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Singh NN, Matson JL, Lancioni GE, Singh AN, Adkins AD, McKeegan GF, Brown SW. Questions About Behavioral Function in Mental Illness (QABF-MI). Behav Modif 2016; 30:739-51. [PMID: 17050763 DOI: 10.1177/0145445506286700] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The Questions About Behavioral Function (QABF), a 25-item rating scale, was developed to identify the function(s) of maladaptive behavior in individuals with developmental disabilities. The authors adapted it for use with individuals with serious mental illness who engage in maladaptive behavior and assessed the psychometric characteristics of the new scale (Questions About Behavioral Function in Mental Illness; QABF-MI) in a sample of 135 adults with serious mental illness from three inpatient psychiatric hospitals. Staff most familiar with each person rated each item on a 5-point Likert-type rating scale, and the ratings were subjected to a number of psychometric analyses. The results of factor analyses provided a conceptually meaningful five-factor solution: physical discomfort, social attention, tangible reinforcement, escape, and nonsocial reinforcement. Congruence between the five factors derived with the QABF-MI and the corresponding factors in the original QABF was perfect. The results indicated that the QABF-MI has robust psychometric properties and may be useful as a screening tool for determining the nature of the variables that maintain maladaptive behavior exhibited by individuals with serious mental illness.
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Singh NN, Lancioni GE, Winton ASW, Adkins AD, Singh J, Singh AN. Mindfulness Training Assists Individuals With Moderate Mental Retardation to Maintain Their Community Placements. Behav Modif 2016; 31:800-14. [DOI: 10.1177/0145445507300925] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The mindfulness procedure Meditation on the Soles of the Feet can help individuals with mild mental retardation control aggressive behavior. In this study, our aim was to teach this mindfulness technique, using a multiple baseline design, to 3 individuals with moderate mental retardation who were at risk of losing their community placements because of their aggressive behavior. These individuals initially found the procedure difficult to comprehend because they could not easily visualize past anger-producing situations, but mastery was achieved when we incorporated recreating-the-scene as a prompt and added a discriminative stimulus on the soles of the participants' feet. Aggressive behavior decreased with mindfulness training, and follow-up data showed that they managed their aggressive behavior in the community for at least 2 years and thus were able to retain their community placements.
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Abstract
The effects of two training procedures for teaching sign language to four me-ntally retarded persons were evaluated. Positive practice overcorrection alone, in combination with positive reinforcement, and a no-training control condition were compared in an alternating treatments design. During baseline, each sub-ject was required to observe the trainer say and sign the target word and then to say and sign the same word upon request. During positive practice overcorre-ction, an error in sign production resulted in the subject having to repeat the correct response five times. For the combined procedure each correct response resulted in positive reinforcement. No assistance or feedback was provided in the no-training control condition. All subjects learned new signs under both training conditions, but the addition of positive reinforcement was superior to positive practice alone with three subjects. Both procedures were equally effect-ive with the fourth subject. No learning took place in the no-training control condition. Two subjects were able to vocalize all words correctly, no change in vocalization was observed in the third, and some improvement was noted in the fourth, particularly under the reinforcement condition.
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Lancioni GE, O'Reilly MF, Singh NN, Sigafoos J, Oliva D, Baccani S, Groeneweg J. Microswitch Clusters Promote Adaptive Responses and Reduce Finger Mouthing in a Boy With Multiple Disabilities. Behav Modif 2016; 30:892-900. [PMID: 17050769 DOI: 10.1177/0145445505283416] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors assessed new microswitch clusters (i.e., combinations of two microswitches) and contingent stimulation to increase adaptive responses (i.e., foot and head movements) and reduce aberrant behavior (i.e., finger mouthing)in a boy with multiple disabilities. Initially, intervention was directed at increasing the frequency of each adaptive response, individually, through contingent use of preferred stimuli. Subsequently, adaptive responses led to preferred stimuli only if they occurred in the absence of finger mouthing. Postintervention checks occurred 1, 2, and 3 months after the end of the intervention. Data showed that the boy (a) increased the frequency of the adaptive responses extensively, (b) learned to perform these responses largely free from finger mouthing, and (c) maintained these changes over time. The importance of microswitch clusters to simultaneously pursue the dual objective of promoting adaptive responses and reducing aberrant ones is underlined.
