Challenges of developing communicative interaction in individuals with congenital profound intellectual and multiple disabilities

Abstract

Background Physiological responses have been used in individuals with acquired disability to enable communicative interaction without motor movement. This study explored four autonomic nervous system (ANS) signals—electrodermal activity, skin temperature, cardiac patterns and respiratory patterns—to enable interaction with individuals born with profound intellectual and multiple disabilities (PIMD).

Method A series of case studies were conducted to teach a 15-year-old individual with PIMD to voluntarily control his ANS signals for the purposes of communicative interaction. Training was carried out according to an alternating treatment single-subject research design.

Results Training was unsuccessful; however, ANS signal patterns revealed issues unique to people with PIMD: profound intrasubject variability, discrepancy between physiological responses and caregiver perspectives, and the participant's lack of contingency awareness. Conclusions These three priority areas unique to people with congenital PIMD must be addressed before ANS signals can be used to enable communicative interaction with this population.

Keywords:

• access pathways
• autonomic nervous system
• congenital disability
• profound intellectual and multiple disabilities
• communicative interaction

Acknowledgement

The authors would like to thank Rudy and his family for their continued support of this work and for their contributions to this study, and Madeleine Shen and Pierre Duez for development of the biofeedback training program and their assistance with data collection.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This funding body has not imposed any restrictions on free access to or publication of the research data.