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Everyday Technology to Help People with Intellectual and Other Disabilities Access Stimulation via Functional Motor Responses and Improved Body Posture
Abstract
Purpose
This study assessed everyday technology to help eight participants with intellectual and sensory-motor disabilities access stimulation via functional arm/hand responses and improved body posture.
Methods
An ABABB¹BB¹ design was used for each participant, with A representing baseline phases, B intervention phases in which arm/hand responses led to a 12-s stimulation, and B¹ intervention phases in which the stimulation for arm/hand responses was conditional on an improved/correct torso and head posture. The technology involved a Samsung Galaxy A10 smartphone fitted with Google Assistant and MacroDroid, a mini voice-recording device, and a portable mini voice amplifier.
Results
All participants had a large increase in arm/hand responses from the baseline periods to the B and B¹ phases. They also had a large increase in correct posture from the B phases to the B¹ phases.
Conclusion
This technology-aided approach may be a helpful resource for people similar to the participants of this study.
... Lancioni et al. [45] worked with eight adults who presented with severe to profound intellectual disability plus visual and/or motor impairments. The objective of the study was to lead the participants to exercise demanding arm responses considered to be beneficial for them (i.e., raising the arm/arms above the head or stretching the arm forward and up) and improve their posture (i.e., reduce the time they spent in an incorrect/unhealthy posture such as head and body forward leaning). ...
... Motivation cannot be expected to originate from their understanding/appreciation of the physical and social benefits of those changes. Instead, it may be ensured through environmental stimulation events that make their performance of adaptive responses and avoidance of problem behavior/posture meaningful to them (i.e., through the presentation of events that the technology can control reliably and without staff time costs) [43][44][45]. Similarly, people with intellectual and multiple disabilities may not be inclined to ambulate because this is a demanding engagement for them and because they have no specific reasons (no personal motivation) to be involved in such an engagement. ...
... For example, the use of the Clicker 5 package and the use of the Macrodroid application require that staff (a) arrange the choice options to be targeted within the intervention, (b) program the computer, smartphone, or tablet to present those options in a way that is suitable to the participants, and (c) identify/select the type of responses through which the participants can choose among those options and eventually access the ones that they prefer. While this arrangement and programming may not be too complicated for staff and caregivers who have basic knowledge of and familiarity with technology and related issues, they may result somewhat problematic for staff and caregivers who have no experience in this area [3,4,9,10,25,45,61]. ...
The paper presents an overview of recent studies assessing technology-aided strategies aimed at helping people with intellectual and multiple disabilities reach relevant rehabilitation goals. The 16 studies included in the paper addressed four specific rehabilitation goals, that is, (a) performance of functional activities, (b) access to leisure and communication and performance of functional activities, (c) increase of adaptive responses and decrease of problem behavior or inadequate posture, and (d) increase of ambulation responses. For each study, the paper reports the participants involved, the technology and the assessment process used, and the results obtained. Following the presentation of the studies, the paper focuses on three practically relevant issues: the role of technology-aided strategies over time, the relative potential of various technology-aided strategies, and the accessibility and applicability of the strategies.
... We have not found any previous studies promoting PA with the use of mobile apps and activity trackers to objectively measure levels of PA in adults with ID. Other studies have shown the measurable benefits of using mobile technologies for healthrelated behaviors and everyday life for individuals with ID (15)(16)(17)(18)(19)(20)(21). Few applications are available for promoting PA in individuals with ID, and the development of such technology in PA promotion is needed. ...
Background: Many individuals with intellectual disability (ID) have a sedentary
lifestyle. Few interventions aimed at increasing their level of physical activity (PA)
have shown lasting effects.
Aim: To assess the feasibility and acceptability of a pilot intervention study using
innovative mobile health (mHealth) support systems to encourage PA in
individuals with ID.
Methods: Nine individuals with ID and a low level of PA, aged 16–36 years, were
included in the present convergent triangulation mixed method design. Two
mHealth support systems (apps) were developed and tested. PA was measured
with a Fitbit smartwatch, accelerometer, the International Physical Activity
Questionnaire—Short Form (IPAQ-S), and Goal attainment scaling. Data were
collected through online pre-, mid- (4 weeks), and post-intervention (12 weeks)
questionnaires and activity trackers. Semi-structured qualitative interviews with
participants and/or a family or staff member were held after the 12-week
follow-up. Data were analyzed using conventional nonparametric statistics and
thematic analyses.
Results: The response rate and retention to the trial were 16% and 100%,
respectively. Data quality was high, except for missing data from Fitbit activity
trackers of approximately 30% from the 4- and 12-week follow-up stages. The
feasibility challenges with activity trackers include rashes, size, non-acceptance,
and loss of motivation. Participants and family members/staff reported interest in
the study theme and were pleased with the data collection method. All but one
participant achieved their PA goals. Most participants reported being satisfied with
the apps as they were enjoyable or provided a reminder for performing physical
and other activities. Social support for PA among family members also increased.
However, app support from staff and family members was needed, and apps were
not used regularly. Two of nine participants (22%) had increased their PA
measured as steps per day with Fitbit at the 12-week follow-up.
... This pilot study will show how the use of a technological tool, such as mHealth, can be tested in research involving individuals with ID. The use of technology as a means of improving health has been explored to some extent in this population [20,21,[55][56][57], but limited studies have investigated the use of mHealth for improving levels of PA for individuals with ID [25,58]. ...
Background:
Several studies have shown that individuals with intellectual disabilities (IDs) have low levels of physical activity (PA), and intervention studies on PA suggest inconsistent evidence. The use of technology as a means of motivation for PA has yet to be extensively explored and needs to be further investigated.
Objective:
We aim to assess the feasibility and acceptability of procedures for an intervention arm in a future trial on mobile health (mHealth) to support PA for individuals with IDs. In addition, we aim to examine how the use of technology can influence motivation for PA among participants, their caregivers, and staff members.
Methods:
A mixed methods pilot study of an intervention arm will be carried out in a planned randomized controlled trial (RCT). Ten participants with ID and their caregivers or a staff member will be included. Information will always be provided by a caregiver or a staff member, or participants with ID if possible. Assessments will be carried out at baseline, follow-up after 4 weeks, and 12 weeks, and include questionnaires on PA, social support, self-efficacy, and challenging behavior. PA will be measured with 2 different activity trackers (Fitbit and Axivity) for 1 week at all assessments. Feasibility will be assessed as recruitment and adherence rate, missing data, usability of the motivational mHealth tool, and estimates of effectiveness. Acceptability of study procedures, activity measures, and motivation for participation in PA will be additionally assessed with qualitative methods at the end of the intervention.
Results:
Enrollment commenced in May 2021. Data collection was completed in March 2022.
Conclusions:
This pilot study will evaluate the feasibility and acceptability of study procedures of the intervention arm of a planned RCT to address feasibility issues, improve study procedures, and estimate effectiveness of the study measures. How the use of technology can influence motivation for PA will also be examined, which can help guide and improve future PA interventions involving the use of technology.
