Indoor travel and simple tasks as physical exercise for people with profound multiple disabilities

2 to 4 30-min. periods of indoor travel and simple tasks were arranged daily as physical exercise for two women with profound mental retardation, deafness, and profound visual impairment. The questions were whether (a) the women could manage this fairly extensive exercise regimen (over about 9 and 4.5 mo.) with support technology and only minimal staff supervision and (b) the exercise could affect aspects of the women's physical condition. Data indicated that both women could successfully manage the exercise regimen with support technology, and the exercise seemed to have some beneficial effects on physical aspects such as bone metabolism and step width.

Using brief assessments to evaluate aberrant behavior maintained by attention

We examined the use of brief functional assessments to identify idiosyncratic variables associated with aberrant behavior maintained by positive reinforcement in the form of attention. Two participants with severe developmental disabilities and their parents were involved in the assessment and treatment evaluation process. A modified attention condition was introduced, which involved both parents interacting with a third person. Results of the assessment demonstrated that aberrant behavior occurred only in the modified attention condition for both participants. Treatment consisted of the parents delivering attention on a fixed-time schedule during this specific social context. Results indicated that the treatment reduced problem behavior. Follow-up evaluations with 1 participant indicated maintenance of treatment effects for up to 6 months.

Assessment of the influence of background noise on escape-maintained problem behavior and pain behavior in a child with Williams syndrome

We examined the influence of background noise on levels of problem behavior and pain behavior under functional analysis conditions for a child with a diagnosis of Williams syndrome and hyperacusis. Background noise was associated with increases in escape-maintained problem behavior and increases in pain behavior such as clasping ears and crying. When the child was fitted with earplugs, there were substantial reductions in both problem and pain behavior under the background noise condition.

A systematic analysis of the influence of prior social context on aggression and self-injury within analogue analysis assessments

Experimental analogue analyses are sometimes used to identify the operant function of aberrant behavior for individuals with developmental disabilities. These methods are proposed to be superior to other assessment techniques because they systematically control for the presence and absence of hypothesized maintaining contingencies within the analogue analysis. Analogue analyses are usually performed over a brief period of time with little reference to the broader social context within which they are conducted. Social interactions that a person experiences prior to an analogue analysis assessment might influence performance within the assessment. The authors examined the influence of prior social conditions on levels of aberrant behavior under analogue assessments with two individuals with severe developmental disabilities. Results indicated that prior social conditions significantly influenced analogue analysis results in idiosyncratic ways for both. These findings are discussed in terms of the need to examine broad contextual influences when conducting functional analyses of aberrant behavior.

A deaf woman learning to control her excessive vocal loudness through a portable feedback system

A deaf woman learned to control her excessive vocal loudness through a portable feedback system, which provided vibratory stimulation when her voice was too loud. The mean percentage of excessively loud talking decreased from 45 prior to the use of feedback to 3 during the use of feedback. This improvement (documented by formal observation) was confirmed by normally hearing people sharing the work environment with the woman. The woman preferred a system with a contact microphone since this was virtually unaffected by environmental noise.

A corrective-feedback system for helping a person with multiple disabilities during indoor travel

An unobtrusive system, which provided corrective feedback (vibratory stimulation) for an incorrect direction, was used to help a woman with deafness and profound intellectual and visual disabilities during her indoor travel. The data showed that the woman used the system very effectively and reached destinations for performing activities independently. Implications of the findings are discussed.

Using an orientation system for indoor travel and activity with persons with multiple disabilities

PURPOSE

The study assessed the effectiveness of an orientation system, consisting of a programmable control device linked to acoustic and light sources, for facilitating independent indoor travel and activity in two persons with profound intellectual disability and blindness or severe visual impairment.

METHOD

The control device was programmed to activate each destination the persons were to reach and the acoustic or light sources leading to it automatically (i.e. after a preset time from the persons reaching the previous destination). One person was exposed to two baseline phases without the system being alternated with two orientation phases with the system; the other person received only one baseline and one orientation phase.

RESULTS

Data showed that during the orientation phases, both persons benefited from the use of the system and could reach the destinations successfully and carry out the activities.

CONCLUSIONS

The possibility of promoting independent indoor travel and activity in persons with multiple disabilities may have important implications for the condition of these persons and for rehabilitation and care centres.

Review of strategies for treating sleep problems in persons with severe or profound mental retardation or multiple handicaps

During the last 15 years, researchers have shown that a large percentage of persons with severe or profound mental retardation or multiple handicaps have serious sleep problems. These problems can cause emotional and physical burdens for caretakers, interfere with the persons' daily learning and occupational performance, and/or exacerbate deviant behaviors. Several studies have been conducted to assess behavioral and pharmacological strategies (e.g., bedtime fading and response cost, extinction, chronotherapy, and the use of melatonin) for reducing sleep problems. Those studies are reviewed here and the effectiveness, suitability, practicality, and acceptability of the strategies are discussed. Relevant issues for future research are also examined.

Evaluation of a computer-aided system providing pictorial task instructions and prompts to people with severe intellectual disability

The present study extended the evaluation of a computer-aided system providing pictorial instructions and prompts to promote task performance in people with severe intellectual disability. Four people were presented with two sets of tasks. The participants used the computer-aided system for one set and a card (control) system for the other. The results indicate that the computer-aided system was more effective than the card system with all participants. Three of the participants preferred the computer-aided system, while one favoured the card system.

Two women with multiple disabilities sharing an acoustic orientation system and traveling together to indoor destinations

This study assessed whether two women with total blindness and profound intellectual disability could share an acoustic orientation system and travel together simultaneously to common indoor destinations to perform occupational and vocational activities. The orientation system provided acoustic cues which indicated the direction to the destinations. Analysis of data indicated that the women were successful in sharing the system and could reach the destinations independently.

A review of research on physical exercise with people with severe and profound developmental disabilities

During the last two decades, a significant amount of research has examined physical exercise with people with severe and profound developmental disabilities. The research has followed three main objectives: 1) finding strategies for allowing the people to engage in physical exercise fairly independent; 2) improving the people's physical fitness; and 3) reducing the people's deviant behavior. This paper reviews the studies related to the aforementioned objectives and comments on the main findings and on the practicality and acceptability of physical exercise.

Mobility versus sedentariness in task arrangements for people with multiple disabilities: an assessment of preferences

This study was an attempt to assess preferences between a task arrangement involving mobility and a task arrangement involving sedentariness with three adults with multiple disabilities. Periods in which participants were exposed to both task arrangements were followed by periods in which they were allowed to choose between them. One participant had a strong preference for the task arrangement involving mobility from the beginning of the assessment. The other two participants developed a strong preference for the same task arrangement and showed higher levels of on-task behavior and/or of positive mood expressions within that arrangement. Aspects of the assessment as well as the use of assessment in daily contexts were discussed.

Task variation versus task repetition for people with profound developmental disabilities: an assessment of preferences

An assessment of preferences between task variation and task repetition with four adults with profound developmental disabilities was implemented. After participants were exposed to both task variation and task repetition conditions, they were allowed to choose between them. Results showed that all participants had strong preferences; three preferred task variation and one task repetition. Aspects of the assessment and use of assessment data for planning daily work conditions were discussed.