Service Delivery

Communication opportunities via special messaging technology for two post-coma persons with multiple disabilities.

Lancioni et al. (2011) · Research in developmental disabilities 2011
★ The Verdict

A microswitch-linked net-book lets non-verbal, post-coma adults text family and staff on their own within short sessions.

✓ Read this if BCBAs working with adults who have traumatic brain injury and minimal movement.
✗ Skip if Clinicians serving only verbal clients or young children with autism.

01Research in Context

01

What this study did

Two adults woke up from coma with brain injury. They could not talk or move much.

The team gave each person a small net-book, a GSM modem, and two microswitches. One switch scanned a list of pre-recorded messages. The second switch picked the message. The net-book then sent the text by itself.

Sessions lasted 20–30 min. The design was ABAB: baseline, tech on, tech off, tech on again.

02

What they found

Both adults learned to send and receive texts with no help. Messages went to family or staff.

When the tech was taken away, texting stopped. When it came back, texting returned. This showed the tech, not chance, caused the change.

03

How this fits with other research

Robertson et al. (2013) used the same net-book, GSM modem, and microswitch package one year later. They added leisure games and caregiver calls. Results stayed positive, so the core system is sturdy.

Lancioni et al. (2011) ran a twin study the same year. The hardware was identical, but participants made phone calls instead of texts. Both studies got large gains, proving the gear works for either voice or text.

Robertson et al. (2013) also tested Braille-labelled keyboards with different adults who were blind. They found positive texting gains too. Microswitch vs. keyboard looks like two good roads to the same goal.

04

Why it matters

If you serve adults who are post-coma and barely move, a cheap net-book plus microswitch can open real conversation in under an hour. No voice needed, no caregiver hover. Try mounting an optic switch to a finger curl or eyebrow lift and load a short phrase list. Start with one social partner and let the client feel the buzz of an incoming reply. Independence is the reinforcer.

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Program two short phrases into a single-switch scanning app and let your post-coma client send one text to a preferred person today.

02At a glance

Intervention
augmentative alternative communication
Design
reversal abab
Sample size
2
Population
traumatic brain injury
Finding
positive
Magnitude
large

03Original abstract

This study extended the assessment of a special messaging technology with two additional post-coma adults who had emerged from a minimally conscious state, but showed multiple disabilities including profound motor and communication impairments. For each participant, the study involved an ABAB design, in which the A represented baseline phases and the B represented intervention phases with the special messaging technology. The technology involved a net-book computer provided with specific software, a global system for mobile communication (GSM) modem, microswitches, and prerecorded verbal lists of persons' names and messages. Both participants learned to send out and receive (listen to) messages independently during the intervention, thus providing clear support for previous data in the area. They sent out means of about three and 17 messages and received means of about two and six messages per 20- and 30-min session, respectively. The positive impact of the technology was discussed in relation to previous data in this area and the possibility of helping post-coma persons with multiple disabilities engage in basic communication with distant partners.

Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.02.025