Trial registration:
ClinicalTrials.gov NCT04929106; https://clinicaltrials.gov/ct2/show/NCT04929106.
International registered report identifier (irrid):
DERR1-10.2196/37849.
... This pilot study will show how the use of a technological tool, such as mHealth, can be tested in research involving individuals with ID. The use of technology as a means of improving health has been explored to some extent in this population [20,21,[55][56][57], but limited studies have investigated the use of mHealth for improving levels of PA for individuals with ID [25,58]. ...
... The use of technology as a means of improving health has been explored to some extent in this population, [54][55][56]20 but only limited studies have investigated the use of mHealth for improving levels of PA for individuals with ID. 24,57 In this pilot trial, motivation for using technology as promotion for PA is being investigated through qualitative methods. This knowledge can guide future development of technology-based PA programs and help improve future intervention studies aiming to improve levels of PA. ...
BACKGROUND
Several studies have shown that individuals with intellectual disabilities have low levels of physical activity (PA), and intervention studies on PA suggest inconsistent evidence. The use of technology as a means of motivation for PA has yet to be extensively explored and needs to be further investigated.
OBJECTIVE
To assess feasibility of procedures for an intervention arm in a future trial on mobile health (mHealth) to support PA for individuals with intellectual disabilities. In addition, we aim to examine how the use of technology can influence motivation for PA among participants, their caregivers, and staff members.
METHODS
Design: A mixed-methods pilot study of an intervention arm in a planned randomized controlled trial. Methods: Ten participants with intellectual disability and their caregivers or a staff member will be included. Information will always be provided by a caregiver or a staff member, or participants with ID if possible. Assessments will be at baseline, follow-up after 4 weeks and 12 weeks, and includes questionnaires on PA, social support, self-efficacy, and challenging behavior. PA will be measured with two different activity trackers (Fitbit and Axivity) for one week at all assessments. Feasibility will be assessed as recruitment and adherence rate, missing data, usability of the motivational mHealth tool, and estimates of effectiveness. Acceptability of study procedures, activity measures, and motivation for participation in PA are assessed with qualitative methods at the end of the intervention.
RESULTS
Enrollment commenced in May 2021 and data collection is ongoing.
CONCLUSIONS
This pilot study will evaluate the feasibility and acceptability of study procedures of the intervention arm of a planned randomized controlled trial to address feasibility issues, improve study procedures, and estimate effectiveness of the study measures. Motivation for using mHealth for PA will also be examined, which can help guide and improve future PA interventions involving the use of technology.
CLINICALTRIAL
The trial is registered at Clinicaltrial.gov with identifier NCT04929106.
Background:
While the participation of adults with visual and severe or profound intellectual disabilities (VSPID) in society and community life is important, evidence-based interventions to improve their participation are lacking. We conducted a process evaluation of the implementation of 'Care for Participation+' (CFP+), a new intervention targeting the attitudes of direct support professionals (DSPs) toward the participation of adults with VSPID, within a residential facility in the Netherlands.
Methods:
CFP+ was inspired by the Boston Psychiatric Rehabilitation Approach and adapted by adopting a new definition and operationalization of the concept of participation for adults with VSPID. Following systematic training, 16 DSPs of adults with VSPID were able to apply key elements of CFP+ to explore diverse roles and activities for this population, facilitating their self-management, teaching them necessary skills for participation, and organizing support. Our process evaluation entailed an investigation of the delivered dose, reach, fidelity, and adaptation of CFP+ during and after the CFP+ intervention. We also evaluated the mechanisms of impact and context using questionnaires, assignments, documentation, interviews, and a logbook.
Results:
The intended dose, reach, and fidelity relating to the implementation of CFP+ were not achieved. Despite this fact, an assessment of the mechanisms of impact indicated that assignments of CFP+ were well (75%) or reasonably well (17%) understood by DSPs. CFP+ was applied by DSPs to stimulate self-management (83% of DSPs), new activities (100%), enhanced involvement in existing activities (67%) and to explore new roles (50%) for adults with VSPID. A negative contextual factor mentioned by the trainer and manager was the DSPs' lack of commitment to the training program. Another negative contextual factor mentioned by DSPs was the lack of time for implementing CFP+.
Conclusions:
CFP+ provides new opportunities to improve the participation of adults with VSPID. Despite the non-optimal conditions for implementing CFP+ and the DSPs' general reluctance to apply the new intervention, some have actively used CFP+ within the residential facility. Future studies should focus on the outcomes of CFP+ regarding attitudinal changes among DSPs relating to the participation of adults with VSPID and their quality of life.
Motor activation is rarely integrated into the support of people with profound intellectual and multiple disabilities (PIMD), which might be the result of the limited evidence‐based knowledge in this field. Practitioners have recently been developing several motor initiatives for people with PIMD, but it remains unclear about what core elements the motor initiatives actually consist of and to what level of quality it is implemented in practice. This study aims to offer an overview and analysis of the content and quality of motor initiatives actually in use for people with PIMD. Motor initiatives were explored by asking practitioners to complete an online inventory form. Documents, expert knowledge, and observations were used to collect data about the characteristics of the motor initiatives. The quality of the motor initiatives which met our eligibility criteria, was analyzed on the basis of the level of evidence for their effectiveness. The inventory yielded 118 motor initiatives of which 17 met the eligibility criteria. We identified four motor initiatives reflecting an approach to motorically activate people with PIMD within various activities, three including power‐assisted exercises, three with aquatic exercises, two frameworks which integrated motor activities into their daily programs, two methods which included small‐scale activities, two rhythmic movement therapies, and one program including gross motor activities. We found limited indications for descriptive evidence from 17 initiatives, limited or no indications for theoretical evidence from 12 and five initiatives respectively, and none of the initiatives provided a causal level of evidence for effectiveness. A wide variety of motor initiatives is used in current practice to activate persons with PIMD, although their effectiveness is actually unproven. Science and practice should cooperate to develop an evidence‐based understanding to ensure more evidence‐based support for the motor activation of people with PIMD in the future.
This study extended the research on technology-aided programs for promoting the independent performance (practice) of functional motor responses (e.g., arm or leg-foot movements) in people with intellectual disabilities and extensive motor impairments. Specifically, the study assessed (a) the suitability of simple commercial technology (i.e., a smartphone) to monitor the responses targeted and provide stimulation contingent on them, and (b) the impact of response performance on the participants’ level of physical exertion (heart rates) and mood. The results showed that the simple commercial technology was effective in helping the participants independently practice the two target responses selected for them. All participants had a significant increase in their heart rates during the intervention sessions, thus suggesting that the performance of the target responses represented a mild form of physical activity. Moreover, all participants displayed mood improvement (i.e., an increase in indices of happiness) during the intervention sessions. The implications of these results are discussed in terms of (a) new technology solutions for intervention programs with people with intellectual disabilities and extensive motor impairments, and (b) potential benefits of those programs.
