Evaluating the Effectiveness of Different Environments on the Learning of Switching Skills in Children with Severe and Profound Multiple Disabilities

Abstract

This exploratory study evaluated the effects of learning switching skills for children with severe and profound multiple disabilities using a multisensory environment and the child's natural environment. Method: A multiple baseline study was employed to investigate the ability of three preschool aged children to learn switching skills in different environments, in association with the development of desired behavioural changes. Observational data were collected on the development of switching skills and on psychosocial changes. Results: The visual inspection of client data revealed improved switching skills with two participants. The third participant, the constant series control, developed switching skills which then decreased; however, significant development in a range of motor and social skills was reported in qualitative interview. Adaptive behaviours improved in all three participants, including behaviours such as reduced frustration and associated crying and eliciting of primitive reflexes. Conclusion: Qualitative interviews with two parents indicated significant changes to behaviour, with a resultant positive effect on the families, strongly supporting the development of psychosocial skills in children with severe and profound multiple disabilities as a result of development of switching skills.

Assistive technology assessment tools for assessing switch use of children: A systematic review and descriptive analysis

“…The assessment tools reviewed include the Switching and Associated Behavioural Response Schedule (SABRS) [11], the Area Cooperative Educational Services (ACES): Assistive technology services referral form [19], Wisconsin Assistive Technology Initiative (WATI): Section 1, Fine motor for computer access [20,21], the Lifespace Access Profile (LAP) [7,22], the Robot Skills [23] and the Barnsley Active Switch Environment (BASE) data logging tool [5]. Are these assessments targeting the children with physical or multiple disabilities?…”

“…For example the SABRS and Robot Skills assessments were designed to collect data at baseline and after an intervention had been applied and therefore required simple methods of scoring to compare the child's switching skills before and after the applied intervention [11,23]. A simple overall scale rating was used for the Robot Skills assessment tool which assessed a child's cognitive ability when using a switch from zero to six [23].…”

“…Both the SABRS and Robot Skills assessment table were used to gather data for a research study while the BASE data logging tool was designed to supplement data collected using other methods [5,11,23].…”

“…As the SABRS's purpose was to gather data on frequencies of displayed behaviours, the categories and more specific items measured had to be associated with behaviours of which frequency can be measured e.g. the number of times a child successfully activates the switch [11]. The level of diversity in categories of the SABRS is not seen in Records idenƟfied through data base searching n=1779…”

“…Moir [11] found insufficient validated, reliable and sensitive assessment tools to measure switch use in children with physical and multiple disabilities. Nicolson et al [12] suggested that greater quantitative research, in the field of assistive technology, is needed which uses reliable and valid outcome measures.…”