectual disabilities. Journal of Special Education, 40, 94–102.
Minnes, P., Perry, A., & Weiss, J. A. (2015). Predictors of distress and well-being in parents of young children with developmental delays and disabilities: The importance of parent perceptions. Journal of Intellectual Disability Research, 59, 551–560.
Mire, S. S., Raff, N. S., Brewton, C. M., & Goin-Kochel, R. P. (2015). Age-related trends in treatment use for children with autism spectrum disorder. Research in Autism Spectrum Disorders, 15–16, 29–41.
O’Connor, A. B., & Healy, O. (2010). Long-term post-intensive behavioral intervention outcomes for five children with Autism Spectrum Disorder. Research in Autism Spectrum Disorders, 4, 594–604.
Pedhazur, E. J., & Schmelkin, L. P. (1991). Measurement, design, and analysis: an integrated approach (studentth ed.). Hillsdale: Erlbaum.
Perilli, V., Lancioni, G. E., Hoogeveen, F., Caffò, A. O., Singh, N. N., O’Reilly, M. F., et al. (2013a). Video prompting versus other instruction strategies for persons with Alzheimer’s disease. American Journal of Alzheimer’s Disease and Other Dementias, 28, 393–402.
Perilli, V., Lancioni, G. E., Laporta, D., Paparella, A., Caffò, A. O., Singh, N. N., et al. (2013b). Computer-aided telephone system for enabling five persons with Alzheimer’s disease to make phone calls independently. Research in Developmental Disabilities, 34, 1991–1997.
Perry, A., Flanagan, H. E., Dunn Geier, J., & Freeman, N. L. (2009). Brief report: the Vineland adaptive behavior scales in young children with autism spectrum disorders at different cognitive levels. Journal of Autism and Developmental Disorders, 39, 1066–1078.
Rakap, S. (2015). Quality of individualised education programme goals and objectives for preschool children with disabilities. European Journal of Special Needs Education, 30, 173–186.
Reichle, J. E. (2011). Evaluating assistive technology in the education of persons with severe dosabilities. Journal of Behavioral Education, 20, 77–85.
Rellini, E., Tortolani, D., Trillo, S., Carbone, S., & Montecchi, F. (2004). Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) correspondence and conflicts with DSM-IV criteria in diagnosis of autism. Journal of Autism and Developmental Disorders, 34, 703–708.
Ripat, J., & Booth, A. (2005). Characteristics of assistive technology service delivery models: Stakeholder perspectives and preferences. Disability and Rehabilitation, 27, 1461–1470.
Roche, L., Sigafoos, J., Lancioni, G. E., Oreilly, M. F., & Green, V. A. (2015). Microswitch technology for enabling self-determined responding in children with profound and multiple disabilities: a systematic review. AAC: Augmentative and Alternative Communication, 31, 246–258.
Saunders, R. R., Saunders, M. D., Struve, B., Munce, A. L., Olswang, L. B., Dowden, P. A., et al. (2007). Discovering indices of contingency awareness in adults with multiple profound disabilities. American Journal on Mental Retardation, 112, 246–260.
Schopler, E., Reichler, R. J., De Vellis, R. F., & Daly, K. (1980). Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS). Journal of Autism and Developmental Disorders, 10, 91–103.
Siegel, S., & Castellan, J. (1988). Nonparametric statistics (2nd ed.). New York: McGraw Hill.
Sigafoos, J. (2011). Editorial: introduction to the special issue: evaluating assistive technology in the education of persons with severe disabilities. Journal of Behavioral Education, 20, 1–3.
Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2005). Vineland-II adaptive behavior scales: survey forms manual. Circle Pines, MN: AGS Publishing.
Stasolla, F., & Caffò, A. O. (2013). Promoting adaptive behaviors by two girls with Rett syndrome through a microswitch-based program. Research in Autism Spectrum Disorders, 7, 1265–1272.
Stasolla, F., & De Pace, C. (2014). Assistive technology to promote leisure and constructive engagement by two boys emerged from a minimal conscious state. NeuroRehabilitation, 35, 253–259.
Stasolla, F., & Perilli, V. (2015). Microswitch-based programs (MBP) to promote communication, occupation, and leisure skills for children with multiple disabilities: a literature overview. In N. Silton (Ed.), Recent advances in assistive technologies to support children with developmental disorders (pp. 195–216). Hershey, PA: IGI Global.
Stasolla, F., Caffò, A. O., Picucci, L., & Bosco, A. (2013). Assistive technology for promoting choice behaviors in three children with cerebral palsy and severe communication impairments. Research in Developmental Disabilities, 34, 2694–2700.
Stasolla, F., Damiani, R., & Caffò, A. O. (2014a). Promoting constructive engagement by two boys with autism spectrum disorders and high functioning through behavioral interventions. Research in Autism Spectrum Disorders, 8, 376–380.