This paper is based on work from the Global Research, Innovation, and Education on Assistive Technology (GREAT) Summit that was coordinated by WHO’s Global Cooperation on Assistive Technology (GATE). The purpose of this paper is to describe the needs and opportunities embedded in the assistive product lifecycle as well as issues relating to the various stages of assistive product mobilization worldwide.
The paper discusses assistive technology product terminology and the dangers of focusing on products outside the context and rolling out products without a plan. Additionally, the paper reviews concepts and issues around technology transfer, particularly in relation to meeting global needs and among countries with limited resources. Several opportunities are highlighted including technology advancement and the world nearing a state of readiness through a developing capacity of nations across the world to successfully adopt and support the assistive technology products and applications.
The paper is optimistic about the future of assistive technology products reaching the people that can use it the most and the excitement across large and small nations in increasing their own capacities for implementing assistive technology. This is expressed as hope in future students as they innovate and in modern engineering that will enable assistive technology to pervade all corners of current and potential marketplaces. Importantly, the paper poses numerous topics where discussions are just superficially opened. The hope is that a set of sequels will follow to continue this critical dialog.
• Implications for Rehabilitation
• Successful assistive technology product interventions are complex and include much more than the simple selection of the right product.
• Assistive technology product use is highly context sensitive in terms of an individual user’s environment.
• The development of assistive technology products is tricky as it must be contextually sensitive to the development environment and market as well.
• As a field we have much to study and develop around assistive technology product interventions from a global perspective.
Purpose: This is a position paper describing the elements of an international framework for assistive technology provision that could guide the development of policies, systems and service delivery procedures across the world. It describes general requirements, quality criteria and possible approaches that may help to enhance the accessibility of affordable and high quality assistive technology solutions.
Materials and methods: The paper is based on the experience of the authors, an analysis of the existing literature and the inputs from many colleagues in the field of assistive technology provision. It includes the results of discussions of an earlier version of the paper during an international conference on the topic in August 2017.
Results and conclusion: The paper ends with the recommendation to develop an international standard for assistive technology provision. Such a standard can have a major impact on the accessibility of AT for people with disabilities. The paper outlines some the key elements to be included in a standard.
• Implications for Rehabilitation
• Assistive technology is a key element in rehabilitation, but many people have no access to affordable AT solutions. The recommendations in the paper aim to inform policies, systems and service delivery procedures on how to improve access to AT across the world.
Background
People with severe/profound multiple (e.g., intellectual, motor, or sensory–motor) disabilities are frequently restricted to a situation of inactivity and dependence, which may be modified by promoting functional activity engagement through assistive technology.
Methods
This study assessed the possibility of promoting functional activity engagement via microswitch-aided programs with nine participants with multiple disabilities between 10 and 29 years of age. Functional activity consisted of constructive interaction with the immediate environment (e.g., reaching/touching or putting away objects) through the use of response schemes considered practical and beneficial for the participants’ physical exercise and general condition. Microswitch-aided programs were used to monitor the participants’ responses and to automatically provide stimulation opportunities contingent on those responses.
Results
All participants had a large/significant increase in their activity engagement (i.e., response frequencies) during the microswitch-aided programs, when compared to the baseline periods. These data, which are in line with previous findings in the area, indicate that the programs targeted activity and responses suitable for the participants and ensured contingent stimulation effective to motivate them.
Conclusion
People with severe/profound multiple disabilities can engage in functional activity with the help of microswitch-aided programs.
Replication research is essential to scientific knowledge. Reviews of replication studies often electronically search for replicat* as a textword, which does not identify studies that replicate previous research but do not self-identify as such. We examined whether the 83 intervention studies published in six non-categorical research journals in special education in 2013 and 2014 might be considered replications regardless of using the term replicat* by applying criteria related to (a) the stated purpose of the study and (b) comparing the findings of the study with the results of previous studies. We coded 26 intervention studies as replications. Authors of 17 of these studies reported that their findings solely agreed with the results of the original study(ies). Author overlap occurred for half of the replicative studies. The likelihood of findings being reproduced did not vary as a function of author overlap. We discuss implications and recommendations based on these findings.
This article studied and compared the two nonprobability sampling techniques namely, Convenience Sampling and Purposive Sampling. Convenience Sampling and Purposive Sampling are Nonprobability Sampling Techniques that a researcher uses to choose a sample of subjects/units from a population. Although, Nonprobability sampling has a lot of limitations due to the subjective nature in choosing the sample and thus it is not good representative of the population, but it is useful especially when randomization is impossible like when the population is very large. It can be useful when the researcher has limited resources, time and workforce. It can also be used when the research does not aim to generate results that will be used to create generalizations pertaining to the entire population. Therefore, there is a need to use nonprobability sampling techniques. The aim of this study is to compare among the two nonrandom sampling techniques in order to know whether one technique is better or useful than the other. Different articles were reviewed to compare between Convenience Sampling and Purposive Sampling and it is concluded that the choice of the techniques (Convenience Sampling and Purposive Sampling) depends on the nature and type of the research.
Regular engagement in physical activity is one of the most powerful predictors of health. Individuals with intellectual disabilities engage in significantly less physical activity than the general population and experience significant health disparities. More research is required to quantify the appropriate amount of physical activity that is necessary for health, as well as how to accurately collect, analyze, and interpret physical activity data on people with intellectual disabilities. Physical activity promotion efforts are especially important in this sub-group of the population due to the far reaching benefits. More research is also needed on the most effective avenues and messaging to promote physical activity in individuals with disabilities.
Although social validation of the goals, methods, and outcomes of evidence-based practices (EBPs) in autism treatment is a significant factor in their selection and effective use, EBPs are typically identified on the basis of the technical soundness of research without consideration of social validity. The authors investigated EBPs and emerging treatments identified by the National Autism Center (NAC) and National Professional Development Center on Autism Spectrum Disorders (NPDC) to determine which interventions have evidence of social validity, and the types of social validation addressed. A review of 828 articles cited by the NAC and NPDC determined that only 221 articles (26.7%) demonstrated direct evidence of the measurement of social validation. Of seven social validity categories analyzed, only consumer satisfaction, clinically significant behavioral change, and socially important dependent variables were consistently reported. A list of EBPs with varying levels of social and empirical validation is presented, and implications for future research are discussed.
In this paper we present a study about multi-sensory content within the context of learning activities aimed at people with intellectual disability. A story was prepared together with traditional stimulus (audio and visual) and multisensory (audio, video, tactile and smell). Knowing that people with intellectual disability, due to their cognitive limitation, have multiple learning difficulties, namely in areas such as: communication, reading/writing and attention [1], it is really important to create innovative and pedagogically effective solutions that may motivate them and assist their learning process. Therefore, this study presents Preliminary results showing an overall improvement regarding the participant's memory when using the very multi-sensory contents.
