The study assessed a smartphone-based technology system, which was designed to enable six participants with intellectual disability and sensory impairment to start and carry out functional activities ...through the use of reminders and verbal or pictorial instructions.
The technology system involved a Samsung Galaxy A22 with Android 11 operating system and four Philips Hue indoor motion sensors. Three to five activities were scheduled per day. At the time at which an activity was due, the system provided the participant with a reminder followed by the verbal or pictorial instruction for the initial part of the first response (e.g., "Go to the bathroom and take the dirty towels"). The instruction would be available (repeated) until the participant responded to it and, in so doing, activated a sensor. Sensor activation caused the presentation of the instruction for the second part of the same (first) response (e.g., "Put the towels in the laundry machine"). The same process occurred for each of the responses involved in the activity. The system was introduced according to nonconcurrent multiple baseline designs across participants.
During baseline, the mean percentage of activities the participants started independently was below 7; the mean frequency of correct responses per activity was below 0.5 (out of a maximum possible of 8). During the intervention (i.e., with the support of the technology system), the mean percentage and mean frequency values increased to nearly 100 and 8, respectively.
The data suggest that the aforementioned technology system may enable people with intellectual disability and sensory impairment to start and carry out functional activities independent of staff.
Background Services employing staff to support people with disability usually provide training in a range of areas including communication and managing challenging behaviour. Given that such training ...can be costly and time-consuming, it is important to evaluate the evidence presented in support of such programs. Efficacy in clinical practice is measured using evidence-based practice. However, there is currently no model that is widely used to compare and evaluate training programs despite the large number of training programs reported each year.
Method Six studies published in the last decade that reported the outcomes of communication-based training and six that reported on the outcomes of challenging behaviour training were evaluated using the 4-level Kirkpatrick model.
Results Comparison of the levels of evidence is made for these 12 studies.
Conclusion The Kirkpatrick model provides one technique for appraisal of the evidence for any reported training program and could be used to evaluate whether a training program is likely to meet the needs and requirements of both the organisation implementing the training and the staff who will participate.
Parents are often expected to be the primary implementers of intervention for their young children with autism spectrum disorder (ASD). The provision of a few hours a week of intervention by a ...trained therapist, in addition to parent-implemented intervention, could increase child outcomes compared to parent-implemented intervention in isolation. This study evaluated the effects of a 12-week parent coaching program based on the Early Start Denver Model (ESDM) followed by 12-weeks of therapist-delivered ESDM intervention for four children with ASD. The effects of these interventions on child participation, functional utterances, and imitation were evaluated using a multiple probe across participants design. Children's participation improved during both interventions. Children generally showed greater improvements in imitation with the therapist than with their parents but showed minimal improvements in functional utterances. This suggests there may be some benefit to low-intensity therapy in addition to parent coaching, but more research is needed.
Purpose of Review
Substantial research exists focusing on the various aspects and domains of early human development. However, there is a clear blind spot in early postnatal development when dealing ...with neurodevelopmental disorders, especially those that manifest themselves clinically only in late infancy or even in childhood.
Recent Findings
This early developmental period may represent an important timeframe to study these disorders but has historically received far less research attention. We believe that only a comprehensive interdisciplinary approach will enable us to detect and delineate specific parameters for specific neurodevelopmental disorders at a very early age to improve early detection/diagnosis, enable prospective studies and eventually facilitate randomised trials of early intervention.
Summary
In this article, we propose a dynamic framework for characterising neurofunctional biomarkers associated with specific disorders in the development of infants and children. We have named this automated detection ‘Fingerprint Model’, suggesting one possible approach to accurately and early identify neurodevelopmental disorders.
