The Use of a Behavior Chain Interruption Strategy to Teach Mands for Help with an Adult with Intellectual Disability and Deaf-Blindness

Individuals with deaf-blindness and co-occurring diagnoses, such as intellectual and developmental disabilities, may experience difficulty with independence, specifically with communication. One behavior-analytic procedure that may be useful for increasing independence and teaching communication to this population is the behavior-chain interruption strategy (BCIS). The current study examined the use of the BCIS to teach a 65-year-old deaf-blind participant with severe intellectual disability to use a SadoTech Elderly Monitoring Pager to notify others in the environment when help was needed. The researcher alternated between establishing operation (EO; help needed, items missing, or inoperable) and abolishing operation (AO; help not needed, items present, and operable) trials for three previously mastered daily living routines. The results demonstrated that following intervention, the participant used the device independently during EO trials and never used it during AO trials across behavior chains, and similar results were obtained during a treatment-extension phase. Limitations and implications for applied practice are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40616-024-00204-8.

Interventions to improve functioning, participation, and quality of life in children with visual impairment: a systematic review

Visual impairment in childhood often has life-long implications. To aim for the highest levels of functioning, participation, and quality of life and to ensure children's well-being, children should be entitled to the most effective rehabilitation programs. We review evidence for the effectiveness of rehabilitation interventions for children with visual impairment to improve skills and behavior, thereby improving participation and quality of life as an ultimate goal. Of the 441 potentially relevant articles identified, 66 studies met our inclusion criteria (i.e., 28 randomized controlled trials, 18 nonrandomized controlled trials, and 20 before-after comparisons). The results suggest that sports camps, prescription and training in the use of low vision devices, and oral hygiene programs might be effective in improving functioning and elements of participation and quality of life in children with visual impairment. Other interventions showed mixed or negative results. The results should be interpreted with caution because of moderate to high risk of bias and suboptimal reporting. Heterogeneity of results and the use of over 50 different outcome measures prevented a meta-analysis. Future studies should focus on promising interventions for which effectiveness is still unclear (e.g., mobility, social skills), with adequately designed methodology.

Effects of Wait Time when Communicating with Children who have Sensory and Additional Disabilities

Introduction

This study utilized wait-time procedures to determine if they are effective in helping children with deafblindness or multiple disabilities that include a visual impairment communicate in their home.

Methods

A single subject with an alternating treatment design was used for the study. Zero- to one-second wait time was utilized before prompting for a response during three baseline sessions. This was compared to 5-, 10-, and 15-second wait-time increments used during six intervention sessions. Three participants with visual impairments, developmental disabilities, and communication delays participated in the study. One of the participants was deafblind.

Results

All three participants responded twice as often during intervention phases as in baseline sessions. The results showed that 5-, 10-, and 15-second wait times were effective when reciprocally communicating with children who have multiple disabilities with a visual impairment or deafblindness.

Discussion

The findings of this study determined that wait time was effective and showed promising results for children with deafblindness or multiple disabilities. The study indicated that such children need time to process what is being asked in order to respond appropriately. Prompting quickly can frustrate the child with disabilities. Limitations of the study included heterogeneity and fragile medical condition of the participants, distractions, and the need for future research on the use of this technique.

Implications for practitioners

By utilizing at least five seconds of wait time, parents and educators may be able to see an increase in appropriate responses from the child. Wait-time interventions could increase opportunities for learning, social interaction, and communication, and are easily implemented with little to no training.

Learning What Works in Sensory Disabilities: Establishing Causal Inference

This article is intended to assist teachers and researchers in designing studies that examine the efficacy of a particular intervention or strategy with students with sensory disabilities. Ten research designs that can establish causal inference (the ability to attribute any effects to the intervention) with and without randomization are discussed.

Deafblindness: a review of the literature

BACKGROUND

Deafblindness or dual sensory loss is a rare condition among young people, but more frequent among older people. Deafblindness is a heterogeneous condition that varies with regard to time of onset and degree of vision and hearing impairment, as well as communication mode, medical aetiology, and number and severity of co-morbidity.

METHOD

We conducted a comprehensive review of public health issues related to deafblindness.

RESULTS

Deafblindness often lead to barriers in language and communication, access to information and social interaction, which can lead to a number of health-related difficulties. Some of the reported consequences are a higher risk of depression, cognitive decline, developmental disorder in children and psychological distress.

CONCLUSIONS

Deafblindness is associated with a number of health-related issues and more knowledge is needed about the impact of dual sensory loss to be able to offer the best support.