RESUMO
Recent literature has shown the possibility of enabling individuals with multiple disabilities to make telephone calls independently via computer-aided telephone technology. These two case studies assessed a modified version of such technology and a commercial alternative to it for a woman and a man with multiple disabilities, respectively. The modified version used in Study 1 (a) presented the names of the persons available for a call and (b) reminded the participant of the response she needed to perform (i.e., pressing a microswitch) if she wanted to call any of those names/persons. The commercial device used in Study 2 was a Galaxy S3 (Samsung) equipped with the S-voice module, which allowed the participant to activate phone calls by uttering the word "Call" followed by the name of the persons he wanted to call. The results of the studies showed that the participants learned to make phone calls independently using the technology/device available. Implications of the results are discussed.
Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Pessoas com Deficiência , Telefone , Interface Usuário-Computador , Adulto , Feminino , Humanos , MasculinoRESUMO
PURPOSE: The present three pilot studies assessed the effectiveness of verbal instructions, presented automatically through simple technology, in helping persons with mild-to-moderate Alzheimer's disease recapture basic daily activities. The activities were morning bathroom routine, dressing, and table-setting. METHOD: The studies that focused on morning bathroom routine and on table-setting included three participants each, while the study that focused on dressing involved four participants. A non-concurrent multiple baseline design across participants was used for each study. The instructions and technology were available only during the intervention phases. RESULTS: Data showed that the intervention strategy involving verbal instructions for the single activity steps presented automatically through technology was effective in helping all participants on each of the activities. The participants' mean percentages of correct steps across activities raised from 13 - 54 during the baseline periods to above 80 or 90 during the intervention periods. CONCLUSIONS: The results suggest that the intervention strategy reported may represent a suitable approach for helping persons with mild or moderate Alzheimer's disease to recapture basic daily activities. New research should target other activities and check maintenance and generalization issues.
Assuntos
Atividades Cotidianas , Doença de Alzheimer/reabilitação , Microcomputadores , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/fisiopatologia , Feminino , Humanos , Masculino , Projetos Piloto , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
Four studies assessed the effectiveness of verbal instructions presented via technology in helping persons with mild or moderate Alzheimer's disease perform daily activities. The first 2 studies were replication efforts concerning morning bathroom routine and table setting and included 4 and 2 participants, respectively. The third study targeted coffee preparation with 3 participants. The fourth study assessed maintenance and generalization of morning bathroom routine and dressing with 1 participant. Nonconcurrent multiple baseline designs served for the first 3 studies and a 5-month postintervention data collection for the fourth study. Verbal instructions for the activity steps presented via technology were effective in helping the participants of the first 3 studies reacquire basic daily activities and the participant of the fourth study retain the reacquired activities across time and settings. These results suggest that the approach reported may be a useful strategy for helping persons with Alzheimer's disease.
Assuntos
Atividades Cotidianas/psicologia , Doença de Alzheimer/terapia , Terapia Comportamental/métodos , Comportamento Verbal/fisiologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
A program relying on microswitch clusters (i.e., combinations of microswitches) and preferred stimuli was recently developed to foster adaptive responses and head control in persons with multiple disabilities. In the last version of this program, preferred stimuli (a) are scheduled for adaptive responses occurring in combination with head control (i.e., head upright) and (b) last through the scheduled time only if head control is maintained for that time. The first of the present two studies was aimed at replicating this program with three new participants with multiple disabilities adding to the three reported by Lancioni et al. [Lancioni, G. E., Singh, N. N., O'Reilly, M. F., Sigafoos, J., Didden, R., Oliva, D., et al. (2007). Fostering adaptive responses and head control in students with multiple disabilities through a microswitch-based program: Follow-up assessment and program revision. Research in Developmental Disabilities, 28, 187-196]. The second of the two studies served to carry out an expert validation of the program's effects on head control and general physical condition with the three participants of Study I as well as the three participants involved in the Lancioni et al. study mentioned above. The expert raters were 72 new physiotherapists and 72 experienced physiotherapists. The results of Study I supported previous data and indicated that the program was effective in helping the participants increase the frequency of adaptive responses in combination with head control and the length of such control. The results of Study II showed that the raters found the effects of the new program more positive than those of other intervention conditions and also considered such program a useful complement to formal motor rehabilitation programs.