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Singh NN, Singh SD, Sabaawi M, Myers RE, Wahler RG. Enhancing Treatment Team Process Through Mindfulness-Based Mentoring in an Inpatient Psychiatric Hospital. Behav Modif 2016; 30:423-41. [PMID: 16723423 DOI: 10.1177/0145445504272971] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors investigated changes in treatment team functioning in an adult inpatient psychiatric hospital after the implementation of a mindfulness-based mentoring intervention. Using a multiple baseline across treatment teams design, the authors assessed levels of functioning of three treatment teams using a 50-item rating scale and then introduced mindfulness-based mentoring successively across the treatment teams. Following intervention, four follow-up assessments at 3-month intervals were undertaken to assess the durability of the enhanced treatment team functioning levels in the absence of mentoring. Results showed that with the introduction of mindfulness-based mentoring, treatment team performance was enhanced, patients'attendance at therapeutic groups and individual therapy sessions was maximized, and patient and staff satisfaction with treatment team functioning was substantially increased, with patient satisfaction showing greater gains than staff satisfaction. Mindfulness-based mentoring may be an efficient and effective intervention for enhancing and maintaining the performance of treatment teams in adult psychiatric hospitals.
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Abstract
Of those who suffer from obsessive-compulsive disorder (OCD), a substantial number do not respond well to the standard treatment of two trials of serotonin reuptake inhibitors and cognitive-behavioral therapy. In addition to being refractory to current treatments, these individuals often have comorbid disorders that contribute to a compromised quality of life. The authors present the case of such an individual who was assisted to improve her quality of life by accepting her OCD as a strength and enhancing her mindfulness so that she was able to incorporate her OCD in her daily life. Results showed that she successfully overcame her debilitating OCD and was taken off all medication within 6 months of intervention. Three years of postintervention follow-up showed that she was well adjusted, had a full and healthy lifestyle and that although some obsessive thoughts remained, they did not control her behavior.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, D'Amico F, Buonocunto F, Navarro J, Lanzilotti C, Fiore P, Megna M, Damiani S. Assistive technology to help persons in a minimally conscious state develop responding and stimulation control: Performance assessment and social rating. NeuroRehabilitation 2016; 37:393-403. [PMID: 26518532 DOI: 10.3233/nre-151269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Post-coma persons in a minimally conscious state (MCS) and with extensive motor impairment and lack of speech tend to be passive and isolated. OBJECTIVE This study aimed to (a) further assess a technology-aided approach for fostering MCS participants' responding and stimulation control and (b) carry out a social validation check about the approach. METHODS Eight MCS participants were exposed to the aforementioned approach according to an ABAB design. The technology included optic, pressure or touch microswitches to monitor eyelid, hand or finger responses and a computer system that allowed those responses to produce brief periods of positive stimulation during the B (intervention) phases of the study. Eighty-four university psychology students and 42 care and health professionals were involved in the social validation check. RESULTS The MCS participants showed clear increases in their response frequencies, thus producing increases in their levels of environmental stimulation input, during the B phases of the study. The students and care and health professionals involved in the social validation check rated the technology-aided approach more positively than a control condition in which stimulation was automatically presented to the participants. CONCLUSIONS A technology-aided approach to foster responding and stimulation control in MCS persons may be effective and socially desirable.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Campodonico F. Case Studies of Technology-aided Interventions to Promote Hand Reaching and Standing or Basic Ambulation in Persons with Multiple Disabilities. Percept Mot Skills 2016; 122:200-19. [PMID: 27420316 DOI: 10.1177/0031512516630017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Motor impairments such as lack of standing and/or independent ambulation are common among persons with multiple disabilities. These two studies assessed technology-aided programs for persons with those impairments. Specifically, Study I assessed a program to teach two non-ambulatory adults to hand reach a stimulation-linked object by standing up. Study II assessed a program to teach a child and a man to ambulate while holding a rail or following a corridor wall. Standing increased from below 15% to about or over 80% of the session duration in Study I. The participants of Study II managed to complete brief ambulation trials independent of guidance. These performance achievements were discussed in relation to the technology-aided programs employed in the studies and the programs' applicability in daily contexts.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, D'Amico F, Renna C, Pinto K. Technology-Aided Programs to Support Positive Verbal and Physical Engagement in Persons with Moderate or Severe Alzheimer's Disease. Front Aging Neurosci 2016; 8:87. [PMID: 27148050 PMCID: PMC4838628 DOI: 10.3389/fnagi.2016.00087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 04/08/2016] [Indexed: 01/10/2023] Open
Abstract
Pilot studies using technology-aided programs to promote verbal reminiscence and mild physical activity (i.e., positive forms of engagement) in persons with moderate or severe Alzheimer's disease have provided promising results (Lancioni et al., 2015a,b). The present two studies were aimed at upgrading and/or extending the assessment of those programs. Specifically, Study 1 upgraded the program for verbal reminiscence and assessed it with eight new participants. The upgraded version automatically monitored the participants' verbal behavior during the sessions, in which photos and brief videos were used to foster verbal reminiscence. Monitoring allowed computer approval and reminders to be consistent with the participants' behavior. Study 2 extended the assessment of the program for promoting mild physical activity with 10 new participants for whom arm-raising responses were targeted. The results of Study 1 showed that the participants' mean percentages of intervals with verbal engagement/reminiscence were below 10 during baseline and control sessions and between above 50 and nearly 80 during the intervention. The results of Study 2 showed that the mean frequencies of arm-raising responses were about or below four and between about 10 and 19 per session during the baseline and the intervention, respectively. The general implications of the aforementioned results and the need for new research in the area were discussed.
