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Filippini C, Lancioni GE, Alberti G, Pezzuoli F, Ceccarani P. A Technology Aid to Help People with Blindness and Moderate Intellectual Disability Retrieve Common Objects from Storage Units: A Proof-of-Concept Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:4453. [PMID: 39065851 PMCID: PMC11281186 DOI: 10.3390/s24144453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/06/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND People with blindness and intellectual disability can have problems locating, identifying, and retrieving objects needed for daily activities (e.g., clothes and food items) from familiar storage contexts, such as cupboards and cabinets. OBJECTIVE This preliminary study assessed a technological system designed to help three people with those problems improve their performance. METHODS The technological system, which involved the use of tags with radio frequency identification codes, a smartphone, and a tag reader, aimed to guide the participants in searching and retrieving objects from three different storage units. In practice, the system provided different feedbacks depending on whether the participants were searching (a) in a wrong storage unit, (b) in a wrong shelf/drawer of the right storage unit, or (c) in the right shelf/drawer of the right storage unit. RESULTS All participants were successful in retrieving objects correctly with the technological system. The results also showed that (a) the participants preferred using the system over a control strategy, (b) were able to switch on and off the system independently, and (b) staff rated the system positively. CONCLUSIONS These preliminary findings suggest that the system might be a useful support tool for people with blindness and intellectual disability.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Orlando I, Chiariello V, Desideri L. Enabling People With Intellectual and Sensory Disabilities to Trigger a Tablet's Delivery of Task Instructions by Walking to the Tablet: Proof-of-Concept Study. JMIR Rehabil Assist Technol 2024; 11:e59315. [PMID: 38865701 PMCID: PMC11208835 DOI: 10.2196/59315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/15/2024] [Accepted: 05/15/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND People with intellectual and sensory or sensory-motor disabilities tend to have problems performing multistep tasks. To alleviate their problems, technological solutions have been developed that provide task-step instructions. Instructions are generally delivered at people's request (eg, as they touch an area of a computer or tablet screen) or automatically, at preset intervals. OBJECTIVE This study carried out a preliminary assessment of a new tablet-based technology system that presented task-step instructions when participants with intellectual and sensory disabilities walked close to the tablet (ie, did not require participants to perform fine motor responses on the tablet screen). METHODS The system entailed a tablet and a wireless camera and was programmed to present instructions when participants approached the tablet, that is, when the camera positioned in front of the tablet detected them. Two instructions were available for each task step. One instruction concerned the object(s) that the participants were to collect, and the other instruction concerned the "where" and "how" the object(s) collected would need to be used. For 3 of the six participants, the two instructions were presented in succession, with the second instruction presented once the required object(s) had been collected. For the other 3 participants, the two instructions were presented simultaneously. Instructions consisted of pictorial representations combined with brief verbal phrases. The impact of the system was assessed for each of the 2 groups of participants using a nonconcurrent multiple baseline design across individuals. RESULTS All participants were successful in using the system. Their mean frequency of correct task steps was close to or above 11.5 for tasks including 12 steps. Their level of correct performance tended to be much lower during the baseline phase when they were to receive the task-step instructions from a regular tablet through scrolling responses. CONCLUSIONS The findings, which need to be interpreted with caution given the preliminary nature of the study, suggest that the new tablet-based technology system might be useful for helping people with intellectual and sensory disabilities perform multistep tasks.
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Sigafoos J, Roche L, O'Reilly MF, Lancioni GE, Marschik PB. Updated systematic-narrative review on communication intervention in Rett Syndrome: 2010-2022. Augment Altern Commun 2023; 39:241-255. [PMID: 37526342 DOI: 10.1080/07434618.2023.2215864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 04/27/2023] [Accepted: 05/08/2023] [Indexed: 08/02/2023] Open
Abstract
Due to loss of spoken language and resulting complex communication needs, people with Rett syndrome are obvious candidates for communication intervention. To advance evidence-based practice and guide future research efforts, we identified and summarized 16 communication intervention studies published since a previous 2009 review on this topic. Studies were summarized in terms of (a) participants, (b) dependent variables related to communication, (c) intervention characteristics, (d) outcomes, and (e) certainty of evidence. Across the 16 studies, intervention was provided to a total of 100 participants from 3 to 47 years of age. Half of the studies used systematic instruction to teach aided AAC. Other interventions and associated technologies included music therapy, eye tracking technology, and transcranial stimulation. Positive outcomes (e.g., using AAC devices to make requests and/or initiate social-communication interactions) were reported in 13 of the studies. These 16 new studies provide additional guidance on how to enhance the communicative functioning of people with Rett syndrome. Future research directions are highlighted.
