Biomedical subjects

Giulio E Lancioni

Publications and source records attributed to Giulio E Lancioni.

At least 19 recordsLinked to original sources

PubMed2006

Enabling two persons with multiple disabilities to access environmental stimuli and ask for social contact through microswitches and a VOCA.

This study assessed the combination of two microswitches with a voice output communication aid (VOCA) with two persons (an adolescent and a young adult) with multiple disabilities. The microswitches allowed the participants to obtain direct access to preferred environmental stimuli; the VOCA enabled them to ask for caregiver's attention. Initially, the participants were taught to use each of the two microswitches individually and then together. Next, they were taught to use the VOCA and, eventually, this was available together with the microswitches. Results showed that the participants learned to operate the microswitches and the VOCA and used all three of them consistently when they were simultaneously available. Implications of these findings and the potential role of a VOCA combined with conventional microswitches were discussed.

Adolescent↗

PubMed2006

PECS and VOCAs to enable students with developmental disabilities to make requests: an overview of the literature.

This paper provides an overview of the literature dealing with the use of the Picture Exchange Communication System (PECS) and voice output communication aids (VOCAs) for promoting the performance of requests by students with developmental disabilities. Computerized and manual searches were carried out to identify the studies published during the last 15 years (i.e., the period between 1992 and 2006 during which PECS and VOCA approaches became popular). Thirty-seven studies were identified and then divided into three groups concerning the use of the PECS or equivalents, the use of VOCAs or equivalents, and the comparison of both these approaches, respectively. Of the 173 students involved in studies using the PECS or equivalents only three could be considered failures, while a fourth one did not progress in the program due to illness. Similarly, of the 39 students who used VOCAs or equivalents only three could be considered failures, while one was partly successful. Finally, of the 11 students involved in the comparisons between PECS and VOCAs none could be classified as a failure. The results are very encouraging but methodological concerns and the relatively limited use of the systems in terms of request items and request opportunities suggest caution. Caution may also be needed in interpreting the reported similarities between the two systems in usability and effectiveness.

Adolescent↗

PubMed2006

Evaluation of a video-based error correction procedure for teaching a domestic skill to individuals with developmental disabilities.

We evaluated a video-based error correction procedure for teaching four adults with developmental disabilities to set a table. Video clips were initially used as an antecedent prompt. However, only one of the adults learned to set the table with this procedure. Consequently, the remaining three adults received intervention in which the video clips were also used as part of an error correction procedure. Specifically, if the participant did not complete the step correctly after an initial viewing of the video clip, they were prompted to watch the same video clip a second time and the trainer completed that step of the task if necessary. All three adults reached 100% correct on the task analysis when the error correction procedure was implemented. This error correction procedure may be useful for individuals who fail to learn with video prompting alone.

Activities of Daily Living↗

PubMed2006

Fostering adaptive responses and head control in students with multiple disabilities through a microswitch-based program: follow-up assessment and program revision.

A program was recently developed to promote adaptive responses and upright head position in students with multiple disabilities through the use of microswitch clusters (i.e., combinations of two microswitches). The five students exposed to the program showed a significant increase in adaptive responses performed with head upright. The first purpose of this study was to carry out a long-term follow-up assessment of the five students' frequencies of adaptive responses and percentages of those responses combined with head upright. Recordings were also made of the length of time the head position was kept during each stimulation period following a successful response event and through the sessions. The second purpose of this study was to arrange a program revision for the students with less favorable data on head upright. The revision consisted of making the stimulation following successful response events synchronous with head upright with a maximum duration of 9s per event. The results of the follow-up assessment showed that two of the students kept the upright head position for nearly the entire stimulation periods that followed successful response events as well as much of the session time. The other three students kept such position for small or intermediate portions of the stimulation periods and of the session time. For these three students, the revised program was applied with substantial benefits. Implications of the findings were discussed.

Abnormalities, Multiple↗

PubMed2006

Assessing correspondence following acquisition of an exchange-based communication system.

