SELF-ADMINISTERED WRITTEN PROMPTS TO TEACH HOME ACCIDENT PREVENTION SKILLS TO ADULTS WITH BRAIN INJURIES

This study evaluated the use of written checklists and task analyses as self-administered prompts to teach home accident prevention skills to 4 adults with brain injuries. Subsequent to baseline, participants used written checklists that identified potential in-home hazards but did not prompt behaviors necessary for hazard remediation. Written individualized task analyses, incorporating specific behavioral steps for correcting hazards that participants had failed to remediate during the checklist phase, were used to prompt appropriate responding when necessary. These were subsequently faded to transfer stimulus control to the natural conditions. A multiple probe technique across participants and settings was used. Results indicated that the checklist alone was sufficient to increase appropriate responses to many of the potential hazards. Individualized task analyses, when needed, resulted in appropriate remediation of all potential hazards. Generalization to untrained potential hazards occurred to some degree for all participants. Follow-up results showed that most skills trained were maintained over a 1-month period.     

Early discrimination among small object collections

Two studies are presented which examine the young child's ability to discriminate between two small object collections on the basis of numerosity and to maintain that discrimination across changes in number-related cues. A transfer procedure and counting tasks were also included. In Study 1, 2-, 3-, and 4-year-olds were reinforced for choosing either a two- or three-item array when length-density cues were manipulated across two training phases of 20 trials each. Training was followed by a transfer task in which one- and four-item arrays were displayed. Most 2-year-olds were able to learn the discrimination while at the same time displaying little quantitative ability. Further, their transfer responses were transpositional in nature. In Study 2, 2-year-olds were given a similar discrimination task in which numerosity was contrasted simultaneously with length-density and area-brightness cues. Again, most children learned the discrimination and transferred that learning on the basis of relational cues.     

An attempt towards differentiating attentional deficits in traumatic brain injury

Attentional deficits in patients suffering traumatic brain injury (TBI) can occur with minor to severe impact to the brain. Based on reviews of both the cognitive and neurobehavioral literature, the following three concepts of attention are addressed: (a) arousal/alertness, (b) selective attention, and (c) energetic aspects of attention, which include such components as effort, resource allocation, and speed of processing. Within each concept, definitions are proposed, the underlying brain mechanisms are identified, and the specific deficits associated with TBI are explored. This review combines theoretical perspectives and clinical findings with the objective of leading toward a diagnostic differentiation that in turn will benefit treatment planning.     

儿童青少年大脑认知功能事件相关电位P_（300）的年龄特征

从发展心理学的角度．对幼儿到大学六个年龄组的儿童青少年进行了事件相关电位Ｐ_（３００）测定．结果发现：反映大脑认知功能的事件相关电位Ｐ_（３００）各成分随着年龄增长而发展的趋势十分明显,从而进一步说明了认知发展的特点与大脑高级神经系统活动功能发展特点的密切关系。     

Self-appraised problem-solving skills and the prediction of secondary complications among persons with spinal cord injuries

Secondary complications following spinal cord injury (SCI) include decubitus ulcers and recurrent urinary tract infections. These conditions can significantly impair quality of life and prove life-threatening; it is also believed that these conditions are mediated by behavioral pathways. According to the social problem-solving model, persons who report effective problem-solving skills should be capable of adhering to long-term therapeutic regimens of self-care necessary to prevent these complications. We tested this assumption in the present study. Discriminant function analyses revealed self-appraised skills in approaching and defining problems contributed to the prediction of secondary complications among 53 persons with SCI. Results are discussed in light of the social problem-solving model, and the utility of problem-solving interventions in rehabilitation is explored.     

Psychological stress,work satisfaction,and brain injury nursing

The psychological stress and work satisfaction of two groups of nurses working with clients having brain injuries were assessed and compared with norm groups of people working with other types of injuries and disabilities. Contrary to previously published reports, there was no evidence that the groups in this study were higher on measures of burnout than the selected norm groups. However, work satisfaction was found to be significantly lower for one of the groups when compared not only with the other group but also with the selected norm groups. This lower work satisfaction was associated with significantly lower scores on certain aspects of the work environment when compared with the other group. Results from semi-structured interviews in the study confirmed the importance of the work environment and provided additional information concerning causes of the lower work satisfaction and possible solutions.     

Emotional behavior as an agenda in neuropsychological evaluation

In an effort to objectify neuropsychologic evaluations, consideration of a patient's emotional behavior has often been neglected. An extensive literature review is undertaken in an effort to document lateralized emotional behaviors commonly found in brain injury populations. This evidence is contrasted with the psychiatric symptoms and lateralized neuropsychologic impairments seen in major depression and schizophrenia. A theoretical model is then proposed that attempts to integrate these functional vs. organic symptoms based upon reciprocal inhibition of lateralized emotional functioning in brain injury and psychiatric disorders. This opponent process model not only seems to account for some of the discrepant findings in the literature, but additionally provides a cogent and useful marker to neurophychologically differentiate neuronal vs. metabolic disorders. The model further suggests new ways of envisioning treatment and recovery from both psychiatric illness and brain injury.     

Stressed organizations and organizational stressors: A systemic analysis of workplace injury

The experiences of five injured workers from one workplace which had been identified as having a very poor workers' compensation claims experience were analyzed using a systemic theory framework. It was predicted that the fundamental stress-producing conflict between safety and profit that exists in industry between workers and their employers is exacerbated when a worker is injured; furthermore, the degree of stress experienced by both the injured worker and the employer is related to the impact of the injury on the organization and on the productivity of the workplace. The increased stress in both the injured worker and the employer results in increased rigidity in responding to the change or threat in the organization caused by workplace injury. A systemic approach to rehabilitation was recommended in which the employer as well as the injured worker were viewed as clients who required varying levels of support and intervention in managing workplace injury.     

GENERALIZED EFFECTS OF A PEER-DELIVERED FIRST AID PROGRAM FOR STUDENTS WITH MODERATE INTELLECTUAL DISABILITIES

Peers with mild intellectual disabilities taught first aid skills to 4 students with moderate intellectual disabilities. A multiple probe design across participants was used to examine the effects of the peer teaching program during an acquisition and a partial sequential withdrawal phase. Generalization assessments were conducted in the participants' homes using novel, randomized simulated injuries. Results suggested that the peer teaching program resulted in acquisition of first aid skills, and the participants' skills generalized to the home, to novel simulated-injury locations, and to new trainers. Additionally, a more detailed analysis of the generalized responding suggested that when given a choice among first aid materials, participants treated burns using large adhesive bandages rather than the materials used in training. Participants also successfully treated injuries when novel instructional cues were used. The findings are discussed with respect to training issues, generalization and maintenance of the acquired skills, and the use of peer tutors with disabilities.     

The urban environment and child pedestrian and bicycle injuries: Interaction of ecological and personality characteristics

It is argued that the study of injuries to child pedestrians and cyclists in urban contexts must involve the study of complex elements interacting within a total environment. This complexity, and the need for further research, is illustrated from a study of 400 child victims in an urban, ecological study, and of 67 individually studied child victims and controls. It is argued that the individual vulnerability of some children puts them at high risk when they live in certain types of urban neighbourhoods.