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Coma arousal therapy should begin as soon as possible or when the patient is medically stable.  The brain must receive frequent and intense repetitions of the stimulus items to be stimulated.  Administration can vary from 1-8 hours/day, depending upon each individual.  Listed below are the sensory modalities to treat and suggestions for different stimulus items.      AREAS TO TREAT Sensory  Modalities Stimulus Items Auditory banging items together ring bells music loud whistle familiar voices of family/friends telephone ringing knock on door call person's name general conversation with patient television/radio Tactile temperatures (warm/cool)  touch (different fabrics such as fur, silk, feathers,         corduroy) pressure (deep pressure massage) vibrator Visual pictures of favorite people, pets, or items bright colors moving objects, flashcards (different shapes/colors) Olfactory familiar fragrance citrus coffee flowers peppermint spices eucalyptus oils garlic Taste swabs (peppermint, lemon) squeeze lemon juice on tongue mustard salt soy sauce sugar sucker Proprioception range of motion exercises (roll side to side) alternating movements (arms/legs raised) Adapted from:  Baker, J. (1988); DeYoung, S., & Grass, R.B. (1987); Mitchell S.,                             Bradley, V.A., Welch, J.L., & Britton, P.G. (1990).

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