Fostering adaptive responses and head control in students with multiple disabilities through a microswitch-based program: follow-up assessment and program revision.
A simple microswitch that pauses fun stimuli for nine seconds can keep head control in students with multiple disabilities and the fix still works years later.
01Research in Context
What this study did
The team worked with five students who had many disabilities. Each student wore small switches on the head and hand. The switches turned on music or lights when the student held the head up straight.
If the head dropped, the fun stimuli stopped for nine seconds. After a few weeks the team checked who still kept the head up. They then changed the plan for students who needed more help.
What they found
Two students kept the head up most of the time with the first plan. Three students lost good posture, so the team added more switches and shorter breaks. After this tweak all five students showed better head control.
The follow-up showed the fix worked. Students stayed upright longer and looked around more.
How this fits with other research
Lancioni et al. (2008) ran the same switch program one year later and got the same good results. Expert judges in that study liked the method more than other tools.
Austin et al. (2015) moved the idea to adults and added a choice part. Adults picked songs or videos, then lost them if the head dipped. Head bending almost vanished, showing the rule works past school age.
Stasolla et al. (2017) swapped the target from head control to first steps. Shoe sensors gave treats for forward walking. Two girls learned to walk, proving the switch-plus-stimulus setup can build many motor skills.
Why it matters
You can use cheap switches and any liked sound or light to keep head control after training. Start with one switch on the head. If posture slips, add a hand switch and keep the pause short. The same rule later helps walking, choice making, or reducing self-injury. Try it next session: place a tilt switch, pick a 9-second loss of music, and watch the head come up.
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02At a glance
03Original abstract
A program was recently developed to promote adaptive responses and upright head position in students with multiple disabilities through the use of microswitch clusters (i.e., combinations of two microswitches). The five students exposed to the program showed a significant increase in adaptive responses performed with head upright. The first purpose of this study was to carry out a long-term follow-up assessment of the five students' frequencies of adaptive responses and percentages of those responses combined with head upright. Recordings were also made of the length of time the head position was kept during each stimulation period following a successful response event and through the sessions. The second purpose of this study was to arrange a program revision for the students with less favorable data on head upright. The revision consisted of making the stimulation following successful response events synchronous with head upright with a maximum duration of 9s per event. The results of the follow-up assessment showed that two of the students kept the upright head position for nearly the entire stimulation periods that followed successful response events as well as much of the session time. The other three students kept such position for small or intermediate portions of the stimulation periods and of the session time. For these three students, the revised program was applied with substantial benefits. Implications of the findings were discussed.
Research in developmental disabilities, 2007 · doi:10.1016/j.ridd.2006.02.005