Learning in post-coma persons with profound multiple disabilities: Two case evaluations

Finding signs of learning in post-coma persons with profound multiple disabilities (i.e., in a vegetative state or minimally responsive) would underline (a) an awareness/consciousness of their responding and its links with environmental stimuli and (b) a positive development in their immediate situation with the possibility of treatment (rehabilitation) advances. This study was aimed at assessing signs of learning in two of these persons (i.e., two adults). The learning setup involved eye blinking as the persons' responses and microswitch technology to detect such responses and to present stimuli. The technology consisted of an electronically regulated optic sensor mounted on an eyeglasses' frame that the persons wore during the sessions and a control system connected to stimulus sources. The study involved an ABABCB sequence, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. Data showed that the level of responding during the B phases was significantly higher than the levels observed during the A phases as well as the C phase (i.e., indicating clear signs of learning by both persons). The implications of these data for assessment and rehabilitation of post-coma persons with profound multiple disabilities are discussed.