An overview of intervention options for promoting adaptive behavior of persons with acquired brain injury and minimally conscious state

Microswitch technology and contingent stimulation to promote adaptive engagement in persons with minimally conscious state: a case evaluation

“…First, they provide largely new evidence as to the potential of individuals who are judged to be at the lower end of the minimally conscious state, that is, they seem to represent an encouraging assessment supplement with individuals with whom only a limited amount of data is available (see Bosco et al 2009;Bruno et al 2011;Lancioni et al 2010a;Spivey 2007). Second, they point out a new (specific) approach for intervening with these individuals.…”

“…First, several studies (particularly those dealing with multisensory stimulation and music therapy) presented weak methodological control, and consequently, their data should be interpreted with caution (Barreca et al 2003;Lancioni et al 2010a). Second, studies using transcortical or deep brain stimulation and those with multisensory stimulation or music therapy were not really directed at building forms of adaptive engagement by the person but rather at promoting abilities (e.g., attention or neurobehavioral schemes) that could be used within an environment controlled by the therapist or caregiver (Dimyan and Cohen 2010;Lancioni et al 2010a;Magee 2007;Schiff et al 2007). Third, studies using contingent stimulation and assistive technology were specifically aimed at promoting adaptive engagement, namely the performance of responses leading to specific environmental events (stimulation) (Lancioni et al 2009a, b).…”

“…The last studies pursued adaptive engagement through the (a) identification of small, feasible responses (i.e., responses that were compatible with the persons' motor impairments), (b) occurrence of positive (motivating) environmental events in connection with the emission of the responses, and (c) use of technology to monitor the responses and ensure the occurrence of the aforementioned events/stimulation automatically (Lancioni et al 2009a(Lancioni et al , 2010a.…”

Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery

“…This was first demonstrated in the 1960s when kittens were deprived of light, and after deprivation, the number of neurons in the visual cortex responding to light was reduced [19]. The rationale for providing sensory stimulation to persons in states of seriously impaired consciousness [12][13][20][21] is based largely on the "use it or lose it" principle.…”

“…In response to this need, the experimental Familiar Auditory Sensory Training (FAST) protocol was developed for examination in a double-blind randomized clinical trial (RCT). We chose to develop a sensory stimulation treatment protocol because, despite the scarcity of evidence regarding therapeutic efficacy, sensory stimulation is customarily provided to patients in states of seriously impaired consciousness [8][9][10][11][12][13].…”