Abstract
This study assessed whether two post-coma persons with minimally conscious state and extensive motor disabilities would learn to use assistive communication technology, namely microswitches, to gain access to preferred environmental stimuli. Each of the participants (adults) was provided with two microswitches that could be activated with small motor responses (e.g., finger movements and eyelid raising). The microswitches were introduced in succession according to a multiple probe design across microswitches/responses and allowed access to different sets of stimuli (i.e., recordings of songs and video-clips). Eventually, the use of the two microswitches was alternated within and across days. Each participant learned to use both microswitches successfully and maintained high levels of responding when the microswitches were alternated. The importance of assistive communication technology within programs for post-coma persons with disorders of consciousness and extensive motor disabilities is discussed.
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References
Baker, P. M., & Moon, N. W. (2008). Wireless technologies and accessibility for people with disabilities: findings from a policy research instrument. Assistive Technology, 20, 149–156.
Barlow, D. H., Nock, M., & Hersen, M. (2009). Single-case experimental designs: Strategies for studying behavior change (3rd ed.). New York: Allyn & Bacon.
Bekinschtein, T., Tiberti, C., Niklison, J., Tamashiro, M., Ron, M., Carpintiero, S., et al. (2005). Assessing level of consciousness and cognitive changes from vegetative state to full recovery. Neuropsychological Rehabilitation, 15, 307–322.
Bernat, J. L. (2006). Chronic disorders of consciousness. The Lancet, 367, 1181–1192.
Bernat, J. L. (2009). Chronic consciousness disorders. Annual Review of Medicine, 60, 381–392.
Bernat, J. L., & Rottenberg, D. A. (2007). Conscious awareness in PSV and MCS: the borderlands of neurology. Neurology, 68, 885–886.
Catania, A. C. (2007). Learning (4th Interim ed.). New York: Sloan.
Chua, K. S. G., Ng, Y. S., Yap, S. G. M., & Bok, C. W. (2007). A brief review of traumatic brain injury rehabilitation. Annals Academy of Medicine Singapore, 36, 31–42.
Coleman, M. R. (2005). The assessment and rehabilitation of vegetative and minimally conscious patients. Neuropsychological Rehabilitation, 15, 161–162.
Davis, A. E., & Gimenez, A. (2003). Cognitive-behavioral recovery in comatose patients following auditory sensory stimulation. Journal of Neuroscience Nursing, 35, 202–209.
Elliott, L., & Walker, L. (2005). Rehabilitation interventions for vegetative and minimally conscious patients. Neuropsychological Rehabilitation, 15, 480–493.
Giacino, J. T. (2004). The vegetative and minimally conscious states: consensus-based criteria for establishing diagnosis and prognosis. NeuroRehabilitation, 19, 293–298.
Giacino, J. T., & Kalmar, K. (2005). Diagnostic and prognostic guidelines for the vegetative and minimally conscious states. Neuropsychological Rehabilitation, 15, 166–174.
Giacino, J. T., & Smart, C. M. (2007). Recent advances in behavioral assessment of individuals with disorders of consciousness. Current Opinion in Neurology, 20, 614–619.
Giacino, J. T., & Trott, C. T. (2004). Rehabilitative management of patients with disorders of consciousness: grand rounds. Journal of Head Trauma Rehabilitation, 19, 254–265.
Holburn, S., Nguyen, D., & Vietze, P. M. (2004). Computer-assisted learning for adults with profound multiple disabilities. Behavioral Interventions, 19, 25–37.
Kalmar, K., & Giacino, J. T. (2005). The JFK coma recovery scale-revised. Neuropsychological Rehabilitation, 15, 454–460.
Kazdin, A. E. (2001). Behavior modification in applied settings (6th ed.). New York: Wadsworth.
Kennedy, K. (2005). Single case designs for educational research. New York: Allyn & Bacon.
Keren, O., Reznik, J., & Groswasser, Z. (2001). Combined motor disturbances following severe traumatic brain injury: an integrative long-term treatment approach. Brain Injury, 15, 633–638.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Oliva, D., Coppa, M. M., & Montironi, G. (2005). A new microswitch to enable a boy with minimal motor behavior to control environmental stimulation with eye blinks. Behavioral Interventions, 20, 147–153.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Oliva, D., Baccani, S., Severini, L., et al. (2006). Micro-switch programmes for students with multiple disabilities and minimal motor behaviour: assessing response acquisition and choice. Pediatric Rehabilitation, 9, 137–143.
Lancioni, G. E., Olivetti Belardinelli, M., Chiapparino, C., Angelillo, M. T., Stasolla, F., Singh, N. N., et al. (2008a). Learning in post-coma persons with profound multiple disabilities: two case evaluations. Journal of Developmental and Physical Disabilities, 20, 209–216.
