International Journal of Behavioral Research & Psychology (IJBRP)    IJBRP-2332-3000-03-001e

Assistive Technologies and Microswitches for Promoting Constructive Engagement by Children with Developmental Disabilities


Stasolla F

Lega del Filo d'Oro Research Center, Molfetta, Italy.

*Corresponding Author

Fabrizio Stasolla,
Lega del Filo d'Oro Research Center,
Molfetta, Italy.
E-mail: f.stasolla@psico.uniba.it

Article Type: Editorial
Received: March 31, 2015; Published: April 02, 2015

Citation: Stasolla F(2015) Assistive Technologies and Microswitches for Promoting Constructive Engagement by Children with Developmental Disabilities. Int J Behav Res Psychol, 3(1e), 1-2. doi: dx.doi.org/10.19070/2332-3000-150003e

Copyright: Stasolla F© 2015. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.



Children with developmental disabilities may fail to constructive engage with the surrounding world, due to their pathologies and clinical conditions. In fact, they are frequently reported as quite passive, isolated, presenting medical complications, dystonic movements, stereotypic behaviours, seizures, breath difficulties. Accordingly, they dispose of a very poor and limited behavioural repertoire, with few and sporadic capacities and opportunities to positively interact with the environmental events. Their situation may seriously hamper their social desirability, image and status, with negative consequences on their quality of life [1, 2]. Traditional rehabilitative programs within medical centres focused on sensorial stimulation and snoezelen rooms, providing them with positive (i.e. pleasant) environmental stimuli, aimed at enhancing their alert and vigilance, with positive consequences on their mood [3, 4]. The aforementioned interventions, however, do not improve participants' active role, relying them on caregivers and parents' assistance [5]. One way to overcome this issue is the use of assistive technologies (AT) [6]. Thus, by using technological supports (e.g. laptop, voca, speech generating devices) one may encourage positive participation of children involved, fostering their constructive engagement and reducing parents and caregivers' burden [7]. One solution within the AT approach is represented by microswitches [8].

Microswitches are electronic devices ensuring a person who exhibit a very low behavioural repertoire with an independent access to preferred (i.e. positive) stimulation. For instance, a child who is described with congenital encephalopathy and multiple (i.e. combination of sensorial, motor and intellectual disabilities) may be recruited for a microswitch-based program. That is, by producing eye blinking (i.e. adaptive response) recorded by an optic sensor fixed on a glasses frame the child could autonomously receive brief (e.g. 5-10 seconds) of preferred songs, through a control system unit [9]. Although no specific rules exist, one may define basic guidelines for a positive outcome concerning a microswitchbased intervention. Thus, the behavioural response should be already included in the child' behavioural repertoire, consequently easily exhibited by the participant (i.e. without any effort), detectable for the microswitch, produced by verbal and/or physical prompts. The stimulation provided contingently to the performing of the adopted response should be adequately motivating (i.e. it should compensate the response cost). Based on learning principles (i.e. causal association between behavioural response and environmental consequences), the child is expected to acquire the awareness concerning the aforementioned association and increasing his/her responding to access to positive stimulation [10]. Conversely to the sensorial stimulation and snoezelen-based interventions, within a microswitch-based program, participants are requested to produce (i.e. exhibit) an adaptive response to access to pleasant stimuli by themselves [11].

Depending upon the level of intellectual, motor and sensorial levels of functioning concerning the participants involved (all those are customer-tailored solutions), one may design different rehabilitative interventions. Beginning at a very low level of functioning, as described above, one may plan a very basic program with a simple (e.g. eye blinking) response to access to a unique category of stimulation (e.g. pleasant songs). Switching to a more favourable outcome (i.e. higher functioning),one may project at least a basic choice program with two minimal responses adapted and two related microswitches selected to detect those responses, allowing participants to request and choice between two different categories of stimuli (e.g. visual and auditory stimulation). Else, one may encourage a combination of microswitch and VOCA (i.e. vocal output communication aid) program, enabling participants to chose whether independently access to pleasant stimuli or ask for social contact with a caregiver. Otherwise, microswitch-clusters technology will pursue the dual goal of increasing an adaptive response (e.g. manipulation of an object) and, at the same time, reducing a challenge behaviour (e.g. head tilting). Moreover, one may provide individuals who present problems of balance with microswitches and contingent stimuli in their walking devices to promote ambulation responses and/or to foster locomotion fluency as integrative interventions compared to the use of treadmills and/or physiotherapy sessions. Finally, for children who are estimated within the normal range of intellectual functioning and who present extensive motor disabilities or developmental disabilities such as autism spectrum disorders with challenge behaviours (e.g. tantrum behaviour), microswitch-based programs combined with a keyboard emulator or a computer mediated intervention, may be considered to improve literacy access and request and choice access, promoting leisure, communication and occupationskills [12-14].

