Post-coma Persons Research Articles

A technology-assisted learning setup as assessment supplement for three persons with a diagnosis of post-coma vegetative state and pervasive motor impairment

Post-coma persons in an apparent condition of vegetative state and pervasive motor impairment pose serious problems in terms of assessment and intervention options. A technology-based learning assessment procedure might serve for them as a diagnostic supplement with possible implications for rehabilitation intervention. The learning assessment procedure adopted in this study relied on hand-closure and eye-blinking responses and on microswitch technology to detect such responses and to present stimuli. Three participants were involved in the study. The technology consisted of a touch/pressure sensor fixed on the hand or an optic sensor mounted on an eyeglasses’ frame, which were combined with a control system linked to stimulus sources. The study adopted an ABABCB sequence, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. Data showed that the level of responding during the B phases was significantly higher than the levels observed during the A phases as well as the C phase for two of the three participants (i.e., indicating clear signs of learning by them). Learning might be deemed to represent basic levels of knowledge/consciousness. Thus, detecting signs of learning might help one revise a previous diagnosis of vegetative state with wide implications for rehabilitation perspectives.

Technology-based intervention options for post-coma persons with minimally conscious state and pervasive motor disabilities

Background: Intervention strategies, based on learning principles and assistive technology, were assessed with four post-coma persons with minimally conscious state and pervasive motor disabilities.Method: The first study taught a man to access environmental stimulation through a response-microswitch combination and another man to access environmental stimulation and request social contact through responses combined with a microswitch or a Voice Output Communication Aid (VOCA). The second study taught a man to access two forms of environmental stimulation via two response-microswitch combinations and another man to request two forms of contact via two response-VOCA combinations.Results: Data showed that all participants had significant increases in response levels (independent of whether the responses were combined with microswitch or VOCA devices) during the intervention phases of the studies.Conclusion: Intervention strategies based on learning principles and technology may be largely helpful for persons with minimally conscious state and pervasive motor disabilities.

Learning in Post-coma Persons with Profound Multiple Disabilities: Two Case Evaluations

Finding signs of learning in post-coma persons with profound multiple disabilities (i.e., in a vegetative state or minimally responsive) would underline (a) an awareness/consciousness of their responding and its links with environmental stimuli and (b) a positive development in their immediate situation with the possibility of treatment (rehabilitation) advances. This study was aimed at assessing signs of learning in two of these persons (i.e., two adults). The learning setup involved eye blinking as the persons’ responses and microswitch technology to detect such responses and to present stimuli. The technology consisted of an electronically regulated optic sensor mounted on an eyeglasses’ frame that the persons wore during the sessions and a control system connected to stimulus sources. The study involved an ABABCB sequence, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. Data showed that the level of responding during the B phases was significantly higher than the levels observed during the A phases as well as the C phase (i.e., indicating clear signs of learning by both persons). The implications of these data for assessment and rehabilitation of post-coma persons with profound multiple disabilities are discussed.