Promoting mouth-drying responses to reduce drooling effects by persons with intellectual and multiple disabilities: a study of two cases.
A DIY pressure napkin that plays 10s of music can teach adults with severe ID to dry their own mouths and stay dry for months.
01Research in Context
What this study did
Two adults with severe intellectual disability drooled heavily.
The team tucked a thick napkin under their chins.
Tiny pressure sensors inside the napkin felt when either person pressed it against their lips to dry their mouth.
Each press turned on a 10-15 second clip of their favorite music or cartoon.
The study ran for several weeks and checked again after three months.
What they found
Both adults quickly learned to blot their mouths.
Chin-wet time dropped and stayed low.
The skill held three months later, even when the team later gave shorter music clips.
How this fits with other research
Lancioni et al. (2008) used almost the same napkin setup three years earlier, but rewarded mouth-wiping instead of mouth-drying.
Both studies got big drops in drool and the gains lasted.
The new paper shows you can swap the exact response and still win.
Smith et al. (2010) used an automatic beep instead of a napkin to cue "tongue in."
That study also cut oral stereotypy and held the gain at three months.
Together the three papers say: automatic micro-tech plus quick reinforcement equals lasting oral control in adults with profound ID.
Why it matters
If you serve adults who drool, you can make a sensor napkin in one afternoon.
No need to block responses or use medication.
Teach the client that drying gives good stuff.
Start with long tunes, then fade to shorter ones to keep the cost low.
Check again after three months; the skill is likely still there.
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02At a glance
03Original abstract
This study assessed the use of microswitch technology to promote mouth-drying responses and thereby reduce the effects of drooling by two adults with severe intellectual and multiple disabilities. Mouth-drying responses were performed via a special napkin that contained pressure sensors, a microprocessor and an MP3 to monitor the responses and ensure positive stimulation contingent on them. Initially, the responses produced 10 or 15 s of preferred stimulation. Subsequently, preferred stimulation was supplemented with matching periods of lower-grade stimulation to extend the inter-response intervals. Results showed that both participants (a) learned to dry their mouth consistently and reduce their chin wetness during the intervention, (b) stabilized their responding at lower frequencies as the lower-grade stimulation was added to the preferred stimulation, and (c) maintained the latter levels at a 3-month follow-up. Procedure and response conditions and outcome implications are discussed.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2010.12.039