We reviewed 18 studies reporting on the use of microswitch technology to enable self-determined responding in children with profound and multiple disabilities. Identified studies that met pre-determined inclusion criteria were summarized in terms of (a) participants, (b) experimental design, (c) microswitches and procedures used, and (d) main results. The 18 studies formed three groups based on whether the microswitch technology was primarily intended to enable the child to (a) access preferred stimuli (7 studies), (b) choose between stimuli (6 studies), or (c) recruit attention/initiate social interaction (5 studies). The results of these studies were consistently positive and support the use of microswitch technology in educational programs for children with profound and multiple disabilities as a means to impact their environment and interact with others. Implications for delivery of augmentative and alternative communication intervention to children with profound and multiple disabilities are discussed.
Technology-aided programs have been reported to help persons with disabilities develop adaptive responding and control problem behavior/posture. This study assessed one such program in which choice of stimulus events was used as adaptive responding for three adults with multiple disabilities. A computer system presented the participants stimulus samples. For each sample, they could perform a choice response (gaining access to the related stimulus whose length they could extend) or abstain from responding (making the system proceed to the next sample). Once choice responding had strengthened, the program also targeted the participants' problem posture (i.e., head and trunk forward bending). The stimulus exposure gained with a choice response was interrupted if the problem posture occurred. All three participants successfully (a) managed choice responses and access to preferred stimuli and (b) gained postural control (i.e., reducing the problem posture to very low levels). The practical implications of those results are discussed.
© The Author(s) 2015.
In health and disease, the benefits of regular participation in moderate to vigorous intensity physical activity are well documented. However, individuals with chronic conditions, such as those with chronic obstructive pulmonary disease (COPD), typically do very little activity at a moderate or vigorous intensity. Much of their day is instead spent in sedentary behaviour, such as sitting or reclining, which requires very little energy expenditure. This high level of time spent in sedentary behaviour can have serious health consequences, including increased risk of diabetes, cardiovascular disease and premature mortality. There is emerging evidence to suggest that participation in light intensity physical activities (e.g. standing or slow walking) may have benefits for cardio-metabolic health. Given the low aerobic capacity of individuals with moderate to severe COPD, increasing light intensity activity (through reducing sedentary time) may be a feasible additional strategy to improve health in this population, alongside traditional recommendations to increase the time spent in moderate to vigorous intensity physical activity. This review provides an overview of physical activity and sedentary behaviour, with a particular emphasis on these behaviours for people with COPD. It provides suggestions for the measurement of these behaviours within the clinical setting, as well as for interventions that may be effective at increasing physical activity and reducing sedentary behaviour in this population.
Physical inactivity and non-adherence to physiotherapy are common problems. Physiotherapists as promoters, preventers and rehabilitators are ideally placed to influence physical activity behaviours. Possessing the knowledge and skills to facilitate this behaviour change and to promote adherence to physiotherapy must be viewed as clinical competency. This paper reviews four psychological strategies; self-determination theory, social cognitive theory, cognitive behavioural therapy and motivational interviewing that have been shown to have a positive influence on exercise behaviour. The origins and theoretical model of all four are discussed and an example of an intervention based on each model from the literature is provided. A review of how physiotherapists can use each to inform their practice follows. To conclude the similarities between all four that can be implemented into practice are discussed.
In response to acute adversity, emotional signals shift the body into a state that permits rapid detection, identification, and appropriate response to a potential threat. The stress response involves the release of a variety of substances, including neurotransmitters, neurotrophic factors, hormones, and cytokines, that enable the body to deal with the challenges of daily life. The subsequent activation of various physiological systems can be both protective and damaging to the individual, depending on timing, intensity, and duration of the stressor. Successful recovery from stressful challenges during early life leads to strengthening of synaptic connections in health-promoting neural networks and reduced vulnerability to subsequent stressors that can be protective in later life. In contrast, chronic intense uncontrollable stress can be pathogenic and lead to disorders such as depression, anxiety, hypertension, Alzheimer's disease, Parkinson's disease, and an increased toxic response to additional stressors such as traumatic brain injury and stroke. This review briefly explores the interaction between stress experienced at different stages of development and exercise later in life.
With rapid advances in the analysis of data from single-case research designs, the various behavior-change indices, that is, effect sizes, can be confusing. To reduce this confusion, nine effect-size indices are described and compared. Each of these indices examines data nonoverlap between phases. Similarities and differences, both conceptual and computational, are highlighted. Seven of the nine indices are applied to a sample of 200 published time series data sets, to examine their distributions. A generic meta-analytic method is presented for combining nonoverlap indices across multiple data series within complex designs.
The purpose of this study is to systematically retrieve, examine and discuss scientific studies focusing on motivational correlates that both contribute to, and can be assumed to be effects of, participation in sport, recreation, or health-related physical activities in persons with intellectual disability (ID).
A systematic analysis of the literature retrieved through electronic databases and other resources was performed, covering articles published from 1980 through 2009. Inclusion criteria were based on terms referring to the participants, the psychosocial correlates and the type of activity.
Twenty-three articles satisfied the inclusion criteria, and were divided into four categories of studies: (1) cross-sectional designs, (2) experimental prospective one-group designs, (3) longitudinal comparative intervention designs, and (4) qualitative designs. The level of quality regarding the intervention studies was assessed using four different scales, and on average they depicted a moderate level of evidence.
Both exercise and sport-related activities seem to contribute to well-being. Improved physical fitness and elevated skill level gained during exercise and sport activities appear to serve as mediators for increased perceptions of self-efficacy and social competence. Peer modelling, as well as video and audio reinforcement, appear to be important modalities in maintaining compliance to exercise programmes.
The purpose of this study was to determine whether the motor abilities of children with spastic cerebral palsy who were receiving functional physical therapy (physical therapy with an emphasis on practicing functional activities) improved more than the motor abilities of children in a reference group whose physical therapy was based on the principle of normalization of the quality of movement.
The subjects were 55 children with mild or moderate cerebral palsy aged 2 to 7 years (median=55 months).
A randomized block design was used to assign the children to the 2 groups. After a pretest, the physical therapists for the functional physical therapy group received training in the systematic application of functional physical therapy. There were 3 follow-up assessments: 6, 12, and 18 months after the pretest. Both basic gross motor abilities and motor abilities in daily situations were studied, using the Gross Motor Function Measure (GMFM) and the self-care and mobility domains of the Pediatric Evaluation of Disability Inventory (PEDI), respectively.
Both groups had improved GMFM and PEDI scores after treatment. No time x group interactions were found on the GMFM. For the PEDI, time x group interactions were found for the functional skills and caregiver assistance scales in both the self-care and mobility domains.
The groups' improvements in basic gross motor abilities, as measured by the GMFM in a standardized environment, did not differ. When examining functional skills in daily situations, as measured by the PEDI, children in the functional physical therapy group improved more than children in the reference group.
The Bobath concept, also known as neurodevelopmental treatment, is a widely used approach in the rehabilitation of hemiparetic subjects in many countries. Despite 50 years of clinical use its effectiveness is questionable. This paper aims to examine whether there is evidence to accept neurodevelopmental treatment as an effective approach. A systematic literature search was undertaken. Fifteen trials have been selected and classified according to a 5-level hierarchic scale of evidence for clinical interventions. Results show no evidence proving the effectiveness of neurodevelopmental treatment or supporting neurodevelopmental treatment as the optimal type of treatment, but neither do methodological limitations allow for conclusions of non-efficacy. Methodological aspects of selected studies are discussed and requirements for further research are suggested.
