Teaching individuals with profound multiple disabilities to access preferred stimuli with multiple microswitches § Gee May Tam, Katrina J. Phillips *, Oliver C. Mudford The University of Auckland, New Zealand 1. Introduction About 1% of people with intellectual disability (mental retardation) are classified as having profound intellectual disabilities (American Psychiatric Association, 2000). Approximately 40% of people with profound intellectual disability are semi- or non- ambulatory (Kobe, Mulick, Rash, & Martin, 1994). Individuals who are non-ambulatory, with profound intellectual disabilities, and have additional physical and developmental impairments (e.g., loss of sight or smell, swallowing difficulties, limited or no language, or neuromuscular dysfunction) are referred to as having profound multiple disabilities (PMD) (Logan et al., 2001; Reid, Phillips, & Green, 1991). Individuals with PMD cannot physically do many movements that individuals without disabilities can. This limits their ability to accomplish basic self-care (Kobe et al., 1994) and they are usually fully dependent on others (e.g., parents/caregivers, or direct support staff) in all aspects of their daily living (Harris, 2006). This dependence, combined with a lack of communication abilities, can leave people with PMD isolated and passive in their surroundings. Fortunately, a growing body of research is showing that the availability of assistive aids, such as microswitches, may enable individuals with PMD to participate more constructively in activities and attain control over specific aspects of their environment. Microswitches, sometimes referred to simply as switches, may be regarded as ‘‘tools of access’’ and can be used as a means of communication (Lancioni, O’Reilly, & Basili, 2001, p. 22). These assistive devices make use of the individual’s limited movements to access environmental stimulation or facilitate communication with others. An individual can activate a switch with a movement of which they are capable (e.g., hand push or head tilt) and the switch turns on or off the Research in Developmental Disabilities 32 (2011) 2352–2361 A R T I C L E I N F O Article history: Received 13 July 2011 Accepted 18 July 2011 Available online 6 August 2011 Keywords: Choice Microswitches Profound and multiple disabilities A B S T R A C T We replicated and extended previous research on microswitch facilitated choice making by individuals with profound multiple disabilities. Following an assessment of stimulus preferences, we taught 6 adults with profound multiple disabilities to emit 2 different responses to activate highly preferred stimuli. All participants learnt to activate both microswitches. Five participants showed a higher overall level of responding when both switches activating preferred stimuli were available concurrently. After completion of microswitch training, a choice assessment was conducted in which participants had access to 2 microswitches concurrently, with 1 connected to the most highly preferred stimulus and the other to a least preferred stimulus. Choice making behavior was shown in 3 participants and provided support for the preference assessment results. The results of the 3 remaining participants showed that both the most highly preferred and the least preferred stimuli may serve as reinforcers for microswitch activation responses. ß 2011 Elsevier Ltd. All rights reserved. § The research was conducted for a Master of Science thesis by the first author, supervised by the second and third authors. * Corresponding author at: Applied Behaviour Analysis Programme, Department of Psychology (Tamaki Campus), The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Tel.: +64 9 9234468; fax: +64 9 3737902. E-mail address: kj.phillips@auckland.ac.nz (K.J. Phillips). Contents lists available at ScienceDirect Research in Developmental Disabilities 0891-4222/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.ridd.2011.07.027