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, Alberti G, Troccoli O, Orlando I, Ricci C. Enabling people with intellectual and other disabilities to make verbal requests using cardboard chips with mini objects or pictures and a smartphone. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1257493. [PMID: 37841067 PMCID: PMC10568128 DOI: 10.3389/fresc.2023.1257493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023]
Abstract
Objective This study aimed to help six participants with intellectual disability combined with sensory and motor impairments to make verbal requests through the use of a technology system involving cardboard chips and a smartphone. Method The participants were divided into two groups of three based on whether they did or did not have visual skills. Each group was exposed to the intervention with the technology system according to a non-concurrent multiple baseline across participants design. During the 20 min intervention sessions, the participants were provided with a smartphone and nine cardboard chips each of which had a picture or object (i.e., a mini object replica or raised object contour) and several radio frequency identification tags attached to it. To make a request, the participants were to bring a cardboard chip in contact with the smartphone. This read the tags attached to the cardboard and verbalized the request related to that cardboard. Results During the baseline (without cardboard chips and smartphone), the participants' mean frequency of independent requests (all non-verbal requests) varied between zero and near 1.5 per session. During the intervention (with cardboard chips and smartphone), the participants' mean frequency of independent requests (all verbal requests) varied between over 4.5 and about 10 per session. Conclusion The results suggest that the system might be useful to help participants like the ones included in this study to make verbal requests with simple responses.
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D'Amico F, Lancioni GE, De Marinis F, Abbinante F, Taurisano P, Abbatantuono C, Alberti G. A simple smartphone-aided program to support meaningful occupation in people with severe neuro-motor and speech disabilities. Int J Rehabil Res 2023; 46:205-208. [PMID: 37039592 DOI: 10.1097/mrr.0000000000000583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
We assessed a simple smartphone-aided program to help three participants with severe neuro-motor and speech disabilities access preferred songs, call or send messages to distant partners, and call the caregiver. The program relied on the use of a smartphone, five cards with identification tags, and a mini speaker. The participants could select one of the cards (engagement options) by touching it with the smartphone. Using the program, all participants managed to access songs, reach partners, and call the caregiver independently and engaged in the related forms of leisure and communication/interaction throughout the 10-min sessions available. The results suggest that the program might be a valuable aid for people with severe neuro-motor and speech disabilities.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Chiariello V, Desideri L, Buono S. Low-Cost Technology-Aided Programs for Supporting People With Motor, Visual, and Intellectual Disabilities in Functional Forms of Occupation and Communication: Proof-of-Concept Study. JMIR Rehabil Assist Technol 2023; 10:e44239. [PMID: 36961483 PMCID: PMC10131918 DOI: 10.2196/44239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/16/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND People with motor, visual, and intellectual disabilities may have serious problems in independently accessing various forms of functional daily occupation and communication. OBJECTIVE The study was aimed at developing and assessing new, low-cost technology-aided programs to help people with motor or visual-motor and intellectual disabilities independently engage in functional forms of occupation and communication with distant partners. METHODS Two programs were set up using a smartphone interfaced with a 2-switch device and a tablet interfaced with 2 pressure sensors, respectively. Single-subject research designs were used to assess (1) the first program with 2 participants who were blind, had moderate hand control, and were interested in communicating with distant partners through voice messages; and (2) the second program with 2 participants who possessed functional vision, had no or poor hand control, and were interested in communicating with their partners through video calls. Both programs also supported 2 forms of occupational engagement, that is, choosing and accessing preferred leisure events consisting of songs and music videos, and listening to brief stories about relevant daily topics and answering questions related to those stories. RESULTS During the baseline phase (when only a conventional smartphone or tablet was available), 2 participants managed sporadic access to leisure or leisure and communication events. The other 2 participants did not show any independent leisure or communication engagement. During the intervention (when the technology-aided programs were used), all participants managed to independently engage in multiple leisure and communication events throughout the sessions and to listen to stories and answer story-related questions. CONCLUSIONS The findings, which need to be interpreted with caution given the nature of the study and the small number of participants, seem to suggest that the new programs may be viable tools for helping people with motor or visual-motor and intellectual disabilities independently access leisure, communication, and other forms of functional engagement.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Chiariello V, Desideri L. A microswitch-aided program to enable people with extensive multiple disabilities to control environmental stimulation through different responses. Front Psychiatry 2022; 13:1073650. [PMID: 36569625 PMCID: PMC9780668 DOI: 10.3389/fpsyt.2022.1073650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