We compared the effects of support strategies for promoting formal mindfulness practices of 9th grade high school students who participated in a 10-week school-based mindfulness education program. The students also completed social validity ratings of the support strategies they selected and the formal mindfulness practices they learned. All of the support strategies were associated with increased average minutes of formal mindfulness practices. Students who did not select an extra support strategy also had increased minutes of formal mindfulness practices but of less magnitude in contrast to the two most effective strategies. The social validity ratings of the support strategies ranged from equivocal to good approval, and the students gave positive ratings to the majority of formal mindfulness practices. We discuss the implications of these findings for designing mindfulness education programs, implementing practice-promoting support strategies, and conducting mindfulness research with school children and youth.
Background
The World Health Organisation has launched a programme to promote Global Cooperation on Assistive Technology. Its aim is to increase access to high‐quality affordable assistive products (AP) for everybody in need. People with intellectual disabilities (ID) are a specific group that could benefit from AP, but use less AP compared to their non‐intellectual disabled peers.
Method
A systematic literature search was carried out to identify barriers and potential facilitators for access to AP for people with ID globally. The search strategy terms were ‘Intellectual Disability’ and ‘Assistive Technology’ with the following electronic literature databases PubMed, Embase, ASSIA, Web of Science, Medline, CINAHL complete, PsycInfo, Scopus and ERIC. The quality and relevance of the studies were assessed. Factors associated with access were identified thematically, categorised into barriers and facilitators and mapped into themes.
Results
In all, 22 key studies were retrieved, describing 77 barriers and 56 facilitators. The most frequently reported barriers were related to lack of funding and cost of AP, lack of awareness about AP and inadequate assessment. An increase of knowledge and awareness about AP and the need of AP for people with ID were most often extracted as factors that could potentially facilitate access.
Conclusions
This review proposes actions linked to the barriers and facilitators that have a particular importance for people with ID to access AP. Yet, only limited research is available describing factors that influence access to AP for people with ID in low and middle income countries and rural areas.
Few studies pertain to caseworkers and their practices for supporting the development of self-determination of adults with intellectual disabilities (ID). This research thus aims at describing the intervention practices of 12 caseworkers from Quebec (Canada). These caseworkers participated in five discussion groups over an 8-month period. The data analysis helped identify a set of interventions conducted with people who have ID and with their environments. The majority of interventions are person-specific, although natural and foster families are also targets for intervention. A number of person-specific and environment-specific variables influence these interventions. These variables concern people with ID, caseworkers, natural families, foster families, service organizations, and the community. The complexity of the intervention process is discussed. Recommendations are formulated for caseworkers, service organizations, and public decision makers. © 2018 International Association for the Scientific Study of Intellectual and Developmental Disabilities and Wiley Periodicals, Inc.
Adults with Intellectual Disability (ID) are at high risk of being in poor health as a result of exercising infrequently; recent evidence indicates this is often due to there being a lack of opportunities to exercise. This pilot study involved an investigation of the use of motion-sensor game technology to enable and encourage exercise for this population. Five adults (two female; 3 male, aged 34-74 [M = 55.20, SD = 16.71] with ID used motion-sensor games to conduct exercise at weekly sessions at a day-centre. Session attendees reported to have enjoyed using the games, and that they would like to use the games in future. Interviews were conducted with six (four female; two male, aged 27-51 [M = 40.20, SD = 11.28]) day-centre staff, which indicated ways in which the motion-sensor games could be improved for use by adults with ID, and barriers to consider in relation to their possible future implementation. Findings indicate motion-sensor games provide a useful, enjoyable and accessible way for adults with ID to exercise. Future research could investigate implementation of motion-sensor games as a method for exercise promotion for this population on a larger scale.
Objective: To assess the feasibility of conducting a randomised controlled trial to determine the
effectiveness of a twenty-week power-assisted exercise intervention in people with profound intellectual
and multiple disabilities and to evaluate the potential beneficial effects of this intervention.
Design: Pilot randomised controlled trial.
Setting: A large-scale twenty-four-hour residential facility in the Netherlands.
Subjects: Thirty-seven persons with profound intellectual and multiple disabilities.
Intervention: Participants in the intervention group received a power-assisted exercise intervention
three times a week for thirty minutes over a twenty-week period. Participants in the control group
received care as usual.
Main measures: Trial feasibility by recruitment process and outcomes completion rates; intervention
feasibility by programme compliance rates; potential outcomes by functional abilities, alertness, body
composition, muscle tone, oxygen saturation, cardiovascular fitness and quality of life.
Results: Thirty-seven participants were recruited (M age = 32.1, SD = 14.6) and were randomly
allocated to intervention (n = 19) and control (n = 18) groups. Programme compliance rates ranged
from 54.2% to 97.7% with a mean (SD) of 81.5% (13.4). Oxygen saturation significantly increased in
the intervention group. Standardised effect sizes on the difference between groups in outcome varied
between 0.02 and 0.62.
Conclusions: The power-assisted exercise intervention and the trial design were feasible and acceptable
to people with profound intellectual and multiple disabilities living in a residential facility. This pilot study suggests that the intervention improves oxygen saturation, but further implementation with the aim of
improving other outcomes should be considered with caution
Background
Current research on employment options for people with Intellectual Disability emphasizes the importance of employee needs and satisfaction. The study aims at systematically reviewing the literature on job satisfaction and related constructs.
Methods
A systematic literature search was conducted. Studies were included if (i) they are specific to effects of work, (ii) assessed variables are related to job satisfaction, QoWL, attitudes towards work or work motivation and if (iii) studies reported intellectual disability-specific results. Twenty-three studies met the inclusion criteria. Findings were classified according to the socio-cognitive model of job satisfaction.
Results
Current literature suggests high job satisfaction in people with intellectual disability. Predictors of job satisfaction are similar to people without disabilities, albeit the importance of factors differs.
Conclusions
Stronger consideration of well-established theories and measures from organizational psychology would enhance future research. Findings indicate that high satisfaction ratings might result from lack of control over vocational decisions.
Background Microswitch-aided programs for persons with multiple disabilities (a) have been rarely used with participants possessing only minimal (e.g., eyelid) responses and (b) have generally targeted simple head or hand responses with higher functioning participants. This study extended the assessment of those programs with both types of participants.
Method Four participants with minimal responses were exposed to programs entailing eyelid and lip movements and optic or camera-based microswitches to control environmental stimulation. Six participants with head, arm, and leg-foot responses were exposed to programs entailing demanding forms of those responses and matching microswitches to achieve control of environmental stimulation and physical exercise.
Results The results showed that all 10 participants increased their response frequencies, reaching a clear level of stimulation control. For the last 6 participants, the response increases also afforded basic physical exercise.