Assuntos
Deficiências do Desenvolvimento/reabilitação , Deficiências do Desenvolvimento/terapia , Movimentos da Cabeça , Modalidades de Fisioterapia/instrumentação , Adaptação Fisiológica , Adolescente , Criança , Deficiências do Desenvolvimento/complicações , Feminino , Humanos , Deficiência Intelectual/complicações , Deficiência Intelectual/reabilitação , Deficiência Intelectual/terapia , Masculino , Atividade Motora , Postura , Desempenho Psicomotor , Reprodutibilidade dos Testes , Tecnologia Assistiva , Inquéritos e Questionários , Gravação de VideoteipeRESUMO
This study assessed whether a child with multiple disabilities would endure a difficult (standing) position more easily if allowed to access preferred stimuli while in that position. The study included an ABAB sequence with 2- and 3-mo. postintervention checks. Data showed that self-managed access to preferred stimuli during the B phases of the study and the postintervention checks reduced the child's indices of unhappiness, frowning and crying, while increasing his object contact and smiles as indices of happiness.
Assuntos
Crianças com Deficiência/reabilitação , Postura/fisiologia , Tecnologia Assistiva/estatística & dados numéricos , Criança , Condicionamento Clássico , Educação de Pessoa com Deficiência Intelectual , Felicidade , Humanos , Sorriso , Cadeiras de RodasRESUMO
A variety of technology-aided programs have been developed to help persons with congenital or acquired multiple disabilities access preferred stimuli or choose among stimulus options. The application of those programs may pose problems when the participants have very limited behavior repertoires and are unable to use conventional responses and microswitches. The present two studies assessed non-conventional response-microswitch solutions for three of those participants. Study I included two participants who were exposed to a program in which forehead skin movement was the response required to access preferred stimulation. The microswitch was an optic sensor combined with a small black sticker on the forehead. Study II included one participant who was exposed to a program in which a smile response was required to choose among stimuli. The microswitch for monitoring the smile was a new camera-based technology. The results of the two studies showed that the response-microswitch solutions were suitable for the participants and enabled them to perform successfully. Implications of the studies for people with limited motor behavior and issues for future research were discussed.
Assuntos
Lesões Encefálicas/reabilitação , Auxiliares de Comunicação para Pessoas com Deficiência , Testa , Deficiência Intelectual/reabilitação , Quadriplegia/reabilitação , Sorriso , Adulto , Lesões Encefálicas/fisiopatologia , Epilepsia/fisiopatologia , Epilepsia/reabilitação , Expressão Facial , Humanos , Deficiência Intelectual/fisiopatologia , Masculino , Pessoa de Meia-Idade , Óptica e Fotônica/instrumentação , Quadriplegia/fisiopatologia , Terapia Assistida por Computador/instrumentação , Adulto JovemRESUMO
Study I used typical microswitch-cluster programs to promote adaptive responding (i.e., object manipulation) and reduce inappropriate head or head-trunk forward leaning with a boy and a woman with multiple disabilities. Optic, tilt, and vibration microswitches were used to record their adaptive responses while optic and tilt microswitches monitored their posture. The study included an ABB(1)AB(1) sequence, in which A represented baseline phases, B represented an intervention phase in which adaptive responses were always followed by preferred stimulation, and B(1) represented intervention phases in which the adaptive responses led to preferred stimulation only if the inappropriate posture was absent. Study II assessed a non-typical, new microswitch-cluster program to promote two adaptive responses (i.e., mouth cleaning to reduce drooling effects and object assembling) with a man with multiple disabilities. Initially, the man received preferred stimulation for each cleaning response. Then, he received stimulation only if mouth cleaning was preceded by object assembling. The results of Study I showed that both participants had large increases in adaptive responding and a drastic reduction in inappropriate posture during the B(1) phases and a 2-week post-intervention check. The results of Study II showed that the man learned to control drooling effects through mouth cleaning and used object assembling to extend constructive engagement and interspace cleaning responses functionally. The practical implications of the findings are discussed.
Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos da Comunicação/reabilitação , Deficiências do Desenvolvimento/reabilitação , Doenças Neurodegenerativas/reabilitação , Tecnologia Assistiva , Reabilitação do Acidente Vascular Cerebral , Criança , Transtornos da Comunicação/psicologia , Deficiências do Desenvolvimento/psicologia , Eletrônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Sialorreia/psicologia , Sialorreia/reabilitação , Acidente Vascular Cerebral/psicologia , Resultado do TratamentoRESUMO
These two case studies assessed technology-based programs for promoting walking fluency and improving foot-ground contact during walking with a man and a woman with multiple disabilities, respectively. The man showed breaks during walking and the woman presented with toe walking. The technology used in the studies included a microprocessor with specific software, an MP3 with the recordings of preferred stimulus items, and optic sensors. Both studies were carried out according to an ABAB design. In Study I, the optic sensors were activated when the man crossed small marks distributed along the travel routes. At each sensor's activation, the man received a brief period of preferred stimulation. In Study II, the woman received preferred stimulation when the sensors at the toe and the heel of her shoes were activated in close time proximity. The man walked virtually without breaks and improved his mood (with an increase in indices of happiness) during the intervention phases of the study. The woman largely increased her percentages of steps with adequate foot-ground contact, which reached a mean of about 80 during the second intervention phase. The results were discussed in terms of rehabilitation implications and technology demands.
Assuntos
Cegueira/reabilitação , Deficiências do Desenvolvimento/reabilitação , Pé/fisiologia , Transtornos Neurológicos da Marcha/reabilitação , Marcha/fisiologia , Paresia/reabilitação , Tecnologia Assistiva , Caminhada/fisiologia , Adulto , Cegueira/complicações , Deficiências do Desenvolvimento/complicações , Deficiências do Desenvolvimento/fisiopatologia , Feminino , Transtornos Neurológicos da Marcha/complicações , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Masculino , Paresia/complicações , Paresia/fisiopatologiaRESUMO
In a recent single-case study, we showed that a new verbal-instruction system, ensuring the automatic presentation of step instructions, was beneficial for promoting the task performance of a woman with multiple disabilities (including blindness). The present study was aimed at replicating and extending the aforementioned investigation with three adults with multiple disabilities. During Part I of the study, the new instruction system was compared with a system requiring the participants to seek instructions on their own. Two tasks were used, one per system. During Part II of the study, the new system was applied with two additional tasks. The results of Part I showed that (a) the participants had a better performance (i.e., in terms of correct steps or task execution time) on the task carried out with the new system than on the task carried out with the comparison/control system, and (b) the performance of this latter task improved rapidly when the new system was used with it. The results of Part II showed satisfactory performance with each of the two tasks carried out directly with the new system. The implications of these data were discussed.
Assuntos
Cegueira/reabilitação , Culinária/métodos , Pessoas com Deficiência/reabilitação , Deficiência Intelectual/reabilitação , Educação Vocacional/métodos , Atividades Cotidianas , Adulto , Lista de Checagem/métodos , Comunicação , Feminino , Humanos , Masculino , Destreza Motora , Análise e Desempenho de TarefasRESUMO
This study assessed the use of microswitch technology to promote mouth-drying responses and thereby reduce the effects of drooling by two adults with severe intellectual and multiple disabilities. Mouth-drying responses were performed via a special napkin that contained pressure sensors, a microprocessor and an MP3 to monitor the responses and ensure positive stimulation contingent on them. Initially, the responses produced 10 or 15 s of preferred stimulation. Subsequently, preferred stimulation was supplemented with matching periods of lower-grade stimulation to extend the inter-response intervals. Results showed that both participants (a) learned to dry their mouth consistently and reduce their chin wetness during the intervention, (b) stabilized their responding at lower frequencies as the lower-grade stimulation was added to the preferred stimulation, and (c) maintained the latter levels at a 3-month follow-up. Procedure and response conditions and outcome implications are discussed.
Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Pessoas com Deficiência , Deficiência Intelectual/reabilitação , Microtecnologia , Sialorreia/reabilitação , Humanos , Deficiência Intelectual/complicações , Masculino , Pessoa de Meia-Idade , Boca , Sialorreia/etiologia , Sialorreia/prevenção & controle , Adulto JovemRESUMO
These two studies assessed adapted orientation technology for promoting correct direction and room identification during indoor traveling by persons with multiple (e.g., sensory, motor and intellectual/adaptive) disabilities. In Study I, two adults were included who had severe visual impairment or total blindness and deafness and used a wheelchair for traveling. In Study II, two adults participated who had visual impairment or total blindness but were ambulatory. All participants were to travel to different rooms located along a hallway to carry out small activities. The orientation technology ensured that the participants received (a) a verbal instruction to go to their right or left and/or a vibratory cue to the right or left side of their body as soon as they exited a room to orient their travel within the hallway and (b) a similar verbal instruction and/or vibratory cue to turn and enter when they reached the next target room entrance. Results of both studies showed that the participants on wheelchairs and those able to ambulate were successful in using the technology, orient their travel, and find the appropriate room entrances. The findings are discussed in relation to the importance of independent indoor traveling and the impact of the new technology.
