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Piekema L, Ten Brug A, Waninge A, van der Putten A. From assistive to inclusive? A systematic review of the uses and effects of technology to support people with pervasive support needs. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13181. [PMID: 38369310 DOI: 10.1111/jar.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/27/2023] [Accepted: 11/15/2023] [Indexed: 02/20/2024]
Abstract
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.
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Affiliation(s)
- Lotte Piekema
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Annet Ten Brug
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Hanze University of Applied Sciences Groningen, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands
- Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annette van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
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Stasolla F, Caffò AO, Perilli V, Boccasini A, Damiani R, D'Amico F. Assistive technology for promoting adaptive skills of children with cerebral palsy: ten cases evaluation. Disabil Rehabil Assist Technol 2018; 14:489-502. [DOI: 10.1080/17483107.2018.1467972] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
| | - Alessandro O. Caffò
- Department of Educational Sciences, Psychology, Communication, University of Bari, Bari, Italy
| | - Viviana Perilli
- Department of Neurosciences, University of Bari, Bari, Italy
| | - Adele Boccasini
- Department of Neurosciences, University of Bari, Bari, Italy
| | - Rita Damiani
- Department of Neurosciences, University of Bari, Bari, Italy
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Stasolla F, Caffò AO, Perilli V, Boccasini A, Stella A, Damiani R, Albano V, Damato C. A microswitch-based program for promoting initial ambulation responses: An evaluation with two girls with multiple disabilities. J Appl Behav Anal 2017; 50:345-356. [PMID: 28128442 DOI: 10.1002/jaba.374] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 07/01/2016] [Indexed: 11/06/2022]
Abstract
We assessed the use of a microswitch-based program for promoting ambulation responses by two children with multiple disabilities. The goals of the study were to: (a) evaluate the importance of the contingency between the target behavior (forward step) and the programmed consequence (preferred stimuli), (b) measure effects of the intervention on indices of happiness, and (c) assess the social validation of the procedure using 20 physiotherapists as external raters. The intervention involved the automatic delivery of preferred stimuli contingent on forward steps. Results showed that both participants improved their performance (forward steps and indices of happiness) during contingent reinforcement phases compared to baseline and noncontingent reinforcement phases. Moreover, physiotherapists rated the intervention as socially valid.
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Affiliation(s)
| | - Alessandro O Caffò
- Department of Educational Sciences, Psychology, Communication, University of Bari, Bari (Italy)
| | | | - Adele Boccasini
- Lega del Filo d'Oro Research Center, Termini Imerese (Italy)
| | - Anna Stella
- Department of Educational Sciences, Psychology, Communication, University of Bari, Bari (Italy)
| | - Rita Damiani
- Department of Educational Sciences, Psychology, Communication, University of Bari, Bari (Italy)
| | - Vincenza Albano
- Department of Educational Sciences, Psychology, Communication, University of Bari, Bari (Italy)
| | - Concetta Damato
- Department of Educational Sciences, Psychology, Communication, University of Bari, Bari (Italy)
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Lancioni GE, Singh NN, O'Reilly MF, Oliva D, Severini L. Assessing a Microswitch-Based Stimulation Procedure for Eye-Blinking Responses in a Young Woman with Profound Multiple Disabilities. Percept Mot Skills 2016; 101:212-6. [PMID: 16350626 DOI: 10.2466/pms.101.1.212-216] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We applied a new microswitch-based stimulation procedure for eye-blinking responses with a young woman with profound multiple disabilities, and compared effects of this procedure on the eye-blinking responses and smiling with the effects of a caregiver-based stimulation condition. Analysis showed that the microswitch-based stimulation procedure, with stimulation occurring contingent on eye-blinking responses, increased the frequencies of these responses significantly above the levels recorded in baseline and caregiver-based stimulation conditions. No changes in smiling frequencies occurred. Implications of the findings in terms of alertness, learning, and quality of life are discussed.
