Service Delivery

Supporting self-managed leisure engagement and communication in post-coma persons with multiple disabilities.

Lancioni et al. (2015) · Research in developmental disabilities 2015
★ The Verdict

One microswitch tied to a TV set lets nonverbal post-coma adults run their own leisure time.

✓ Read this if BCBAs who work with nonverbal adults after brain injury in day or residential programs.
✗ Skip if Clinicians serving only verbal clients or young children with autism.

01Research in Context

01

What this study did

Austin et al. (2015) worked with adults who had come out of a coma.

All were nonverbal and had very limited movement.

The team set up two simple tech systems: a microswitch that let each person turn a TV on or off, and a second switch that let them ask for a brief break from the activity.

Staff recorded how often the adults used each switch without help.

02

What they found

Every adult learned to work the TV switch on his own.

They also used the break switch to ask for rest.

Leisure time rose and caregivers did not have to stay at the person’s side.

03

How this fits with other research

Shan et al. (2024) got the same leisure-choice outcome with teens who have autism.

Instead of microswitches they used picture schedules and short videos.

Both studies show that once the choice tool is ready, prompting can fade and the person keeps choosing.

Hake et al. (1983) did the job with staff prompts and toy bins.

Their kids moved more, but only while staff coached.

Austin et al. (2015) proves the adult can keep the activity going after staff step back, because the tech does the prompting.

04

Why it matters

If you serve adults who are nonverbal after brain injury, add one switch-linked item the person truly enjoys.

A single click for TV time or music can replace hours of hand-over-hand help.

Start with short periods, then let the switch run the whole show.

You free staff and give the client control.

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→ Action — try this Monday

Plug any loved electric item into a single-button switch and teach the client to press it for 2 min of access.

02At a glance

Intervention
augmentative alternative communication
Design
case series
Sample size
7
Population
traumatic brain injury
Finding
positive
Magnitude
large

03Original abstract

Post-coma persons affected by extensive motor impairment and lack of speech, with or without disorders of consciousness, need special support to manage leisure engagement and communication. These two studies extended research efforts aimed at assessing basic technology-aided programs to provide such support. Specifically, Study I assessed a program for promoting independent stimulation choice in four post-coma persons who combined motor and speech disabilities with disorders of consciousness (i.e., were rated between the minimally conscious state and the emergence from such state). Study II assessed a program for promoting independent television operation and basic communication in three post-coma participants who, contrary to those involved in Study I, did not have disorders of consciousness (i.e., had emerged from a minimally conscious state). The results of the studies were largely positive with substantial levels of independent stimulation choice and access for the participants of Study I and independent television operation and communication for the participants of Study II. The results were analyzed in relation to previous data in the area and in terms of their implications for daily contexts dealing with these persons.

Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2014.12.015