Applying Skinner's analysis of verbal behavior to persons with dementia

Skinner's 1957 analysis of verbal behavior has demonstrated a fair amount of utility to teach language to children with autism and other various disorders. However, the learning of language can be forgotten, as is the case for many elderly suffering from dementia or other degenerative diseases. It appears possible that Skinner's operants may facilitate not only acquisition of language but also the ability to recall items or objects that may have appeared to be “forgotten.” The present study examined the utility of having a series of adults in long-term care emit tacts, echoics, or intraverbals upon presentation of various visual stimuli. Compared to a no-verbal response condition, it appears that the incorporation of Skinner's verbal operants can in fact improve recall for this population. Implications for the retraining of lost language are presented.     

The role of context in remembering familar persons: insights from semantic dementia

Semantic dementia (SD) is a progressive condition characterized by an insidious and gradual breakdown in semantic knowledge. Patients suffering from this condition gradually lose their knowledge of objects and their attributes, concepts, famous persons, and public events. In contrast, these patients maintain a striking preservation of autobiographical memory. The aim of the present study was to examine in a patient suffering from SD the role of context in the ability to recall knowledge of familiar persons. In an experiment, patient J.M. was asked to name and identify familiar persons that appeared on family photographs from recent and remote periods of her life. In the first experimental condition, the pictures represented personally familiar persons present in a specific spatial and temporal context. In a second experimental condition, the pictures showed personally familiar persons who were presented without any specific episodic context. Results indicate that the patient was able to name and identify familiar persons irrespective of the context of presentation (with/without context) and of the time period (recent/remote). No temporal gradient was found using family photographs. Finally, in contrast with familiar persons, J.M. presented a severe anomia for celebrities. Results are discussed in light of recent research in the field.     

Brief report: Non-intrusive operant analysis of aggressive behavior in persons with mental retardation

A procedure for operant analysis of aggressive behavior was derived from multi-element assessment methods that have been previously applied to both self-injurious and stereotypic responding. Analog sessions included No Interaction Baseline, Social Disapproval, Demand, Social Reinforcement, and Discriminated Extinction conditions, repeatedly presented within a multi-element design. Three men with differing severity of mental retardation, communicative deficits and aggressive behavior were exposed to multiple brief analog sessions embedded within their normal meal-time routines in group home settings. Mean frequencies of aggressive behavior and concurrent eating indicate that, while aggressive behavior was negatively reinforced in all three participants, both social and non-social contingencies were also prominent. The same contingencies which have been demonstrated to maintain self-injury and stereotypic behavior can therefore also maintain aggression. Results suggest the feasibility of conducting relatively non-intrusive analog assessments in community residences, and support the-extension of functional analysis across differing classes of aberrant behavior.     

The role of neuropsychology in the assessment and treatment of persons with epilepsy.

Several areas of current interest in the neuropsychology of epilepsy are briefly reviewed in this article. These include variables pertaining to seizures, seizure history, antiepileptic drugs, and methods of neuropsychological evaluation. It is apparent that epilepsy is a multifaceted area: Psychologists not only can be of great assistance to patients with this condition, but may also learn a great deal from this complex disorder.     

Evaluating the influence of time of day on activity engagement in persons with dementia

Dementia is a serious disease affecting a growing number of people. With the onset of dementia comes a decline in social activity engagement that can negatively impact multiple aspects of a person's life. Research suggests that time of day may influence a person with dementia's behavior, including activity engagement, but such research is limited. The purpose of this study was to evaluate the influence of time of day on engagement in activities in persons diagnosed with dementia. An alternating treatments design was used with three participants to measure activity engagement during two times of day, morning and afternoon, and during two activities, a moderately preferred and a low preferred. Results showed no differentiation in engagement between morning and afternoon activities for all three participants, with high levels of engagement during both times of day. For two participants, results showed no differentiation in engagement between moderately preferred and low preferred activities. For one participant, levels of engagement were higher during moderately preferred activities than during low preferred activities.     

The role of the pupil's size in the perception of other persons

Studies by Hess (1975) show that the pupil serves as a source of information in perception of the emotional state of another person. Large pupils are interpreted in a positive sense. Basing on the results of Hess, the hypothesis that pupil size does not become a relevant variable in person perception until after puberty, was formed. The following result would be interpreted as supporting the hypothesis: since girls reach puberty before boys, more girls should react to pupil size than boys of the same age. 121 students between the ages of 11 and 16 years judged in several statements which of two face photos of a teacher expressed a greater degree of positive attention and esteem towards the students. The two face photos were identical with the exception of pupil size. All age groups rated the photos with larger pupils more positively. Sex differences occurred in the ratings of the 11 to 12-year-olds. Some basic differences between this experiment and that of Hess are discussed.     

