Post-coma persons with motor and communication/consciousness impairments choose among environmental stimuli and request stimulus repetitions via assistive technology

This study assessed whether a program based on microswitch and computer technology would enable three post-coma participants (adults) with motor and communication/consciousness impairments to choose among environmental stimuli and request their repetition whenever they so desired. Within each session, 16 stimuli (12 preferred and 4 non-preferred) were scheduled for the participants. For each stimulus, a computer system provided a sample of a 3-s duration. During the intervention, participants’ responding (e.g., eye blinking and hand closure) in relation to a stimulus sample activated a microswitch and led the computer system to turn on that stimulus for 20 s. Participants’ lack of responding led the computer system to pause briefly and then present the next scheduled stimulus sample. When participants responded immediately after (i.e., within 6 s from) the end of a stimulus presentation, that stimulus was repeated. Intervention data showed response increases, which were very consistent for two participants and moderate for the third one. All participants asked for the repetition of preferred stimuli and showed minimal responding in relation to non-preferred stimuli. The results were discussed in light of their possible implications for new, person-centered rehabilitation programs for post-coma persons with multiple disabilities.