Assistive technology to promote leisure and constructive engagement by two boys emerged from a minimal conscious state.

BACKGROUND: Post-coma persons with multiple disabilities may represent a challenge to rehabilitation centers, due to their clinical conditions. Moreover, they can failed to engage adaptive responses aimed at the self-management of environmental stimuli. OBJECTIVES: To assess the impact and social rating of a new assistive technology set-up for promoting constructive engagement by two post-coma boys emerged from a minimal conscious state. METHOD: During baseline sessions, the participants were provided with a mouse to manage the computer system. During intervention phases, a new technology was implemented, allowing both participants to manage environmental stimuli with a microswitch instead of the mouse. Furthermore, a social validation assessment was carried out, involving students as raters. RESULTS: Data showed an increasing of constructive engagement by both participants during intervention phases. Sixty psychology students (social raters) favoured the new technology on a six items questionnaire (i.e. enjoyment, suitability, rehabilitation, independence, daily context and support). CONCLUSIONS: The new technology was suitable, affordable, effective and socially preferable.

Technology-assisted programmes to promote leisure engagement in persons with acquired brain injury and profound multiple disabilities: two case studies.

OBJECTIVE. To evaluate technology-assisted programmes for enabling a woman and a man with brain injury and profound multiple disabilities to acquire leisure engagement. METHOD. The technology for the woman (Study I) involved a portable computer with mouse, a Clicker 4 software package, a touch/pressure microswitch, and an interface to connect the Clicker with the microswitch. This technology allowed the woman to choose with a simple hand response among four stimulus categories (e.g., watching a film and interacting with others), each of which included several alternatives. The technology for the man (Study II) involved a computer-based choice system that allowed him to select preferred songs through a microswitch-aided finger-movement response. RESULTS. Data showed that the two participants learned to use the technology available and selected among the stimulus events thus reaching positive leisure engagement. CONCLUSION. Technology-assisted programmes may provide persons with acquired brain injury and multiple disabilities leisure engagement opportunities.

Communication opportunities via special messaging technology for two post-coma persons with multiple disabilities.

This study extended the assessment of a special messaging technology with two additional post-coma adults who had emerged from a minimally conscious state, but showed multiple disabilities including profound motor and communication impairments. 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 messaging technology. The technology involved a net-book computer provided with specific software, a global system for mobile communication (GSM) modem, microswitches, and prerecorded verbal lists of persons' names and messages. Both participants learned to send out and receive (listen to) messages independently during the intervention, thus providing clear support for previous data in the area. They sent out means of about three and 17 messages and received means of about two and six messages per 20- and 30-min session, respectively. The positive impact of the technology was discussed in relation to previous data in this area and the possibility of helping post-coma persons with multiple disabilities engage in basic communication with distant partners.

Use of microswitch technology and a keyboard emulator to support literacy performance of persons with extensive neuro-motor disabilities.

OBJECTIVE: To assess the effectiveness and acceptability of microswitch technology and a keyboard emulator to enable three participants with extensive neuro-motor disabilities to write words. METHOD: In Study I, two participants triggered an automatic scanning keyboard and selected/wrote letters via a small sliding movement of their hand(s) activating a touch/pressure panel (microswitch). In Study II, a third participant used the sliding movement and panel and a vocalization response with a voice-detecting microswitch. The sliding movement allowed her to light up the keyboard and select the letters and the vocalization to perform the scanning. RESULTS: Participants showed a better performance (shorter writing time) or an equally effective but less tiring performance with the new microswitch technology and response(s). They also preferred using this technology, and social validation ratings favoured such technology over previous solutions. CONCLUSION: The aforementioned technology may be useful to enable persons with extensive neuro-motor disabilities to write successfully.

Persons with multiple disabilities accessing stimulation and requesting social contact via microswitch and VOCA devices: new research evaluation and social validation.

The first of these two studies assessed whether 11 participants with multiple disabilities of 5.3-18.2 (M=10.7) years of age would succeed in combining a microswitch for accessing preferred environmental stimuli and a Voice Output Communication Aid (VOCA) for requesting social contact. The second study conducted a social validation assessment of the aforementioned microswitch-VOCA combination. Data showed that all participants learned to use the microswitch and the VOCA. Moreover, the 10 participants, who received a 1-month post-intervention check, largely maintained their responding. The social validation assessment indicated that the raters (i.e., 110 university psychology students) favored the combination of microswitch and VOCA over the microswitch or the VOCA alone, and hypothetical combinations of microswitches or VOCAs.