Using multiple microswitches to promote different responses in children with multiple disabilities.

Two boys with severe multiple disabilities each got three microswitches. The team taught one switch at a time. Each switch needed a different move: chin press, hand lift, or foot tap. When the boys hit a switch, music or a toy lit up for five seconds. After each switch worked alone, the boys got all three at once. The study counted how many times they hit any switch during ten-minute play sessions.

The kids were five and seven years old. They could not talk or walk. The study used an A-B design for each child. Phase A was baseline with no switches. Phase B first taught single switches, then offered the full set together. Sessions ran three to five times a week at their school table.

Both boys learned to use every switch when it was the only one available. Response rates stayed high when all three switches were open at the same time. Total presses climbed because the kids could pick the easiest move at any moment. No extra training was needed once the switches were combined.

The chin switch stayed the favorite, but the boys still used the other two enough to keep the toys running. Teachers saw new hand and foot movements that had been rare before.

Lancioni et al. (2009) ran almost the same setup eight years later and got the same good results. Their kids also kept high switch use and showed fewer stiff, twisty moves. The match makes the 2001 data look solid, not a one-off fluke.

Ghaemmaghami et al. (2018) shaped complex communication moves piece by piece, just like this study chained microswitch moves. Both papers show that adding small steps, then blending them, grows bigger response sets without problem behavior coming back.

Leif et al. (2020) used prompts inside an assessment to make kids touch toys more. The tactic is different—prompts versus microswitches—but the idea is the same: embed the cue inside the task, then let reinforcement keep the new skill alive.

If you work with kids who have limited movement, one switch is rarely enough. This paper gives you a quick map: teach each move alone, then stack the switches so the child can choose. You multiply response chances without extra teaching time. Try it next session—add a second switch after the first is solid, and let the learner decide which one to hit.