Supporting self-managed leisure engagement and communication in post-coma persons with multiple disabilities

• Published in: Research in developmental disabilities 2015-03, Vol.38 (Mar), p.75-83
• Main Authors: Lancioni, Giulio E., Singh, Nirbhay N., O’Reilly, Mark F., Sigafoos, Jeff, Belardinelli, Marta Olivetti, Buonocunto, Francesca, D’Amico, Fiora, Navarro, Jorge, Lanzilotti, Crocifissa, Denitto, Floriana, De Tommaso, Marina, Megna, Marisa
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Choice Behavior; Coma - rehabilitation; Communication; Communication Aids for Disabled; Communication Disorders - rehabilitation; Computer-Assisted Instruction - methods; Consciousness Disorders - rehabilitation; Disabled Persons - rehabilitation; Emergence from MCS; Female; Humans; Leisure Activities; Leisure engagement; Male; Middle Aged; Minimally conscious state (MCS); Motor Skills Disorders - rehabilitation; Persistent Vegetative State - rehabilitation; Self Care - methods; Self-Help Devices; Technology-aided programs; Television; Therapy, Computer-Assisted - methods
• ISSN: 0891-4222; 1873-3379
• DOI: 10.1016/j.ridd.2014.12.015

•Two computer-aided programs were used with seven post-coma persons with multiple disabilities.•One program was to teach four persons with disorders of consciousness to manage stimulation choice and access.•The other program was to teach three persons without disorders of consciousness television operation and communication.•Both programs were effective and the participants achieved the skills targeted. Post-coma persons affected by extensive motor impairment and lack of speech, with or without disorders of consciousness, need special support to manage leisure engagement and communication. These two studies extended research efforts aimed at assessing basic technology-aided programs to provide such support. Specifically, Study I assessed a program for promoting independent stimulation choice in four post-coma persons who combined motor and speech disabilities with disorders of consciousness (i.e., were rated between the minimally conscious state and the emergence from such state). Study II assessed a program for promoting independent television operation and basic communication in three post-coma participants who, contrary to those involved in Study I, did not have disorders of consciousness (i.e., had emerged from a minimally conscious state). The results of the studies were largely positive with substantial levels of independent stimulation choice and access for the participants of Study I and independent television operation and communication for the participants of Study II. The results were analyzed in relation to previous data in the area and in terms of their implications for daily contexts dealing with these persons.