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Res Dev Disabil. 2014 May;35(5):1110-8. doi: 10.1016/j.ridd.2014.01.029. Epub 2014 Feb 28.

Occupation and communication programs for post-coma persons with or without consciousness disorders who show extensive motor impairment and lack of speech.

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University of Bari, Italy. Electronic address:
Medical College of Georgia, Georgia Regents University, Augusta, USA.
University of Texas at Austin, USA.
Victoria University of Wellington, New Zealand.
S. Raffaele Rehabilitation Center, Ceglie Messapica, Italy.
University of Bari, Italy.


These two studies were aimed at extending the assessment of technology-aided programs for post-coma persons with extensive motor impairment and lack of speech. Specifically, Study I assessed a new program arrangement, in which stimulation access and caregiver attention could be obtained with variations of the same response (i.e., single- versus double-hand closure) by three participants who were diagnosed at the upper level of the minimally conscious state at the start of the study. Study II was aimed at enabling two persons who had emerged from a minimally conscious state to engage in leisure activities, listen to audio-recordings of family members, and send and receive messages. The responses selected for these participants were hand pressure and eyelid closure, respectively. The results of both studies were positive. The participants of Study I increased their responding to increase their stimulation input and caregiver interaction. The participants of Study II managed to successfully select all the options the program included (i.e., the leisure options, as well as the family and communication options). General implications of the programs and the related technology packages for intervention with post-coma persons with multiple disabilities are discussed.


Communication; Emergence from minimally conscious state; Leisure; Minimally conscious state; Stimulation; Technology-based programs

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