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Singh NN, Lancioni GE, Karazsia BT, Myers RE. Caregiver Training in Mindfulness-Based Positive Behavior Supports (MBPBS): Effects on Caregivers and Adults with Intellectual and Developmental Disabilities. Front Psychol 2016; 7:98. [PMID: 26903906 PMCID: PMC4746712 DOI: 10.3389/fpsyg.2016.00098] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 01/18/2016] [Indexed: 01/09/2023] Open
Abstract
Caregivers often manage the aggressive behavior of individuals with intellectual and developmental disabilities that reside in community group homes. Sometimes this results in adverse outcomes for both the caregivers and the care recipients. We provided a 7-day intensive Mindfulness-Based Positive Behavior Support (MBPBS) training to caregivers from community group homes and assessed the outcomes in terms of caregiver variables, individuals' behaviors, and an administrative outcome. When compared to pre-MBPBS training, the MBPBS training resulted in the caregivers using significantly less physical restraints, and staff stress and staff turnover were considerably reduced. The frequency of injury to caregivers and peers caused by the individuals was significantly reduced. A benefit-cost analysis showed substantial financial savings due to staff participation in the MBPBS program. This study provides further proof-of-concept for the effectiveness of MBPBS training for caregivers, and strengthens the call for training staff in mindfulness meditation.
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Lancioni GE, O’Reilly MF, Singh NN, Sigafoos J, Boccasini A, La Martire ML, Perilli V, Spagnuolo C. Technology to support positive occupational engagement and communication in persons with multiple disabilities. ACTA ACUST UNITED AC 2016. [DOI: 10.1515/ijdhd-2015-0023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractPersons with multiple (intellectual and sensory-motor) disabilities can have serious difficulties managing their independent engagement in leisure activities and communication, particularly with partners not present in their immediate environment.This study assessed two versions of a technology-aided program (involving a computer system to present leisure and communication options and a microswitch to choose among them) with four participants with multiple disabilities. Two participants used the first version of the program, which allowed them to choose among leisure (music) options. The other two participants used the second version of the program, which allowed them to choose among leisure (music and videos) and communication (telephone calls) options. Each program version was implemented according to a non-concurrent multiple baseline design across participants.Data showed that both program versions were successful in helping the participants achieve the objectives pursued, that is, choose and access leisure or leisure and communication options independently.Technology-aided programs can enable persons with multiple disabilities to manage positive occupational engagement and communication.
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, D’Amico F, Ferlisi G, Zullo V, Denitto F, Lauta E, Abbinante C, Pesce CV. A basic technology-aided programme for leisure and communication of persons with advanced amyotrophic lateral sclerosis: performance and social rating. Disabil Rehabil Assist Technol 2015; 12:145-152. [DOI: 10.3109/17483107.2015.1104561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Lancioni GE, Singh NN, O'reilly MF, Sigafoos J, Buonocunto F, D'amico F, Quaranta S, Navarro J, Lanzilotti C, Colonna F. EXTENDING THE ASSESSMENT OF TECHNOLOGY-AIDED PROGRAMS TO SUPPORT LEISURE AND COMMUNICATION IN PEOPLE WITH ACQUIRED BRAIN INJURY AND EXTENSIVE MULTIPLE DISABILITIES. Percept Mot Skills 2015; 121:621-34. [PMID: 26445152 DOI: 10.2466/15.pms.121c19x1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Intervention programs for people with acquired brain injury and extensive motor and communication impairment need to be diversified according to their characteristics and environment. These two studies assessed two technology-aided programs for supporting leisure (i.e., access to songs and videos) and communication (i.e., expressing needs and feelings and making requests) in six of those people. The three people participating in Study 1 did not possess speech but were able to understand spoken and written sentences. Their program presented leisure and communication options through written phrases appearing on the computer screen. The three people participating in Study 2 did not possess any speech and were unable to understand spoken or written language. Their program presented leisure and communication options through pictorial images. All participants relied on a simple microswitch response to enter the options and activate songs, videos, and communication messages. The data showed that the participants of both studies learned to use the program available to them and to engage in leisure and communication independently. The importance of using programs adapted to the participants and their environment was discussed.