Objectives This study assessed whether a simple technology-aided program (i.e., a program involving the use of microswitches linked to a smartphone) could be set up to enable people with motor, sensory and intellectual disabilities to control preferred environmental stimulation through two different response movements. Methods Ten participants were involved in the study. Each of them was exposed to an ABAB design, in which A represented baseline phases without the program and B intervention phases with the use of the program. The study assessed whether the participants (a) had significant increases of each of the two response movements available and/or showed response variability across sessions and over time and (b) had signs of satisfaction/happiness during the study sessions, in connection with their stimulation access and control. Results The program was effective in increasing the participants' responding and consequently their self-regulated stimulation input. Half of the participants showed a significant increase of both responses available from the first intervention phase. Other participants seemed to focus more on one of the two responses. Even so, they tended to have occasionally high performance frequencies also with regard to their non-dominant (not significantly increased) response. Finally, all participants showed clear signs of satisfaction/happiness during the intervention sessions. Conclusions The program represents a potentially useful approach for enabling people with extensive multiple disabilities to self-regulate their access to preferred environmental stimulation and improve their mood.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Desideri L. Behavioral intervention approaches for people with disorders of consciousness: a scoping review. Disabil Rehabil 2022; 44:7677-7692. [PMID: 34613851 DOI: 10.1080/09638288.2021.1985634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE This review was intended to provide an overall picture of work conducted during the last decade to assess the impact of behavioral intervention strategies on people with disorders of consciousness (i.e., comatose state, vegetative state/unresponsive wakefulness, or minimally conscious state). The intervention strategies considered were those not based on music or including music as a component of the intervention package. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, a scoping review was carried out to identify and provide a synthesis of eligible studies published in English during the 2010-2021 period. Three databases (i.e., PubMed, PsycINFO, and Web of Science) were employed for the literature search. RESULTS Forty studies met the inclusion criteria. Those studies were grouped into three categories based on whether they assessed the effects of: (i) verbal stories/messages, (ii) multiple stimulation, and (iii) response-contingent stimulation. Then, a narrative synthesis of the studies of each of the three categories was provided to specify the types of patients involved, the intervention and assessment conditions implemented, and the outcome attained. CONCLUSIONS The evidence reported in most of the studies might be considered encouraging and convincing. Even so, it might be very difficult to view the evidence of the various studies cumulatively and make general/conclusive statements due to a number of differences in the intervention conditions applied.Implications for rehabilitationAn informative picture of the studies using behavioral interventions with people with disorders of consciousness is essential to any professional working in the area.Such picture can be highly useful in providing a view of the intervention strategies used for those people, of the variations existing within and across strategies, and of the evidence available.An analysis of the strategies, their implementation and their effects may provide new insights for improving those strategies and eventually increasing their impact.The individuals charged with the implementation process (e.g., family members or nurses) may have a relevant influence on the overall impact of the strategy.
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Lancioni GE, Belardinelli MO, Singh NN, O’Reilly MF, Sigafoos J, Alberti G, Desideri L. A Behavioral Approach to Treatment and Assessment of People with Disorders of Consciousness: The Response-contingent Stimulation Strategy. J Integr Neurosci 2022; 21:158. [DOI: 10.31083/j.jin2106158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/06/2022] Open
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, Alberti G, Fiore A. People with intellectual and multiple disabilities access leisure, communication, and daily activities via a new technology-aided program. Front Psychol 2022; 13:994416. [PMID: 36160503 PMCID: PMC9490367 DOI: 10.3389/fpsyg.2022.994416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
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.
