Camera-based microswitch technology for eyelid and mouth responses of persons with profound multiple disabilities: two case studies

From assistive to inclusive? A systematic review of the uses and effects of technology to support people with pervasive support needs

BACKGROUND

Although particular technologies can enhance the quality of life (QoL) of people with profound intellectual and multiple disabilities (we use the term pervasive support needs), their objectives and outcomes are understudied. A systematic literature review was therefore conducted to explore this topic.

METHOD

A search of four databases yielded 64 studies. Data were extracted on their general characteristics, methods and sample characteristics as well as the technology types, QoL domains and application within ecological systems. A narrative synthesis was subsequently developed.

RESULTS

Most of the studies applied assistive technology (AT) and focused on personal development and self-determination on an individual level.

CONCLUSIONS

Technology can enhance the QoL of people with pervasive support needs. There are indications that although MT and UD-based technology are used in practice, few studies have examined these technologies. Therefore, there is a knowledge gap regarding the kinds of technology that are used in practice.

Looking back, looking forward: Methodological challenges and future directions in research on persons with profound intellectual and multiple disabilities

BACKGROUND

Within the context of the Special Interest Research Group (SIRG) on Persons with Profound Intellectual and Multiple Disabilities (PIMD), researchers often discuss the methodological problems and challenges they are confronted with. The aim of the current article was to give an overview of these challenges.

METHODS

The challenges are centred on six topics. These reflect the main components of a study's design: (a) participant demarcation, (b) participant recruitment, (c) data collection and instruments, (d) data analysis, (e) ethics/including the "voice" of persons with PIMD and (f) theoretical models.

RESULTS

Next, to describing the specific challenges, possible solutions and pathways to address them are discussed. These are illustrated by recent studies by the authors and other researchers in the field.

CONCLUSIONS

The current contribution wants to stimulate further discussion and exchange of ideas, and the development of creative research techniques.

New camera-based microswitch technology to monitor small head and mouth responses of children with multiple disabilities

OBJECTIVE

Assessing a new camera-based microswitch technology, which did not require the use of color marks on the participants' face.

METHOD

Two children with extensive multiple disabilities participated. The responses selected for them consisted of small, lateral head movements and mouth closing or opening. The intervention was carried out according to a multiple probe design across responses. The technology involved a computer with a CPU using a 2-GHz clock, a USB video camera with a 16-mm lens, a USB cable connecting the camera and the computer, and a special software program written in ISO C++ language.

RESULTS

The new technology was satisfactorily used with both children. Large increases in their responding were observed during the intervention periods (i.e. when the responses were followed by preferred stimulation).

CONCLUSION

The new technology may be an important resource for persons with multiple disabilities and minimal motor behavior.

Two persons with multiple disabilities use camera-based microswitch technology to control stimulation with small mouth and eyelid responses

BACKGROUND

A camera-based microswitch technology was recently developed to monitor small facial responses of persons with multiple disabilities and allow those responses to control environmental stimulation. This study assessed such a technology with 2 new participants using slight variations of previous responses.

METHOD

The technology involved a computer with a CPU using a 2GHz clock, a USB video camera with 16-mm lens, and special software. Small colour spots were used under the lower lip of one participant and on the eyelid of the other participant to aid the camera and computer to detect their mouth and eyelid responses. The study involved an ABAB design and included a 3-week post-intervention check.

RESULTS

The participants' mouth and eyelid responses increased during the intervention (B) phases and post-intervention check (i.e., when the technology allowed them to control stimulation).

CONCLUSIONS

Camera-based microswitch technology can help persons with multiple disabilities control stimulation with small responses.

Technology-based programs to support forms of leisure engagement and communication for persons with multiple disabilities: two single-case studies

OBJECTIVE

To extend the assessment of technology-based programs for promoting stimulus choice and staff/caregiver calls or radio operation and text messaging.

METHOD

In Study I, the program involved a portable computer, commercial software, and a microswitch to allow a man with motor impairment and moderate intellectual disability to choose among preferred stimuli (e.g., songs and film clips) and persons to call. In Study II, the programs involved (a) a radio device and an electronic control unit or (b) a net-book computer and a global system for mobile communication. A woman with blindness and moderate intellectual disability used a microswitch to operate the radio or send and listen to text messages.

RESULTS

The participants succeeded in using the technology-aided programs through simple microswitch activations involving partial hand closure (Study I) or hand pressure (Study II).

CONCLUSION

Technology-based programs can provide persons with multiple disabilities relevant leisure and communication opportunities.

Persons with multiple disabilities select environmental stimuli through a smile response monitored via camera-based technology

OBJECTIVE

To assess whether two persons with multiple disabilities could use smile expressions and new camera-based microswitch technology to select environmental stimuli.

METHOD

Within each session, a computer system provided samples/reminders of preferred and non-preferred stimuli. The camera-based microswitch determined whether the participants had smile expressions in relation to those samples. If they did, stimuli matching the specific samples to which they responded were presented for 20 seconds.

RESULTS

The smile expression could be profitably used by the participants who managed to select means of ∼70% or 75% of the preferred stimulus opportunities made available by the environment while avoiding almost all the non-preferred stimulus opportunities.

CONCLUSION

Smile expressions (a) might be an effective and rapid means for selecting preferred stimulation and (b) might develop into cognitively more elaborate forms of responding through the learning experience (i.e. their consistent association with positive/reinforcing consequences).

Post-coma persons with extensive multiple disabilities use microswitch technology to access selected stimulus events or operate a radio device

The present two studies extended research evidence on the use of microswitch technology by post-coma persons with multiple disabilities. Specifically, Study I examined whether three adults with a diagnosis of minimally conscious state and multiple disabilities could use microswitches as tools to access brief, selected stimulus events. Study II assessed whether an adult, who had emerged from a minimally conscious state but was affected by multiple disabilities, could manage the use of a radio device via a microswitch-aided program. Results showed that the participants of Study I had a significant increase of microswitch responding during the intervention phases. The participant of Study II learned to change radio stations and seemed to spend different amounts of session time on the different stations available (suggesting preferences among the programs characterizing them). The importance of microswitch technology for assisting post-coma persons with multiple disabilities to positively engage with their environment was discussed.