Conclusions Microswitch-aided programs can be adapted to the participants’ condition to help them achieve relevant goals.
Background People with profound intellectual and multiple disabilities (PIMD) are at risk of being motorically inactive. This study investigated the degree and type of motor activation in daily practice and its relationship to personal and contextual factors.
Method A total of 58 participants with PIMD participated in the study. Data concerning the motor activation were collected by means of a diary over a period of 14 days. Relationships to personal and contextual factors were analysed using multilevel analyses.
Results The mean number of transfers was 3.1 times per day (range: 0–9, SD = 1.4), the mean number of relocations was 7.7 times per day (range: 2–13, SD = 2.5), and the mean number of motor activities offered was 1.5 per day (range: 0–10, SD = 1.9). Relationships to age, gender, location, and day of week were found.
Conclusion Motor activation seems to be a minor part of the support provided to people with PIMD.
Replicating previously reported empirical research is a necessary aspect of an evidence-based field of special education, but little formal investigation into the prevalence of replication research in the special education research literature has been conducted. Various factors may explain the lack of attention to replication of special education intervention research, including emphasis on quantity of publications, esteem for novel findings, and barriers to publishing high-quality studies with null or negative effects. This article introduces the special issue on replication of special education intervention research by first providing an overview of concepts and issues related to replication. Specific attention is then given to replication as it relates to group design and single case experimental design research, two prominent albeit philosophically different empirical methodologies. We then briefly describe how replications using these research designs can be conducted in complementary ways to better understand intervention effects and advance evidence-based practices in special education.
Motor impairments such as lack of standing and/or independent ambulation are common among persons with multiple disabilities. These two studies assessed technology-aided programs for persons with those impairments. Specifically, Study I assessed a program to teach two non-ambulatory adults to hand reach a stimulation-linked object by standing up. Study II assessed a program to teach a child and a man to ambulate while holding a rail or following a corridor wall. Standing increased from below 15% to about or over 80% of the session duration in Study I. The participants of Study II managed to complete brief ambulation trials independent of guidance. These performance achievements were discussed in relation to the technology-aided programs employed in the studies and the programs' applicability in daily contexts.
Background:
Multi-sensory storytelling (MSST) was developed to include persons with profound intellectual and multiple disabilities in storytelling culture. In order to increase the listeners' attention, MSST stories are individualised and use multiple sensory stimuli to support the verbal text. In order to determine the value of MSST, this study compared listeners' attention under two conditions: (1) being read MSST books and (2) being read regular stories.
Method:
A non-randomised control study was executed in which the intervention group read MSST books (n = 45) and a comparison group (n = 31) read regular books. Books were read 10 times during a 5-week period. The 1st, 5th and 10th storytelling sessions were recorded on video in both groups, and the percentage of attention directed to the book and/or stimuli and to the storyteller was scored by a trained and independent rater. Two repeated measure analyses (with the storytelling condition as a between-subject factor and the three measurements as factor) were performed to determine the difference between the groups in terms of attention directed to the book/stimuli (first analysis) and storyteller (second analysis). A further analysis established whether the level of attention changed between the reading sessions and whether there was an interaction effect between the repetition of the book and the storytelling condition.
Results:
The attention directed to the book and/or the stimuli was significantly higher in the MSST group than in the comparison group. No significant difference between the two groups was found in the attention directed to the storyteller. For MSST stories, most attention was observed during the fifth reading session, while for regular stories, the fifth session gained least attentiveness from the listener.
Conclusion:
The persons with profound intellectual and multiple disabilities paid more attention to the book and/or stimuli in the MSST condition compared with the regular story telling group. Being more attentive towards the book and stimuli might give persons with PIMD the opportunity to apprehend the story and to be included in storytelling culture.
Multisensory storytelling (MSST) is a storytelling method developed for people with profound intellectual and multiple disabilities (PIMD). The developers of MSST have established specific guidelines aimed at increasing the listener's attention. Whether, and to what extent, these guidelines indeed increase the listener' attentiveness is unknown. This study analyzed the relationship between the effects of these guidelines and the attentiveness of listeners with PIMD. Some 45 storytellers created an MSST book tailored to a person with PIMD. The book was read 10 times, and video recordings were made of the first, fifth, and tenth reading sessions. For each session, the percentage of attention paid to the storyteller and to the book was scored using an interval method. The relationship between adherence to the guidelines (repetition, use of original text, offering stimuli actively, and use of neutral background) and attentiveness of the person with PIMD was then analyzed. During storytelling, the listeners were attentive to MSST for an average of 69% of the time. The attention increased between the first and fifth reading sessions, and then dropped between the fifth and tenth sessions. Part of the guidelines (repetition, actively offering the stimuli and duration of the story) were positively related to the amount of the listeners' attention; for other parts of the guidelines (using original text and using neutral background), no significant correlations were found. The results of this study can help with developing clearer instructions to new storytellers. To optimize the attentiveness of a person with PIMD to an MSST story, the authors recommend that the storyteller takes ample time to read the book and provides the listener with active access to the stimuli.
Background This study aimed to assess a microswitch-aided program for helping 2 persons with multiple disabilities, who presented with head and shoulder posture problems, to exercise a combination of appropriate head and arm movements. Method The program involved microswitches for monitoring participants' head and arm movements. A computer system recorded those movements and provided brief stimulation contingent on them during intervention. Three intervention phases took place, which focused on head movements, arm movements, and the combination of the 2 movements, respectively. Four weeks after the last intervention phase, a post-intervention check occurred. Results Both participants increased the frequencies of (a) the head and the arm movements during the first 2 intervention phases, respectively, and (b) those movements combined during the third intervention phase. Positive performance was maintained at the post-intervention check. Conclusions Microswitch-aided programs can support exercise of complex response schemes of persons with multiple disabilities.
Background
Incontestable epidemiological trends indicate that, for the foreseeable future, mortality and morbidity will be dominated by an escalation in chronic lifestyle-related diseases. International guidelines recommend the implementation of evidence-based approaches to bring about health behaviour changes. Motivational interventions to increase adherence and physical activity are not part of traditional physiotherapy for any condition.
Objective
To evaluate the evidence for the effectiveness of adding motivational interventions to traditional physiotherapy to increase physical activity and short- and long-term adherence to exercise prescriptions.
Data sources
A literature search of PubMed, EMBASE, Scopus, CINAHL, PsychINFO, Amed and Allied Health Evidence database using keywords and subject headings.
Study selection
Only randomised controlled trials comparing two or more arms, with one arm focused on motivational interventions influencing exercise and one control arm, were included. The search identified 493 titles, of which 14 studies (comprising 1504 participants) were included.
Data extraction
The principal investigator extracted data that were reviewed independently by another author. Methodological quality was assessed independently by two authors using the Cochrane Risk of Bias tool and the PEDro scale. Outcomes were measured at the level of impairment, activity limitation and participation restriction. The standardised mean difference between the control and intervention groups at follow-up time points was used as the mode of analysis. I2≤50% was used as the cut-off point for acceptable heterogeneity, above which a random effects model was applied.
