ABSTRACT
An approach is presented which uses exclusively non-aversive methods in the behavioural rehabilitation of people with severe behaviour problems resulting from acquired brain injury. The approach has five components: (1) behavioural assessment: analysing the way all aspects of a person's functioning may affect their behaviour, (2) positive programming: teaching the skills necessary to allow the person to achieve their desired ends without resorting to inappropriate behaviour, (3) ecological change: altering the environment to achieve a better match with the individual's cognitive deficits, (4) focused treatment: using behavioural contingencies to achieve a rapid reduction in target behaviour, and (5) reactive strategies: specifying action to be taken to gain short-term control over episodes of challenging behaviour. The current literature on behavioural rehabilitation is reviewed in the context of this approach. Two case studies are presented illustrating the use of the approach in practice. The strengths and potential pitfalls of the approach are discussed, along with issues which need to be considered for effective implementation.
Subject(s)
Anger , Anxiety Disorders/etiology , Anxiety Disorders/therapy , Brain Injuries/psychology , Adaptation, Psychological , Adult , Anxiety Disorders/diagnosis , Brain Injuries/diagnosis , Female , Humans , Injury Severity Score , Male , Neuropsychological Tests , Severity of Illness IndexABSTRACT
The expressive and receptive use of three written words was taught to three mute autistic adolescents using a procedure based on Terrace's errorless discrimination model and Premack's language training with chimps. Expressive language was measured by the subject's selection of the appropriate word card from among the available alternatives when the corresponding object was presented. Receptive language was measured by the subject's selection of the appropriate object from among the available alternatives when the corresponding word card was presented. The sequence of the presentations and the order of placement of the available alternatives were randomized. The three subjects required 979, 1,791, and 1,644 trails, respectively, to master both the expressive and receptive use of the three words. The correct response rates for the three subjects over the entire training program were 92, 92, and 90%, respectively. It was concluded that, as concrete visual symbols, written words may provide a viable communication system for the mute autistic. The implications for treatment are discussed and suggestions for future research are made.