Two students with developmental disabilities were taught to request six snack items. Requesting involved giving a graphic symbol to the trainer in exchange for the matching snack item. Following acquisition, we assessed the correspondence between requests and subsequent item selections by requiring the student to select the previously requested snack item from an array containing all six items. The effects of acquisition training were evaluated in a multiple-probe across subjects design. Acquisition was achieved in from 9 to 29 trials per item. Following acquisition, Jason showed a high level of correspondence between requesting and selecting, but Ryan required additional training to achieve correspondence. These data support the use of exchange-based communication systems, but suggest that some students may require explicit correspondence training.

Adolescent↗

PubMed2006

Enabling students with multiple disabilities to request and choose among environmental stimuli through microswitch and computer technology.

This study assessed the possibility of enabling two students with multiple disabilities to request and choose among environmental stimuli through microswitch and computer technology. Each student was provided with two basic microswitches the activation of which made a computer system present a sample of a preferred or non-preferred stimulus. The student could select or reject such a stimulus by vocal utterances discriminated by the computer system as 'yes' or 'no'. If the student selected the stimulus, the computer system presented it for a preset time. If the student rejected the stimulus, the computer system waited for the next input of one of the basic microswitches. Data showed that both students learned to activate the basic microswitches consistently, selected the preferred stimuli about 90% of the times, and largely rejected the non-preferred stimuli. The students also showed some preferences between the two basic microswitches/responses. The performance was maintained at the post-intervention checks carried out 3 and 6 weeks after the end of the intervention. Implications of the findings are discussed technically, practically, and in terms of quality of life.

Adolescent↗

PubMed2006

Effects of embedded instruction versus discrete-trial training on self-injury, correct responding, and mood in a child with autism.

BACKGROUND: Embedded instruction and discrete-trial training are both recommended for teaching children with autism, but there is little research available comparing the two. The present study compared embedded instruction with discrete-trial training for a 12-year-old boy with autism. METHOD: An initial functional analysis indicated that the boy's self-injury was maintained by escape from task demands. Instructional sessions to teach adaptive behaviours were conducted under two conditions: (i) during embedded instruction, learning trials were inserted into ongoing activities at a rate of approximately 1.5 per minute; (ii) during discrete-trial training, instructional opportunities were incorporated into structured sessions at a rate of 4 per minute. In both conditions, the system of least prompts was used to teach relevant target responses. Effects of the two teaching formats were evaluated using an ABABA design. RESULTS: Higher rates of self-injury and fewer correct responses occurred during discrete-trial training. Mood ratings were also lower during discrete-trial training. CONCLUSIONS: The results suggest that self-injury, correct responding, and mood may be sensitive to the type of instructional format. Although discrete-trial training can be highly effective, it may be preferable to start with embedded instruction when the child presents with self-injurious escape behaviour.

Adaptation, Psychological↗

PubMed2006

Microswitch clusters promote adaptive responses and reduce finger mouthing in a boy with multiple disabilities.

The authors assessed new microswitch clusters (i.e., combinations of two microswitches) and contingent stimulation to increase adaptive responses (i.e., foot and head movements) and reduce aberrant behavior (i.e., finger mouthing)in a boy with multiple disabilities. Initially, intervention was directed at increasing the frequency of each adaptive response, individually, through contingent use of preferred stimuli. Subsequently, adaptive responses led to preferred stimuli only if they occurred in the absence of finger mouthing. Postintervention checks occurred 1, 2, and 3 months after the end of the intervention. Data showed that the boy (a) increased the frequency of the adaptive responses extensively, (b) learned to perform these responses largely free from finger mouthing, and (c) maintained these changes over time. The importance of microswitch clusters to simultaneously pursue the dual objective of promoting adaptive responses and reducing aberrant ones is underlined.

Abnormalities, Multiple↗

PubMed2006

Questions about behavioral function in mental illness (QABF-MI): a behavior checklist for functional assessment of maladaptive behavior exhibited by individuals with mental illness.

