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Biomedical subjects

G E Lancioni

Publications and source records attributed to G E Lancioni.

At least 19 recordsLinked to original sources

Microswitch clusters to enhance adaptive responses and head control: a programme extension for three children with multiple disabilities.

PURPOSE: We assessed the possibility of extending adaptive responding and head control in three children with multiple disabilities through the use of microswitch clusters. METHOD: The children had previously learned to perform an adaptive hand response and to control head position during that response. They were now taught one or two new adaptive responses (foot lifting, leg touching, or vocalization) and to combine such responses with appropriate head position. Microswitch clusters served to ensure that an adaptive response was followed by positive stimulation only if it was combined with appropriate head position. RESULTS: The results were positive with the children learning the new adaptive responses and combining them with appropriate head position. This performance was maintained during two- or three-month post-intervention checks. During these checks, the children were also successful in using the old adaptive hand response with appropriate head position. CONCLUSIONS: The use of microswitch clusters was effective to extend the level of adaptive responding and enhance appropriate head position during this responding. This outcome, which indicates a successful technical replication and procedural extension of previous work in the area, has positive practical implications for educational and occupational programmes for children with multiple disabilities.

Child↗

An overview of research on increasing indices of happiness of people with severe/profound intellectual and multiple disabilities.

PURPOSE: This paper was to provide an overview of research studies aimed at increasing indices of happiness of persons with severe/profound intellectual and multiple disabilities. METHODS: Computerized and manual searches were carried out to identify the studies published from 1990 to 2004 (i.e., the period during which the issues of quality fo life and happiness in people with disabilities have become more prominent). Twenty-four research studies were identified. They involved the use of six different procedures, that is, structured stimulation sessions, microswitch-based simulation sessions, leisure activities and favourite work tasks or conditions, positive environment or positive behaviour support programmes and mindful caregiving, favourite stimulation automatically delivered on exercise engagement, and snoezelen. RESULTS AND CONCLUSION: Data tended to be positive with increases in the participants' indices of happiness, but some failures also occurred. The outcomes were discussed in relation to (a) methodological issues, such as designs of the studies, length of the intervention, and number of participants, and (b) personal and practical implications of the procedures. Some suggestions for future research (particularly focused on extending evidence and overcoming present methodological weakness) were also examined.

Behavior Therapy↗

Extending the evaluation of a computer system used as a microswitch for word utterances of persons with multiple disabilities.

BACKGROUND: Micro-switches can be vital tools to help individuals with extensive multiple disabilities acquire control of environmental stimulation. This study was aimed at extending the evaluation of a computer system used as a microswitch for word utterances with three participants with multiple disabilities. METHOD: Sets of 7 or 12 word utterances were used for the participants. The utterances were divided into three groups, which were exposed to intervention successively. During the intervention and a 2-month post-intervention check, the participants' emission of the target utterances led the system to present favourite, matching stimuli (i.e. provided that it recognized the utterances). RESULTS: Intervention data showed that (1) the participants increased the frequencies of the target utterances and (2) the computer system recognized approximately 80% of those utterances. These findings were maintained at the post-intervention check. An analysis of the levels of occurrence of individual utterances showed statistically significant differences among them, in line with the notions of preference and choice. CONCLUSIONS: The computer system was useful as a microswitch to enable access to favourite stimuli. There is a need to improve the accuracy of the system with respect to its recognition of the participants' utterances.

Adolescent↗

Further evaluation of microswitch clusters to enhance hand response and head control in persons with multiple disabilities.

This study was a further evaluation of microswitch clusters (combinations of two microswitches) to improve adaptive responding together with correct head position in two persons with multiple disabilities. The two participants were 19.7 and 6.6 yr. old and had profound intellectual disabilities, spastic tetraparesis, and visual impairment. They were initially taught an adaptive hand response that activated a pressure microswitch and produced favorite stimulation. Thereafter, their performance of the hand response produced favorite stimulation only when it was combined with a correct head position (detected through a mercury microswitch). Analysis showed that both participants increased the frequency of the hand response and, subsequently, the percentage of times they emitted this response in combination with correct (upright) head position. In essence, they were able to coordinate constructive occupation with exercise of appropriate posture. Performance was maintained at a 2-mo. postintervention check.

Adult↗

A microswitch cluster to enhance arm-lifting responses without dystonic head tilting by a child with multiple disabilities.

