title: Assistive technology to help persons in a minimally conscious state develop responding and stimulation control: Performance assessment and social rating.
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.
authors.affiliation: University of Bari, Bari, Italy.
authors.forename: Giulio E
authors.initials: GE
authors.lastname: Lancioni
authors.affiliation: Medical College of Georgia, Georgia Regents University, Augusta, GA, USA.
authors.forename: Nirbhay N
authors.initials: NN
authors.lastname: Singh
authors.affiliation: University of Texas at Austin, TX, USA.
authors.forename: Mark F
authors.initials: MF
authors.lastname: O'Reilly
authors.affiliation: Victoria University of Wellington, New Zealand.
authors.forename: Jeff
authors.initials: J
authors.lastname: Sigafoos
authors.affiliation: Lega F. D'Oro Research Center, Osimo, Italy.
authors.forename: Fiora
authors.initials: F
authors.lastname: D'Amico
authors.affiliation: S. Raffaele Rehabilitation Center, Ceglie Messapica, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Buonocunto
authors.affiliation: S. Raffaele Rehabilitation Center, Ceglie Messapica, Italy.
authors.forename: Jorge
authors.initials: J
authors.lastname: Navarro
authors.affiliation: S. Raffaele Rehabilitation Center, Ceglie Messapica, Italy.
authors.forename: Crocifissa
authors.initials: C
authors.lastname: Lanzilotti
authors.affiliation: University of Bari, Bari, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Fiore
authors.affiliation: University of Bari, Bari, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: Megna
authors.affiliation: University of Bari, Bari, Italy.
authors.forename: Sabino
authors.initials: S
authors.lastname: Damiani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003128:Coma / Q000209:etiology / Q000523:psychology; D003143:Communication Devices for People with Disabilities; D004777:Environment; D005143:Eyelids; D005260:Female; D005385:Fingers; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000523:psychology* / Q000534:rehabilitation*; D011597:Psychomotor Performance; D015203:Reproducibility of Results; D012656:Self-Help Devices; D012919:Social Behavior; D013060:Speech; D013064:Speech Disorders / Q000209:etiology / Q000534:rehabilitation; D016896:Treatment Outcome; D055815:Young Adult
keywords: Assistive technology; minimally conscious state; social validation; stimulation control