The Questions About Behavioral Function (QABF), a 25-item rating scale, was developed to identify the function(s) of maladaptive behavior in individuals with developmental disabilities. The authors adapted it for use with individuals with serious mental illness who engage in maladaptive behavior and assessed the psychometric characteristics of the new scale (Questions About Behavioral Function in Mental Illness; QABF-MI) in a sample of 135 adults with serious mental illness from three inpatient psychiatric hospitals. Staff most familiar with each person rated each item on a 5-point Likert-type rating scale, and the ratings were subjected to a number of psychometric analyses. The results of factor analyses provided a conceptually meaningful five-factor solution: physical discomfort, social attention, tangible reinforcement, escape, and nonsocial reinforcement. Congruence between the five factors derived with the QABF-MI and the corresponding factors in the original QABF was perfect. The results indicated that the QABF-MI has robust psychometric properties and may be useful as a screening tool for determining the nature of the variables that maintain maladaptive behavior exhibited by individuals with serious mental illness.

Adaptation, Psychological↗

PubMed2006

Teaching 'Yes' and 'No' responses to children with multiple disabilities through a program including microswitches linked to a vocal output device.

The present study introduced two children (a boy and a girl of 9.2 and 12.3 yr. of age, respectively, with multiple disabilities) to an intervention program for establishing Yes and No responses in relation to preferred and nonpreferred stimuli and assessed the acquisition and generalization of those responses. The program involved the use of microswitches, which monitored the nonverbal Yes and No responses performed by the children and ensured that these responses produced the matching verbal utterances via a vocal output device. Analysis showed children acquired Yes and No responses in relation to the stimuli used for the intervention and, to a comparable degree, to the stimuli used for generalization checks as well. An interview of 30 educational staff of a center for persons with multiple disabilities indicated that they considered the presence of Yes and No verbal utterances preferable to the absence of such utterances, and thought that the utterances could be helpful for the children's response acquisition and would be useful and pleasing for staff and parents. General implications of the findings were discussed.

Child↗

PubMed2005

Treatment of hand mouthing in individuals with severe to profound developmental disabilities: a review of the literature.

This paper reviews studies investigating the assessment and treatment of hand mouthing in individuals with severe to profound developmental disabilities. A literature search identified 101 studies carried out between 1969 and 2004. The trend in the studies indicated a shift away from aversive interventions in the last 10 years, so this review included studies conducted from 1995. Twenty-three studies were identified within this period and were included in this review. The 23 studies were sorted into seven intervention categories and one assessment category. The seven intervention categories included (a) antecedent interventions, (b) multicomponent interventions (e.g., differential reinforcement and response effort), (c) pharmacological interventions, (d) interventions that utilized reinforcement, (e) response blocking interventions, (f) response effort interventions, and (g) sensory stimulation interventions. The one assessment category included studies that investigated the function of hand mouthing. One main finding in these studies was that the various intervention strategies led to decreases in hand mouthing in individuals with severe to profound developmental disabilities. This finding is discussed in relation to its effect on issues of health, adaptive behavior, and social functioning. A second finding indicated that hand mouthing is often maintained by automatic reinforcement (i.e., non-social contingencies). The implications of this finding are discussed in terms of how assessments and treatments associated with automatically maintained challenging behavior might be more effectively linked. Potential issues for future research are also examined.

Child↗

PubMed2005

Mindful staff increase learning and reduce aggression in adults with developmental disabilities.

Aggression by individuals with developmental disabilities may threaten their community placement. In a multiple baseline design across group homes, we provided group home staff with behavioral training and later with mindfulness training to assess the impact on aggressive behaviors and the number of learning objectives mastered by individuals in their care. We also assessed other outcomes including activities engaged in by the individuals, use of restraint by staff, and measures of satisfaction. The effect of varying staff-resident ratios was evaluated on all measures. When compared to baseline, the number of staff interventions for aggression showed some reduction following behavioral training, but decreased substantially only following mindfulness training. There was also some increase in the number of learning objectives mastered by the individuals following behavioral training, but greater and more consistent increases were obtained only after mindfulness training. Improvements also occurred on the other measures assessed after behavioral training, but these were always greater and more consistent following mindfulness training. In addition, consistent gains followed behavioral training only with a high staff-resident ratio whereas the larger gains after mindfulness training occurred with both medium and low staff-resident ratios. Our results suggest that the addition of mindfulness training considerably enhanced the ability of the group home staff to effectively manage the aggressive behavior and learning of the individuals.

Adult↗

PubMed2005

Children with multiple disabilities and minimal motor behavior using chin movements to operate microswitches to obtain environmental stimulation.

