Increasing the happiness of individuals with profound multiple disabilities: replication and extension

A multielement design was used to compare the effects of three treatments on the happiness of 3 individuals with profound multiple disabilities. The conditions were typical programming using materials selected by staff, presentation of preferred materials plus social interaction, and social interaction alone with no materials present. Both the presentation of the preferred items with social interaction and social interaction alone resulted in higher happiness indicators than typical programming. The combination of preferred items and social interactions was somewhat superior to social interaction alone.     

A longitudinal study of active treatment of adaptive skills of individuals with profound mental retardation.

A longitudinal study indicated that a single group of adults living in a large state institution (O'Berry Center in Goldsboro, North Carolina) benefited from receiving active treatment, although no control group was permitted. After five years, 59 individuals with profound mental retardation improved their skills in six general areas of dressing, grooming, eating, toileting, communication, and social interaction. After five more years of active treatment, 51 persons who had remained in the program maintained their skills in dressing, grooming, eating, and communication. Significant improvement in the use of toilet and a loss in social interaction were observed. Although the participants were 10 years older at the end of this study, their adaptive behaviors, in comparison to the date of entry, either improved or were maintained. Therefore, aging was not associated with decline in skills.     

Reducing indices of unhappiness among individuals with profound multiple disabilities during therapeutic exercise routines.

A program was developed to reduce indices of unhappiness that accompanied therapeutic exercise routines among people with profound multiple disabilities. Indices of unhappiness were recorded, using an observation system that had been validated through previous research involving happiness-related variables, while support personnel conducted exercises with 3 participants. A multicomponent program was then implemented that involved presenting highly preferred stimuli before, during, and after each exercise session. Results indicated that the program was accompanied by reduced indices of unhappiness for each participant relative to the traditional method of conducting the exercises, although changes in the preferred stimuli used with 1 participant were required before consistent reductions occurred. Results are discussed regarding the importance of reducing unhappiness indices as a means of enhancing aspects of the daily quality of life for people with profound multiple disabilities. Areas for future research are also discussed, focusing on expanding the unhappiness-reduction procedures to other routine events that may occasion indices of unhappiness.     

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.     

EEG mu rhythm and imitation impairments in individuals with autism spectrum disorder

Imitation ability has consistently been shown to be impaired in individuals with autism. A dysfunctional execution/observation matching system has been proposed to account for this impairment. The EEG mu rhythm is believed to reflect an underlying execution/observation matching system. This study investigated evidence of differential mu rhythm attenuation during the observation, execution, and imitation of movements and examined its relation to behaviorally assessed imitation abilities. Fourteen high-functioning adults with autism spectrum disorder (ASD) and 15 IQ- and age-matched typical adults participated. On the behavioral imitation task, adults with ASD demonstrated significantly poorer performance compared to typical adults in all domains of imitation ability. On the EEG task, both groups demonstrated significant attenuation of the mu rhythm when executing an action. However, when observing movement, the individuals with ASD showed significantly reduced attenuation of the mu wave. Behaviorally assessed imitation skills were correlated with degree of mu wave attenuation during observation of movement. These findings suggest that there is execution/observation matching system dysfunction in individuals with autism and that this matching system is related to degree of impairment in imitation abilities.     

The effect of age of acquisition on older individuals with and without cognitive impairments

The present study compared the effects of age of acquisition (AoA) on object naming across groups of older individuals with cognitive impairments, healthy older controls, and young healthy controls. All participants named a set of 80 pictures, within which both AoA and frequency were manipulated orthogonally. Early-acquired objects were named faster than late-acquired objects across all groups. Response time also declined with age and with cognitive impairment between the groups. The effect of AoA differed across groups, with AoA effects being largest for the older group with cognitive impairments and smallest for the young control group. The present study adds strength to the suggestion that AoA of picture names is one of the factors that influence survival or loss of memories in dementia and cognitive decline, and this could therefore be used as a potential screening test for cognitive impairment disorders in the future.     

Improving accepting and giving compliments with individuals with developmental disabilities

Individuals with developmental disabilities, such as autism spectrum disorder, typically exhibit conversation skill deficits, with two prevailing deficits including giving and accepting compliments. The current study used an individualized approach to assess and teach accepting and giving compliments specific to performance, possession, and appearance with three adolescents and young adults with developmental disabilities. We taught these skills using behavioral skills training and prompting during conversations utilizing a multiple-baseline design across participants. We also observed generalization and treatment extension of the participants' skills in conversations with adults not associated with teaching and in the absence of any teaching procedures. The results support the efficacy of the procedures used toward improving giving and accepting compliments within the context of a conversation. We discuss considerations to improve the social acceptability of and refinements to the teaching procedures and acquired skills.     

Indoor travel and simple tasks as physical exercise for people with profound multiple disabilities

2 to 4 30-min. periods of indoor travel and simple tasks were arranged daily as physical exercise for two women with profound mental retardation, deafness, and profound visual impairment. The questions were whether (a) the women could manage this fairly extensive exercise regimen (over about 9 and 4.5 mo.) with support technology and only minimal staff supervision and (b) the exercise could affect aspects of the women's physical condition. Data indicated that both women could successfully manage the exercise regimen with support technology, and the exercise seemed to have some beneficial effects on physical aspects such as bone metabolism and step width.     

Facilitating ambulation and activity in persons with profound multiple disabilities through a visual orientation system

A visual orientation system was employed to help two adults with profound multiple disabilities ambulate to programmed activity destinations and carry out familiar activities. The system consisted of a portable control device and light sources. The person participating in experiment 1 was to operate the control device for activating the programmed destinations (and turning on light sources showing the way to them). The person participating in experiment 2 did not need to operate the control device; this activated each programmed destination automatically. A new destination was activated after a preset time had elapsed from the person reaching the previous destination. Results indicated that both persons used the visual orientation system successfully and thus could reach the destinations and carry out activities on their own. General implications of the findings are discussed. © 1998 John Wiley & Sons, Ltd.     