People with mild to moderate intellectual or multiple disabilities may have serious difficulties in accessing leisure events, managing communication exchanges with distant partners, and performing ...functional daily activities. Recently, efforts were made to develop and assess technology-aided programs aimed at supporting people in all three areas (i.e., leisure, communication, and daily activities). This study assessed a new technology-aided program aimed at helping four participants with intellectual and multiple disabilities in the aforementioned areas. The program, which was implemented following a non-concurrent multiple baseline across participants design, relied on the use of a smartphone or tablet connected
via
Bluetooth to a two-switch device. This device served to select leisure and communication events and to control the smartphone or tablet’s delivery of step instructions for the activities scheduled. Data showed that during the baseline phase (with only the smartphone or tablet available), three participants failed in each of the areas (i.e., leisure, communication and functional activities) while one participant managed to access a few leisure events. During the intervention phase (with the support of the technology-aided program), all participants managed to independently access leisure events, make telephone calls, and carry out activities. These results suggest that the program might be a useful tool for helping people with intellectual and multiple disabilities improve their condition in basic areas of daily life.
This study assessed whether a simple technology-aided program (i.e., a program involving the use of microswitches linked to a smartphone) could be set up to enable people with motor, sensory and ...intellectual disabilities to control preferred environmental stimulation through two different response movements.
Ten participants were involved in the study. Each of them was exposed to an ABAB design, in which A represented baseline phases without the program and B intervention phases with the use of the program. The study assessed whether the participants (a) had significant increases of each of the two response movements available and/or showed response variability across sessions and over time and (b) had signs of satisfaction/happiness during the study sessions, in connection with their stimulation access and control.
The program was effective in increasing the participants' responding and consequently their self-regulated stimulation input. Half of the participants showed a significant increase of both responses available from the first intervention phase. Other participants seemed to focus more on one of the two responses. Even so, they tended to have occasionally high performance frequencies also with regard to their non-dominant (not significantly increased) response. Finally, all participants showed clear signs of satisfaction/happiness during the intervention sessions.
The program represents a potentially useful approach for enabling people with extensive multiple disabilities to self-regulate their access to preferred environmental stimulation and improve their mood.
► We reviewed 14 experimental studies comparing different preference assessments. ► The studies were summarized in terms of the predictive validity and consistency. ► Most of the assessments ...identified the most effective reinforcing stimulus. ► MSWO may be the most efficient and reliable preference assessment procedure.
We reviewed 14 experimental studies comparing different preference assessments for individuals with developmental disabilities that were published in peer-reviewed journals between 1985 and 2012. Studies were summarized based on the following six variables: (a) the number of participants, (b) the type of disability, (c) the number and type of stimuli, (d) the average duration of administration, (e) compared procedures, and (f) results. Studies were also classified in terms of the predictive validity and consistency of the preference assessment results. The results suggest the preference assessment procedures that may produce more accurate predictions for the reinforcing effects of identified stimuli and consistent preference results. The findings are discussed in relation to the previous literature. Evidence based modifications of the most efficient preference assessment are also discussed.
Response-contingent stimulation is a behavioral strategy used to improve the situation of patients with disorders of consciousness. Such strategy involves the presentation of brief periods (e.g., 10 ...to 15 s) of stimulation considered preferred by the patients, contingent on (immediately after) the emission of specific patients’ responses. The aim is to help the patients learn the link between their responding and the preferred stimulation and thus learn to use their responding to access the stimulation in a self-determined/independent manner. Achieving these goals is considered important for the patients’ recovery process and thus the response-contingent stimulation strategy that promotes such an achievement can be considered a valuable treatment approach. The same strategy combined with the use of periods of non-contingent stimulation (i.e., stimulation delivered independent of responding) may also serve as an assessment supplement with patients with apparent unresponsive wakefulness. The patients’ increase in responding during the response-contingent stimulation and decline in responding during the non-contingent stimulation could be taken as a sign of discrimination between conditions, and possibly a sign of awareness of the immediate environmental situation, compatible with a diagnosis of minimally conscious state. This paper analyzes a number of studies aimed at using the response-contingent stimulation as a treatment strategy and a number of studies aimed at combining response-contingent stimulation with non-contingent stimulation for treatment and assessment purposes. The results of the studies are discussed in terms of the effectiveness, accessibility and affordability of the strategy. The need for new research (i.e., replication studies) is also pointed out.
