An assistive technology program for enabling five adolescents emerging from a minimally conscious state to engage in communication, occupation, and leisure opportunities

A Technology System to Help People With Multiple Disabilities Increase Contact With Objects and Control Environmental Stimulation: Single-Case Research Design

BACKGROUND

People with severe-to-profound intellectual disability and sensory-motor impairment tend to be passive and detached from their immediate context.

OBJECTIVE

This study assessed a new technology system using a webcam to detect participants' responses (ie, hand contact with objects) and to trigger computer delivery of preferred environmental stimulation, such as music, contingent on (immediately after) the occurrence of those responses.

METHODS

In total, 8 adults with severe to profound intellectual disability and extensive motor and visual impairments participated in the study. Each participant was exposed to an ABACB design. The technology system did not provide stimulation during the A (baseline) phases, provided stimulation contingent on the responses during the B (intervention) phases, and provided stimulation throughout the sessions during the C (control) phase. Sessions lasted 5 minutes.

RESULTS

During the first baseline phase, the participants' mean frequency of responses per session was between about 3 and 6.5. During the first intervention phase, it increased to between about 10 and 18. It showed a clear decline during the second baseline phase, remained low during the control phase, and increased again during the second intervention phase. During this phase, it ranged from about 13 to 19.5.

CONCLUSIONS

The new technology system might be a useful tool to help people with intellectual and sensory-motor disabilities increase object contact and stimulation control.

Technology for helping people with neuromotor, intellectual, and speech disabilities engage in leisure and communication activities: a proof-of-concept study

We extended the assessment of our recently developed technology to help people with neuromotor, intellectual, and speech disabilities access (listen to) music, communicate with distant partners, and answer questions. The technology included a tablet (1) fitted with an Internet connection, a SIM card, WhatsApp Messenger, and MacroDroid application, and (2) interfaced with different pairs of response sensors. Six participants were included in the study, which was carried out according to a nonconcurrent multiple baseline design across participants. During the baseline phase (5-8 sessions carried out over 1-2 weeks), participants were unable to access music, make video calls, or answer questions using a regular tablet. During the intervention phase (50-102 sessions carried out with the technology over 2-4 months), however, they activated means of 4.7-7.6 songs and 0.4-3.6 video calls per session. Moreover, they answered correctly a mean of 69-96% of the questions presented to them. These results suggest that our technology solution is a viable and potentially valuable resource for people with extensive disabilities.

Pediatric disorders of consciousness: Considerations, controversies, and caveats

Pediatric disorders of consciousness (PedDOC) encompass conditions that may occur following very severe traumatic or other forms of acquired brain injury sustained during childhood. As in adults, PedDOC is described as a disturbance of awareness and/or responsiveness. PedDOC is a complex condition that requires specialized care, infrastructures, and technologies. PedDOC poses many challenges to healthcare providers and caregivers during recovery and throughout development. In this commentary, we intend to highlight some considerations, controversies, and caveats on the diagnosis, prognosis and treatment of PedDOC.

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

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.

People with intellectual and multiple disabilities access leisure, communication, and daily activities via a new technology-aided program

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.