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| The Application of Behavior Analysis within a Neuro-Behavioral Rehab Setting on Individuals with Brain Injuires |
| Sunday, May 25, 2008 |
| 10:30 AM–11:50 AM |
| 4A |
| Area: CBM; Domain: Applied Research |
| Chair: Robert S. Hirschman (Lakeview Specialty Hospital & Rehabilitation Center) |
| Abstract: Individuals with acquired or traumatic brain injuries are regularly at-risk of re-injury due to decreased levels of independent functioning, participation in at-risk/dangerous behaviors due to impulsivity issues, and participating incorrectly in normal functional activities. Through the systematic application of behavioral strategies many of these risks can be minimized and independent living skills re-learned making the return to a patient's family home or a less-restrictive community residential setting possible. This symposium will present the efficacy of behavioral treatment strategies within a neuro-rehab hospital. |
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| Doing a Stand-up Job: Using a Multi-Faceted Staff Intervention to Decrease Patient Falls within a Neuro-Rehab Hospital. |
| JAMES PARA-CREMER (Lakeview Specialty Hospital & Rehabilitation Center), Lorri Carpenter (Lakeview Specialty Hospital & Rehabilitation Center), Amber Rich (Lakeview Specialty Hospital & Rehabilitation Center), Mahin L. Para-Cremer (Lakeview Specialty Hospital & Rehabilitation Cente), Robert S. Hirschman (Lakeview Specialty Hospital & Rehabilitation Center) |
| Abstract: A common but serious problem in healthcare facilities is patient falls. Nationwide injuries resulting from falls are associated with decreases in a patient’s level of independent functioning, delays in recovery, and increases in mortality. Falls happen for many reasons such as environmental hazards (e.g., floor rugs, slippery showers, extension cords), patient behavior (e.g., confusion, physical agitation, reduced bowel and/or bladder control), and staff behavior (e.g., not using wheel chair brakes when a chair isn’t being used, insufficient monitoring of patients, not communicating potential risks to co-workers). The Joint Commission on Accreditation of Healthcare Organizations has identified reducing the risk of patient harm resulting from falls as a National Patient Safety Goal. This study reviews the efficacy of a falls reduction program in a Midwestern neuro-behavioral hospital setting across a 16 month span. The study shows that despite the implementation of antecedent interventions such as staff education through the use of departmental meetings, newsletters, and bulletin boards the rate of patient falls and patient falls resulting in injury were higher than the national average. Through the application of a multi-faceted intervention using both antecedent strategies (staff education on falls preventions strategies) and consequence strategies (in-situ performance feedback and a lottery incentive program) the number of patient falls and patient falls resulting in injury were decreased to levels at or below the national average. |
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| The Effects of a Self-Governance System on Challenging Behaviors in Individuals with Diabetes Insipidus and Acquired Brain Injury. |
| MAHIN L. PARA-CREMER (Lakeview Specialty Hospital & Rehabilitation Center), James Para-Cremer (Lakeview Specialty Hospital & Rehabilitation Center), Amber Rich (Lakeview Specialty Hospital & Rehabilitation Center), Robert S. Hirschman (Lakeview Specialty Hospital & Rehabilitation Center) |
| Abstract: Diabetes Insipidus (DI) is a condition where the body has difficulty maintaining appropriate levels of fluids resulting in blood dilution and high levels of sodium. This serious medical condition is most commonly the result of damage to the pituitary gland or the hypothalamus area of the brain. Individuals diagnosed with DI are at high risk of stroke, brain damage, or dehydration. Treatment for DI regularly requires the close management of fluid and sodium consumption.
This study reviews the effects of a self-monitoring system and opportunities for choice through daily schedules to manage patients' DI and the challenging behaviors related to fluid restriction. |
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| The Effects of Fluency Training on the Acquisition of Math Facts with Children with Brain Injuries. |
| AMBER RICH (Lakeview Specialty Hospital & Rehabilitation Center), James Para-Cremer (Lakeview Specialty Hospital & Rehabilitation Center), Mahin L. Para-Cremer (Lakeview Specialty Hospital & Rehabilitation Center), Robert S. Hirschman (Lakeview Specialty Hospital & Rehabilitation Center), Mary Ann Jandura (Hillside School) |
| Abstract: Children recovering from brain injuries regularly struggle to succeed within academic settings. Nationally, increases in classroom census and the demands placed on teachers' performance has placed a premium on the time available for individualized classroom instruction. At times these children may become frustrated with their inability to acquire or recall previously mastered skills and engage in challenging behaviors resulting in their removal from the classroom.
This study reviews the effects of brief, in-classroom fluency training sessions on the acquisition of math facts for children with brain injuries. |
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| Re-learning the Basics: Teaching a 9-Year-Old Boy the Basic Skills Necessary to Return to His Family's Home after Brain Surgery. |
| MARY LAZARUS (Lakeview Specialty Hospital & Rehabilitation Center), Matt L. Velissaris (Cardinal Stritch University), James Para-Cremer (Lakeview Specialty Hospital & Rehabilitation Center), Amber Rich (Lakeview Specialty Hospital & Rehabilitation Center), Robert S. Hirschman (Lakeview Specialty Hospital & Rehabilitation Center) |
| Abstract: This presentation is a case-review of a 9-year-old boy recovering from surgery to remove a neurofibromatosis type 1 brain stem tumor. The case-review will highlight the success found through the systematic application of multiple behavioral strategies to improve time on-task, compliance with staff directives, community access, participation in therapies, completion of school work, and awake/sleep behaviors. |
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