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Lancioni GE, Singh NN, O'Reilly M, Sigafoos J, Alberti G, Desideri L. Programs Using Stimulation-Regulating Technologies to Promote Physical Activity in People With Intellectual and Multiple Disabilities: Scoping Review. JMIR Rehabil Assist Technol 2022; 9:e35217. [PMID: 35389365 PMCID: PMC9031065 DOI: 10.2196/35217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/04/2022] [Accepted: 03/21/2022] [Indexed: 12/22/2022] Open
Abstract
Background People with intellectual and multiple disabilities tend to engage in very low levels of physical activity. Objective This review paper aims to provide a comprehensive picture of intervention programs using stimulation-regulating technologies to promote forms of physical activity in people with intellectual and multiple disabilities. Methods Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, a scoping review was conducted to identify and provide a synthesis of eligible studies published in English between 2010 and 2021. Studies were identified by searching PubMed, Web of Science, PsycINFO, ERIC, and CINAHL as well as by using Google Scholar and manual searches. Studies were included if they involved individuals with intellectual or multiple disabilities, used stimulation-regulating technology systems to help participants engage in physical activity, and reported data on the impact of the intervention. Results A total of 42 studies met the inclusion criteria. These studies were divided into 2 groups based on whether they pursued the increase in physical activity through technology-aided delivery of brief periods of preferred stimulation contingent on specific responses or the use of video games (exergames) and related auditory and visual stimulation. Subsequently, a narrative synthesis of the studies was provided. Conclusions The evidence reported by the 2 groups of studies is encouraging. However, further research is needed to compare the overall applicability and impact of the intervention strategies proposed by these groups of studies.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Campodonico F, Chiariello V, Desideri L, Buono S. Everyday Technology to Help People with Intellectual and Other Disabilities Access Stimulation via Functional Motor Responses and Improved Body Posture. Dev Neurorehabil 2022; 25:59-67. [PMID: 34629013 DOI: 10.1080/17518423.2021.1989513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE 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. METHODS 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. RESULTS 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. CONCLUSION This technology-aided approach may be a helpful resource for people similar to the participants of this study.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Chiariello V, Campodonico F, Desideri L. Technology-Aided Spatial Cues, Instructions, and Preferred Stimulation for Supporting People With Intellectual and Visual Disabilities in Their Occupational Engagement and Mobility: Usability Study. JMIR Rehabil Assist Technol 2021; 8:e33481. [PMID: 34787588 PMCID: PMC8663578 DOI: 10.2196/33481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/29/2021] [Accepted: 10/03/2021] [Indexed: 02/05/2023] Open
Abstract
Background Persons with severe or profound intellectual disability and visual impairment tend to be passive and sedentary, and technology-aided intervention may be required to improve their condition without excessive demands on staff time. Objective This study aims to extend the assessment of technology-aided interventions for supporting functional occupational engagement and mobility in 7 people with intellectual disability and visual impairment and to use a technology system that is simpler and less expensive than those previously used. Methods The technology system involved a Samsung Galaxy A10, 4 Philips Hue indoor motion sensors, and 4 mini speakers. Within each session, the participants were to collect 18 objects (ie, one at a time) from 3 different areas (stations) located within a large room, bring each of the objects to a central desk, and put away each of those objects there. For each object, the participants received verbal (spatial) cues for guiding them to the area where the object was to be collected, a verbal instruction (ie, request) to take an object, verbal (spatial) cues for guiding them to the central desk, a verbal instruction to put away the object collected, and praise and preferred stimulation. Results During baseline, the frequency of responses completed correctly (objects collected and put away independently) was 0 or near 0. During the intervention phase (ie, with the support of the technology setup), the frequency increased for all participants, reaching a mean of almost 18 (out of 18 response opportunities) for 6 participants and about 13 for the remaining participant. The mean session duration ranged from 12 to 30 minutes. Conclusions A program, such as the one used in this study, can be useful in promoting occupational engagement and mobility in persons with intellectual disability and visual impairment.
