Microswitch-cluster technology to enhance adaptive engagement and head upright by a post-coma man with multiple disabilities

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Abstract
To evaluate microswitch-cluster technology to help a post-coma man with multiple disabilities increase adaptive responding and reduce head forward tilting. The intervention programme initially focused on promoting a simple adaptive response (i.e. manipulating and moving a wobbling, ball-like device), which produced brief periods of preferred stimulation. Subsequently, this response produced the stimulation only if performed in the presence of head upright. Moreover, the stimulation lasted the scheduled time only if the head upright was maintained. Data showed that the programme was successful in increasing the frequency of adaptive responses and in reducing the unhealthy posture of head forward tilting. Toward the end of the programme, the participant performed virtually all responses with his head upright and kept this posture through nearly the entire length of the sessions. Microswitch-cluster technology might help post-coma persons with multiple disabilities improve adaptive engagement and head posture simultaneously.