An outcome management program for extending advances in choice research into choice opportunities for supported workers with severe multiple disabilities

We evaluated an outcome management program for increasing choice opportunities provided by 2 job coaches for 5 supported workers with severe multiple disabilities in a community job. The program involved specifying and monitoring behavioral outcomes among workers and staff, training staff, and supportive and corrective feedback. Increased choice provision occurred for both job coaches across a 1-year period. Results indicate how outcome management can help translate advances in choice research into routine practice.     

A microswitch program to foster simple foot and leg movements in adult wheelchair users with multiple disabilities

This study assessed a microswitch program to foster simple foot and leg movements in 2 adult wheelchair users with multiple disabilities. The participants' mood (indices of happiness) was recorded throughout the study. Data showed that participants rapidly increased the target foot and leg movements and maintained those movements during the course of the study, which lasted about 4.5 months. With regard to indices of happiness, 1 participant showed a fairly modest increase during the intervention while the other participant showed a substantial increase. Implications of the findings are discussed.     

A cognitive-behavioral intervention program for students with special reading disabilities

Interaction among cognitive, meta-cognitive, and emotional factors seems to play a determining part in achievement behavior and especially in scholastic performance. In this study some preliminary results are presented of the implementation of a multidimensional cognitive-behavioral psychoeducational program especially designed for students with reading disabilities in which parents and teachers also take part. The aim of the program was to provide students with appropriate emotional and cognitive skills with which to address their learning problems. First results on the efficacy of the implemented program to 20 primary school boys and girls with special reading disabilities encourage research on management of learning problems with focus on cognitive and emotional aspects in which parents and teachers contribute. Research including a control group is necessary.     

Microswitch programs for persons with multiple disabilities: an overview of the responses adopted for microswitch activation

Background: To introduce a person with multiple disabilities to a microswitch-aided program, one has to select a plausible response(s), that is, a response(s) that can be performed reliably and without excessive effort by the person and can successfully activate the microswitch(es) available (producing preferred stimuli). This paper provides an overview of the responses adopted for microswitch activation in research studies during the last 20 years. Method: Computerized and manual searches were carried out to identify the studies published between 1986 and 2005. Forty-eight research studies were identified. They concerned the use of (1) a single (typical) response, (2) a single (non-typical) response, (3) multiple (typical and non-typical) responses, and (4) multiple (vocal) responses. Results and discussion: The results showed that 151 of the 190 participants involved in the studies had a positive outcome (i.e., clear increases in their responding, which suggested that they had learned the association between responding and consequent preferred stimuli). Failures were largely concentrated in the first group of studies. The discussion focused on (a) the importance of selecting plausible responses for increasing the chances of success, (b) the need of non-typical responses for persons with minimal motor behavior, (c) implications of programs with multiple responses on engagement and choice, and (d) relevance of using vocal utterances. Some suggestions for future research concerning these points were also examined.     

Access to environmental stimulation via eyelid responses for persons with acquired brain injury and multiple disabilities: a new microswitch arrangement

This study assessed a new microswitch arrangement for eyelid responses using an optic sensor placed above the cheekbone and a small sticker on the person's eyelid. This new arrangement, which was designed to avoid interference of the microswitch with the person's visual functioning, was tested on three adults with acquired brain injury and multiple (consciousness, communication, and motor) disabilities. The study was carried out according to a non-concurrent multiple baseline design across participants. Data showed the new microswitch arrangement was suitable for all three participants, who increased their responding during the intervention phase of the study when their responses allowed them to access preferred stimulation. Practical implications of the findings are discussed.     

Enabling a man with multiple disabilities and limited motor behavior to perform a functional task with help of microswitch technology

This study evaluated the extent to which two microswitches used as interfaces would enable a man with multiple disabilities and limited motor behavior to operate an electric door opener at the entrance of the day center that he attended. Analysis showed the man (a) learned to use the two microswitches, (b) preferred the microswitch placed at his wheelchair's footrest (which also allowed more effective responding) over the microswitch placed at his wheelchair's armrest, and (c) maintained his positive performance at the 1- and 2-mo. postintervention checks. The results were discussed from a technical and practical standpoint and in terms of implications for the quality of life of persons with disabilities.     