Lancioni, G. E., Olivetti Belardinelli, M., Oliva, D., Signorino, M., Stasolla, F., Tommaso, D., et al. (2008b). Successful extension of assessment and rehabilitation intervention for an adolescent with postcoma multiple disabilities through a learning setup. European Journal of Physical and Rehabilitation Medicine, 44, 449–453.
Lancioni, G. E., Olivetti Belardinelli, M., Stasolla, F., Singh, N. N., O’Reilly, M. F., Sigafoos, J., et al. (2008c). Promoting engagement, requests and choice by a man with post-coma pervasive motor impairment and minimally conscious state through a technology-based program. Journal of Developmental and Physical Disabilities, 20, 379–388.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Sigafoos, J., Oliva, D., Antonucci, M., et al. (2008d). Microswitch-based programs for persons with multiple disabilities: an overview of some recent developments. Perceptual and Motor Skills, 106, 355–370.
Lancioni, G. E., O’Reilly, M. F., Singh, N. N., Buonocunto, F., Sacco, V., Colonna, F., et al. (2009a). Technology-based intervention options for post-coma persons with minimally conscious state and pervasive motor disabilities. Developmental Neurorehabilitation, 12, 24–31.
Lancioni, G. E., Singh, N. N., O’Reilly, M. F., Sigafoos, J., Buonocunto, F., Sacco, V., et al. (2009b). Two persons with severe post-coma motor impairment and minimally conscious state use assistive technology to access stimulus events and social contact. Disability and Rehabilitation: Assistive Technology, 4, 367–372.
Leong, B. (2002). The vegetative and minimally conscious states in children: spasticity, muscle contracture and issues for physiotherapy treatment. Brain Injury, 16, 217–230.
Lombardi, F., Gatta, G., Sacco, S., Muratori, A., & Carolei, A. (2007). The Italian version of the coma recovery scale-revised (CRS-R). Functional Neurology, 22, 47–61.
McNaughton, D., & Bryen, D. N. (2007). AAC technologies to enhance participation and access to meaningful societal roles for adolescents and adults with developmental disabilities who require AAC. Augmentative and Alternative Communication, 23, 217–229.
Naudé, K., & Hughes, M. (2005). Considerations for the use of assistive technology in patients with impaired states of consciousness. Neuropsychological Rehabilitation, 15, 514–521.
Noda, R., Maeda, Y., & Yoshino, A. (2004). Therapeutic time window for musicokinetic therapy in a persistent vegetative state after severe brain damage. Brain Injury, 18, 509–515.
Petry, K., Maes, B., & Vlaskamp, C. (2005). Domains of quality of life of people with profound multiple disabilities: the perspective of parents and direct support staff. Journal of Applied Research in Intellectual Disabilities, 18, 35–46.
Sarà, M., Pistoia, F., Mura, E., Onorati, P., & Govoni, S. (2009). Intrathecal baclofen in patients with persistent vegetative state: 2 hypotheses. Archives of Physical Medicine and Rehabilitation, 90, 1245–1249.
Schnakers, C., Vanhaudenhuyse, A., Giacino, J., Ventura, M., Boly, M., Majerus, S., et al. (2009). Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment. BMC Neurology, 9, 35.
Siegel, S., & Castellan, N. J. (1988). Nonparametric statistics (2nd ed.). New York: McGraw-Hill.
Simpson, D. M., Gracies, J. M., Yablon, S. A., Barbano, R., Brashear, A., & the BoNT/TZD Study Team. (2009). Botulinum neurotoxin versus tizanidine in upper limb spasticity: a placebo-controlled study. Journal of Neurology, Neurosurgery, and Psychiatry, 80, 380–385.
Tsuchiya, N., & Adolphs, R. (2007). Emotion and consciousness. Trends in Cognitive Sciences, 11, 158–167.
Wales, L., & Waite, C. (2005). Children in vegetative state and minimally conscious state: a survey of sensory and cognitive intervention. British Journal of Occupational Therapy, 68, 486–494.
Wilson, F. C., Harpur, J., & McConnell, N. (2007). Vegetative and minimally conscious state(s) survey: attitudes of clinical neuropsychologists and speech and language therapists. Disability and Rehabilitation, 29, 1751–1756.
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Lancioni, G.E., O’Reilly, M.F., Singh, N.N. et al. Post-coma Persons with Minimal Consciousness and Motor Disabilities Learn to Use Assistive Communication Technology to Seek Environmental Stimulation. J Dev Phys Disabil 22, 119–129 (2010). https://doi.org/10.1007/s10882-009-9163-7
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DOI: https://doi.org/10.1007/s10882-009-9163-7