|From Children to Elderlies: A Collaborative Translational Approach in Japan—With Participation From the Multicultural SIG: Multicultural Alliance of Behavior Analysts
|Sunday, May 25, 2014
|3:00 PM–4:50 PM
|W187c (McCormick Place Convention Center)
|Area: PRA/CSE; Domain: Applied Research
|Chair: Sakurako Sherry Tanaka (Mutlicultural Alliance of Behavior Analysts)
|Discussant: Jane Yip (Purdue University)
|CE Instructor: Sakurako Sherry Tanaka, Ph.D.
This special symposium presents four related yet distinct studies by the Japanese behaviour analytic practitioners who emphasize on strong multi-disciplinary team efforts: combining basic and applied, as well as cognitive, physical, and behavioral, translating autism behavior intervention into gerontology. The first paper discusses how the Upper-Body Dressing Scale (UBDS), which assesses the behavioral chains of upper-body dressing and determines prompting level , enables rehabilitation therapists to document the critical stages in dressing and to assess motor and processing skills of stroke patients. The second paper examines the relation between knee strength and lower extremity behavioral functions with dementia patients. The study contributes towards the prediction of the loss of socially valid behavior functions. The third paper provides data on predicting the recovery of cognitive, physical, and behavioral functions after stroke. It will present a logarithmic modeling with mathematical procedures that is simple enough to be adopted in daily clinical practice. The fourth paper reports a social skills training (SST) for autistic children in which the generative aspects of SST are used as social reinforcement. The use of cultural emphasis on group interaction as a potential establishing operation is discussed as an avenue to behavioral cusps.
|Keyword(s): autism, behavioral assessment, gerontology, social skill
Development of Behavioral Assessment Scale: The Upper-Body Dressing Scale for a Buttoned Shirt
|ARISA ENDO (Department of Rehabilitation Medicine, Sakuradai K), Shotaro Sasaki (Department of Rehabilitation Medicine, St. Mariann)
Post-stroke patients with hemiplegia are unable to use the same behavioral chains that are used by healthy persons to accomplish dressing tasks. However, if function-based individualized behavioral chains are learned, patients can achieve a degree of independence in dressing. We developed the Upper-Body Dressing Scale (UBDS), which assesses the behavioral chains of upper-body dressing and determines for prompts given by therapists during evaluation of upper-body dressing ability, and provided data on repricability, validity and sensitivity to clinical change. This study included two rounds of data collections: 51 stroke patients (women 25, men 38; mean age 69.4) enrolled in the first round for the purpose of item generation and repricability, and 161 stroke patients (women 67, men 94; mean age 67.6) participated in the second round for questionnaire validation. Intra-class correlation coefficient was 0.87-0.99 for repricability. The level of correlation between UBDS score and the dressing item scores of activities daily living scales were 0.84 to 0.85. The score and duration of UBDS on the first day of training was a significant independent predictor of dressing ability. This detailed UBDS assessment enables rehabilitation therapists to document the most difficult stages in dressing and to assess motor and process skills for independence of dressing.
|The Relation Between Knee Extension Strength and Lower Extremity Behavioral Functions
|NAOYUKI CHIBA (Department of Rehabilitation Medicine, Sakuradai Kojinkai Hospital), Yoshitsugu Omori (Department of Rehabilitation Medicine, St. Marianna University, Yokohama City Seibu Hospital)
|Abstract: Lower limb weakness has been identified as an important risk factor for inability to perform behavioral functions. Despite the benefit of behavioral training programs, little is known about the relation between knee extension strength and behavioral functions. We assessed the relation between knee extension strengths and socially valid behavioral functions. This study included two rounds of data collections: 56 dementia patients (women 45, men 11; mean age 84.5) enrolled in the first round and 183 elderly male patients (median age 81.0) participated in the second round. Throughout the strength measurement, each subject was given consistent verbal encouragement and praise as reinforcement. Knee extension strength was a significant predictor of the ability to dress the lower body, toileting, and transferring to bed/toilet/shower. The curve of the negative and positive predictive values indicated that a cut off score of 0.8 Nm/kg would provide the best balance for dressing the lower body and toileting; and 1.2 Nm/kg for transferring to bed/toilet/shower. In addition, the association between knee extension strength and gait speed was curvilinear. Below 0.37 of normalized strength against body weight, the walking speed reduced remarkably. These cut-off values of knee extension strength contribute towards prediction of the loss of behavioral functions.
Predicting Recovery of Cognitive, Physical and Behavioral Functions
|MAKOTO SUZUKI (Kitasato University)
The accurate prediction facilitates proper definition of goals of intervention for individual patients, thus improving the quality and efficacy of behavioral interventions. We provided data on predicting the recovery of cognitive, physical and behavioral functions after stroke. This study included two rounds of data collections: 43 stroke patients (women 24, men 19; mean age 72.4) enrolled in the first round for prediction of cognitive recovery, and 21 stroke patients (women 11, men 10; mean age 73.5) participated in the second round for prediction of physical and behavioral functions recovery. All patients received conventional rehabilitation training for 5 days per week. The patients were given specific feedback and praise as reinforcement concerning cognitive, physical and behavioral functions. The time course of early-phase recovery for cognitive, physical and behavioral functions resembled logarithmic function. Scores of cognitive, physical and behavioral functions sampled at two baseline points based on logarithmic regression modeling could estimate prediction of those recoveries (cognitive function, R2 = 0.52-0.68, p < 0.0001; physical functions, R2 = 0.74-0.95, p < 0.0001; behavioral function, R2 = 0.78-0.80, p < 0.0001). This logarithmic modeling with mathematical procedures is simple enough to be adopted in daily clinical practice.
From Social Skills Training to Behavioral Cusps: Aren't We Just Having Fun?
|KOZUE MATSUDA (Children Center), Sakurako Sherry Tanaka (Mutlicultural Alliance of Behavior Analysts)
Social skill is the ability to elicit social reinforcement from others. In this study, we examined five children with autism, ages 6 to 7 years old, none of whom exhibited social interaction with peers at their own preschools. We implemented a social skills training (SST) in summer school. Prior to the summer school, we conducted functional behavioral assessments in each childs own school setting to identify the target behavior based on social validity and the current baseline, and planned a curriculum and activities that included social reinforcement. During the summer session, we use the generative aspect of SST and the activities as social reinforcement rather than preceding tangible reinforcement or token economy system. The data was gathered from direct observations as well as videotaped. The study reveals that each childs social interaction increased almost immediately at the start of summer school and was maintained until the final days of classes. The use of cultural emphasis on group interaction as a potential establishing operation is discussed as an avenue to behavioral cusps.