Raincoats are regular attire for Richard and Muriel Saunders when they travel to Seattle. Seattle is a research site for a research project funded by the National Institutes of Health on microswitch use in persons with profound multiple impairments. The research is conducted at Fircrest, a residential facility that is home to approximately 200 individuals with mental retardation. The Saunders work with staff and residents in the Skilled Nursing Facility (SNF), although parts of the facility also have ICF-MR funding. The individuals served in the SNF require 24-hour nursing care. All residents have multiple impairments: 74% have severe orthopedic impairments including contractures, scoliosis, quadriplegia, and so forth; 72% are blind or severely visually impaired; 23% are deaf or hearing impaired; 95% have a diagnosed seizure disorder; and 46% are fed by tube. None of the participants have the ability to reach and grasp objects. None have the ability to communicate either by spoken word, communication devices, gestures, or in many cases, by facial expression.
The Saunders are investigating ways to enable these individuals to control their personal environments and to request attention through the use of a microswitch. A microswitch may be a pressure-sensitive disk, joy-stick, mercury filled tube, or motion detector. When the switch is closed, moved, or otherwise enabled, it causes electricity to flow to an electrical device. Leisure items that can be controlled by Fircrest residents include audio tape players, fans, vibrators, mechanical toys, and computer-delivered entertainment. The signal devices are usually those that buzz or “ding dong” when the switch is closed.
Microswitches are prevalent in schools serving children with multiple impairments, so why did the Saunders choose Seattle as a research site? SNF staff typically are not aggressive about providing training in areas of communication and learning. Fircrest staff began making microswitches around 1985 and before switches were commercially available. Staff also designed and produced a databox that automatically measured the number and length of switch closures. Although staff no longer make switches, they are able to repair them. They also have refined their databox. Therefore, the site offered a knowledgeable and eager staff who were interested in continuing their ongoing switch program. Dr. Leslie Olswang, Associate Director of the Speech and Hearing Department, also showed an interest in the research and was willing to provide graduate students to act as research assistants.
The project is currently in its third year of funding. Three Masters-level students and one Ph.D.-level student have worked on the project. In addition, 5 speech-language pathologists, 1 psychologist, 3 recreation therapists, and 3 program coordinators from Fircrest have assisted with the project. Muriel and Dick communicate regularly by phone and email as well as access to a common website.
Visits to Seattle occur every 6-8 weeks, and yes, it always rains except in the middle of summer. The temperature is typically around 55° all year. As some of you may know, the Saunders have acted as consultants to the Fircrest program for a number of years. Seattle has had two major snowstorms in the last decade and both occurred during their visits. Unfortunately, Fircrest staff think of the Saunders as harbingers of snow to their rainy city.