Microswitch-aided programs to support physical exercise or adequate ambulation in persons with multiple disabilities

Treatment of Aggression in an Adult With Intellectual Disability and Physical Impairment Through Function-Based Ambulatory Support

We report the case of a man who had intellectual disability and physical impairment, required assistance from care-providers when ambulating, and demonstrated aggression during transitions between locations. Results of a functional analysis suggested that aggression was negatively reinforced by termination of transition-assisted guidance from care-providers. Intervention evaluation found that aggression during transitions was eliminated by providing the man with ambulatory support through a gait-trainer device that removed the need for care-provider assistance. The case study supports and extends previous research on the analysis and treatment of problem behaviors occurring during environmental transitions.

Promoting Functional Activity Engagement in People with Multiple Disabilities through the Use of Microswitch-Aided Programs

Background

People with severe/profound multiple (e.g., intellectual, motor, or sensory–motor) disabilities are frequently restricted to a situation of inactivity and dependence, which may be modified by promoting functional activity engagement through assistive technology.

Methods

This study assessed the possibility of promoting functional activity engagement via microswitch-aided programs with nine participants with multiple disabilities between 10 and 29 years of age. Functional activity consisted of constructive interaction with the immediate environment (e.g., reaching/touching or putting away objects) through the use of response schemes considered practical and beneficial for the participants’ physical exercise and general condition. Microswitch-aided programs were used to monitor the participants’ responses and to automatically provide stimulation opportunities contingent on those responses.

Results

All participants had a large/significant increase in their activity engagement (i.e., response frequencies) during the microswitch-aided programs, when compared to the baseline periods. These data, which are in line with previous findings in the area, indicate that the programs targeted activity and responses suitable for the participants and ensured contingent stimulation effective to motivate them.

Conclusion

People with severe/profound multiple disabilities can engage in functional activity with the help of microswitch-aided programs.

A microswitch-based program for promoting initial ambulation responses: An evaluation with two girls with multiple disabilities

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.

Case Studies of Technology-aided Interventions to Promote Hand Reaching and Standing or Basic Ambulation in Persons with Multiple Disabilities

Motor impairments such as lack of standing and/or independent ambulation are common among persons with multiple disabilities. These two studies assessed technology-aided programs for persons with those impairments. Specifically, Study I assessed a program to teach two non-ambulatory adults to hand reach a stimulation-linked object by standing up. Study II assessed a program to teach a child and a man to ambulate while holding a rail or following a corridor wall. Standing increased from below 15% to about or over 80% of the session duration in Study I. The participants of Study II managed to complete brief ambulation trials independent of guidance. These performance achievements were discussed in relation to the technology-aided programs employed in the studies and the programs' applicability in daily contexts.