Observing and Influencing Alertness in Individuals With Profound Intellectual and Multiple Disabilities in Multisensory Environments

Abstract

While alertness is widely acknowledged as one of the most important preconditions for learning and development, individuals with profound intellectual and multiple disabilities (PIMD) experience a wide range of difficulties in the contact with their environment. The aim of the present study was to identify aspects of stimulation situations that influence the alertness levels of individuals in the target population.Based on video recordings of 24 participants, alertness levels and environmental conditions were scored. Descriptive analyses and multilevel logistic regression analysis were used to identify the aspects of the stimulation situation that were related to occurrence of alertness.The results show that visual stimuli (optimally in combination with auditory stimuli) produced the highest alertness levels. Furthermore, the effects of stimuli outweighed the effect of time. The role of direct support persons is thus especially important in alertness stimulation of individuals with PIMD.

Initiation of activities and alertness in individuals with profound intellectual and multiple disabilities

“…; Munde et al . ). In addition, a previous study on the development of alertness over time has shown that alertness in individuals of the target group changes in ‘waves’ (Munde et al .…”

“…Another explanation can be formulated concerning the different reactions to the different sorts of stimuli. The result may actually be related to the nature of the stimuli (Mitchell & Le Pelley 2010;Munde et al 2012a). A coloured toy may, for example, be more likely to tempt an individual with PIMD to explore and show active behaviour than would swinging in a hammock.…”

“…Similarly, DSPs may allow more exploration of a visual stimulus such as a coloured toy than they would when the individual with PIMD is experiencing a vestibular stimulus such as lying in a hammock. It is possible that individuals with PIMD would be able to show even more actively alert behaviour if the DSP created more possibilities for them to do so (Green et al 1994;Munde et al 2012a). In addition, a previous study on the development of alertness over time has shown that alertness in individuals of the target group changes in 'waves' (Munde et al 2012b): a period of alertness is followed by a period of non-alert behaviour, but then another period of alertness often follows after that.…”

Speech and language therapists’ approaches to communication intervention with children and adults with profound and multiple learning disability

“…Munde et al . () contribute research on influencing alertness levels in people with PMLD. Integrating this information with empirical evidence on interventions and clinical expertise is essential in a field where the evidence base is still limited.…”

Identifying perception behaviours in people with profound intellectual and multiple disabilities

“…These changes in perception behaviour could indicate increased alertness. Research conducted by Munde, Vlaskamp, Maes, and Ruijssenaars () reported changes in the alertness level of people with PIMD after offering them several sensory stimuli. In their study, sensory stimuli appeared to lead to temporarily increased alertness, which seems to coincide with the findings of this study.…”