In light of above, future research perspectives in this topic area should deal with the following crucial points:

  1. Further extension to new participants with severe to profound clinical conditions of the aforementioned programs,
  2. Planning follow-up and/or maintenance/generalization phases addressed to the acquired skills,
  3. Considering indices of happiness as outcome measure of the quality of life of participants involved,
  4. Assessing social validation procedures recruiting professionals, parents and caregivers as raters, and
  5. Finding out and checking for updated new basic technological solutions, which should be at the same time cheap (i.e. not expensive) and rigorously customer-tailored designed, positively responding to a wide range of participants involved, depending upon their general and clinical conditions [15].


References

  1. Lancioni GE, Singh NN, O'reilly MF, Oliva D, Smaldone A, et al. (2006) Assessing the effects of stimulation versus microswitch-based programmes on indices of happiness of students with multiple disabilities. Journal of Intellectual Disability Research 50:739-747.
  2. Singh NN, Lancioni GE, Winton ASW, Molina EJ, Sage M, et al. (2004) Effects of Snoezelen room, Activities of Daily Living skills training, and Vocational skills training on aggression and self-injury by adults with mental retardation and mental illness. Res Dev Disabil 25:285-293.
  3. Lancioni GE, Singh NN, O'Reilly MF, Oliva D, Basili G. (2005) An overview of research on increasing indices of happiness of people with severe/ profound intellectual and multiple disabilities. Disabil Rehabil 27:83-93.
  4. Lancioni GE, O'Reilly MF, Singh NN, Sigafoos J, Oliva D, et al. (2008) Microswitch-based programs for persons with multiple disabilities: An overview of some recent developments. Percept Mot Skills 106:355-370.
  5. Lancioni GE, Bosco A, Belardinelli MO, Singh NN, O'Reilly MF, et al. (2014) Technology-based intervention programs to promote stimulation control and communication in post-coma persons with different levels of disability. Frontiers in Human Neuroscience 8(1 FEB).
  6. Lancioni G. E, Singh N. N (2014) Assistive technologies for people with diverse abilities. New York: Springer.
  7. Pike J, Jones E, Rajagopalan K, Piercy J, Anderson P. (2012) Social and economic burden of walking and mobility problems in multiple sclerosis. BMC Neurology 12.
  8. Stasolla F, Caffò AO, Picucci L, Bosco A. (2013) Assistive technology for promoting choice behaviors in three children with cerebral palsy and severe communication impairments. Res Dev Disabil 34:2694-2700.
  9. Stasolla F, Caffò AO (2013) Promoting adaptive behaviors by two girls with Rett syndrome through a microswitch-based program. Research in Autism Spectrum Disorders 7:1265-1272.
  10. Stasolla F, Perilli V, Damiani R, Caffo A. O, Di Leone A, et al. (2014). A microswitch-cluster program to enhance object manipulation and to reduce hand mouthing by three boys with autism spectrum disorders and intellectual disabilities. Research in Autism Spectrum Disorders 8(9):1071-1078.
  11. Stasolla F, Damiani R, Caffò AO (2014) Promoting constructive engagement by two boys with autism spectrum disorders and high functioning through behavioral interventions. Research in Autism Spectrum Disorders 8:376-380.
  12. Stasolla F, De Pace C (2014) Assistive technology to promote leisure and constructive engagement by two boys emerged from a minimal conscious state. NeuroRehabilitation 35:253-259.
  13. Stasolla F, Caffò AO, Damiani R, Perilli V, Di Leone A, et al. (2015) Assistive technology-based programs to promote communication and leisure activities by three children emerged from a minimal conscious state. Cognitive Processing 16;69-78.
  14. Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Oliva D, et al. (2010) Promoting ambulation responses among children with multiple disabilities through walkers and microswitches with contingent stimuli. Res Dev Disabil 31:811-816.
  15. Stasolla F, Perilli V, Di Leone A, Damiani R, Albano V, et al. (2015) Technological aids to support choice strategies by three girls with Rett syndrome. Res Dev Disabil 36:36-44.

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