Behavior state is potentially a major variable that affects the level of alertness and responsiveness of persons with profoundly handicapping conditions. Two studies were conducted involving 50 students with severe, profound, and multiply handicapping conditions who ranged in age from 1 year and 8 months up to 21 years. In Study 1, behavior slate conditions for each student were observed across 20 sessions in classroom settings. Data were analyzed according to profile groups that reflected similarities and differences in behavior state conditions. The analyses also included short and long term measures of state stability. Results indicated that these stability measures further differentiated the profile groups. The data also showed that the students were observed to spend an average of 42% of their classroom time in slate conditions that were not judged optimal for learning. In Study 2, developmental, medical, environmental, and student characteristic data were compared statistically for the profile groups identified in Study 1. These results showed some different characteristics and conditions associated with each of the behavior state profiles. Overall results suggested that behavior state conditions have significant implications for the education and treatment of students with the most profound handicaps.
Behavior states and related developmental and medical variables were observed during all or part of the first 4 years of life for 34 infants identified with severe cognitive and multiple disabilities. Eight infants died before 1 year of age. Extensive data were then collected for an additional group of 8 infants who were observed through the age of 4 years. Findings demonstrated emerging state profiles during this time period that were consistent with those found among older populations observed in previous investigations. Different behavior state profiles at age 4 years were indicated by several developmental skills in the first year of life. These results suggest the need for specific, early interventions with infants whose state patterns are inconsistent with optimal learning and development.
This article presents the results of a multiple baseline design, across subjects, to assess the effect of vibratory stimulation on head-erect behavior in subjects who were prone. The subjects were three children with severe multiple handicaps whose mean age was 2 years 4 months and whose conditions included seizures and muscle tone disorders. Frequency of head lifts and cumulative duration of head-erect behavior were recorded during three-minute sessions with the subjects positioned prone on their forearms over a wedge. After baseline observations were recorded, vibration was applied to the paraspinal muscles of the neck and upper back for the first two minutes of each intervention session. In addition, electromyographic activity was recorded for a three-minute session at least once during both the baseline and intervention conditions. Results of the study demonstrated an increase in the cumulative duration of head-erect behavior for the three subjects and an accompanying increase in EMG activity during muscle vibration. The diversity of handicapping conditions (ie, seizures, hypertonia, and hypotonia) appeared to have no effect on the benefits received from muscle vibration for these subjects. Limitations of the study and implications for future research are discussed.
A review is presented of recent research on state behavior among children and youth with profound disabilities. A model depicting interactions of state with endogenous and exogenous variables is presented along with a discussion of the importance of state diversity potential to this analysis and considerations for investigating and understanding state organization patterns in this population. Applications of the model are illustrated through case studies of four students with profound disabilities who display different state patterns. Measurable attributes of state reveal major characteristics that define functionally profound disabilities and have important implications for intervention.
A multiple baseline design across subjects was used to assess the effect of vestibular stimulation on the acquisition of erect and symmetrical sitting of preschoolers with severe and multiple handicaps. The subjects were three children aged 3-5 with various handicapping conditions. Measurements of erect and symmetrical sitting were taken in separate 3-minute time samples following vestibular stimulation. All three subjects made gains in erect sitting. Results from the symmetrical sitting measure were less conclusive. The two subjects with athetosis appeared to maintain these gains across a 4-month follow-up period while the subject with hypertonicity did not.
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