The role of behavior analysis in the rehabilitation of persons with dementia

With the rapidly aging population, it is expected that increases in cases of dementia will double over the next 20 years. Currently, there is no cure for diseases such as Alzheimer's disease or frontotemporal dementia (FTD) that cause progressive dementia, and only a few pharmacological interventions that slow the progression of the decline exist. Given that there is no cure available, a rehabilitation approach that emphasizes maintaining existing abilities and removing excess disability (as opposed to emphasizing cure or recovery) for as long as possible is warranted. The current paper proposes that nonpharmacological rehabilitation efforts need to target 5 broad areas/targets: memory enhancement, altering social contingencies and communication styles, improving self-care skills, the arrangement of physical environments to maintain and improve functioning, and increasing physical fitness/physical activity. The purpose of this paper is to review specific behaviorally oriented interventions that target these 5 areas and show promise for inclusion in comprehensive rehabilitation efforts for individuals with dementia.     

Novel metaphor comprehension: Semantic neighbourhood density interacts with concreteness

Previous research suggests that metaphor comprehension is affected both by the concreteness of the topic and vehicle and their semantic neighbours (Kintsch, 2000; Xu, 2010). However, studies have yet to manipulate these 2 variables simultaneously. To that end, we composed novel metaphors manipulated on topic concreteness and semantic neighbourhood density (SND) of topic and vehicle. In Experiment 1, participants rated the metaphors on the suitability (e.g. sensibility) of their topic-vehicle pairings. Topic concreteness interacted with SND such that participants rated metaphors from sparse semantic spaces to be more sensible than those from dense semantic spaces and preferred abstract topics over concrete topics only for metaphors from dense semantic spaces. In Experiments 2 and 3, we used presentation deadlines and found that topic concreteness and SND affect the online processing stages associated with metaphor comprehension. We discuss how the results are aligned with established psycholinguistic models of metaphor comprehension.     

Healthy and chronically‐ill children's generalisation of illness to biological and non‐biological categories

Using children's naïve theory of biology as a framework, this study investigated children's developing understanding of illness by examining their generalisation of illness to biological and non‐biological categories. In addition to differences associated with age, the children's health status was investigated for any possible linkwith their understanding. Healthy and chronically‐ill children, aged 4–11 years, were randomly assigned to one of three conditions, according to which exemplar (child, dog or duck) was described as suffering from an imaginary illness. Using a card‐sorting technique, the children assessed whether each entity out of 30 entities (five representatives in each of six categories: humans, mammals, non‐mammals, birds, plants and artifacts) could be afflicted by that illness. The children's generalisations indicated a grasp of the distinctiveness of the various categories, although they seemed less certain about the biological status of plants. Furthermore, the type of exemplar on which the children had been taught influenced their responses. However, the children's reasoning appeared unaffected by their health status and largely unaffected by age or gender. Copyright © 2004 John Wiley & Sons, Ltd.     

Modeling the Information Preferences of Parents of Children with Mental Health Problems: A Discrete Choice Conjoint Experiment

Although materials informing parents about children’s mental health (CMH) problems can improve outcomes, we know relatively little about the design factors that might influence their utilization of available resources. We used a discrete choice conjoint experiment to model the information preferences of parents seeking mental health services for 6 to 18 year olds. Parents completed 30 choice tasks presenting experimentally varied combinations of 20 four-level CMH information content, transfer process, and outcome attributes. Latent class analysis revealed three segments with different preferences. Parents in the Action segment (43%) chose materials providing step-by-step solutions to behavioral or emotional problems. They preferred weekly meetings with other parents and coaching calls from a therapist. The Information segment (41%) chose materials helping them understand rather than solve their child’s problems. These parents were more sensitive to logistical factors such as receiving information in groups, the location where information was available, the modality in which the information was presented, and the time required to obtain and use the information. The Overwhelmed segment (16%) reported more oppositional and conduct problems, felt their children’s difficulties exerted a greater adverse impact on family functioning, and reported higher personal depression scores than those in the Action or Information segments. Nonetheless, they did not choose information about, or solutions to, the problems their children presented. Simulations predicted that maximizing utilization and realizing the potential benefits of CMH information would require knowledge transfer strategies consistent with each segment’s preferences.