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Lancioni GE, Simone IL, De Caro MF, Singh NN, O'Reilly MF, Sigafoos J, Ferlisi G, Zullo V, Schirone S, Denitto F, Zonno N. Assisting persons with advanced amyotrophic lateral sclerosis in their leisure engagement and communication needs with a basic technology-aided program. NeuroRehabilitation 2015; 36:355-65. [PMID: 26409339 DOI: 10.3233/nre-151224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Eye-tracking communication devices and brain-computer interfaces are the two resources available to help people with advanced amyotrophic lateral sclerosis (ALS) avoid isolation and passivity. OBJECTIVE This study was aimed at assessing a technology-aided program (i.e., a third possible resource) for five patients with advanced ALS who needed support for communication and leisure activities. METHODS The participants were exposed to baseline and intervention conditions. The technology-aided program, which was used during the intervention, (a) included the communication and leisure options that each participant considered important for him or her (e.g., music, videos, statements/requests, and text messaging) and (b) allowed the participant to access those options with minimal responses (e.g., finger movement or eyelid closure) monitored via microswitches. RESULTS The participants started leisure and communication engagement independently only during the intervention (i.e., when the program was used). The mean percentages of session time spent in those forms of engagement were between about 60 and 80. Preference checks and brief interviews indicated that participants and families liked the program. CONCLUSIONS The program might be viewed as an additional approach/resource for patients with advanced ALS.
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J. Assistive Technology for Behavioral Interventions for Persons with Severe/Profound Multiple Disabilities: A Selective Overview. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/15021149.2011.11434352] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, D'Amico F, Ferlisi G, Denitto F, De Vanna F, Belardinelli MO. Patients with moderate Alzheimer's disease engage in verbal reminiscence with the support of a computer-aided program: a pilot study. Front Aging Neurosci 2015; 7:109. [PMID: 26089797 PMCID: PMC4452885 DOI: 10.3389/fnagi.2015.00109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/22/2015] [Indexed: 11/24/2022] Open
Abstract
This study focused on the assessment of a program recently developed for helping patients with moderate Alzheimer’s disease engage in computer-mediated verbal reminiscence (Lancioni et al., 2014a). Sixteen participants were involved in the study. Six of them used the original program version with the computer showing a virtual partner posing questions and providing attention and guidance. The other 10 used a slightly modified program version with the computer presenting photos and videos and providing encouragements to talk as well as attention and guidance. Participants were exposed to brief program sessions individually. The results showed that 15 participants (five of those using the first version and all of those using the second version) had a clear and lasting increase in verbal engagement/reminiscence during the intervention sessions with the program. Those 15 participants had mean percentages of intervals with verbal engagement/reminiscence below 10 during baseline and between about 45 and 75 during the intervention. The results’ implications and the need for new research were discussed.