Assuntos
Cegueira/reabilitação , Deficiência Intelectual/reabilitação , Orientação , Auxiliares Sensoriais , Caminhada , Estimulação Acústica , Adulto , Lesões Encefálicas/reabilitação , Sinais (Psicologia) , Surdez/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Vibração , Cadeiras de RodasRESUMO
Children with severe or profound intellectual and motor disabilities often present problems of balance and ambulation and spend much of their time sitting or lying, with negative consequences for their development and social status. Recent research has shown the possibility of using a walker (support) device and microswitches with preferred stimuli to promote ambulation with these children. This study served as a replication of the aforementioned research and involved five new children with multiple disabilities. For four children, the study involved an ABAB design. For the fifth child, only an AB sequence was used. All children succeeded in increasing their frequencies of step responses during the B (intervention) phase(s) of the study, although the overall frequencies of those responses varied largely across them. These findings support the positive evidence already available about the effectiveness of this intervention approach in motivating and promoting children's ambulation. Practical implications of the findings are discussed.
Assuntos
Deficiência Intelectual/reabilitação , Transtornos das Habilidades Motoras/reabilitação , Tecnologia Assistiva , Andadores , Caminhada , Criança , Pré-Escolar , Auxiliares de Comunicação para Pessoas com Deficiência , Eletrônica Médica/instrumentação , Feminino , Humanos , Masculino , Motivação , Baixa Visão/reabilitaçãoRESUMO
These two studies involved a boy and a man with multiple disabilities, who were taught to use a mouth-drying response to reduce the effects of their drooling. Both studies relied on microswitch technology to monitor the drying response and follow it with positive stimulation (i.e., during intervention). In Study I, the boy performed the drying response via a special napkin. The microswitch technology consisted of touch/pressure sensors and a radio transmitter hidden inside the napkin. Drying responses led the boy to 8s of preferred stimulation. In Study II, the man performed the drying response via a handkerchief. The microswitch technology consisted of an optic sensor and a radio transmitter at the man's chest. Drying responses led the man to 8-10s of preferred stimulation. The stimulation time/conditions were subsequently modified to promote a reduction in the man's response frequency. The experimental design involved an ABAB sequence (Study I) or an ABABB(1)B(2) sequence (Study II), with the second B or the B(1)B(2) combination spreading over periods of about 3 months. The results indicated vast increases in drying responses and decreases in chin wetness during the intervention phases. The frequencies of the drying response remained consistent for the boy and stabilized at a lower level (i.e., in line with the manipulation of the stimulation conditions) for the man. Implications of the findings and limitations of the studies are discussed.
Assuntos
Pessoas com Deficiência/reabilitação , Sialorreia/reabilitação , Xerostomia/reabilitação , Adulto , Criança , Auxiliares de Comunicação para Pessoas com Deficiência/normas , Eletrônica Médica , Humanos , MasculinoRESUMO
BACKGROUND: Three studies assessed the (a) effectiveness of verbal instructions presented via technology in helping persons with moderate Alzheimer's disease perform daily activities and (b) impact of activity engagement on mood. METHODS: The 3 studies targeted coffee preparation with 2 women, use of make-up with 2 women, and use of make-up and tea preparation with 3 women. Intervention effects on activity performance were assessed through nonconcurrent multiple baseline designs across participants or multiple baseline designs across activities. The impact of activity on mood was assessed by recording indices of happiness during activity trials and parallel nonactivity periods. RESULTS: Verbal instructions presented via technology were effective in helping all participants perform the target activities. The participants also showed mood improvement (ie, increases in indices of happiness) during the activity. CONCLUSION: These results suggest that the approach reported may be a useful strategy for helping persons with Alzheimer's disease.