Academic journal article Journal of Visual Impairment & Blindness

Microswitch Technology to Promote Adaptive Responses and Reduce Mouthing in Two Children with Multiple Disabilities

Academic journal article Journal of Visual Impairment & Blindness

Microswitch Technology to Promote Adaptive Responses and Reduce Mouthing in Two Children with Multiple Disabilities

Article excerpt

Abstract: This study assessed the viability of using microswitch clusters (combinations of microswitches) plus contingent stimulation to promote adaptive responding and to reduce aberrant behavior in two children with multiple disabilities. The results revealed that both children increased their adaptive responses, learned to perform these responses free from aberrant behavior, and maintained this level of performance three months later.

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Persons with multiple disabilities, such as severe to profound mental retardation combined with motor and visual impairments, may have few adaptive responses and fail to engage in constructive activity and to control environmental stimuli (Holburn, Nguyen, & Vietze, 2004; Mechling, 2006). They may also engage in aberrant behavior, such as protruding their tongues, mouthing their hands, or poking their eyes, which hampers their social image and overall social acceptance (Lancioni et al., 2002; Lancioni, Smaldone et al., in press; Luiselli, 1998; Saloviita & Pennanen, 2003).

Microswitch-based programs can be valuable tools to help these persons increase their adaptive responses and produce preferred stimuli (Lancioni et al., 2006; Lancioni, Singh et al., in press). Once these persons have consolidated their adaptive responses, they may learn to combine them with the control of their aberrant behavior. For example, a person may be initially taught to perform hand or foot movements to produce preferred stimuli. Subsequently, he or she may be able to produce the stimuli only if the hand or foot movements occur in the absence of aberrant behavior (such as mouthing a hand) (Lancioni et al., 2004).

This dual goal of promoting adaptive responses and reducing aberrant behavior may be pursued through a novel intervention technology that is based on microswitch clusters (combinations of microswitches that concurrently monitor adaptive and aberrant responses) and preferred stimuli that are available for adaptive responses that occur in the absence of aberrant ones (see, for example, Lancioni et al., 2006). Three single-case studies were recently conducted to investigate this opportunity, and their results were satisfactory (Lancioni et al., 2006; Lancioni, Singh et al., in press; Lancioni, Smaldone et al., in press). All three participants in the studies increased their adaptive responding (hand, head, and leg movements or all three) and reduced their aberrant behavior (mouthing their fingers or hands, poking their eyes, or hiding their faces).

The study presented here served as a replication and extension of the previous three studies. It assessed the effectiveness of microswitch cluster technology with two new participants: Children who had some functional or residual vision or were blind and had an intellectual disability and a motor impairment. The children's adaptive responding consisted of manipulating or moving an object that was attached to a wobble microswitch or knocking objects on the table to activate a vibration microswitch. The children's aberrant behavior consisted of mouthing their hands or objects.

Method

PARTICIPANTS

The participants, Ginny and Kirk, were aged 7.6 and 12.3 years, respectively, and were considered to function in the profound intellectual disability range, although no IQ scores were available. They presented with encephalopathy related to premature birth, general hypotone or spastic tetraparesis, epilepsy (largely controlled through medication), and the lack of speech. Ginny had residual vision that allowed her to control stimuli in the immediate proximity (within less than 1 meter, or about 3.3 feet) and at the center of her visual field, and Kirk was totally blind (see Morse, Teresi, Rosenthal, Holmes, & Yatzkan, 2004; Sakai et al., 2002). They did not have self-help or constructive occupational skills and spent most of their waking time sitting. Ginny had minimal interaction with objects and tended to mouth her hands. …

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