Relationship between neuropsychological data and response to behavioral treatment in a case of carbon monoxide toxicity and dementia

The ability of learning measures to predict a behavioral treatment response was of interest in this study. A severely impaired and behaviorally disturbed female neuropsychiatric patient was unable to demonstrate any learning on "direct" tests involving multiple free recall trials or cued paired associate recall. However, she performed normally on an "indirect" test involving implicit learning of new associations. To assess whether direct or indirect measures tapped the kind of learning required by a positive reinforcement-based treatment approach, a token program was carried out. There was a 72.5% reduction in maladaptive behavior relative to baseline, indicating a positive treatment response. The results are discussed in terms of the potential treatment utility and predictive validity of indirect measures of learning and memory and the relation of neuropsychological data to intervention issues in general.