Service Delivery

Technology-aided recreation and communication opportunities for post-coma persons affected by lack of speech and extensive motor impairment.

Lancioni et al. (2013) · Research in developmental disabilities 2013
★ The Verdict

A simple hand-closure or mouth-opening switch lets non-verbal, immobile post-coma adults run music, videos, and short messages on their own.

✓ Read this if BCBAs working with post-coma adults in long-term care or rehab hospitals.
✗ Skip if Clinicians serving only verbal clients or children with ASD.

01Research in Context

01

What this study did

Two adults who could not talk or move much after coma tried a new tech set-up.

Each used a tiny switch: one closed his hand, the other opened his mouth.

The switch ran music, videos, and simple text messages on a screen.

02

What they found

Both adults learned the switch fast and picked their own songs and clips.

They also sent short pre-written messages like “I want water.”

Staff saw smiles and eye contact rise during tech time.

03

How this fits with other research

Lancioni et al. (2011) first showed the same switch could run a text-only system. The new study keeps the switch idea and adds fun content, so it extends the 2011 work.

Robertson et al. (2013) ran a direct twin study the same year with the same clients and gear. Both papers report success, making the finding a clean replication.

Van Hanegem et al. (2014) later swapped leisure for work tasks and tried five people. That paper builds on this one by showing the switch can also run job-like activities.

04

Why it matters

If you serve adults after coma, know that a one-dollar microswitch can open both joy and a voice. Start with a single reliable movement, link it to music, then add short messages. The client chooses, the client contacts, and session stress drops.

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→ Action — try this Monday

Tape a microswitch to the client’s easiest movement, plug it into a laptop, and let one press start a favorite song.

02At a glance

Intervention
augmentative alternative communication
Design
case series
Sample size
2
Population
traumatic brain injury
Finding
positive

03Original abstract

This study assessed technology-aided intervention programs for two post-coma men who had re-acquired consciousness, but were unable to engage in personally or socially relevant occupations, given their lack of functional speech and their extensive motor disabilities. The microswitches used for accessing the program contents consisted of (a) a pressure sensor fixed in the palm of the first man's hand that could be activated with a small hand closure movement, and (b) an optic sensor fixed under the chin of the second man that could be activated by mouth opening movements. The programs' content consisted of recreation and communication options, which involved activating music, videos, and basic requests, sending and receiving (listening to) text messages, and placing phone calls. The results showed that the men (a) used the technology-aided programs successfully to manage the recreation and communication options available and (b) showed consistent preference for the sessions with the technology-aided program over other daily events. Family and staff members interviewed about the participants' programs (seven members for each participant) thought that the participants enjoyed the intervention sessions with the programs and that the programs had beneficial effects for them. Implications of the findings are discussed.

Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.06.006