This paper presents an overview of recent technology-aided programs (i. e., technology-aided support tools) designed to help people with significant disabilities (a) engage in adaptive responses, ...functional activities, and leisure and communication, and thus (b) interact with their physical and social environment and improve their performance/achievement. In order to illustrate the support tools, the paper provides an overview of recent studies aimed at developing and assessing those tools. The paper also examines the tools' accessibility and usability, and comments on possible ways of modifying and advancing them to improve their impact. The tools taken into consideration concern, among others, (a) microswitches linked to computer systems, and aimed at promoting (i.e., through positive stimulation) minimal responses or functional body movements in individuals with intellectual disabilities and motor impairments; (b) computer systems, tablets, or smartphones aimed at supporting functional activity engagement of individuals with intellectual disabilities or Alzheimer's disease; and (c) microswitches with computer-aided systems, elaborate communication devices, and specifically arranged smartphones or tablets, directed at promoting leisure, communication, or both.
People with intellectual and sensory or sensory-motor disabilities tend to have problems performing multistep tasks. To alleviate their problems, technological solutions have been developed that ...provide task-step instructions. Instructions are generally delivered at people's request (eg, as they touch an area of a computer or tablet screen) or automatically, at preset intervals.BACKGROUNDPeople with intellectual and sensory or sensory-motor disabilities tend to have problems performing multistep tasks. To alleviate their problems, technological solutions have been developed that provide task-step instructions. Instructions are generally delivered at people's request (eg, as they touch an area of a computer or tablet screen) or automatically, at preset intervals.This study carried out a preliminary assessment of a new tablet-based technology system that presented task-step instructions when participants with intellectual and sensory disabilities walked close to the tablet (ie, did not require participants to perform fine motor responses on the tablet screen).OBJECTIVEThis study carried out a preliminary assessment of a new tablet-based technology system that presented task-step instructions when participants with intellectual and sensory disabilities walked close to the tablet (ie, did not require participants to perform fine motor responses on the tablet screen).The system entailed a tablet and a wireless camera and was programmed to present instructions when participants approached the tablet, that is, when the camera positioned in front of the tablet detected them. Two instructions were available for each task step. One instruction concerned the object(s) that the participants were to collect, and the other instruction concerned the "where" and "how" the object(s) collected would need to be used. For 3 of the six participants, the two instructions were presented in succession, with the second instruction presented once the required object(s) had been collected. For the other 3 participants, the two instructions were presented simultaneously. Instructions consisted of pictorial representations combined with brief verbal phrases. The impact of the system was assessed for each of the 2 groups of participants using a nonconcurrent multiple baseline design across individuals.METHODSThe system entailed a tablet and a wireless camera and was programmed to present instructions when participants approached the tablet, that is, when the camera positioned in front of the tablet detected them. Two instructions were available for each task step. One instruction concerned the object(s) that the participants were to collect, and the other instruction concerned the "where" and "how" the object(s) collected would need to be used. For 3 of the six participants, the two instructions were presented in succession, with the second instruction presented once the required object(s) had been collected. For the other 3 participants, the two instructions were presented simultaneously. Instructions consisted of pictorial representations combined with brief verbal phrases. The impact of the system was assessed for each of the 2 groups of participants using a nonconcurrent multiple baseline design across individuals.All participants were successful in using the system. Their mean frequency of correct task steps was close to or above 11.5 for tasks including 12 steps. Their level of correct performance tended to be much lower during the baseline phase when they were to receive the task-step instructions from a regular tablet through scrolling responses.RESULTSAll participants were successful in using the system. Their mean frequency of correct task steps was close to or above 11.5 for tasks including 12 steps. Their level of correct performance tended to be much lower during the baseline phase when they were to receive the task-step instructions from a regular tablet through scrolling responses.The findings, which need to be interpreted with caution given the preliminary nature of the study, suggest that the new tablet-based technology system might be useful for helping people with intellectual and sensory disabilities perform multistep tasks.CONCLUSIONSThe findings, which need to be interpreted with caution given the preliminary nature of the study, suggest that the new tablet-based technology system might be useful for helping people with intellectual and sensory disabilities perform multistep tasks.
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