Promoting engagement, requests and choice by a man with post-coma pervasive motor impairment and minimally conscious state through a technology-based program

We assessed a program to promote constructive engagement, requests, and choice by a man with post-coma pervasive motor impairment and minimally conscious state. The program was based on learning principles and use of assistive technology (e.g., sensors to monitor the man's responses and trigger environmental stimulation). The initial objective was the man's acquisition of a thumb response to activate visual stimulation. Next objective was his acquisition of a dual vocal response (i.e., longer or shorter vocal utterances) to call his mother and sister who presented him with various stimuli. Then, an analysis was carried out of the man's choice between vocal utterances (i.e., between mother and sister). Eventually, the thumb response and the dual vocal response were combined and an analysis of the man's choice between these responses was conducted. Data indicated that the man learned the target responses and also provided evidence of purposeful choice between the vocal utterances as well as between such utterances and the thumb response. These data were discussed in terms of usefulness of the learning paradigm and assistive technology in providing persons with multiple disabilities and consciousness disorders the opportunity to advance their condition meaningfully