Assistive technology to help persons in a minimally conscious state develop responding and stimulation control: Performance assessment and social rating

Issue title: Assistive Technologies for Cognition/Cognitive Support Technologies

Guest editors: Marcia J. Scherer and Stefano Federici

Article type: Research Article

Authors: Lancioni, Giulio E.^{a; *} | Singh, Nirbhay N.^b | O’Reilly, Mark F.^c | Sigafoos, Jeff^d | D’Amico, Fiora^e | Buonocunto, Francesca^f | Navarro, Jorge^f | Lanzilotti, Crocifissa^f | Fiore, Piero^a | Megna, Marisa^a | Damiani, Sabino^a

Affiliations: [a] University of Bari, Bari, Italy | [b] Medical College of Georgia, Georgia Regents University, Augusta, GA, USA | [c] University of Texas at Austin, TX, USA | [d] Victoria University of Wellington, New Zealand | [e] Lega F. D’Oro Research Center, Osimo, Italy | [f] S. Raffaele Rehabilitation Center, Ceglie Messapica, Italy

Correspondence: [*] Address for correspondence: G.E. Lancioni, Department of Neuroscience and Sense Organs, University of Bari, Corso Italia 23, 70121 Bari, Italy. Tel.: +39 0805717864; E-mail: [email protected]

Abstract: BACKGROUND:Post-coma persons in a minimally conscious state (MCS) and with extensive motor impairment and lack of speech tend to be passive and isolated. OBJECTIVE:This study aimed to (a) further assess a technology-aided approach for fostering MCS participants’ responding and stimulation control and (b) carry out a social validation check about the approach. METHODS:Eight MCS participants were exposed to the aforementioned approach according to an ABAB design. The technology included optic, pressure or touch microswitches to monitor eyelid, hand or finger responses and a computer system that allowed those responses to produce brief periods of positive stimulation during the B (intervention) phases of the study. Eighty-four university psychology students and 42 care and health professionals were involved in the social validation check. RESULTS:The MCS participants showed clear increases in their response frequencies, thus producing increases in their levels of environmental stimulation input, during the B phases of the study. The students and care and health professionals involved in the social validation check rated the technology-aided approach more positively than a control condition in which stimulation was automatically presented to the participants. CONCLUSIONS:A technology-aided approach to foster responding and stimulation control in MCS persons may be effective and socially desirable.

Keywords: Assistive technology, minimally conscious state, stimulation control, social validation

DOI: 10.3233/NRE-151269

Journal: NeuroRehabilitation, vol. 37, no. 3, pp. 393-403, 2015