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Sigafoos J, Roche L, O’Reilly MF, Lancioni GE. Persistence of Primitive Reflexes in Developmental Disorders. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021. [DOI: 10.1007/s40474-021-00232-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lancioni GE, Desideri L, Singh NN, O'Reilly MF, Sigafoos J, De Caro MF, Taurisano P. Use of technology to sustain mobility in older people with cognitive impairment and dementia: a scoping review. Disabil Rehabil Assist Technol 2021:1-15. [PMID: 33751919 DOI: 10.1080/17483107.2021.1900935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This paper provides a review of studies that evaluated technology devices to sustain various forms of mobility in older people with cognitive impairment or dementia and mobility problems (e.g., inability to ambulate or difficulties to orient with consequent failures to reach relevant destinations). METHODS A literature search was performed for English language articles indexed in PubMed, PsycINFO, and Web of Science. This search was then supplemented with an ancestral and forward search. The search covered the period ranging between January 2010 and October 2020. RESULTS Twenty-seven articles were included in the review. They were divided into four groups according to whether they aimed to promote (a) supported ambulation, (b) use of safe power wheelchair, (c) ambulation guided by orientation cues, and (d) ambulation with GPS-based assistance. The studies were coded in terms of the objective pursued, technology used, participants involved, strategies applied to assess the technology, and outcome reported. CONCLUSION A variety of technology devices are available to address the mobility problems of older people with cognitive impairment or dementia. The devices' accessibility and usability differ widely. Data on their impact are still largely preliminary and new systematic research is needed.IMPLICATIONS FOR REHABILITATIONA variety of mobility problems may afflict older people with cognitive impairment or dementia and curtail their opportunities to freely move indoor or outdoor.Technology devices have been developed to (a) promote forms of supported ambulation, (b) facilitate safe use of power wheelchairs, (c) deliver orientation/navigation cues, and (d) ensure tracking and possible assistance.The technology devices differ in terms of accessibility and affordability, with some of them readily available and others at a developmental stage.Data on the effectiveness of the various technology devices in reducing the impact of the mobility problems are still largely preliminary and new systematic research is needed.
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Lancioni GE, Desideri L, Singh NN, Sigafoos J, O’Reilly MF. A commentary on standards for single-case experimental studies. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:781-783. [PMID: 36210905 PMCID: PMC9542874 DOI: 10.1080/20473869.2020.1870420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 06/16/2023]
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Singh NN, Lancioni GE, Medvedev ON, Hwang YS, Myers RE. Real-Time Telehealth Treatment Team Consultation for Self-Injury by Individuals with Autism Spectrum Disorder. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2021; 5:170-182. [PMID: 33490369 PMCID: PMC7813971 DOI: 10.1007/s41252-021-00192-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Self-injurious behavior (SIB) refers to any repeated self-directed, non-suicidal, behavior that may cause or has the potential to cause physical harm to the person's body. Behavioral interventions provide the standard evidence-based treatments for SIB by people with autism spectrum disorder (ASD) and intellectual disabilities (ID). Translating the proven effectiveness of behavioral interventions to treatment of self-injury in community settings by clinicians and caregivers has not been totally successful. The aim of the present study was to advance translational research by providing real-time telehealth consultation to a treatment team at a community-based mental health agency that provided inpatient and outpatient services to individuals with ASD and ID. METHOD The participants of this single-case experimental study were three adolescents with ASD who had been referred for services because of their increasingly unmanageable SIB both at home and at school. The telehealth consultant provided real-time assistance to the treatment team within a translational model of care in the development and implementation of a behavior support plan and an informal mindfulness-based Soles of the Feet (SoF) program. RESULTS Both visual and statistical analyses demonstrated reductions in the frequency of SIB for all three adolescents, with overall clinically significant reductions only with the SoF intervention. CONCLUSION The results of this translational study suggest that telehealth consultation might be a viable technological alternative in situations which preclude face-to-face consultation. Telehealth consultation could be one method of supporting people with behavioral difficulties during pandemics, such as COVID-19.