Embedded evaluation of preferences sampled from person-centered plans for people with profound multiple disabilities

We investigated a brief, embedded assessment for evaluating preferences sampled from person-centered plans. After developing person-centered plans for individuals with multiple disabilities, systematic assessments were conducted with preferences sampled from the plans. An assessment of sampled preferences was then embedded within the participants' daily routines. The two assessments identified similar preferences based on participant approach responses. Both assessments also indicated inconsistencies with reported preferences in the person-centered plans. Overall, results suggested the embedded assessment may be an alternative means of evaluating some preferences reported through person-centered planning.     

A systematic evaluation of preferences identified through person-centered planning for people with profound multiple disabilities

Person-centered planning is becoming a popular means of designing supports for people with disabilities. However, very little research evaluating person-centered planning exists. We evaluated the degree to which items and activities reported to be preferred in person-centered plans represented accurate preferences based on how individuals responded when presented with the items and activities. Person-centered planning meetings were conducted with 4 individuals with profound multiple disabilities to develop preference maps and to identify leisure-related preferences. A sample of the reported preferences in the plans was then systematically assessed by observing each participant's approach and avoidance responses to the items and activities. Of the sampled items and activities reported to be preferred in the plans, 42% represented moderate preferences based on the latter assessment process and 33% represented strong preferences. With 2 participants, several preferences identified in the plans were nonpreferred items and activities based on the preference assessments, and some were frequently avoided. These results suggested that although person-centered plans may identify some accurate preferences for people with profound multiple disabilities, this approach should be used cautiously. Results also suggested that such plans should be supplemented with systematic preference assessments to ensure the accuracy of identified preferences. Future research areas focus on evaluating other aspects of person-centered planning.     

Assisted ambulation and activity for restless or passive persons with profound multiple disabilities: assessing performance and preferences

Two adults with profound multiple disabilities and restlessness or passivity were exposed to two occupational conditions involving (a) robot‐assisted ambulation and activity in a fairly large area and (b) unassisted ambulation and activity in a small area. The aim was to examine the participants' performance (independent activities, ambulation, and challenging behavior) in the two conditions and their possible preferences between those conditions. Data showed that the participants had higher percentages of independent activities, higher percentages of ambulation, and somewhat lower percentages of challenging behavior in the condition with the robot. The participants also seemed to prefer this condition over the one without the robot. Implications of the findings were discussed. Copyright © 2000 John Wiley & Sons, Ltd.     

Determining the power of multiple regression analyses both with and without repeated measures

Power analysis guides researchers in planning how much data to collect. This article describes BWPower, a computer program for the Windows 95 environment that performs power analyses for research designs that may or may not include both between- and within-subjects factors. We discuss how BWPower easily accommodates both between- and within-subjects factors and provide examples of BWPower’s use in performing power analyses on designs with only between-subjects factors, designs with only repeated measures, and with mixed between- and within-subjects designs. We highlight the major features of BWPower’s user interface, such as the ability to iteratively increment or decrement the number of subjects and the automatic recalculation of power when the number of subjects or effect sizes is changed.     

Analysis of response allocation in individuals with multiple forms of stereotyped behavior

Three experiments were conducted to evaluate response allocation of stereotypy during free-operant and restricted-operant conditions. Five children with autism or related developmental disabilities participated in at least one and up to three of the experiments. In Experiment 1, the stereotypic response that emerged as most probable during a free-operant phase was restricted, and response allocation was again evaluated. The results for 3 participants showed that restricting the high-probability response was correlated with covarying reductions in a nontargeted stereotypy. In Experiment 2, the effect of environmental enrichment on response allocation was evaluated. One participant reallocated behavior to appropriate object manipulation, 1 participant showed no change in behavior, and a 3rd participant reallocated behavior to object manipulation only when the putative stimulus products of the object manipulation matched those of stereotypy. In Experiment 3, additional interventions were implemented to promote response reallocation. Results showed that both response restriction and reinforcement for object manipulation decreased stereotypy and increased object manipulation. Collectively, the results of these experiments point to a need for complex evaluations of interventions for stereotypy.     

Positivity ratio of flourishing individuals: Examining the moderation effects of methodological variations and chronological age

We tested the relationship between flourishing and positivity ratio while accounting for different measures of affect and rating scale formats. We further examined age-related differences in positivity ratio. Studies 1 and 2 showed that positivity ratio is affected by the measure used, but not by the rating scale format. Study 3 further showed that positivity ratio is higher among older adults. The above pattern of methodological variations was replicated in Study 4 with daily ratings of emotions and in Study 5 where emotions were rated on an extended scale. Study 5 also replicated the aforementioned age effect. Together these studies suggest that positivity ratio is moderated by methodological variants and individual differences, such as chronological age. Future studies should account for these possible moderation effects when exploring the positivity ratio and its relationship to flourishing.     

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.     

Face learning with multiple images leads to fast acquisition of familiarity for specific individuals

Matching unfamiliar faces is a difficult task. Here we ask whether it is possible to improve performance by providing multiple images to support matching. In two experiments we observe that accuracy improves as viewers are provided with additional images on which to base their match. This technique leads to fast learning of an individual, but the effect is identity-specific: Despite large improvements in viewers’ ability to match a particular person's face, these improvements do not generalize to other faces. Experiment 2 demonstrated that trial-by-trial feedback provided no additional benefits over the provision of multiple images. We discuss these results in terms of familiar and unfamiliar face processing and draw out some implications for training regimes.