This study assessed whether a microswitch duster with favorite stimulation could help a 9.1-yr.-old child with multiple disabilities increase arm-lifting responses without dystonic, sideways head tilting. The microswitch cluster involved two microswitches, one at the child's arm to monitor the lifting response, and the other at the child's head to monitor whether it was tilted during arm lifting. Analysis showed that the percentage of arm-lifting responses occurring without head tilting increased most visibly when favorite stimulation focused on those (appropriate) responses.

Arm↗

Microswitch clusters to support responding and appropriate posture of students with multiple disabilities: three case evaluations.

PURPOSE: This study extended the evaluation of microswitch clusters to support responding and appropriate posture with three students with multiple disabilities. METHOD: Initially, a baseline level was established for the target response selected for each student. Then, Intervention I was implemented to increase the frequency of that response through the presentation of favourite stimuli. During Intervention II, the response was followed by favourite stimuli only if the microswitch cluster detected it in combination with appropriate posture. Post-intervention checks were carried out within 2 or 3 months from the end of Intervention II. RESULTS AND CONCLUSIONS: All students showed an increase in the frequency of the target response during Intervention I and in the percentage of times the response occurred in combination with appropriate posture during Intervention II. These changes lasted over time. The importance of microswitch clusters to enhance the performance of students with multiple disabilities was underlined.

Child↗

Assessing a new response-microswitch combination with a boy with minimal motor behavior.

This study assessed whether a boy with profound multiple disabilities and minimal motor behavior could learn to use a new response-microswitch combination to control environmental stimulation. The response selected was a chin movement; a mechanical microswitch was set up for this response. The boy learned to use the microswitch, increasing the frequency of the chin response and the level of pleasant stimulation following such response. The performance was retained at a 2-mo. post-intervention check.

Adolescent↗

Effects of automatically delivered stimulation on persons with multiple disabilities during their use of a stationary bicycle.

We assessed the effects of automatically delivered favorite stimulation on engagement and indices of happiness of two adults with multiple disabilities during their use of a stationary bicycle. The participants typically received four 5-min. sessions per day over a period of about 3.5 mo. Analysis showed that one participant had a significant increase in both those measures while the other participant had a significant increase in engagement during the intervention phases of the study (when the stimulation was present) as opposed to the baseline periods (when the stimulation did not occur). Implications of the findings are discussed.

Abnormalities, Multiple↗

Adapting a grid into a microswitch to suit simple hand movements of a child with profound multiple disabilities.

We adapted a grid into a microswitch for the hand movements of a girl with profound multiple disabilities who lay on her back. The grid, suspended above the girl's face, was equipped with two mercury devices, i.e., small sealed ampoules containing a mercury drop and ending with conductive leads. A lateral or forward movement of the grid would make the mercury drop of at least one device slide to the conductive leads and activate the device. During the intervention, activations of the devices, i.e., microswitch activations, produced the occurrence of favorite stimuli. Analysis showed that the girl increased the frequency of hand movements and microswitch activations during the intervention phases compared to the baseline phases (when the favorite stimuli were not available). The increase was retained at a 1-mo. postintervention check.

Abnormalities, Multiple↗

Assessing influence of stimulation on mood and aberrant behavior of persons with multiple disabilities during brief treadmill sessions.

This study assessed the influence of favorite stimuli on indices of happiness, e.g., smiling or excited vocalizations, and aberrant behavior, e.g., cantilena-like vocalizations or hand waving, of two young adults with multiple disabilities during 5-min. treadmill sessions. Several favorite stimuli, e.g., music and vibratory events, were available for the participants. The stimuli were presented in a rotation fashion during the sessions. To control for the effects of the stimuli, treadmill sessions without stimuli were also conducted. Analysis showed that the treadmill sessions with stimuli led to higher indices of happiness and lower aberrant behavior for both participants, compared to the treadmill sessions without stimuli.

Abnormalities, Multiple↗

Microswitch clusters to enhance non-spastic response schemes with students with multiple disabilities.

PURPOSE: The study explored whether the use of microswitch clusters could enhance the performance of correct (non-spastic) response schemes by two students with multiple disabilities. METHOD: The study started with baseline on the two responses selected for each student. Then, intervention was implemented on the first response. This was followed by new baseline and intervention on the second response. Subsequently, intervention sessions on the two responses were alternated. Post-intervention checks were carried out over periods of 4 and 2.5 months. RESULTS AND CONCLUSIONS: Both students had an increase in correct response schemes and, conversely, a decline in spastic response schemes. The importance and practicality of microswitch clusters to enhance appropriate responding in students with multiple disabilities were discussed.