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Singh NN, Lancioni GE, Medvedev ON, Hwang YS, Myers RE, Townshend K. Using mindfulness to improve quality of life in caregivers of individuals with intellectual disabilities and autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 66:370-380. [PMID: 34150199 PMCID: PMC7942792 DOI: 10.1080/20473869.2020.1827211] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Caring for individuals with intellectual disabilities (ID) or autism spectrum disorder (ASD) can be gratifying as well as stressful. Professional staff employed as caregivers often report compromised mental and physical wellbeing due to the stressful nature of working with clients who exhibit aggressive and destructive behaviors. Prolonged work-related stress results in diminished quality of life for the caregivers. The aim of the present study was to evaluate the comparative effects of three programs-mindfulness program, psychoeducational program, and inservice training-as-usual-on the quality of life of professional caregivers who provide services to adolescent and adult clients with ID and ASD. METHODS Professional caregivers (N = 216) were randomized into three experimental conditions, and trained in mindfulness, psychoeducation, and inservice training-as-usual. The effects of the training on the caregivers' quality of life were assessed in terms of perceived stress, compassion satisfaction, compassion fatigue (i.e. burnout, secondary traumatic stress), and symptoms of depression at the end of 32 weeks of implementation. RESULTS Perceived stress, burnout, and secondary traumatic stress decreased significantly in the mindfulness condition, followed by psychoeducation, but not in the inservice training-as-usual condition. Compassion satisfaction increased significantly in the mindfulness condition, followed by psychoeducation, but not in the inservice training-as-usual condition. Symptoms of depression, which were rated in the borderline clinical range prior to intervention, decreased significantly to within normal levels in the mindfulness condition, decreased minimally in the psychoeducation condition, and showed no change in the training-as usual condition. CONCLUSIONS A 3-day training in mindfulness meditations and associated contemplative practices provides a better basis for enhancing caregivers' quality of life than psychoeducation or inservice training-as-usual.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Chiariello V, Desideri L. People with intellectual and visual disabilities access basic leisure and communication using a smartphone's Google Assistant and voice recording devices. Disabil Rehabil Assist Technol 2020; 17:957-964. [PMID: 33078974 DOI: 10.1080/17483107.2020.1836047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE 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. METHODS 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. RESULTS 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. CONCLUSION The new technology system may be a useful resource to help people like the participants of this study access basic leisure and communication independently.Implications for rehabilitationA 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.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Chiariello V, Carrella L. Everyday Technology to Support Leisure and Daily Activities in People with Intellectual and Other Disabilities. Dev Neurorehabil 2020; 23:431-438. [PMID: 32118503 DOI: 10.1080/17518423.2020.1737590] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The study evaluated a smartphone-aided program to support independent access to leisure events and performance of daily activities in seven participants with moderate intellectual disability, four of whom also had severe hearing loss. Method: The program relied on the use of a Samsung Galaxy J4 Plus smartphone with Android 9.0 operating system. The smartphone's functioning was automated via the MacroDroid application. The program was to allow the participants to alternate access to leisure events (delivered via the smartphone) with performance of vocational activities (guided through smartphone-delivered pictorial or pictorial and verbal instructions) over sessions of about 30 min. Results: During the baseline, the participants failed to access leisure events and perform scheduled activities independently. When the program was used, however, all participants succeeded in both accessing leisure events and performing activities independently. Conclusions: The smartphone-aided program can be a useful tool for people like the participants of this study.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Chiariello V, Buono S. Extended smartphone-aided program to sustain daily activities, communication and leisure in individuals with intellectual and sensory-motor disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 105:103722. [PMID: 32623249 DOI: 10.1016/j.ridd.2020.103722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/08/2020] [Accepted: 06/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Smartphone-aided programs were recently developed to support leisure engagement and communication with distant partners in individuals with special needs. This study evaluated an extended smartphone-aided program that supported daily activities in addition to communication and leisure in individuals with intellectual and visual or visuo-motor disabilities. METHOD Six participants were involved who had been exposed to an earlier smartphone-aided program supporting communication and leisure. The extended program (a) relied on the use of a Samsung Galaxy J4 Plus smartphone, which was fitted with Android 9.0 operating system and MacroDroid, and (b) alternated periods in which the participants could engage in communication and leisure with periods in which they were provided with instructions for daily activities. RESULTS During the baseline (i.e., with the earlier smartphone-aided program), the participants engaged in communication and leisure, but did not start any activity. During the post-intervention phase (i.e., with the extended smartphone-aided program), the participants maintained successful communication and leisure engagement and started and carried out daily activities successfully. Staff rated the extended program largely preferable to the original program. CONCLUSIONS The extended program can be a useful tool for widening the functional occupation of individuals like the participants of this study.