In these two studies, two children with multiple disabilities and minimal motor behavior were assessed to see if they could use chin movements to operate microswitches to obtain environmental stimulation. In Study I, we applied an adapted version of a recently introduced electronic microswitch [Lancioni, G. E., O'Reilly, M. F., Singh, N. N., Sigafoos, J., Oliva, D., & Baccani, S., et al. (2004). Technological aids to promote basic developmental achievements by children with multiple disabilities: evaluating two cases. Cognitive Processing 5, 232-238]. In Study II, we set up a new microswitch detecting the chin-movement response through an optic sensor. Each study was carried out according to an ABAB sequence in which A represented baseline and B intervention phases. A 2-month post-intervention check also occurred. The data showed that both children increased the frequency of the chin response, thus increasing the level of environmental stimulation, during the intervention phases. This performance was retained at the post-intervention check. The overall suitability of this response and related microswitches as well as the need to explore other potential responses and microswitches for children with minimal motor behavior is discussed.

Brain Diseases↗

PubMed2004

A microswitch program to foster simple foot and leg movements in adult wheelchair users with multiple disabilities.

This study assessed a microswitch program to foster simple foot and leg movements in 2 adult wheelchair users with multiple disabilities. The participants' mood (indices of happiness) was recorded throughout the study. Data showed that participants rapidly increased the target foot and leg movements and maintained those movements during the course of the study, which lasted about 4.5 months. With regard to indices of happiness, 1 participant showed a fairly modest increase during the intervention while the other participant showed a substantial increase. Implications of the findings are discussed.

Abnormalities, Multiple↗

PubMed2004

Using paired-choice assessment to identify variables maintaining sleep problems in a child with severe disabilities.

In this study, we used a paired-choice assessment protocol to identify the relative reinforcing value of stimuli and activities for a child with severe disabilities when she failed to settle to sleep at night. The results of this assessment indicated that the child preferred the mother's attention relative to other activities presented. Assessment results were incorporated into an intervention, that produced a reduction in sleep disturbance that was maintained at a 12-month follow up.

Child, Preschool↗

PubMed2004

A microswitch program including words and choice opportunities for students with multiple disabilities.

Two students with multiple disabilities were provided with two or three request microswitches and one choice microswitch. Activation of a request microswitch triggered the verbal announcement of one of the stimulus events related to it. The student could choose such an event through the choice microswitch or bypass it. The request microswitches were introduced individually and made available simultaneously by the end of the intervention and the postintervention period. Analysis showed that both students learned to use the microswitches. Transfer of the microswitch program into the students' home was very successful with one student and presented some difficulties with the other. Implications of the findings and new possible developments were discussed.

Adolescent↗

PubMed2003

Functional analysis and intervention to reduce self-injurious and agitated behavior when removing protective equipment for brief time periods.

The authors conducted studies that were designed to maintain low levels of hand-to-head self-injury when protective equipment was removed (i.e., rigid arm sleeves and a protective helmet) for brief time periods with an individual with profound intellectual disabilities. A series of assessments was first conducted of a topographically similar form of behavior to self-injury when the person was wearing protective equipment (i.e., hitting helmet with rigid arm sleeves). Results of these assessments indicated that head hitting (with equipment) was not sensitive to social consequences (Study 1) but that it was reduced substantially when the individual had access to items that produced vibration or vibration and sound (Study 2). A treatment protocol that included items that produced vibration and vibration with sound produced substantial reductions in attempts at self-injury and agitation when protective equipment was removed for brief time periods (Study 3).

Acoustic Stimulation↗

PubMedDate not supplied

Assessing the effects of automatically delivered stimulation on the use of simple exercise tools by students with multiple disabilities.

We assessed the effects of automatically delivered stimulation on the activity level and mood (indices of happiness) of three students with multiple disabilities during their use of a stepper and a stationary bicycle. The stimulation involved a pool of favorite stimulus events that were delivered automatically, through an electronic control system, while the students were active in using the aforementioned exercise tools. Data showed that stimulation had an overall positive impact, but this was not evident on both measures (i.e., level of activity and indices of happiness) or with both exercise tools across students. These findings are discussed in relation to the outcome of an earlier study in the area by the same authors and in terms of practical implications for daily contexts.

Adult↗