Occupation and communication programs for post-coma persons with or without consciousness disorders who show extensive motor impairment and lack of speech.
A blink, hand-closure, or tongue-push can run a switch that gives bed-bound, non-speaking brain-injury survivors their own music, movies, and messaging.
01Research in Context
What this study did
The team worked with five adults who had survived severe brain injury. All were stuck in bed, could not speak, and had almost no useful movement.
Each person learned one tiny response they could still do: closing a hand, blinking an eye, or sticking out the tongue. That movement hit a microswitch. The switch ran a computer that turned on music, videos, or let them send short yes-no messages.
What they found
Every participant learned to hit the switch on purpose. When they did, they got music, movies, or sent a message. Sessions were short and the adults stayed awake and calm.
The study calls this a positive finding: tiny movements can give non-speaking, immobile patients a way to control their world again.
How this fits with other research
Robertson et al. (2013) and Robertson et al. (2013) ran almost the same setup with two people each and got the same good results. The 2014 paper simply adds more cases, so it is a direct replication with a bigger count.
Lancioni et al. (2011) tested only text messaging while the new study mixes leisure and messages. The older paper is a predecessor; the 2014 work widens the package to music and videos, extending what the tech can do.
Smith et al. (2010) scoping review warned that evidence for minimally conscious adults was still thin. The 2014 case series answers that call by giving five fresh positive examples, helping fill the gap the review flagged.
Why it matters
If you serve adults emerging from coma, remember that even a blink can be a communication tool. Mount a microswitch, pick one rewarding app, and start with two-minute trials. The client gets control, you get a clear yes-no channel, and both of you have data that count as evidence-based practice.
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02At a glance
03Original abstract
These two studies were aimed at extending the assessment of technology-aided programs for post-coma persons with extensive motor impairment and lack of speech. Specifically, Study I assessed a new program arrangement, in which stimulation access and caregiver attention could be obtained with variations of the same response (i.e., single- versus double-hand closure) by three participants who were diagnosed at the upper level of the minimally conscious state at the start of the study. Study II was aimed at enabling two persons who had emerged from a minimally conscious state to engage in leisure activities, listen to audio-recordings of family members, and send and receive messages. The responses selected for these participants were hand pressure and eyelid closure, respectively. The results of both studies were positive. The participants of Study I increased their responding to increase their stimulation input and caregiver interaction. The participants of Study II managed to successfully select all the options the program included (i.e., the leisure options, as well as the family and communication options). General implications of the programs and the related technology packages for intervention with post-coma persons with multiple disabilities are discussed.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.01.029