Results
Exercise attendance was measured in six studies (n = 378), and the results indicate that there was no significant difference in exercise attendance between the groups (REM, standardised mean difference 0.33, 95% confidence interval -0.03 to 0.68, I2 62%). Perceived self-efficacy results were pooled from six studies (n = 722), and there was significant difference between the groups in favour of the interventions (FEM, standardised mean difference 0.71, 95% confidence interval 0.55 to 0.87, I2 41%). The results for levels of activity limitation were pooled (n = 550), and a significant difference was found between the groups in favour of the interventions (REM, standardised mean difference -0.37, 95% confidence interval -0.65 to -0.08, I2 61%).
Limitations
The majority of the included studies were of medium quality, and four studies were of low quality. Data were pooled from a wide variety of different populations and settings, increasing the assortment of study characteristics.
Conclusions
Motivational interventions can help adherence to exercise, have a positive effect on long-term exercise behaviour, improve self-efficacy and reduce levels of activity limitation. The optimal theory choice and the most beneficial length and type of intervention have not been defined, although all interventions showed benefits. There is a need to determine how practising physiotherapists currently optimise adherence, and their current levels of knowledge about motivational interventions.
Implications of key findings
The results indicate that motivational interventions are successful for increasing healthy physical activity behaviour. Physiotherapists are ideally placed to take on this role, and motivational interventions must become part of physiotherapy practice.
While it is generally agreed that motor activity promotes motor, cognitive, and social development, the specific benefits in people with severe or profound intellectual disabilities (S-PID) are as yet unknown. The aim of this study was to systematically review the evidence related to motor interventions designed to improve motor, cognitive, and/or social outcomes in people with S-PID. A systematic review of empirical studies published between 1982 and 2012 was conducted using four databases (MEDLINE, PsycINFO, ERIC, and CINAHL). Data were extracted regarding the aim of the study, study design, sample characteristics, theoretical framework, intervention, the measurement tools utilized, and outcomes. Of 295 articles reviewed, 46 met our inclusion criteria and covered 45 different studies. Forty articles used single-subject designs and five used a group design. The majority of the articles focused on behavioural techniques with (n = 21) or without (n = 15) assistive technology. Theoretical frameworks were explicitly reported in nine (20%) of the 45 articles. Thirty-eight articles reported improvement in basic motor skills and eight articles reported improvement in recreational or more specialist motor skills. None of the articles reported negative effects due to motor interventions. Further research is required to determine which motor interventions are the most effective in improving motor outcomes and/or cognitive and social outcomes, and on the longer term effects of these interventions in people with S-PID.
Background
When providing activities to individuals with profound intellectual and multiple disabilities (PIMD), direct support persons (DSPs) often face questions that are, among other things, related to the alertness of the person with PIMD. While previous studies have revealed that stimulation might have a greater impact on levels of alertness than the internal conditions of the individual, they have also emphasized the importance of interaction in order to influence the level of alertness. Because the initiation of this interaction has been described as one of its core components, the present study has focused on the relationship between the stimuli presented, the initiation of the activity (by the person with PIMD or the DSP), and the level of alertness of the person with PIMD.Method
Videotapes of the one-to-one interactions of 24 individuals with PIMD and their DSPs in multisensory environments have been scored using the Alertness Observation List. In a sequential analysis, the percentages of stimuli presented were related to the percentages of initiation. Furthermore, two other analyses focused on the relationship between the level of alertness and the preceding and subsequent percentages of initiation respectively.ResultsThe results show that high percentages of the activities are initiated by the DSPs. In addition, activities that were initiated by the individual with PIMD were preceded and followed by higher percentages of alert behaviour than those initiated by the DSP. Outcomes differed for the different types of stimuli.Conclusions
These results have striking implications for the lives of individuals with PIMD. It is quite possible that DSPs often act too quickly, whereas they would be better off waiting for a reaction on the part of their client. In general, DSPs need to find a balance between being passive themselves and promoting in the individual with PIMD a state of being as active and alert as possible.
There has been a paucity of guidance on the methodological details needed for measuring and sampling the independent variable or actual intervention occurrences in research and practice. Furthermore, the planning and support necessary to document the independent variable in both circumstances may be considerable. The current study extends prior research by reviewing the methods used to document procedural fidelity in school-based intervention research with student participants published between 2005 and 2012 in journals known for publishing school-related intervention studies. Two hundred sixty-six articles met the inclusion criteria and the majority (70 %) used fidelity data in the analysis of intervention effectiveness. By systematically examining contributions of school-based intervention researchers across targeted variables as well as qualities of interventions and settings, suggestions can be made for (a) planning measurement of fidelity across phases of the intervention, (b) sampling fidelity occurrences, (c) preventing intervention failure by providing needed supports, and (d) responding to patterns of fidelity required for intervention and outcome measurement in both research and practice.
The latest researchers have employed software technology to turn gyration air mice into a high performance limb detector to detect specific limb movement, and to further collaborate using the preferred environmental stimulation to help people with disabilities to suppress unwanted behaviors or habits and to reward good behaviors. This study extended the functionality of a gyration air mouse, and used the mouse as a precise physical activity detector integrated with the preferred environmental stimulation to assess if this integrated set can be used to help two disabled people who are overweight and lacking in exercise to actively perform physical activities. The study was conducted based on an A-B-A-B design. The results showed that both participants increased significantly the time duration required for them to maintain their physical activity status so that they could obtain their favorite environmental stimulation during the intervention phases. Both the practical and developmental implications of the findings are then discussed.
Study I used typical microswitch-cluster programs to promote adaptive responding (i.e., object manipulation) and reduce inappropriate head or head-trunk forward leaning with a boy and a woman with multiple disabilities. Optic, tilt, and vibration microswitches were used to record their adaptive responses while optic and tilt microswitches monitored their posture. The study included an ABB(1)AB(1) sequence, in which A represented baseline phases, B represented an intervention phase in which adaptive responses were always followed by preferred stimulation, and B(1) represented intervention phases in which the adaptive responses led to preferred stimulation only if the inappropriate posture was absent. Study II assessed a non-typical, new microswitch-cluster program to promote two adaptive responses (i.e., mouth cleaning to reduce drooling effects and object assembling) with a man with multiple disabilities. Initially, the man received preferred stimulation for each cleaning response. Then, he received stimulation only if mouth cleaning was preceded by object assembling. The results of Study I showed that both participants had large increases in adaptive responding and a drastic reduction in inappropriate posture during the B(1) phases and a 2-week post-intervention check. The results of Study II showed that the man learned to control drooling effects through mouth cleaning and used object assembling to extend constructive engagement and interspace cleaning responses functionally. The practical implications of the findings are discussed.
To investigate the effectiveness of a novel dynamic standing intervention compared with a conventional passive standing intervention on bone health in children with cerebral palsy who are nonambulatory.
