Persons with multiple disabilities increase adaptive responding and control inadequate posture or behavior through programs based on microswitch-cluster technology

Multimodal communication reported by familiar caregivers to build communication capacity in persons who are minimally conscious

PURPOSE

Limited clinical and research evidence is available to support healthcare practitioners in the communication assessment and intervention of persons who are minimally conscious. This study placed a specific focus on the multimodal communication strategies familiar caregivers of persons who are minimally conscious observed, as well as the verbal and the nonverbal communication strategies they employed to build communication capacity. This may inform clinical practice as it provides valuable autobiographical information as well as familiar stimuli that may elicit responses from persons in a minimally conscious state.

METHOD

A descriptive qualitative design employing in-depth semi-structured interviews with familiar caregivers was utilised to address the purpose of the study.

RESULT

Familiar caregivers reported that they used both nonverbal and verbal communication strategies to obtain a response from persons who are minimally conscious. These caregivers also reported that these persons appeared to rely on nonverbal communication strategies to express 36 different communication functions.

CONCLUSION

Based on the findings of this study, it is clear that caregivers can be beneficial to persons who are minimally conscious, if they are able to observe and capitalise on naturally occurring multimodal communication strategies and functions. This study emphasises that familiar caregivers respect and value the dignity of persons who are minimally conscious and want to improve their communication capacity, but often lack confidence in their own communication skills.

Everyday Technology to Help People with Intellectual and Other Disabilities Access Stimulation via Functional Motor Responses and Improved Body Posture

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.

Psychological eHealth interventions for people with intellectual disabilities: A scoping review

BACKGROUND

The use of eHealth, which has accelerated in the wake of the COVID-19 pandemic, could contribute to the access to tailor-made psychological interventions for people with intellectual disabilities.

METHOD

A scoping review was conducted on peer-reviewed studies between 1996-2019.

RESULTS

Thirty-three studies reported on the use of psychological eHealth interventions focused on mental health problems and/or challenging behaviour. The vast majority of these studies reported on interventions that were delivered at the individual level. The context in which these interventions were delivered varied, primarily ranging from the home setting to residential settings, as well as day or activity centres and schools. The studies described various types of interventions: telehealth interventions, computerized cognitive behavioural therapy, and interventions focused on (social) learning principles targeting challenging behaviour.

CONCLUSIONS

eHealth provides new opportunities for both therapists and lay-therapists to deliver psychological interventions. Future studies should focus on the effectiveness of psychological eHealth interventions.

Assistive technology for people with PIMD in challenging scenarios

Purpose

The purpose of this study is to examine in what type of scenarios of daily life assistive technology such as the INSENSION system would provide considerable benefit for people with profound intellectual and multiple disabilities (PIMD).

Design/methodology/approach

A series of focus group workshops were held with relatives of people with PIMD and direct support professionals (DSPs), as well as experts in information and communications technology (ICT). They were oriented towards the design thinking approach and moderated as per the Disney method.

Findings

The participants identified transitions from known to unknown caregivers, provision of care during the night and the impact of external factors on a person’s mood as challenging situations within the PIMD context.

Practical implications

Solving these problems would lead to considerable benefits to the affected people. Based on the ideas gathered in workshops, three technological applications for the INSENSION system were derived, i.e. communication application, multimedia player and smart room devices, all of which will provide remedies in specific usage scenarios.

Originality/value

Methods drawing on the participant’s creativity in combination with the workshops’ multi-perspectivity facilitated a direct reference to the daily life of the target group. In this manner, the innovative ICT system INSENSION can be oriented towards the requirements of this vulnerable group.

Persons with multiple disabilities engage in stimulus choice and postural control with the support of a technology-aided program

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.

People with multiple disabilities learn to engage in occupation and work activities with the support of technology-aided programs

These two studies were aimed at assessing technology-aided programs to help persons with multiple disabilities engage in basic occupation or work activities. Specifically, Study I focused on teaching two participants (an adolescent and an adult) with low vision or total blindness, severe/profound intellectual disabilities, and minimal object interaction to engage in constructive object-manipulation responses. The technology monitored their responses and followed them with brief stimulation periods automatically. Study II focused on teaching three adults with deafness, severe visual impairment, and profound intellectual disabilities to perform a complex activity, that is, to assemble a five-component water pipe. The technology regulated (a) light cues to guide the participants through the workstations containing single pipe components and the carton for completed pipes and (b) stimulation events. The results of both studies were positive. The participants of Study I showed consistent and independent engagement in object-manipulation responses. The participants of Study II showed consistent and independent pipe assembling performance. General implications of the two programs and the related technology packages for intervention with persons with multiple disabilities are discussed.

Further evaluation of a telephone technology for enabling persons with multiple disabilities and lack of speech to make phone contacts with socially relevant partners

This study assessed whether a girl and a woman with multiple disabilities could (a) make phone contacts with relevant partners through a special telephone technology, and (b) enjoy their telephone-mediated communication with them. The technology involved a net-book computer, a global system for mobile communication modem (GSM), an optic microswitch, and specific software. The technology was programmed to present the names of the partners available for contact, and the participants could choose at each presentation sequence the one they wanted to contact with a simple microswitch response. Such response triggered the computer to place a phone call to that partner. Both participants (a) learned to use the technology quite rapidly to contact relevant partners and maintained the successful use of it over the intervention and post-intervention sessions, (b) showed high levels of indices of happiness during the phone calls as opposed to pre-baseline control sessions, and (c) showed preferences among the partners. Implications of the findings are discussed.