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Lancioni GE, Bosco A, De Caro MF, Singh NN, O'Reilly MF, Green VA, Ferlisi G, Zullo V, D'Amico F, Addante LM, Denitto F, Zonno N. Effects of response-related music stimulation versus general music stimulation on positive participation of patients with Alzheimer's disease. Dev Neurorehabil 2015; 18:169-76. [PMID: 23869934 DOI: 10.3109/17518423.2013.802388] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Assessing the effects of response-related music stimulation versus general (response-unrelated) music stimulation on positive participation of 11 new patients with Alzheimer's disease. METHOD The patients were functioning in the severe and low-moderate ranges of the disease. Positive participation included behaviors such as, singing or rhythmic movements and smiles. Both music conditions relied on the display of music/song videos on a computer screen. In the response-related (active) condition, the patients used a simple hand response and a microswitch to determine music stimulation inputs. In the general (unrelated/passive) condition, music stimulation was automatically presented throughout the sessions. RESULTS Data showed that six of the 11 patients had higher levels of positive participation in the response-related stimulation condition. The remaining five patients did not have differences between the two conditions. CONCLUSION Based on this evidence and previous findings, one might consider the use of the active condition beneficial for daily programs.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Perilli V, Campodonico F, Marchiani P, Lang R. Persons with multiple disabilities engage in stimulus choice and postural control with the support of a technology-aided program. Behav Modif 2015; 39:454-71. [PMID: 25733662 DOI: 10.1177/0145445515572187] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Technology-aided programs have been reported to help persons with disabilities develop adaptive responding and control problem behavior/posture. This study assessed one such program in which choice of stimulus events was used as adaptive responding for three adults with multiple disabilities. A computer system presented the participants stimulus samples. For each sample, they could perform a choice response (gaining access to the related stimulus whose length they could extend) or abstain from responding (making the system proceed to the next sample). Once choice responding had strengthened, the program also targeted the participants' problem posture (i.e., head and trunk forward bending). The stimulus exposure gained with a choice response was interrupted if the problem posture occurred. All three participants successfully (a) managed choice responses and access to preferred stimuli and (b) gained postural control (i.e., reducing the problem posture to very low levels). The practical implications of those results are discussed.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Belardinelli MO, Buonocunto F, D'Amico F, Navarro J, Lanzilotti C, Denitto F, De Tommaso M, Megna M. Supporting self-managed leisure engagement and communication in post-coma persons with multiple disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 38:75-83. [PMID: 25546297 DOI: 10.1016/j.ridd.2014.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 12/09/2014] [Indexed: 06/04/2023]
Abstract
Post-coma persons affected by extensive motor impairment and lack of speech, with or without disorders of consciousness, need special support to manage leisure engagement and communication. These two studies extended research efforts aimed at assessing basic technology-aided programs to provide such support. Specifically, Study I assessed a program for promoting independent stimulation choice in four post-coma persons who combined motor and speech disabilities with disorders of consciousness (i.e., were rated between the minimally conscious state and the emergence from such state). Study II assessed a program for promoting independent television operation and basic communication in three post-coma participants who, contrary to those involved in Study I, did not have disorders of consciousness (i.e., had emerged from a minimally conscious state). The results of the studies were largely positive with substantial levels of independent stimulation choice and access for the participants of Study I and independent television operation and communication for the participants of Study II. The results were analyzed in relation to previous data in the area and in terms of their implications for daily contexts dealing with these persons.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, D'Amico F, Sasanelli G, De Vanna F, Signorino M. Persons with Alzheimer's disease engage in leisure and mild physical activity with the support of technology-aided programs. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 37:55-63. [PMID: 25460220 DOI: 10.1016/j.ridd.2014.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 11/06/2014] [Indexed: 06/04/2023]
Abstract
Three studies were conducted to assess technology-aided programs to promote leisure engagement and mild physical activity in persons with Alzheimer's disease. Specifically, Study I assessed a program aimed at enabling three patients with mild or moderate Alzheimer's disease to choose among different music options and activate the preferred ones. Studies II and III were directed at patients in the low moderate or severe stages of the Alzheimer's disease who were no longer capable of ambulating and spent their time generally inactive, sitting in their wheelchairs. In particular, Study II used a program to help three patients exercise an arm-raising movement. Study III used a program to help three patients exercise a leg-foot movement. Each study was carried out according to a nonconcurrent multiple baseline design across patients. Results were very encouraging. The patients of Study I learned to choose and activate their preferred music pieces. The patients of Studies II and III enhanced their performance of the target movements and increased their indices of positive participation (e.g., smiles and verbalizations) during the sessions. The applicability of the programs in daily contexts and their implications for the patients involved are discussed.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Olivetti Belardinelli M, Buonocunto F, D'Amico F, Navarro J, Lanzilotti C, Ferlisi G, Denitto F. Technology-aided programs for post-coma patients emerged from or in a minimally conscious state. Front Hum Neurosci 2014; 8:931. [PMID: 25538593 PMCID: PMC4257021 DOI: 10.3389/fnhum.2014.00931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 10/31/2014] [Indexed: 11/17/2022] Open
