Basic Technology to Support Stimulation Access, Activity, and Correct Posture in Individuals With Intellectual and Multiple Disabilities: Development and Usability Study.

backgroundPeople with severe to profound intellectual disability and visual or visual and motor impairments often experience passivity and isolation. This can lead to limited environmental stimulation, reduced physical activity, and the acquisition of incorrect body postures. Approaches to improve the situation have generally involved increasing environmental stimulation, which was regulated by the context or controlled by the people through adaptive responding and assistive technology.

objectiveThis study assessed 2 intervention programs serving as extensions and advancements of previous approaches aimed at helping participants with intellectual and multiple disabilities control environmental stimulation through their own responses and assistive technology. The first program was designed to help 4 participants with severe intellectual disability and blindness alternate between periods of preferred music stimulation and mild physical activity. The second program was designed to help 5 participants with severe to profound intellectual disability, visual and motor impairments, and postural problems (ie, a tendency to tilt their torso and head forward). These participants were led to access preferred environmental stimulation, engage in mild physical activity, and increase correct posture.

methodsEach of the 2 programs was implemented according to a single-case research design. The technology for the first program involved (1) a smartphone with the MacroDroid app, which regulated the intervention conditions; (2) pressure sensors that allowed the participants to activate music stimulation; (3) a proximity sensor that monitored the participants' physical activity responses (ie, placing objects in a container high up in front of them); and (4) a mini speaker. The same technology was also used for the second program. In this program, the participants' physical activity responses consisted of arm-stretching movements, and the smartphone also served for monitoring the participants' correct posture. Within each program, a session included 7 music periods and 6 activity periods.

resultsDuring programs 1 and 2, the mean percentage of music pieces activated independently of research assistants' guidance was between 94.7% and 99.4%. The mean percentage of objects placed in the carton and of shelf-touching responses performed independently was between 98.7% and 99.7%. The baseline mean percentages were between 0% and 24.5%. The mean percentage of session time in a correct posture (program 2) increased to 71.1%-89.6% from baseline values of 18.8%-36.5%. A total of 8 of the 9 participants involved in the 2 programs showed higher levels of indices of happiness during program sessions than control sessions.

conclusionsThe results suggest that the programs might be a useful resource for supporting people with severe to profound intellectual disability and visual or visual and motor impairments.