Response consistency on a semantic memory task in persons with dementia of the Alzheimer type

The purpose of this investigation was to determine the test-retest response consistency rate on a semantic memory task in persons with dementia of the Alzheimer type (DAT). Ten mildly and 13 moderately impaired DAT subjects and 14 normal controls matched for age, years of education, and estimated IQ participated in this study. The Peabody Picture Vocabulary Test (PPVT) was administered twice to each subject with a 7-day intertest interval. The mild and moderate DAT subjects responded inconsistently to significantly more PPVT items than normal controls. When the effects of guessing were considered, moderate DAT subjects gave significantly more inconsistent PPVT responses than normal controls and mild DAT subjects showed a trend toward giving more inconsistent responses. These results substantiate the conclusion that the impairment of specific conceptual knowledge in DAT subjects cannot be reliably measured with a single administration of a semantic memory task such as the PPVT.     

Translational behavior analysis: from laboratory science in stimulus control to intervention with persons with neurodevelopmental disabilities

Throughout its history, laboratory research in the experimental analysis of behavior has been successful in elucidating and clarifying basic learning principles and processes in both humans and nonhumans. In parallel, applied behavior analysis has shown how fundamental behavior-analytic principles and procedures can be employed to promote desirable forms of behavior and to prevent or ameliorate undesirable forms in clinical, educational, and other settings. Less obviously, there has also emerged a small but identifiable bridging field that can potentially connect and inform both basic and applied behavior analysis. Although such translational behavior analysis uses laboratory methodologies, research targets are selected largely for their value in ultimate application to improve the human condition. I will discuss the distinction of translational behavior analysis from basic and applied behavior analysis and consider the potential contribution that translational research can make in the development of the science of behavior.     

The longitudinal effects of early behavior problems in the dementia caregiving career

Using multiregional, 3-year data from early career dementia caregivers, this study determines how behavior problems that occur early in the caregiving career influence time to nursing home placement and change in burden and depression over time. A Cox proportional hazards model indicated that caregivers who managed frequent behavior problems earlier are more likely to institutionalize. After controlling for important time-varying covariates in a series of growth-curve models, caregivers who were faced with severe, early behavior problems reported greater increases in burden and depression over the 3-year study period. The findings suggest the need to consider experiences early in the dementia caregiving career when accounting for key longitudinal outcomes and also emphasize the importance of attrition when attempting to model the health implications of informal long-term care over time.     

A DBT Skills training group for family caregivers of persons with dementia

A Dialectical Behavior Therapy Skills training manual (DBT Skills) was adapted for use with caregivers of individuals with dementia. Implementation occurred in a community clinic with a heterogeneous caregiver group at risk for elder abuse. Sixteen caregivers completed the 9-week group. The results point to improved psychosocial adjustment, particularly increased problem-focused coping, enhanced emotional well-being, and less fatigue. Caregivers tended to utilize individual therapeutic services at a higher rate during the period of group attendance, indicative of appropriate help-seeking behavior in highly demanding situations. Six of the 16 caregivers repeated the training sequence in “booster” groups. Follow-up data from the booster groups suggest that high-risk caregivers may require continuing support to maintain treatment gains. In addition to demonstrating the feasibility of DBT Skills with caregivers, the results warrant a controlled outcome evaluation.     

Exploring the utility of functional analysis methodology to assess and treat problematic verbal behavior in persons with acquired brain injury

Functional analyses were conducted on four adults with acquired brain injuries who regularly displayed instances of inappropriate verbal behavior including depressive, aggressive, suicidal, profane, and sexually inappropriate utterances. After the functional analysis yielded a maintaining variable for each participant, a function‐based intervention consisting of differential reinforcement of alternative verbal behavior was implemented. Results of the behavioral interventions show that instances of vocal behavior can be assessed and subsequently treated using the functional analysis methodology often reserved for nonverbal forms of behavior. The utility of functional analysis for assessing complex human behavior is discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

The role of inhibition in neurotic behavior

Neurotic behavior is explained according to the theory of Pavlov as collision between excitation and inhibition. This internal inhibition imposes a burden on the nervous system. The stress can be relieved by what Pavlov called external inhibition, which is actually excitation of another activity. This principle is applied to the human being in explaining the interaction between nervous centers, the advantage of voluntary self-discipline over imposed discipline. Rioting and social unrest is explained in the terms of conflict between excitation and inhibition.