Rita Damiani’s research while affiliated with University of Bari Aldo Moro and other places

Objectives: To extend the use of assistive technology for promoting adaptive skills of children with cerebral palsy. To assess its effects on positive participation of ten participants involved. To carry out a social validation recruiting parents, physiotherapists and support teachers as external raters. Method: A multiple probe design was implemented for Studies I and II. Study I involved five participants exposed to a combined program aimed at enhancing choice process of preferred items and locomotion fluency. Study II involved five further children for a combined intervention finalized at ensuring them with literacy access and ambulation responses. Study III recruited 60 external raters for a social validation assessment. Results: All participants improved their performance, although differences among children occurred. Indices of positive participation increased as well. Social raters favorably scored the use of both technology and programs. Conclusion: Assistive technology-based programs were effective for promoting independence of children with cerebral palsy. • Implications for Rehabilitation • A basic form of assistive technology such as a microswitch-based program may be useful and helpful for supporting adaptive skills of children with cerebral palsy and different levels of functioning. • The same program may improve the participants' indices of positive participation and constructive engagement with beneficial effects on their quality of life. • The positive social rating provided by external experts sensitive to the matter may recommend a favorable acceptance and implementation of the program in daily settings.

We further extended the use of a microswitch-based program for assessing contingency awareness and promoting locomotion fluency of five adolescents with Rett syndrome. A second goal was to evaluate the effectiveness and the suitability of the rehabilitative intervention on participants’ indices of happiness as outcome measure of their quality of life and on the reduction of their stereotypic behaviors. Finally, a social validation procedure involving 40 parents of children with severe developmental disabilities and 40 caregivers was carried out. The study was conducted according to an ABABCBCB experimental sequence for each participant, with A representing baselines, B indicating the contingent intervention closely linked to the adaptive responding, and C reporting a non-contingent control phase with positive stimulation occurring throughout the session, irrespective of the adaptive behavior. Results showed an improved performance for all the participants during contingent intervention phases. The control phases revealed that all participants acquired the contingency awareness. The indices of happiness increased as sign of an enhanced quality of life. Both groups of raters favorably scored the use of such technology. Clinical, practical, and psychological implications of the findings were discussed.

We compared two behavioral strategies (i.e., self-monitoring [SM] and differential reinforcement of an alternative behavior [DRA]) to promote on-task behavior by three children with cerebral palsy and developmental disabilities during classroom activities. The first objective of the study was to evaluate the effectiveness and the suitability of each strategy individually within a school setting, and make their systematic comparison. A second aim of the study was to assess the effects of the intervention on participants' mood as an outcome measure concerning the quality of life. The third objective was to assess the preference checks for each participant. Finally, a social validation procedure, involving 24 teachers as raters, was conducted for corroborating the clinical validity and providing the study with a formal endorsement by sensitive and expert professionals. The study was carried out according to an alternating treatment embedded in a non-concurrent multiple baseline Life Span and Disability Stasolla F. et al. _______________________________________________________________________________________________________________________________ 64 reversal design across participants. Furthermore, a maintenance phase, three months after the end of the intervention, was realized. Results showed that both interventions were successful, increasing on-task behavior for all participants involved, as well as improving their mood. All participants preferred self-monitoring during preference checks. Raters involved in the social validation assessment considered SM as more positive than DRA. Clinical, educational, psychological and rehabilitative implications of the findings were discussed.

This chapter provides the reader with a selective overview of the intervention options available in the literature within the last sixteen years (i.e., 2000-2016) for assessing and recovering post-coma persons in a vegetative state. Overall 15 studies were retained with 113 participants involved. Three basic groups of rehabilitative strategies were identified, namely (a) electrical stimulation, (b) environmental stimulation, and (c) assistive technology-based programs. Strengths and weakness of the examined empirical evidences were emphasized. Results were widely positive, although few failures occurred. Clinical, practical, and rehabilitative implications of the analyzed contributions were discussed. Some useful suggestions for future research and practice were addressed.

We extended the use of microswitch-cluster technology to six children with severe to profound developmental disabilities and autism spectrum disorders. The primary aim of the intervention was to improve the adaptive behavior (ie, insert three objects in three different containers within 3 s) and simultaneously decrease the challenging behavior of hand/objects mouthing. The second aim was to assess the effects of the intervention on the indices of happiness. An ABCAC experimental sequence was adopted for each participant. Thus, subsequent to a baseline condition, a first intervention phase was implemented for increasing the adaptive responding irrespective of the challenging behavior, followed by a cluster phase in which positive stimulation was provided contingent on an adaptive response, only if the challenging behavior was absent. A 3 month follow-up occurred. Results showed a performance improvement for all participants involved. Additionally, they all consolidated the adaptive responding during the follow-up. Sixty external raters favorably endorsed the use of such technology. Implications of the findings were discussed.

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

We assessed a computer-based rehabilitative program (i.e., tablet device with touch screen and adapted software) to improve academic performance and to increase the on-task behavior of three children with autism spectrum disorders and mild intellectual disabilities in a school setting. Furthermore, the study pursued the following objectives: (a) monitor its effects on the generalization process, occurring two months after the end of the intervention, within home context, (b) reduce repetitive (stereotypic) behaviors exhibited by the participants (i.e., hand clapping, washing and voice noises), and (c) carry out a social validation assessment involving 48 support teachers (i.e., professionals who follow children with developmental disabilities with a special and individualized training program within a school context) as external raters. The study was conducted according to a changing criterion design for each participant. Results showed an improvement in performance (i.e., Life Span and Disability Stasolla F. et al. _________________________________________________________________________________________________ _______________________________ 154 academic activities correctly achieved and percentage of intervals with on-task behavior), for all participants recruited, that they generalized once the program was implemented within their homes. Moreover, all children showed a reduction of repetitive behaviors during intervention phases compared to baseline. Finally, external raters (i.e., support teachers) considered the use of the technology favorably. Educational, practical and psychological implications of the findings were discussed.

Objectives: To extend the use of assistive technology (AT) for promoting a new adaptive response and to reduce hand mouthing, by three boys with fragile X syndrome. To monitor the effects of the intervention program on the positive mood. To carry out a three month follow-up phases. To conduct a social validation assessment involving 30 parents of children who presented multiple disabilities as raters. Methods: The study was implemented according to an ABAB experimental design, where A represented baseline phases (technology available but inactive) and B represented intervention phases (the technology ensured 7 s of positive stimulation). Results: All participants improved and consolidated their performance. Parents involved in the social validation assessment rated positively the use of such technology. Conclusion: AT-based program was useful, affordable, and effective for enhancing constructive engagement, self-determination, and for improving quality of life by children with fragile X syndrome and severe to profound developmental disabilities.