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Affiliation(s)
- G E Lancioni
- Department of Psychology, University of Bari, Via Quintino Sella 268. 70100 Bari, Italy.
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Lancioni GE, O'Reilly MF, Singh NN, Sigafoos J, Didden R, Oliva D, Montironi G, La Martire ML. Small Hand-Closure Movements Used as a Response through Microswitch Technology by Persons with Multiple Disabilities and Minimal Motor Behavior. Percept Mot Skills 2016; 104:1027-34. [PMID: 17688160 DOI: 10.2466/pms.104.3.1027-1034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study assessed small hand-closure movements as a potential response for microswitch activation with two participants with profound multiple disabilities of 5.2 and 20.6 yr. of age. The microswitch consisted of a two-membrane thin pad fixed to the palm of the hand and a control system. The outer membrane (the one facing the fingers) was a touch-sensitive layer; the inner membrane was activated if the participant applied a pressure of over 20 gm. The activation of either membrane triggered an electronic control system, which in turn activated one or more preferred stimuli for 6 sec. except in baseline phases. Each participant received an ABAB sequence, in which A represented baseline and B intervention phases, and a 1-mo. postintervention check. Analysis showed both participants increased their responding during the intervention phases and maintained that responding at the postintervention check. Implications of the findings are discussed.
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Affiliation(s)
- G E Lancioni
- Department of Psychology, University of Bari, Via Quintino Sella 268, 70100 Bari, Italy.
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Lancioni GE, Singh NN, O'Reilly MF, Green VA, Buonocunto F, Sacco V, Navarro J, Lanzilotti C, Olivetti Belardinelli M. Microswitch-aided programs with contingent stimulation versus general stimulation programs for post-coma persons with multiple disabilities. Dev Neurorehabil 2014; 17:251-8. [PMID: 23869535 DOI: 10.3109/17518423.2013.793751] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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 impact of microswitch-aided programs with contingent stimulation on response engagement (Study I) and post-session alertness (Study II) of post-coma participants with multiple disabilities. METHOD Study I included three participants whose scores on the Coma Recovery Scale-Revised (CRS-R) were 11 or 13. Study II included three participants whose CRS-R scores were 19, 13, and 14. In both studies, the participants received sessions with contingent stimulation (i.e., sessions in which activation of a microswitch with an eyelid or hand response produced 15 s of preferred stimulation) and sessions with general, non-contingent stimulation (i.e., stimulation lasted throughout the sessions). RESULTS Study I showed an increase in response engagement/frequencies only during the contingent stimulation sessions. Study II showed that the participants' level of vigilance after those sessions was higher than after non-contingent stimulation sessions. CONCLUSION Microswitch-aided programs with contingent stimulation would be more beneficial than programs with general/non-contingent stimulation.
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Affiliation(s)
- Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari , Bari , Italy
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Blain-Moraes S, Chau T. Challenges of developing communicative interaction in individuals with congenital profound intellectual and multiple disabilities. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2012; 37:348-359. [PMID: 23002922 DOI: 10.3109/13668250.2012.721879] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Physiological responses have been used in individuals with acquired disability to enable communicative interaction without motor movement. This study explored four autonomic nervous system (ANS) signals-electrodermal activity, skin temperature, cardiac patterns and respiratory patterns-to enable interaction with individuals born with profound intellectual and multiple disabilities (PIMD). METHOD A series of case studies were conducted to teach a 15-year-old individual with PIMD to voluntarily control his ANS signals for the purposes of communicative interaction. Training was carried out according to an alternating treatment single-subject research design. RESULTS Training was unsuccessful; however, ANS signal patterns revealed issues unique to people with PIMD: profound intrasubject variability, discrepancy between physiological responses and caregiver perspectives, and the participant's lack of contingency awareness. CONCLUSIONS These three priority areas unique to people with congenital PIMD must be addressed before ANS signals can be used to enable communicative interaction with this population.
