Extending microswitch-based programs for people with multiple disabilities: use of words and choice opportunities.

Two adults with severe multiple disabilities got four microswitches. Three switches said "I want ___" for food, drink, or toys. The fourth switch let them pick one of two items on a tray.

Staff recorded how often each switch was hit during 15-minute sessions. Baseline lasted until responding was flat. Then every hit gave the item over the study period.

Both learners touched the request switches 80-100 times per session within the first week. They also used the choice switch on a large share of trials.

Gains stayed high when staff moved the setup to the living room and cafeteria. No extra teaching was needed.

Lancioni et al. (2009) later added mom or dad to the session and saw the same strong results two months later. The 2003 study is the bare-bones version; 2009 shows the idea lasts.

Ghaziuddin et al. (1996) used a talking box instead of switches. Both studies got requests working fast, so the tool matters less than the contingent delivery.

McGonigle et al. (2014) taught girls with Rett syndrome to press a voice-output switch for snacks. One brief FCT session worked, mirroring the rapid learning seen here.

You can give non-verbal clients a voice in one afternoon. Tape three big buttons to a table, load cheap recorded messages, and let each press deliver the item. Start with highly preferred snacks and 10-minute trials. No fancy software is required, and the same four-switch layout teaches both requesting and choosing. Try it while you wait for high-tech AAC funding.