Using multiple microswitches to promote different responses in children with multiple disabilities
Introduction
During the last two decades, considerable attention has been given to the development and evaluation of microswitches to assist persons with severe and profound multiple disabilities overcome their isolation and obtain desired environmental stimulation Behrmann et al 1989, Crawford and Schuster 1993, Dewson and Whiteley 1987, Kinsley and Langone 1995. Microswitches are considered to be critical tools of access, means whereby persons can activate toys, sound and light displays, or other sources of stimulation. Thus, microswitches may prove essential for these persons to achieve a form of positive interaction with the environment and a level of control over the stimuli that the environment can provide Green and Reid 1994, Gutowski 1996, Leatherby et al 1992, Parette et al 1986, Sullivan and Lewis 1990, Sullivan and Lewis 1993.
Most of the research studies have reported the use of a single microswitch requiring a single type of response. Such response activated a single stimulus or a stimulus that could change across sessions Ivancic and Bailey 1996, Leatherby et al 1992, Realon et al 1988, Realon et al 1990, Sobsey and Reichle 1989, Wacker et al 1988. Some other studies have used two or more microswitches Crawford and Schuster 1993, Dattilo 1986, Dattilo 1987, Sullivan et al 1995, Sullivan and Lewis 1990. Yet, these microswitches were not always available simultaneously. Moreover, they were not necessarily different in terms of position or characteristics so as to require different types of responses, involving different schemes or parts of the body (Lancioni, O’Reilly, & Basili, 2001).
In view of the above, one can argue that although there is large agreement on the use of microswitches as a basic strategy to improve the general condition of people with severe and profound multiple disabilities, the data available are relatively circumscribed. Very little evidence exists as to the possibility of establishing various microswitches, requiring different responses, to allow the person a wider range of motor activity, a greater and a more widely differentiated level of input, and an opportunity to select the type of input according to possible preferences Ferrier et al 1996, Kinsley and Langone 1995, Ko et al 1998, Sullivan et al 1995, Sullivan and Lewis 1993. The present study assessed the possibility of establishing different microswitches and responses with two boys with multiple disabilities. Prior to the beginning of this study, one of the boys was taught to use a new microswitch for enhancing vocalization (Lancioni, O’Reilly, Oliva, & Coppa, in press). The other boy had never participated in investigations involving microswitches.
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Participants
The two boys involved in the study (Participants 1 and 2) were 9.7 and 13.3 years old. Participant 1 had congenital cerebropathy due to posthemorrhagic cerebral atrophy, with hydrocephalus, spastic tetraparesis, and severe scoliosis. He had limited head control, lack of trunk control, epilepsy, minimal residual vision, and lack of speech. He was considered to be in the profound range of intellectual disability. He would react to familiar sounds and songs, loud noises, and praise by alerting
Results
The data of the two participants are summarized in Fig. 1, Fig. 2. All the baseline measurements for Participant 1 indicated relatively low frequencies of occurrence for the target responses to be exposed to treatment. Treatment on head-to-midline increased the frequency of such response to a mean of 24 per session during the initial 14 sessions (i.e., when treatment was focused only on that response). Subsequently, when treatment conditions applied to the previously established vocalization
Discussion
The data of this study showed that both participants were able to use multiple microswitches (available individually or in combinations of two or three) for obtaining a variety of positive environmental events. This achievement can lead to several considerations. First, the fairly rapid consolidation of the responses and their maintenance may suggest that (a) the events used contingent on those responses had strong reinforcing power, and (b) the participants’ level of functioning was
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