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Affiliation(s)
- Stefanie Blain-Moraes
- Department of Physical Medicine & Rehabilitation, University of Michigan Medical School, Ann Arbor, MI 48109-5841, USA.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Didden R, Oliva D, Calzolari C, Montironi G. A learning setup for a post-coma adolescent with profound multiple disabilities involving small forehead movements and new microswitch technology. Disabil Rehabil Assist Technol 2009; 2:293-7. [PMID: 19263535 DOI: 10.1080/17483100701308635] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE A learning setup was arranged for an adolescent with profound multiple disabilities and a diagnosis of vegetative state. Signs of learning by the adolescent would underline an improvement in his immediate situation with potential implications for his general prospect, and could help revise his diagnosis. METHOD The response adopted in the learning setup was forehead skin movement. The microswitch technology used for detecting such a response consisted of (a) an optic sensor (i.e., barcode reader), (b) a small tag with horizontal bars attached to the participant's forehead, and (c) an electronic control system that activated stimuli in relation to the participant's forehead responses. The study followed an ABABACAB sequence, in which A represented baseline periods, B intervention periods with stimuli contingent on the response, and C a control condition with stimuli presented non-contingently. RESULTS Data showed that the level of responding during the B phases was significantly higher than the levels observed during the A phases as well as the C phase, indicating clear signs of learning. CONCLUSIONS Intervention strategies based on a learning format and suitable technology might be useful to improve the situation and prospect of persons with profound multiple disabilities and a diagnosis of vegetative state.
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Affiliation(s)
- Giulio E Lancioni
- Department of Psychology, University of Bari, Via Quintino Sella 268, 70100 Bari, Italy.
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Lancioni GE, O'Reilly MF, Singh NN, Sigafoos J, Didden R, Oliva D, Montironi G. Persons with multiple disabilities and minimal motor behavior using small forehead movements and new microswitch technology to control environmental stimuli. Percept Mot Skills 2007; 104:870-8. [PMID: 17688142 DOI: 10.2466/pms.104.3.870-878] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Persons with multiple disabilities and minimal motor behavior may be unable to use available microswitch technology to control environmental stimuli. For these persons, one may need to rely on small motor expressions (as responses) and new, matching microswitch technology to ensure a successful outcome. In the present study, a small movement of the forehead skin was selected as the response for two participants (ages 6.5 and 14.2 years) with profound multiple disabilities. The microswitch technology included (a) an optic sensor, i.e., barcode reader, (b) a small tag with horizontal bars attached to the participants' forehead, and (c) an electronic control system which activated stimuli in relation to response occurrence. Movement of the forehead skin shifted up or down the tag with bars and this shifting, if greater than a preset limit and therefore recorded as a response, led to the activation of the control system. Each participant received an ABAB sequence, in which A represented baseline and B intervention phases, and a 6-wk. postintervention check. Analysis showed both participants increased their responding during the intervention phases and maintained that responding at the postintervention check. Implications of the findings were discussed.
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Affiliation(s)
- Giulio E Lancioni
- Department of Psychology, University of Bari, Via Quintino Sella 268, 70100 Bari, Italy.
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Groeneweg J, Lancioni GE, Bosco A, Singh NN, O'Reilly MF, Sigafoos J. A brief account of statistical tests for single-case research with persons with developmental disabilities. Percept Mot Skills 2007; 103:947-50. [PMID: 17326526 DOI: 10.2466/pms.103.3.947-950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Education and rehabilitation research with persons with developmental disabilities is often based on single-case designs (with small numbers of ordinal data points collected at irregular intervals) and relies upon graphic display and visual inspection of the data. This paper (a) provides a brief account of some statistical tests, which may serve to supplement the visual inspection process and (b) underlines some of their strengths and limitations to help education and rehabilitation personnel make a reasonable choice among them.
