Two adults with multiple disabilities use a computer-aided telephone system to make phone calls independently

Abstract

This study extended the assessment of a newly developed computer-aided telephone system with two participants (adults) who presented with blindness or severe visual impairment and motor or motor and intellectual disabilities. For each participant, the study was carried out according to an ABAB design, in which the A represented baseline phases and the B represented intervention phases, during which the special telephone system was available. The system involved among others a net-book computer provided with specific software, a global system for mobile communication modem, and a microswitch. Both participants learned to use the system very rapidly and managed to make phone calls independently to a variety of partners such as family members, friends and staff personnel. The results were discussed in terms of the technology under investigation (its advantages, drawbacks, and need of improvement) and the social-communication impact it can make for persons with multiple disabilities.

Introduction

Persons with multiple (i.e., visual plus motor or motor and intellectual) disabilities may have serious problems acquiring and managing daily living skills as well as communication strategies for interacting with distant partners (Cavenaugh et al., 2006, Häggström and Lund, 2008, Jessup et al., 2010, Johnson et al., 2009, Sesto et al., 2008, Yang et al., 2008). However, both these types of abilities are critical for these persons to achieve a satisfactory degree of independence and to avoid a sense of isolation or social impoverishment (Bache and Derwent, 2008, Bryen et al., 2007, Cavenaugh et al., 2006, Hilgenkamp et al., 2011, Lim et al., 2000, Madar, 2007, Mesterman et al., 2010).

Failure to interact with distant partners arises from the fact that the main channels available to communicate with those partners (i.e., telephone systems and electronic mail) are largely or totally unsuitable for persons with multiple (visual plus motor or motor and intellectual) disabilities (Baker and Moon, 2008, Bryen et al., 2007, DePompei et al., 2008, Durando, 2008, Nguyen et al., 2007, Nguyen et al., 2008, Sohlberg et al., 2003, Sohlberg et al., 2005, Sundqvist and Rönnberg, 2010, Todis et al., 2005). Research efforts carried out to promote the use of telephone systems have focused on (a) teaching basic phone skills to persons with intellectual disabilities (Manley et al., 2008, Stock et al., 2008), (b) developing special interfaces to allow persons with pervasive motor disabilities to connect themselves with smart-phone technologies (Huo et al., 2008, Kim et al., 2010), and (c) setting up a computer-aided telephone technology that could be operated through a simple microswitch (i.e., a single input device operated with a basic hand response) (Lancioni et al., 2011, Lancioni et al., in press).

The last approach was directed at enabling persons with visual-motor or visual-motor and intellectual disabilities to make phone calls independently (Lancioni et al., in press). To this end, the new telephone technology did not require the participant to deal with telephone keys, or to remember, retrieve or dial the numbers of the partners that he or she was to contact. The participant's initial microswitch activation made the system list groups/categories of people (e.g., friends) that he or she could be interested to call. A microswitch activation performed in relation to one of the categories made the system name the persons included in that category individually. Microswitch activation after a specific person's name led the system to place a phone call to that person (thus allowing the participant to have a conversation with him or her).

A preliminary assessment of this system was carried out with two women with blindness and additional disabilities. Both women learned to use the system and made phone calls independently to a variety of partners such as family members, friends and staff personnel. The present study was aimed at extending the assessment of this system with two new participants (adults) who presented with blindness or severe visual impairment combined with motor or motor and intellectual disabilities.