Persons with multiple disabilities increase adaptive responding and control inadequate posture or behavior through programs based on microswitch-cluster technology.
Microswitch clusters that deliver favorite stimulation right away can lift good posture and cut drooling in clients with severe multiple disabilities.
01Research in Context
What this study did
Two adults with severe multiple disabilities sat in wheelchairs. One drooled constantly. The other let his head flop to the side.
Researchers clipped tiny micro-switches to their clothes. One switch sensed when the head was upright. Another sensed when the mouth was closed.
If the client held good posture for three seconds, a favorite song or vibration played for five seconds. Bad posture paused the fun. Sessions ran 10 minutes, three times a day.
What they found
Good posture and closed-mouth moments jumped from almost zero to 70-80 % of the time. Drooling and head-leaning dropped by half.
The clients learned fast. Gains showed up in the first week and stayed for the whole month-long study.
How this fits with other research
Eussen et al. (2016) built a motor test called Movakic for the same population. Their tool lets you track tiny gains the switches create.
Verriden et al. (2019) also cut problem behavior, but they used mild punishers added to NCR+DRA. Robertson et al. (2013) got the same drop without any punishment—just fun stuff for good form.
Mombarg et al. (2013) used Wii balance boards for motor skills. Both studies show cheap tech can beat expensive gear when the reward is instant and liked.
Why it matters
You can build a microswitch setup for under $30 with parts from any electronics store. Pick a client who drools or slumps, tape a switch to the desired position, and plug in a preferred song or toy. Deliver the fun only when the head is up or the lips are closed. Track the change with simple 10-minute probes. No staff prompts needed—the machine does the work while you run other programs.
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02At a glance
03Original abstract
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.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.07.014