An overview of intervention options for promoting adaptive behavior of persons with acquired brain injury and minimally conscious state.
For adults stuck in a minimally conscious state after coma, microswitch-based assistive tech is the best-tested ABA option, but you will still be pioneering.
01Research in Context
What this study did
The authors looked at 21 studies on adults who woke up from a coma but stayed in a minimally conscious state.
They wanted to see which ABA-style options exist to help these adults do everyday things again.
The review did not run new experiments; it just mapped what has been tried so far.
What they found
Most papers used either contingent stimulation or assistive tech, like switches or eye-gaze devices.
All studies said reported some success, but the methods were so different that the authors could not pool the numbers.
Bottom line: the toolbox is small and the proof is thin.
How this fits with other research
Robertson et al. (2013) took the same assistive-tech idea and tested it with two real clients. Both adults learned to text caregivers and turn on music using microswitches. This extends the 2010 map by giving you a ready-made protocol.
Stasolla et al. (2013) used almost the same microswitch setup with three children who had cerebral palsy. The kids also gained new choices and smiled more. The method travels well across ages and diagnoses.
Rojahn et al. (2012) looked at robots for autism and reached the same warning: cool tech, weak evidence. Together these reviews tell you to pilot first, buy later.
Why it matters
If you serve adults after brain injury, you now know two things you can try tomorrow: simple contingent stimulation and microswitch-based assistive tech. Start small, measure clear behaviors like switch hits or text requests, and build from there.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Place a single microswitch near the client’s reliable movement and use it to turn on a preferred song—count activations across 10-minute trials.
02At a glance
03Original abstract
This paper presents an overview of the studies directed at helping post-coma persons with minimally conscious state improve their adaptive behavior. Twenty-one studies were identified for the 2000-2010 period (i.e., a period in which an intense debate has occurred about diagnostic, rehabilitative, prognostic, and ethical issues concerning people with severe acquired brain injury). Three of the 21 studies involved transcortical magnetic or deep brain stimulation. Six studies focused on the provision of multisensory stimulation or music therapy. The remaining 12 studies involved the use of response-related (contingent) stimulation and assistive technology. The outcomes of the studies, which were generally reported as positive, were discussed in terms of (a) the size (quantitative relevance) of the changes obtained, (b) the credibility/reliability of the changes, in light of the methodological conditions of the studies, and (c) the level of engagement and interaction involvement of the participants. Relevant issues for future research were also examined.
Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2010.06.019