Biomedical Engineering Reference
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Data showed that all nine participants increased their microswitch responding during
the intervention. Seven of them also showed increases in indices of happiness during
those periods.
Measuring the opinion of staff, parents, or other plausible raters such as physiothera-
pists and psychology students through social validation procedures helps define (1) the
level of acceptance/support that these people have of the programs evaluated in the study,
and (2) their likely backing of the implementation of those programs within daily con-
texts. For example, Lancioni et al (2006a) conducted a study in which 140 teacher trainees
and 84 parents were involved in rating microswitch-based programs versus interaction/
stimulation conditions for participants with multiple disabilities. All teacher trainees and
parents scored the two conditions on a seven-item questionnaire concerning the partici-
pants' enjoyment of the two conditions, the possible impact and practical benefits of those
conditions, and the raters' personal view of those conditions in terms of likeableness. Data
indicated that both teacher trainees and parents provided the microswitch programs with
higher (more positive) scoring on all seven items. These scores seemed to constitute a very
strong endorsement of the microswitch-based programs and a level of evidence totally
in line with the positive outcomes of the programs in terms of participants' response
frequencies.
18.5.2 Implications of the Studies and Practical Perspectives
The aforementioned overview and comments stress first of all the importance of identi-
fying and targeting single, nontypical responses for conducting successful microswitch-
based interventions with persons with minimal motor behavior. The studies adopting
those responses have collected a new level of encouraging evidence as to the possibility of
helping the aforementioned (most affected) persons (i.e., persons who could not possibly
be involved in intervention programs relying on typical motor responses and traditional
microswitches) (Lancioni et al. 2005b, 2008b). Enabling these persons to be active and
responsible of their environmental stimulation through various periods of the day (i.e.,
various intervention sessions) could represent a very relevant achievement with multiple
implications in terms of the individuals' social status and quality of life as well as from a
technical standpoint (Lachapelle et al. 2005; Petry et al. 2005, 2009).
On an individual level, it might be argued that the person's ability to be constructively
engaged and to independently determine his or her level of stimulation can increase his
or her overall satisfaction, improve his or her general mood, and present a more advanced
social image (Wehmeyer and Schwartz 1998; Szymanski 2000; Browder et al. 2001;
Zekovic and Renwick 2003; Karvonen et al. 2004; Petry et al. 2005, 2009; Lancioni et al.
2006d, 2006e, 2007d). From a technical standpoint, one may underline and appreciate the
relevance of having (1) isolated and successfully targeted a series of specific responses,
and (2) built and assessed interfaces (microswitch devices) for those responses. Such
interfaces proved viable to allow the participants to use those small responses to control
relevant environmental events and maintain constructive engagement. Among the inter-
faces, the new camera-based technology may deserve special attention; it allows the pos-
sibility of monitoring small responses through the use of one or two color marks rather
than through support frames in contact with the participant's face and head (Lancioni
et al. 2010a).
The nontypical responses assessed in the studies reviewed above consisted of vocaliza-
tion, chin and lip movements, eyelid and eyebrow movements, small hand-closure move-
ments, and forehead skin movements. Although those responses represent a range of