Abstract
Post-coma persons in a minimally conscious state (MCS) or emerged/emerging from such state (E-MCS), who are affected by extensive motor impairment and lack of speech, may develop an active role and interact with their environment with the help of technology-aided intervention programs. Although a number of studies have been conducted in this area during the last few years, new evidence about the efficacy of those programs is warranted. These three studies were an effort in that direction. Study I assessed a technology-aided program to enable six MCS participants to access preferred environmental stimulation independently. Studies II and III assessed technology-aided programs to enable six E-MCS participants to make choices. In Study II, three of those participants were led to choose among leisure and social stimuli, and caregiver interventions automatically presented to them. In Study III, the remaining three participants were led to choose (a) among general stimulus/intervention options (e.g., songs, video-recordings of family members, and caregiver interventions); and then (b) among variants of those options. The results of all three studies were largely positive with substantial increases of independent stimulation access for the participants of Study I and independent choice behavior for the participants of Studies II and III. The results were analyzed in relation to previous data and in terms of their implications for daily contexts working with MCS and E-MCS persons affected by multiple disabilities.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Ferlisi G, Zullo V, Schirone S, Prisco R, Denitto F. A computer-aided program for helping patients with moderate Alzheimer's disease engage in verbal reminiscence. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3026-3033. [PMID: 25124700 DOI: 10.1016/j.ridd.2014.07.047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 07/22/2014] [Indexed: 06/03/2023]
Abstract
This study assessed a simple computer-aided program for helping patients with moderate Alzheimer's disease engage in verbal reminiscence. In practice, the program was aimed at fostering the patient's verbal engagement on a number of life experiences/topics previously selected for him or her and introduced in the sessions through a friendly female, who appeared on the computer screen. The female asked the patient about the aforementioned experiences/topics, and provided him or her with positive attention, and possibly verbal guidance (i.e., prompts/encouragements). Eight patients were involved in the study, which was carried out according to non-concurrent multiple baseline designs across participants. Seven of them showed clear improvement during the intervention phase (i.e., with the program). Their mean percentages of intervals with verbal engagement/reminiscence ranged from close to zero to about 15 during the baseline and from above 50 to above 75 during the intervention. The results were discussed in relation to previous literature on reminiscence therapy, with specific emphasis on the need for (a) replication studies and (b) the development of new versions of the technology-aided program to improve its impact and reach a wider number of patients.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Renna C, Pinto K, De Vanna F, Caffò AO, Stasolla F. Persons with moderate Alzheimer's disease use simple technology aids to manage daily activities and leisure occupation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2117-2128. [PMID: 24881006 DOI: 10.1016/j.ridd.2014.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 05/05/2014] [Indexed: 06/03/2023]
Abstract
Two studies assessed technology-aided programs to support performance of daily activities and selection/activation of music items with patients with moderate Alzheimer's disease. In Study I, four patients were presented with activity-related pictorial instructions via a computer fitted with inexpensive, commercial software. In Study II, four patients were (a) presented with different music options and (b) allowed to select and activate the preferred option via a microswitch response. Study I showed that each patient learned to perform the two activities available with percentages of correct responses exceeding 85 by the end of the intervention. Study II showed that all patients learned to choose and activate music options. Psychology students, employed in a social validation check, scored the patients' behavior within the program better than their behavior in a control situation. The relevance and usability of simplified pictorial-instruction programs and music choice programs for patients with moderate Alzheimer's disease were discussed.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Perilli V, Oliva D, Buono S. Microswitch-aided programs to support physical exercise or adequate ambulation in persons with multiple disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2190-2198. [PMID: 24915648 DOI: 10.1016/j.ridd.2014.05.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 05/16/2014] [Indexed: 06/03/2023]
Abstract
Three microswitch-aided programs were assessed in three single-case studies to enhance physical exercise or ambulation in participants with multiple disabilities. Study I was aimed at helping a woman who tended to have the head bending forward and the arms down to exercise a combination of appropriate head and arms movements. Study II was aimed at promoting ambulation continuity with a man who tended to have ambulation breaks. Study III was aimed at promoting ambulation with appropriate foot position in a girl who usually showed toe walking. The experimental designs of the studies consisted of a multiple probe across responses (Study I), an ABAB sequence (Study II), and an ABABB(1) sequence (Study III). The last phase of each study was followed by a post-intervention check. The microswitches monitored the target responses selected for the participants and triggered a computer system to provide preferred stimuli contingent on those responses during the intervention phases of the studies. Data showed that the programs were effective with each of the participants who learned to exercise head and arms movements, increased ambulation continuity, and acquired high levels of appropriate foot position during ambulation, respectively. The positive performance levels were retained during the post-intervention checks. The discussion focused on (a) the potential of technology-aided programs for persons with multiple disabilities and (b) the need of replication studies to extend the evidence available in the area.
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