Assistive Technology Programming for a Young Child with Profound Disabilities

Abstract

Background and Purpose: The purpose of this study was to use single-subject research methods, combined with social validation procedures, as part of an evaluation/intervention process exploring the effects of adapted switch-operated devices on self-initiated behaviors of a 6-year-old child with profound multiple disabilities.

Method: A single-subject withdrawal design with multiple phases, including one alternating treatments phase, was used to investigate the participant's ability to perform selective, voluntary motions as indicators of contingency awareness and preferences. Social validity also was assessed.

Results: The child demonstrated the ability to use two switch sites to activate adapted switch-operated devices when a preferred stimulus was contingent on a specific motor action, and she demonstrated the ability to communicate preferences as indicated by more frequent switch activations for one consequence than for a second consequence. Social validity results indicated that both the parents and school personnel generally viewed the evaluation/intervention process as positive.

Conclusions: Single-subject research methods, combined with social validation procedures, can be used effectively in the evaluation/intervention process for children with profound multiple disabilities.

Key Words:

• Cerebral palsy
• participation
• pediatrics
• self-initiation

Additional information

Notes on contributors

Jennifer Shull

Michael Lepp, PT, is in private practice, Associate Instructor of the Upledger Institute, and Clinical Instructor, Case Western Reserve University School of Dentistry, Cleveland, OH.

Marie McKenzie, MS, OTR, is in private practice. She was Coordinator of Occupational Therapy at Scottish Rite Hospital at the time of this study.

Heather Miller, MS, OTR/L, is currently employed by Madison County Educational Service Center, providing therapy services to the county's pre-schools. This research was completed in partial fulfillment of the requirements of an MS degree at Ohio State University.

Linda Viscardis, BA, is Team Leader and Community Development Worker, Peterborough Family Enrichment Centre. She is Co-Founder of P.R.O.S.P.E.C.T.S., a support and advocacy group for families who have children with special needs.

Debra Stewart, BSc, OT(C), is Occupational Therapist, Erinoak, Serving Young People with Physical Disabilities, Mississauga, ON, and Clinical Lecturer, School of Rehabilitation Science, McMaster University.

Janette McDougall, MA, was Project Coordinator

Kip Husted, BEd, was a parent representative on the study team.

Aviva Yochman, MA, OTR, was a student in the School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel at the time of this study.

Imelda Burgman, MA OTR/L BCP, completed her MA in Movement Sciences at Teachers College, Columbia University, and was an Occupational Therapist at The Shield Institute, Bronx, NY. She is currently Lecturer, Habilitation, School of Community Health, Faculty of Health Studies, Charles Sturt University, Albury, N.S.W., Australia.

Barbara J. Steva, OTWL, BCP, is Occupational Therapist, University of New England Community Occupational Therapy Clinic, Saco, ME. She was Director of Occupational Therapy and Therapeutic Recreation, Franciscan Children's Hospital and Rehabilitation Center, Boston, MA, when this work was completed.