Adolescent↗

Microswitch responding and awareness of contingency in persons with profound multiple disabilities.

This study was aimed at evaluating acquisition of responding on microswitches and awareness of contingency with 3 adolescents who had profound multiple disabilities. Their favorite stimulation was used contingently and noncontingently on their responding on microswitches. Analysis showed that they acquired and maintained high responding frequencies only with contingent stimulation, indicating that such responding reflected an awareness of contingency rather than stimulation-related arousal and activity. Implications of the findings are discussed.

Abnormalities, Multiple↗

Extending the use of familiar microswitches to difficult daily situations: two case evaluations.

This study assessed the possibility of successfully extending the use of familiar microswitches by two adults with multiple disabilities to a difficult, standing-with-support situation. Analysis showed that the introduction of the familiar microswitches into this situation increased the participants' constructive engagement; they had repeated contacts with the microswitch systems and activated them fairly consistently. For one of the participants, improvement also occurred in terms of mood (smiling) and standing time.

Abnormalities, Multiple↗

Using microswitches with persons who have profound multiple disabilities: evaluation of three cases.

This study evaluated the effectiveness of microswitch programs in promoting and maintaining responding of persons with profound multiple disabilities. Three participants were provided one or two microswitches. Their responding (microswitch activation) produced favorite stimuli. Analysis showed that all participants increased responding significantly, albeit with clear differences among them, during the intervention period of a few weeks. Two participants continued with the microswitch program in the daily context and had 3-mo. follow-up data similar to the intervention data. One participant did not continue with the program (reportedly because of inconsistent/low responding) and so did not receive a follow-up assessment. Links between responding and vigilance conditions and stereotypy are discussed.

Adolescent↗

Snoezelen: an overview of research with people with developmental disabilities and dementia.

PURPOSE: This paper was to provide an overview of the research studies on snoezelen with people with developmental disabilities and dementia. METHOD: Computerized and manual searches were carried out to identify the aforementioned studies. Within-session, post-session, and longer-term effects of snoezelen were examined. RESULTS AND CONCLUSION: Twenty-one research studies were identified, 14 concerning people with developmental disabilities and seven people with dementia. Of those studies: 14 reported positive within-session effects; four positive post-session effects; and two positive longer-term effects. These findings were discussed in relation to: (1) methodological aspects (weaknesses) of the studies; (2) the cost of arranging a snoezelen programme and possibilities of reducing the range of stimuli available in the programme; and (3) some research issues for advancing the understanding and effectiveness of intervention programmes with people with developmental disabilities and dementia.

Child↗

Evaluating the use of multiple microswitches and responses for children with multiple disabilities.

BACKGROUND: The present study assessed the feasibility of (1) establishing multiple microswitches and responses (some of which had not been used before) with two children with multiple disabilities, and (2) maintaining such microswitches and responses in the children's daily contexts. METHODS: The microswitches were introduced individually and then combined. During the last part of treatment and the follow-up, each child had three microswitches. RESULTS: The data show that both children learned to use all three available microswitches. Moreover, they retained fairly high levels of responding with the microswitches in their daily contexts during follow-up periods of 4 and 6 months. CONCLUSIONS: The personal and practical implications of these findings are discussed.

Adolescent↗

Urine alarms and prompts for fostering daytime urinary continence in a student with multiple disabilities: a replication study.

The study evaluated a treatment approach based on urine-alarm signals and staff prompts to foster daytime urinary continence of a student with multiple disabilities. Reinforcement was used for urination in the toilet. The study alternated two baseline with two treatment phases. A 3-mo. follow-up also occurred. The student became almost totally free from large urinary accidents, replacing them with self-initiated toileting and small accidents (wetting only a disposable tissue), and retained his improvement over time. Implications of the findings were discussed.

Adolescent↗

Promoting functional activity engagement at appropriate times with people with multiple disabilities.

This study was aimed at teaching three persons with multiple disabilities to carry out functional activities at appropriate times independently. To this end, an electronic time system that produced vibratory alarms at preset times and a board with object-cues (instructions for the activities) were used. Data indicated that all three persons learned to perform the scheduled activities at the preset times independent of prompts from staff. Implications of the data and the combination of these activities with structured occupational periods were discussed.

Activities of Daily Living↗