Stasolla, F., Damiani, R., Perilli, V., Di Leone, A., Albano, V., Stella, A., et al. (2014b). Technological supports to promote choice opportunities by two children with fragile X syndrome and severe to profound developmental disabilities. Research in Developmental Disabilities, 35, 2993–3000.
Stasolla, F., De Pace, C., Damiani, R., Di Leone, A., Albano, V., & Perilli, V. (2014c). Comparing PECS and VOCA to promote communication opportunities and to reduce stereotyped behaviors by three girls with Rett syndrome. Research in Autism Spectrum Disorders, 8, 1269–1278.
Stasolla, F., Perilli, V., & Damiani, R. (2014d). Self monitoring to promote on-task behavior by two high functioning boys with autism spectrum disorders and symptoms of ADHD. Research in Autism Spectrum Disorders, 8, 472–479.
Stasolla, F., Perilli, V., Damiani, R., Caffò, A. O., Di Leone, A., Albano, V., et al. (2014e). A microswitch-cluster program to enhance object manipulation and to reduce hand mouthing by three boys with autism spectrum disorders and intellectual disabilities. Research in Autism Spectrum Disorders, 8, 1071–1078.
Stasolla, F., Caffò, A. O., Damiani, R., Perilli, V., Di Leone, A., & Albano, V. (2015a). Assistive technology-based programs to promote communication and leisure activities by three children emerged from a minimal conscious state. Cognitive Processing, 16, 69–78.
Stasolla, F., Damiani, R., Perilli, V., D’Amico, F., Caffò, A. O., Stella, A., et al. (2015b). Computer and microswitch-based programs to improve academic activities by six children with cerebral palsy. Research in Developmental Disabilities, 45–46, 1–13.
Stasolla, F., Perilli, V., Di Leone, A., Damiani, R., Albano, V., Stella, A., et al. (2015c). Technological aids to support choice strategies by three girls with Rett syndrome. Research in Developmental Disabilities, 36, 36–44.
Stasolla, F., Perilli, V., & Boccasini, A. (2016a). Assistive technologies for persons with severe-profound intellectual and developmental disabilities. In J. K. Luiselli & A. J. Fisher (Eds.), Computer-assisted and web-based innovations in psychology, special education and health (pp. 287–310). Amsterdam: Elsevier academic press.
Stasolla, F., Perilli, V., Damiani, R., & Albano, V. (2016b). Assistive technology to promote occupation and reduce mouthing by three boys with fragile X syndrome. Developmental Neurorehabilitation. doi:10.3109/17518423.2015.1133724. in press
Strauss, K., Mancini, F., & Fava, L. (2013). Parent inclusion in early intensive behavior interventions for young children with ASD: a synthesis of meta-analyses from 2009 to 2011. Research in Developmental Disabilities, 34, 2967–2985.
Visser, E. M., Berger, H. J. C., Van Schrojenstein Lantman-de Valk, H. M. J., Prins, J. B., & Teunisse, J. P. (2015). Cognitive shifting and externalising problem behavior in intellectual disability and autism spectrum disorder. Journal of Intellectual Disability Research, 59, 755–766.
Wacker, D. P., Berg, W. K., Wiggins, B., Muldoon, M., & Cavanaugh, J. (1985). Evaluation of reinforcer preferences for profoundly handicapped students. Journal of Applied Behavior Analysis, 18, 173–178.
Wacker, D. P., Wiggins, B., Fowler, M., & Berg, W. K. (1988). Training students with profound or multiple handicaps to make requests via microswitches. Journal of Applied Behavior Analysis, 21, 331–343.
Weightman, M. M., Bolgla, R., McCulloch, K. L., & Peterson, M. D. (2010). Physical therapy recommendations for service members with mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 25, 206–218.
Weinkauf, S. M., Zeug, N. M., Anderson, C. T., & Ala’i-Rosales, S. (2011). Evaluating the effectiveness of a comprehensive staff training package for behavioral interventions for children with autism. Research in Autism Spectrum Disorders, 5, 864–871.
Werner, S., & Shulman, C. (2015). Does type of disability make a difference in affiliate stigma among family caregivers of individuals with autism, intellectual disability or physical disability? Journal of Intellectual Disability Research, 59, 272–283.
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Stasolla, F., Perilli, V., Caffò, A.O. et al. Extending Microswitch-Cluster Programs to Promote Occupation Activities and Reduce Mouthing by six Children with Autism Spectrum Disorders and Intellectual Disabilities. J Dev Phys Disabil 29, 307–324 (2017). https://doi.org/10.1007/s10882-016-9525-x
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DOI: https://doi.org/10.1007/s10882-016-9525-x