Enabling persons with multiple disabilities to choose among environmental stimuli and request stimulus repetitions through microswitch and computer technology

This study assessed microswitch and computer technology to enable two participants with multiple disabilities, 32 and 19 years of age, to choose among environmental stimuli and request their repetition whenever they so desired. Within each session, 18 stimuli (12 preferred and 6 nonpreferred) were available. For each stimulus, a computer system provided a sample of 3 sec. duration. During the intervention, participants' vocal responding in relation to a stimulus sample activated a microswitch and a computer system turned on that stimulus for 15-30 sec. When participants did not vocally respond, the computer system paused briefly and then presented the next scheduled stimulus sample. When participants vocally responded at the end of a stimulus presentation, the stimulus was repeated. Intervention data showed that the participants learned to choose preferred stimuli and bypass nonpreferred ones as well as to request repetitions of the preferred stimuli. This performance was maintained at a 1-mo. postintervention check and transferred to sets of stimuli not used in the intervention. The implications of these results were discussed.     

Adapting a grid into a microswitch to suit simple hand movements of a child with profound multiple disabilities

We adapted a grid into a microswitch for the hand movements of a girl with profound multiple disabilities who lay on her back. The grid, suspended above the girl's face, was equipped with two mercury devices, i.e., small sealed ampoules containing a mercury drop and ending with conductive leads. A lateral or forward movement of the grid would make the mercury drop of at least one device slide to the conductive leads and activate the device. During the intervention, activations of the devices, i.e., microswitch activations, produced the occurrence of favorite stimuli. Analysis showed that the girl increased the frequency of hand movements and microswitch activations during the intervention phases compared to the baseline phases (when the favorite stimuli were not available). The increase was retained at a 1-mo. postintervention check.     

Promoting adaptive foot movements and reducing hand mouthing and eye poking in a boy with multiple disabilities through microswitch technology

This study assessed the viability of a microswitch cluster (i.e. a combination of microswitches) plus contingent stimulation for promoting adaptive responding and reducing aberrant behavior in a boy with profound multiple disabilities. The boy was initially taught an adaptive foot-movement response that activated a motion microswitch and produced preferred stimuli. Subsequently, his foot response led to preferred stimuli only if it occurred in the absence of aberrant behavior (i.e. hand mouthing and eye poking which were detected through optic microswitches). Moreover, full access to the stimuli required that the boy refrain from aberrant behavior during their presentation as well. The study also included a 3-month post-intervention check and a social validation assessment. Data showed that the boy (i) increased his adaptive responding, (ii) learned to perform this responding largely free from aberrant behavior and refrained from that behavior for most of the session time, and (iii) maintained this performance at the post-intervention check. The social validation ratings of 40 teachers and teacher assistants significantly favored the last intervention period (in which aberrant behavior was reduced) over the initial period.     

Teaching 'Yes' and 'No' responses to children with multiple disabilities through a program including microswitches linked to a vocal output device

The present study introduced two children (a boy and a girl of 9.2 and 12.3 yr. of age, respectively, with multiple disabilities) to an intervention program for establishing Yes and No responses in relation to preferred and nonpreferred stimuli and assessed the acquisition and generalization of those responses. The program involved the use of microswitches, which monitored the nonverbal Yes and No responses performed by the children and ensured that these responses produced the matching verbal utterances via a vocal output device. Analysis showed children acquired Yes and No responses in relation to the stimuli used for the intervention and, to a comparable degree, to the stimuli used for generalization checks as well. An interview of 30 educational staff of a center for persons with multiple disabilities indicated that they considered the presence of Yes and No verbal utterances preferable to the absence of such utterances, and thought that the utterances could be helpful for the children's response acquisition and would be useful and pleasing for staff and parents. General implications of the findings were discussed.     

Writing program with word prediction for a young man with multiple disabilities: a preliminary assessment

This study assessed a writing program with word prediction, which completed the writing of a word and spoke it out only when there was certainty that such a word was the correct one. The assessment was carried out with a young man with multiple disabilities, who typically used a word-processing program without word prediction. The two programs were compared on the time required by the participant for writing general sentences, through a social validation assessment, and eventually a check on the participant's preference. Analysis showed the program with word prediction was significantly more effective in terms of the writing time, which was halved, and was deemed preferable by 40 raters (psychology students) involved in the social validation assessment and by the participant himself. Implications of the findings are discussed.     

A microswitch‐based program for promoting initial ambulation responses: An evaluation with two girls with multiple disabilities

We assessed the use of a microswitch‐based program for promoting ambulation responses by two children with multiple disabilities. The goals of the study were to: (a) evaluate the importance of the contingency between the target behavior (forward step) and the programmed consequence (preferred stimuli), (b) measure effects of the intervention on indices of happiness, and (c) assess the social validation of the procedure using 20 physiotherapists as external raters. The intervention involved the automatic delivery of preferred stimuli contingent on forward steps. Results showed that both participants improved their performance (forward steps and indices of happiness) during contingent reinforcement phases compared to baseline and noncontingent reinforcement phases. Moreover, physiotherapists rated the intervention as socially valid.     

