NeuroRehabilitation 37 (2015) 393–403
DOI:10.3233/NRE-151269
IOS Press
393
Assistive technology to help persons
in a minimally conscious state develop
responding and stimulation control:
Performance assessment and social rating
Giulio E. Lancioni
a,*
, Nirbhay N. Singh
b
, Mark F. O’Reilly
c
, Jeff Sigafoos
d
, Fiora D’Amico
e
,
Francesca Buonocunto
f
, Jorge Navarro
f
, Crocifissa Lanzilotti
f
, Piero Fiore
a
, Marisa Megna
a
and Sabino Damiani
a
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
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
*
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: giulio.lancioni@
uniba.it.
1. Introduction
Post-coma persons in a minimally conscious state
(MCS) and with pervasive motor impairment and
lack of speech tend to be passive and isolated and,
consequently, may experience a severe reduction in
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