Enhancement and the ethics of development

Much of the debate about the ethics of enhancement has proceeded according to two framing assumptions. The first is that although enhancement carries large social risks, the chief benefits of enhancement are to those who are enhanced (or their parents, in the case of enhancing the traits of children). The second is that, because we now understand the wrongs of state-driven eugenics, enhancements, at least in liberal societies, will be personal goods, chosen or not chosen in a market for enhancement services. This article argues that both framing assumptions must be rejected, once it is understood that some enhancements--especially those that are most likely to garner resources and become widespread--will increase human productivity. Once one appreciates the productivity-increasing potential of enhancements, one can begin to see that enhancement need not be primarily a zero sum affair, that the social costs of forgoing enhancements may be great, and that the state may well take an interest in facilitating biomedical enhancements, just as it does in facilitating education and other productivity-increasing traditional enhancements. Appreciating the productivity-increasing potential of enhancements also makes it possible to view the enhancement debate in a new light, through the lens of the ethics of development.     

Publication trends in behavioral gerontology in the past 25 years: are the elderly still an understudied population in behavioral research?

The case is made that issues facing the elderly are problems of social importance that should be of interest to applied behavior analysts. An electronic review of eight prominent behaviorally‐oriented journals was conducted in order to examine the frequency of publications over the past 25 years that were concerned with issues related to aging. A total of 109 articles were devoted to aging across the eight journals, with about 30% of these involving participants with cognitive impairments. Results also indicate that each of these journals has published less than one article per year related to aging. The role behavior analysts can play in serving both the elderly and their caregivers is discussed. Copyright © 2008 John Wiley & Sons, Ltd.     

Retrieval of emotional memories

Long-term memories are influenced by the emotion experienced during learning as well as by the emotion experienced during memory retrieval. The present article reviews the literature addressing the effects of emotion on retrieval, focusing on the cognitive and neurological mechanisms that have been revealed. The reviewed research suggests that the amygdala, in combination with the hippocampus and prefrontal cortex, plays an important role in the retrieval of memories for emotional events. The neural regions necessary for online emotional processing also influence emotional memory retrieval, perhaps through the reexperience of emotion during the retrieval process.     

Right-handers' reaching in contralateral hemispace: a kinematic observation

C. Gabbard and C. Helbig (2004) found, when examining seated participants' limb selection for reaching and grasping in hemispace, that right-handers preferred to switch to the nondominant left arm for objects located approximately 20 degrees horizontally from body midline (90 degrees) in left hemispace. In the present study, the authors examined 13 strongly lateralized seated right-handers' kinematics of reaching to object positions ranging from body midline to 40 degrees horizontally in left hemispace. Participants executed faster reaches with the left arm than with the right arm to objects placed 20 degrees-40 degrees from midline, whereas they did not change the proportion of time they spent accelerating the hands when the position of the object changed. A 2nd main finding was an increase in the left hand's trajectory curvature as object position moved farther from midline, with a corresponding decrease in the contribution of upper-arm motion to the reach. Those observations suggest that the switch from dominant right-arm reaching to nondominant left-arm reaching in left hemispace reported in the aforementioned study may have emerged from a shift from a shoulder-driven reach to an elbow-driven action.     

Neighborhood Risk, Parental Supervision and the Onset of Substance Use among African American Adolescents

The consequences of the early onset of substance use on later outcomes are a public health concern. In the present study, we examined neighborhood risk factors as a possible predictor of the onset of substance use in adolescents. In addition, we assessed the potential buffering effects of parental supervision on the relationship between neighborhood risk and the onset of substance use. The participants included 95, abstinent, African American 6th graders (mean age = 11.5 years) who enrolled in one site of a national, multi-site study of high-risk youth participating in a federally sponsored program. In the 6th and 8th grades, the participants completed self-report measures regarding substance use, perceived negative neighborhood activities and parental supervision. Logistic regression analyses demonstrated that both exposure to negative neighborhood activities and low parental supervision increase the onset of substance use by the 8th grade among African American adolescents. However, the results suggested that parents can protect their adolescents from the impact of exposure to adverse neighborhood factors by providing appropriate supervision.