Promoting Engagement, Requests and Choice by a Man with Post-Coma Pervasive Motor Impairment and Minimally Conscious State through a Technology-Based Program

Lancioni, Giulio E.; Belardinelli, Marta Olivetti; Stasolla, Fabrizio; Singh, Nirbhay N.; O’Reilly, Mark F.; Sigafoos, Jeff; Angelillo, Maria Teresa

doi:10.1007/s10882-008-9104-x

Cited by 36 publications

(13 citation statements)

References 45 publications

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“…University students, moreover, positively supported the assistive technology-based program. This finding is in line with previous studies (Lancioni, Belardinelli et al, 2008;Lancioni et al, 2011). Thus, participants could request desired items to a caregiver (their father or mother, brother, sister or a research assistant) by responding and by activating the related microswitch.…”

Section: Discussionsupporting

confidence: 89%

“…Several studies had already develop microswitch and VOCA (vocal output communication aid) technologies to ensure the participants the access to preferred stimuli independently or to ask for social contact with the caregiver (Lancioni, Belardinelli et al, 2008;. Some studies were carried out to allow the participants to manage television and/or radio .…”

Section: Introductionmentioning

confidence: 99%

“…Some studies were carried out to allow the participants to manage television and/or radio . Other studies were aimed to develop programs including request and choice opportunities Lancioni, Belardinelli et al, 2008;. Although the importance of assistive technology for helping these patients in their recovery and functional progress is quite obvious, there is a lacking of research evidence concerning the use of such technology for those persons.…”

Section: Introductionmentioning

confidence: 99%

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Assistive technology to promote leisure and constructive engagement by two boys emerged from a minimal conscious state

Stasolla¹,

Pace

2014

NRE

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BACKGROUND: Post-coma persons with multiple disabilities may represent a challenge to rehabilitation centers, due to their clinical conditions. Moreover, they can failed to engage adaptive responses aimed at the self-management of environmental stimuli. OBJECTIVES: To assess the impact and social rating of a new assistive technology set-up for promoting constructive engagement by two post-coma boys emerged from a minimal conscious state. METHOD: During baseline sessions, the participants were provided with a mouse to manage the computer system. During intervention phases, a new technology was implemented, allowing both participants to manage environmental stimuli with a microswitch instead of the mouse. Furthermore, a social validation assessment was carried out, involving students as raters. RESULTS: Data showed an increasing of constructive engagement by both participants during intervention phases. Sixty psychology students (social raters) favoured the new technology on a six items questionnaire (i.e. enjoyment, suitability, rehabilitation, independence, daily context and support). CONCLUSIONS: The new technology was suitable, affordable, effective and socially preferable.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assistive technology to promote leisure and constructive engagement by two boys emerged from a minimal conscious state

Stasolla¹,

Pace

2014

NRE

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“…To this end, Bekinschtein et al ( 2009 ) demonstrated that some patients diagnosed as in VS are able to learn associations between stimuli, and concluded that these individuals might have a partially preserved conscious processing, which cannot be detected by standard behavioral assessments. Lancioni et al ( 2007 , 2008a , b , c , 2009a , b ) assessed learning in people with disorders of consciousness using a non-verbal procedure, technically supported by microswitches detecting simple responses (e.g., minimal forehead wrinkling, eye-blinking, slight movements, etc.) and electronic control systems providing the person with contingent feedback to these responses.…”

Section: Discussionmentioning

confidence: 99%

Questioning the dichotomy between vegetative state and minimally conscious state: a review of the statistical evidence

Liberati

Hünefeldt

Belardinelli

2014

Front. Hum. Neurosci.

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Given the enormous consequences that the diagnosis of vegetative state (VS) vs. minimally conscious state (MCS) may have for the treatment of patients with disorders of consciousness, it is particularly important to empirically legitimate the distinction between these two discrete levels of consciousness. Therefore, the aim of this contribution is to review all the articles reporting statistical evidence concerning the performance of patients in VS vs. patients in MCS, on behavioral or neurophysiological measures. Twenty-three articles matched these inclusion criteria, and comprised behavioral, electroencephalographic (EEG), positron emission tomography (PET) and magnetic resonance imaging (MRI) measures. The analysis of these articles yielded 47 different statistical findings. More than half of these findings (n = 24) did not reveal any statistically significant difference between VS and MCS. Overall, there was no combination of variables that allowed reliably discriminating between VS and MCS. This pattern of results casts doubt on the empirical validity of the distinction between VS and MCS.

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“…A diagnosis of minimally conscious state offers, in fact, some opportunities for the partial recovery of functions (e.g., responding in a meaningful manner to environmental stimulation). This in turn provides encouragement as to the person's ability to interact with his or her surroundings and justifies efforts to develop customized rehabilitation and communication programs (Giacino and Kalmar 2005;Lancioni et al 2008c).…”

mentioning

confidence: 99%

Learning as a possible sign of non-reflective consciousness in persons with a diagnosis of vegetative state and pervasive motor impairment

et al. 2009

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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.

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Promoting Engagement, Requests and Choice by a Man with Post-Coma Pervasive Motor Impairment and Minimally Conscious State through a Technology-Based Program

Cited by 36 publications

References 45 publications

Assistive technology to promote leisure and constructive engagement by two boys emerged from a minimal conscious state

Assistive technology to promote leisure and constructive engagement by two boys emerged from a minimal conscious state

Questioning the dichotomy between vegetative state and minimally conscious state: a review of the statistical evidence

Learning as a possible sign of non-reflective consciousness in persons with a diagnosis of vegetative state and pervasive motor impairment

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