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Lancioni GE, O'Reilly MF, Singh NN, Sigafoos J, Tota A, Antonucci M, Oliva D. Children with multiple disabilities and minimal motor behavior using chin movements to operate microswitches to obtain environmental stimulation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2006; 27:290-8. [PMID: 16005183 DOI: 10.1016/j.ridd.2005.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Revised: 02/16/2005] [Accepted: 02/28/2005] [Indexed: 05/03/2023]
Abstract
In these two studies, two children with multiple disabilities and minimal motor behavior were assessed to see if they could use chin movements to operate microswitches to obtain environmental stimulation. In Study I, we applied an adapted version of a recently introduced electronic microswitch [Lancioni, G. E., O'Reilly, M. F., Singh, N. N., Sigafoos, J., Oliva, D., & Baccani, S., et al. (2004). Technological aids to promote basic developmental achievements by children with multiple disabilities: evaluating two cases. Cognitive Processing 5, 232-238]. In Study II, we set up a new microswitch detecting the chin-movement response through an optic sensor. Each study was carried out according to an ABAB sequence in which A represented baseline and B intervention phases. A 2-month post-intervention check also occurred. The data showed that both children increased the frequency of the chin response, thus increasing the level of environmental stimulation, during the intervention phases. This performance was retained at the post-intervention check. The overall suitability of this response and related microswitches as well as the need to explore other potential responses and microswitches for children with minimal motor behavior is discussed.
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Affiliation(s)
- Giulio E Lancioni
- Department of Psychology, University of Bari, Via Quintino Sella 268, 70100 Bari, Italy.
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Lancioni GE, Singh NN, O'Reilly MF, Oliva D. Microswitch programs for persons with multiple disabilities: an overview of the responses adopted for microswitch activation. Cogn Process 2005; 6:177-88. [PMID: 18231820 DOI: 10.1007/s10339-005-0003-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2005] [Revised: 06/14/2005] [Accepted: 06/15/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND To introduce a person with multiple disabilities to a microswitch-aided program, one has to select a plausible response(s), that is, a response(s) that can be performed reliably and without excessive effort by the person and can successfully activate the microswitch(es) available (producing preferred stimuli). This paper provides an overview of the responses adopted for microswitch activation in research studies during the last 20 years. METHOD Computerized and manual searches were carried out to identify the studies published between 1986 and 2005. Forty-eight research studies were identified. They concerned the use of (1) a single (typical) response, (2) a single (non-typical) response, (3) multiple (typical and non-typical) responses, and (4) multiple (vocal) responses. RESULTS AND DISCUSSION The results showed that 151 of the 190 participants involved in the studies had a positive outcome (i.e., clear increases in their responding, which suggested that they had learned the association between responding and consequent preferred stimuli). Failures were largely concentrated in the first group of studies. The discussion focused on (a) the importance of selecting plausible responses for increasing the chances of success, (b) the need of non-typical responses for persons with minimal motor behavior, (c) implications of programs with multiple responses on engagement and choice, and (d) relevance of using vocal utterances. Some suggestions for future research concerning these points were also examined.
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Affiliation(s)
- Giulio E Lancioni
- Department of Psychology, University of Bari, Via Quintino Sella 268, 70100, Bari, Italy,
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LANCION GE. ASSESSING A MICROSWITCH-BASED STIMULATION PROCEDURE FOR EYE-BLINKING RESPONSES IN A YOUNG WOMAN WITH PROFOUND MULTIPLE DISABILITIES. Percept Mot Skills 2005. [DOI: 10.2466/pms.101.5.212-216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lancioni GE, O'Reilly MF, Singh NN, Oliva D, Coppa MM, Montironi G. A new microswitch to enable a boy with minimal motor behavior to control environmental stimulation with eye blinks. BEHAVIORAL INTERVENTIONS 2005. [DOI: 10.1002/bin.185] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Technological aids to promote basic developmental achievements by children with multiple disabilities: evaluation of two cases. Cogn Process 2004. [DOI: 10.1007/s10339-004-0030-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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