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, Alberti G, Campodonico F, Acquaviva G, Chiariello V, Desideri L. Persons with intellectual and multiple disabilities activate via non-verbal responses a smartphone's Google Assistant to access preferred stimulation. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:518-527. [PMID: 35937160 PMCID: PMC9351553 DOI: 10.1080/20473869.2020.1827213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/18/2020] [Accepted: 09/13/2020] [Indexed: 06/15/2023]
Abstract
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.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, D'Amico F, Buonocunto F, Lanzilotti C, Alberti G, Navarro J. Mainstream technology to support basic communication and leisure in people with neurological disorders, motor impairment and lack of speech. Brain Inj 2020; 34:921-927. [PMID: 32442386 DOI: 10.1080/02699052.2020.1763462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess a simple technology solution to support basic communication and leisure in people with neurological disorders, extensive motor impairment, and absence of speech. DESIGN The design was a non-concurrent multiple baseline across participants. METHODS The study included eight participants and assessed a technology setup including a Samsung Galaxy Tab S2 LTE tablet and a Samsung Galaxy A3 smartphone. The smartphone, automated via MacroDroid, presented the participant with leisure, messages, and caregiver options. Choosing leisure or messages (by activating the smartphone's proximity sensor) led the smartphone to present the alternatives available for that option and eventually verbalize the alternative selected. This verbalization triggered the tablet's Google Assistant and led the tablet to present a leisure event or start a message exchange. Choosing the caregiver led the smartphone to invite the caregiver to interact with the participant. RESULTS During baseline (i.e., when a standard smartphone was available), the participants did not activate any of the options. During intervention and post-intervention (i.e., with the technology described above), participants activated all options and spent most of the session time positively engaged with them. CONCLUSIONS The aforementioned technology seems to be a useful tool for individuals like those involved in this study.
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Singh NN, Lancioni GE, Medvedev ON, Hwang YS, Myers RE. A Component Analysis of the Mindfulness-Based Positive Behavior Support (MBPBS) Program for Mindful Parenting by Mothers of Children with Autism Spectrum Disorder. Mindfulness (N Y) 2020; 12:463-475. [PMID: 32421103 PMCID: PMC7223597 DOI: 10.1007/s12671-020-01376-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives Mindfulness-Based Positive Behavior Support (MBPBS) has been shown to be effective in reducing stress and burnout in parents and professional caregivers of children and adolescents with intellectual and developmental disabilities (IDD) and autism spectrum disorder (ASD). The aim of this study was to assess the comparative effects of the mindfulness (MB) and positive behavior support (PBS) components against the MBPBS program for mindful parenting. Methods The study utilized a three-arm randomized controlled trial design, with a 10-week pre-treatment control condition, 30 weeks of intervention, and 3 years of post-intervention follow-up. Mothers of children with ASD were randomly assigned to the MB, PBS, and MBPBS conditions and provided 3 days of training specific to each condition. The effects of these programs were assessed on the mothers (i.e., training attendance, meditation time, perceived psychological stress) and spillover effects were assessed on their children with ASD (i.e., aggression, disruptive behavior, compliance with mothers' requests). Results Mothers in the MBPBS condition reported greater reductions in perceived psychological stress, followed by those in the MB condition, and with no significant changes reported by those in the PBS condition. Reduction in the children's aggression and disruptive behavior followed a similar pattern, with most to least significant reductions being in MBPBS, MB, and PBS condition, respectively. Significant increases in compliance (i.e., responsiveness to mothers' requests) were largest in the MBPBS condition, followed by MB, and then PBS. Changes across all variables for both mothers and their children were maintained for 3 years post-intervention. After time and training type were controlled for, meditation time was a significant predictor in reducing aggressive and disruptive behaviors, and in enhancing compliance of the children with mothers' requests. Conclusions Positive outcomes for mothers and their children with ASD were significantly greater in the MBPBS condition, followed by the MB condition, and least in the PBS condition. MBPBS appears to be an effective mindful parenting program on the assessed variables.
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, D’Amico F, Vincenti A, Buonocunto F, Susco V, Lanzilotti C, Navarro J. Basic smartphone-aided communication and leisure for people with extensive neuro-motor impairment and absence of speech. NeuroRehabilitation 2019; 45:311-322. [DOI: 10.3233/nre-192811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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