Biomedical Engineering Reference
In-Depth Information
overall frequencies of adaptive responses eventually performing most of those responses
free from the inappropriate posture. Such a posture (i.e., head forward tilting) remained
absent through most of the stimulation periods and through most of the session times.
These positive findings were supported by an expert validation assessment of the pro-
gram, which was conducted by physiotherapist trainees and professionals. Both groups
indicated that such a program could represent a useful complement to formal motor reha-
bilitation procedures and thus become a regular part of the intervention package.
18.6 Conclusions
In conclusion, the studies analyzed within this chapter underline in an unequivocal man-
ner the importance that forms of assistive technology, such as microswitches and VOCAs
(and possibly microswitch clusters), can have within programs for persons with severe/
profound multiple disabilities. Programs adopting microswitches can help these persons
acquire constructive occupation and control access to stimulation independently. The ben-
efits of such programs would grow considerably if combinations of microswitches (rather
than single microswitches) are used. Programs adopting microswitches and VOCAs can
help the persons on their occupation, access to stimulation, as well as on their social contact
with relevant caregiving figures. Programs adopting microswitch clusters can improve
the performance and advance the development of those persons by enhancing their adap-
tive responses and curbing their problem behavior/postures.
New research initiatives could be envisaged to improve the aforementioned forms of
technology and their applications. For example, one might investigate new solutions to
extend and upgrade the microswitches for monitoring minimal, nontypical responses.
One such solution for these responses could be relying on the employment of camera-
based technology. This technology would ensure high reliability and eliminate the need
of using devices on the person's body (e.g., optic sensors fixed on eyeglasses; see Lancioni
et al. 2010a; Leung and Chau 2010). One could also design various forms of microswitch-
cluster programs to help reduce different posture problems and deterioration of persons
with extensive motor disabilities (Begnoche and Pitetti 2007; Leyshon and Shaw 2008).
Summary of the Chapter
Forms of assistive technology such as microswitches and VOCAs may be essential
resources to help persons with profound and multiple disabilities learn to control rele-
vant stimuli of their environment and ask for social contact through simple (minimal)
responses. This chapter is divided into four sections. The first section focuses on stud-
ies using experimental microswitches developed to monitor small (nontypical) responses,
such as eyelid and lip movements, and thus to suit individuals with minimal motor behav-
ior. The second section analyzes studies that have combined two or more microswitches
to allow the person direct access to different types of stimulation and choice opportuni-
ties. The third section examines studies that have combined microswitches with VOCAs
