Technology-based intervention options for post-coma persons with minimally conscious state and pervasive motor disabilities.
ABSTRACT Intervention strategies, based on learning principles and assistive technology, were assessed with four post-coma persons with minimally conscious state and pervasive motor disabilities.
The first study taught a man to access environmental stimulation through a response-microswitch combination and another man to access environmental stimulation and request social contact through responses combined with a microswitch or a Voice Output Communication Aid (VOCA). The second study taught a man to access two forms of environmental stimulation via two response-microswitch combinations and another man to request two forms of contact via two response-VOCA combinations.
Data showed that all participants had significant increases in response levels (independent of whether the responses were combined with microswitch or VOCA devices) during the intervention phases of the studies.
Intervention strategies based on learning principles and technology may be largely helpful for persons with minimally conscious state and pervasive motor disabilities.
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ABSTRACT: Objectives: To summarise available evidence for responsiveness of six key assessments used with patients with disorders of consciousness: Coma Recovery Scale – Revised (CRS-R), Disorders Of Consciousness Scale (DOCS), Sensory Modality Assessment and Rehabilitation Technique (SMART), Sensory Stimulation Assessment Measure (SSAM), Wessex Head Injury Matrix (WHIM), and the Western Neuro Sensory Stimulation Profile (WNSSP).Method: A literature search of five electronic databases was conducted using a systematic search strategy. Relevant literature was evaluated and pertinent information extracted.Results: Database searches using key terms initially yielded 132 articles. Following review for inclusion identified 24 articles. No studies were specifically designed to investigate responsiveness of any of the measures and therefore responsiveness data were either based on statistical significance of change post-treatment or descriptive analysis of change scores. The majority of studies identified used the CRS-R (n = 11), WHIM (n = 5) and WNSSP (n = 6) and have established responsiveness to change. There is some preliminary evidence for the responsiveness of the other measures, based on very few available studies: DOCS (n = 2), SMART (n = 1) or SSAM (n = 1).Conclusion: Future studies should seek to include responsiveness analysis, particularly in relation to the DOCS, SMART and SSAM.Brain Impairment 12/2013; 13(3):285-315. DOI:10.1017/Brlmp.2012.29 · 0.88 Impact Factor
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ABSTRACT: The process of matching a person who has a disability with the most appropriate assistive technology requires a series of assessments, typically administered by multidisciplinary teams at specialized centers for technical aid. Assistive Technology Assessment Handbook fills the need for a reference that helps assistive technology experts perform assessments that more effectively connect the person and the technology. Emphasizing the well-being of the individual with a disability, the book proposes an ideal model of the assistive technology assessment process and outlines how this model can be applied in practice internationally. Organized into three parts, the handbook: Gives readers a toolkit for performing assessments Describes the roles of the assessment team members, among them the new profession of the psychotechnologist, who is skilled in understanding individuals and their psychosocial and technological needs and preferences Reviews cutting-edge technologies for rehabilitation and independent living, including brain–computer interfaces and microswitches The book synthesizes information scattered throughout the international literature, focusing on aspects that are particularly representative or innovative. It also addresses the challenges posed by the variety of health and social care systems and the different ways that individuals who need aid are defined—are they users, patients, clients, or consumers, and how does that affect the assessment?01/2012: pages 446; CRC Press., ISBN: 978-1-4398-3865-5
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ABSTRACT: A diagnosis of vegetative state represents a serious predicament, which basically precludes/minimizes rehabilitation perspectives. Reliability of the assessment approach in these situations is of paramount importance, but not easy to achieve. In recent studies, a learning assessment procedure has been suggested as a supplement in the diagnostic process and assessed with eight patients. The procedure involves an ABABCB sequence in which A represents baseline phases with no stimulation available, B intervention phases with stimuli delivered contingently on target responses, and C a control condition. This condition involves stimulation presented non-contingently. The patients' ability to associate responding with environmental stimuli and thus increase such responding during the B phases, and reduce it during the A and C phases, may be considered a sign of learning. Learning might be viewed as representative of forms of concrete knowledge and presumably basic levels of consciousness. Preliminary results indicate that (a) signs of learning may appear in patients with a previous diagnosis of vegetative state and (b) the presence of those signs may require a revision of their diagnostic label and a reappraisal of their rehabilitation perspectives.Cognitive Processing 11/2009; 10:355-359. DOI:10.1007/s10339-009-0334-3 · 1.57 Impact Factor