Association for Behavior Analysis International

As the aging population continues to grow and the prevalence of neurocognitive disorder increases, there is an increased need for behavioral gerontology and opportunities for research with a wide range of empirical questions needing to be answered. This will ultimately inform behavior analytic treatments available and increase the quality of life of older adults diagnosed with neurocognitive disorder (NCD). This symposium includes three talks that will cover wide applications of behavioral gerontology from basic preparations: (a) Stimulus control and Extinction with Older Adults with Neurocognitive Disorder: A Basic Research Study, in which researchers will present data from an ongoing evaluation on reinforcement, extinction and stimulus control; (b) Reinforcer Identification Form- a Tool to Identify Preferred Stimuli for Older Adults with Neurocognitive Disorder. Researchers will present on the development and use of a tool to assist in the identification of preferred stimuli; and (c) Lounge Layout to Facilitate Communication and Engage People with Dementia, which will expand upon previous literature by demonstrating the importance of living arrangement design and the impact of modifications of those arrangements on older adults’ communication and engagement levels.

graduate students in behavior analysis, board certified behavior analysts, behavioral gerontology practitioners, behavioral gerontology researchers.

The effects of extinction have been demonstrated in community dwelling older adults (Plaud, Plaud, & Duvillard, 1999), but to date, there have been limited empirical demonstrations of the the effects of extinction for older adults with neurocognitive disorder. Therefore, the purpose of the study was to examine whether withdrawal of a reinforcer from a previously reinforced behavior would result in behavior change for this population. This study extends a study presented last year with the use of a multielement design rather than a reversal. Preferred stimuli (pictures) were identified prior to implementation through use of a preference assessment followed by reinforcer assessment. The effects of the schedules were assessed with a computer program on a tablet PC. Conditions were signaled by the presentation of various shapes along with the buttons. The effects of reinforcement were compared with extinction and/or non-contingent reinforcement schedules. The experimental arrangement consisted of a presentation of two buttons that (a) would activate a preferred picture; (b) produce nothing (in the extinction condition); or (c) produced nothing (but pictures were available on a time-based schedule). These data will be discussed with respect to the implications for both basic and applied research.

An important line of research within behavioral gerontology has been skill acquisition and activity engagement procedures with older adults with neurocognitive disorder. A critical underlying aspect of such work is to ensure that the stimuli that are being used in these procedures are functioning as reinforcers. Currently, research on preference assessments with older adults appears to involve the arbitrary selection of items informed by existing structured, close-ended and non-individualized tools. This approach is problematic because it may lead to the identification and selection of items that may not be preferred by an individual, and can lead to poor programming. Therefore, the purpose of this study is to evaluate the utility of a new tool, The Reinforcer Identification Form, and to validate the items identified by implementing a stimulus preference assessment and a modified engagement assessment.

Direct measures of indices of happiness, engagement, and communication can serve as proxies for measures of quality of life in people with dementia. The design of care settings for people with dementia is often guided by expert opinion rather than empirical data. We evaluated the effect of arranging lounge furniture in different configurations on communication, engagement with activities, and indices of happiness in people with dementia living on a specialized dementia ward. We found that the common configuration of chairs placed around the outside of the room resulted in the least communication, engagement, and indices of happiness. Communication occurred most when the furniture was arranged in small groups, and engagement occurred most when the furniture was arranged to maximize the salience of the available activities. Our data show that simple antecedent manipulations that do not require extensive staff training or involvement can improve the quality of life of people with dementia in care settings.