Four children in passive standers and 5 in dynamic standers were followed for 15 months (standing 30 min/d, 5 d/wk). Dual-energy x-ray absorptiometry scans of the distal femur were obtained at 3-month intervals to measure changes in bone mineral density (BMD), bone mineral content, and area.
Increases in BMD were observed during dynamic standing (P < .001), whereas passive standing appeared to maintain the baseline BMD. Increases in bone mineral content were observed in each standing intervention (P < .001), with dynamic standing inducing greater increases. Increases in area were comparable between interventions (P = .315).
Dynamic standing demonstrated the potential of moderate-magnitude, low-frequency loading to increase cortical BMD. Further investigations could provide insight into the mechanisms of bone health induced through loading interventions.
Background
While optimally activities are provided at those moments when the individual with profound intellectual and multiple disabilities (PIMD) is focused on the environment' or alert', detailed information about the impact that the design and timing of the activity has on alertness is lacking. Therefore, the aim of the present study is to shed light on the sequential relationship between different stimuli and alertness levels in individuals with PIMD. Method
Video observations were conducted for 24 participants during one-on-one interactions with a direct support person in multisensory environments. Time-window sequential analyses were conducted for the 120s following four different stimuli. ResultsFor the different stimuli, different patterns in terms of alertness became apparent. Following visual stimuli, the alertness levels of the individuals with PIMD changed in waves of about 20s from active alert' to passive alert'. While auditory and tactile stimuli led to alert' reactions shortly after the stimulation, alertness levels decreased between seconds 20 and 120. Reactions to vestibular stimuli were only visible after 60s; these were active alert' or withdrawn'. Conclusions
The results of the present study show that individuals with PIMD show their reactions to stimuli only slightly, so that waves' might reflect the optimal alertness pattern for learning and development. Consequently, it is especially important that direct support persons follow and stimulate these individual waves' in the activities they provide to their clients.
Multi-sensory environments (MSEs) are reportedly being increasingly used in schools but there is little research on funding,
rationale, ways they are used and perceived benefits. A survey was conducted of special schools enrolling children with severe
disabilities in New South Wales, Australia. More than half the 36 responding schools reported having a MSE installed. Schools
typically relied on advice from other teachers, therapists and equipment suppliers in their decisions to install MSEs, with
very little examination of research. A wide range of uses and benefits were reported, with limited emphasis on active teaching
of skills. There was a widespread acceptance of the inherent value of sensory stimulation. Policy implications for school
systems considering or using MSEs are discussed.
KeywordsMulti-sensory environments–Snoezelen–Evidence-based practice–School
The latest researches have adopted software technology by applying the Nintendo Wii Remote Controller to the correction of hyperactive limb behavior. This study extended Wii Remote Controller functionality for improper head position (posture) correction (i.e. actively adjusting abnormal head posture) to assess whether two people with multiple disabilities would be able to actively keep the upright head position by controlling their favorite stimulation using a Wii Remote Controller with a newly developed active head position correcting program (AHPCP). The study was performed according to an ABAB design, in which A represented the baseline and B represented intervention phases. Results showed that both participants significantly increased their time duration of maintaining upright head position (TDMUHP) to obtain the desired environmental stimulation during the intervention phases. Practical and developmental implications of the findings were discussed.
This exploratory study examined the relationships between consumers' involvement in the pre-purchase decision-making process, their perceptions of feeling informed, and their degree of being satisfied with and use of assistive technology (AT). Does consumer information and participation in decision-making process lead to improved satisfaction and use of AT?
A link to an project-specific web-based survey, sent to several online disability forums and independent living centres, resulted in a sample of 145 individuals with a range of disabilities, who used a range of AT and were geographically dispersed.
There is a significant relationship between being feeling informed and being satisfied with an AT device (F(13,278) = 27.79, p = 0.000). Feeling that personal needs were not assessed led to lower satisfaction (β = -0.15, p < 0.07), while feeling informed resulted from a number of different factors. Lack of consumer involvement in the pre-purchase decision-making process led to somewhat greater rates of abandonment in some categories of AT (some with small n's).
Talking with other users, auditioning the device and searching the Internet are important ways for consumers to gather information. When consumers feel informed, they are more likely to be satisfied with the AT and retain it.
The latest researches adopted software technology turning the Nintendo Wii Balance Board into a high performance change of standing posture (CSP) detector, and assessed whether two persons with multiple disabilities would be able to control environmental stimulation using body swing (changing standing posture). This study extends Wii Balance Board functionality for standing posture correction (i.e., actively adjust abnormal standing posture) to assessed whether two persons with multiple disabilities would be able to actively correct their standing posture by controlling their favorite stimulation on/off using a Wii Balance Board with a newly developed standing posture correcting program (SPCP). The study was performed according to an ABAB design, in which A represented baseline and B represented intervention phases. Data showed that both participants significantly increased time duration of maintaining correct standing posture (TDMCSP) to activate the control system to produce environmental stimulation during the intervention phases. Practical and developmental implications of the findings were discussed.
There is a growing use of multisensory therapy in enhancing sense of well-being and reducing challenging or stereotypic self-stimulating behaviour in people with a developmental disability.
This review aimed to present the best available evidence on the effect of multisensory therapy in adult clients with developmental disabilities on the frequency of challenging behavior, stereotypic self-stimulating behavior, and positive behaviour; and changes of physiological measures.
Systematic review.
A search of electronic databases of published research studies (January 1985-December 2008) was conducted, using appropriate search terms. The reference lists and bibliographies of retrieved articles were reviewed to identify research not located through other search strategies.
Studies that investigated the effects of multisensory environment in relation to outcomes were examined. Data were extracted independently by two reviewers. Methodological quality was also assessed by two reviewers against key quality criteria.
One hundred and thirty-two studies were identified from database search of which 17 met the inclusion criteria for review. The evidence supports that participants' had displayed more positive behaviour after multisensory therapy sessions. There is no strong evidence supporting that multisensory therapy could help in reducing challenging behaviour or stereotypic self-stimulating behaviour.
This systematic review demonstrates a beneficial effect of multisensory therapy in promoting participants' positive emotions. While the reviewers acknowledge the difficulty in carrying out randomized controlled trial in people with developmental disabilities and challenging behavior, the lack of trial-derived evidence makes it difficult to arrive at a conclusion of the effectiveness of the multisensory therapy. Future study should use well-designed randomised controlled trials to evaluate the short and long term effectiveness of multisensory therapy. There is also a need for qualitative studies which allow the clients to tell the stories of their experiences.
Vineland Adaptive Behavior Scales represent a revision of the Vineland Social Maturity Scale, which, over the last sixty years, has made major contributions to our knowledge of adaptive behavior assessment and our understanding of mental retardation
characteristics of adaptive behavior / construction of the Vineland Adaptive Behavior Scales / validity assessments of the Vineland Adaptive Behavior Scales / administration / scoring / interpretation / case examples / uses of the Vineland Adaptive Behavior Scales (PsycINFO Database Record (c) 2012 APA, all rights reserved)