|Behavior Analysis and Traumatic Brain Injury
|Monday, May 30, 2016
|4:00 PM–4:50 PM
|Crystal Ballroom C, Hyatt Regency, Green West
|Area: CBM; Domain: Service Delivery
|Chair: Anneka Hofschneider (Centre for Neuro Skills)
|Discussant: Chris Persel (Centre for Neuro Skills)
|CE Instructor: Anneka Hofschneider, M.A.
An estimated 2.5 million Americans sustain an isolated or compounding brain injury. According to the Centers for Disease Control (CDC), a diagnosis of Traumatic Brain Injury (TBI) affected more than 280,000 hospitalizations and 2.2 million Emergency Department visits (2010). Survivors may suffer effects lasting several days to their whole lifetime. These conditions include impairments in cognition, executive functioning, movement, sensation, and emotional and behavior functioning (CDC, 2010). Maladaptive behaviors observed following a brain injury vary across individuals. Common factors identified to contribute to their occurrence include location and severity of injury, verbal and physical skills, time post-injury, and treatment course. In addition, hospitalization and further medical treatment impact maladaptive behaviors, from pharmacological restraints to inappropriate consequence contingencies which do not address function of behavior. The purpose of this symposium is to feature several cases that have greatly benefitted from Applied Behavior Analysis procedures integrated into the Neurorehabilitation setting. Such procedures were implemented as function-based and have been observed to impact overall improvements in rehabilitation potential, level of care, and quality of life.
|Keyword(s): brain injury, independent living, neurorehabilitation
"I Love You, but I Gotta Get the !@#$% Outta Here"
|CHRIS PERSEL (Centre for Neuro Skills)
This talk will present a case study on a 49-year-old male who suffered a traumatic brain injury. Admission to a post-acute rehabilitation program with behavior analytic programming was prioritized for this individual due to history of maladaptive behaviors observed during hospitalization and acute care. Upon admission, confusion, agitation, swatting, body-shoving, exiting, and perseverative speech were observed. These behaviors appeared to be escape-maintained and impeded therapy. Procedures that included escape extinction were implemented. Cooperation and participation in therapy and safe behaviors, necessary for discharge and return to work, were measured pre- and post-implementation. Data monitoring indicated marked improvements ranging from 0% cooperation at admission to 100% cooperation at discharge. Post-intervention data demonstrated an increase to 100% cooperation at discharge. Data and graphical analyses will be presented, along with limitations.
|Brain Injury, Language Deficits, and Escape: Overcoming Challenges in Rehabilitation
|MATTHEW SABO (Centre for Neuro Skills), Anneka Hofschneider (Centre for Neuro Skills)
|Abstract: Further applications of escape-extinction procedures are analyzed. Findings from two case studies utilizing similar design procedures will be presented. Similarities between the clinical features of these cases, including receptive aphasia and apraxia, will be discussed. The first case study will discuss history, injury severity, and maladaptive behaviors as demonstrated by a 63- year-old male. Maladaptive behaviors included exiting, spitting, nonsensical speech, and yelling. Visual cues and modeling were utilized along with use of written instructions to promote skill reacquisition. Graduated guidance was utilized in compliance training. Results demonstrated gradual lessening of maladaptive behaviors with application of strategy. The second case will review the implementation of similar procedures to address confusion, yelling, and noncompliance secondary to expressive aphasia demonstrated by a 63-year-old- male. The use of escape extinction, response interruption, verbal and physical prompting will be discussed. Findings and limitations will be reviewed as well.