Brief report: Building choice opportunities within a robot-assisted occupational program: A case study

Choice opportunities were built within an existing robot-assisted occupational program. The new version of the program (with choice opportunities) was then employed with a low-functioning, multiply handicapped man who had previously been trained in the old version of the same program (the one with no choice opportunities). The results have shown that the man responded “purposefully” to choice situations and maintained highly accurate activity engagement. The importance of providing choice opportunities to people with severe and multiple handicaps and the cost and benefits of the program used in this study are discussed.     

An enriched teaching program for reducing resistance and indices of unhappiness among individuals with profound multiple disabilities

We evaluated an enriched teaching program for reducing resistance and indices of unhappiness displayed by 3 individuals with profound multiple disabilities during teaching sessions. The program involved presentation of preferred activities before, during, and after each teaching session, discontinuation of identified nonpreferred activities, and a brief break and preferred activity following occurrence of resistance. Implementation of the enriched teaching program was accompanied by reductions in resistance and indices of unhappiness for each participant. Results also indicated no negative impact of the program on participant performance of the teaching steps or staff teaching proficiency. Staff questionnaire responses provided a degree of social validation for the observed changes in that staff reported the participants liked the enriched teaching program more than the traditional teaching process. Directions for future research discussed include identifying critical aspects of the overall program and the potential relation between teaching proficiency and the program's enrichment effectiveness.     

Multiple microswitches for persons with multiple disabilities: a basic procedure to examine the persons' choice behavior

This study examined a basic choice-analysis procedure to clarify choice between two responses and related stimuli by five persons with multiple disabilities ages 17.1 to 50.2 yr. The procedure was based on reversing the links between responses and stimuli to assess whether the stimuli accounted for differences in response levels. When this was not the case, the procedure added extra stimuli for the less preferred response to judge whether such an increase would compensate for the apparent disadvantage of that response, e.g., its higher physical cost. Analysis showed that the choice of three of the five participants seemed motivated by the stimuli following the responses. The choice of the other two persons seemed related to a preference for one of the responses which was partially or largely modified when extra stimuli were added.     

Dropout policies and trends for students with and without disabilities

Students with and without disabilities are dropping out of school at an alarming rate. However, the precise extent of the problem remains elusive because individual schools, school districts, and state departments of education often use different definitional criteria and calculation methods. In addition, specific reasons why students drop out continues to be speculative and minimal research exists validating current dropout prevention programs for students with and without disabilities. This study examined methods secondary school principals used to calculate dropout rates, reasons they believed students dropped out of school, and what prevention programs were being used for students with and without disabilities. Results indicated that school districts used calculation methods that minimized dropout rates, students with and without disabilities dropped out for similar reasons, and few empirically validated prevention programs were being implemented. Implications for practice and directions for future research are discussed.     

Use of response cards with a group of students with learning disabilities including those for whom English is a second language

The current study compared the effects of hand raising and response cards during a writing instruction class in a middle-school resource classroom with students who were learning English as their second language. Response cards increased the rate and accuracy of academic responding, increased weekly quiz scores, and had mixed effects on off-task behavior, but most students reported that they preferred hand raising.     

Comparison of simultaneous prompting with and without error correction in teaching science vocabulary words to high school students with mild disabilities

This study compared the effectiveness and efficiency of simultaneous prompting with and without error correction during daily probe sessions in teaching science vocabulary words. The teacher presented the vocabulary word definitions as instructive feedback during training sessions. Five 16–17 year old students with disabilities participated in an adapted alternating treatments design that evaluated the simultaneous prompting strategy, error correction and instructive feedback. Instruction occurred in a group format using choral responding. The results indicate that (a) all students learned to read the vocabulary words, (b) simultaneous prompting with error correction was slightly more efficient for three of the five subjects in learning the targeted words, and four of the five students made fewer errors in this condition, (c) all students preferred simultaneous prompting with error correction over simultaneous prompting without error correction, (d) words mastered in both conditions generalized equally, (e) there were minimal differences between the two conditions in the collected maintenance data, and (e) students experienced only minimal improvement in their ability to define vocabulary words (instructive feedback). Discussion focuses on issues for further research and implications for instructional practice with simultaneous prompting, error correction and instructive feedback.