CH 11 Neurobehavioral Complications

Question 1

List 5 factors that influence the type and extent of neurobehavioral change after brain injury

Answer 1

site of injury
severity of injury
pre-injury characteristics of personality
intelligence and learning style
current environment (i.e. demands, support, stimulation)

Question 2

List practical strategies to manage an individual emerging from coma

Answer 2

Environmental (decrease noise, visitors, no TV)
Interventions & Demands (routines, same staff, re-orientation, safe-roaming)
Edu & Research (educate all staff and family)

Question 3

What is the safest recommendation for managing individuals during Coma-Emergent Agitation?

Answer 3

present in estimated 30-70% of cases, usuallyy <10 days
goal is to minimize unfamiliar, complex or unexpected stimuli and promote safety and stability thru familiarity and orientation

Question 4

Describe the stability triangle

Answer 4

Establish behavioral stability AND promote medical stability THEN develop stable activity plan
establish via assessing addressing problematic behaviors first (i.e. aggression and elopement)
promote via pain, sleep, vestibular meds/tx
develop by exploring how to support person in individual interests and personal routines in safest, structured way

Question 5

What is the definition of behavior?

Answer 5

anything that a person does that can be measured

Question 6

What is Applied Behavior Analysis?

Answer 6

goal is to discover variables that reliably influence behavior in order to either predict or promote behavior change

Question 7

What are influencing factors considered by behavior analysts?

Answer 7

the individual and the environment

Question 8

What are the elements of a behavior program?

Answer 8

Functional analysis: assess behavior
Operational Definition: define target behavior
Determine Data to collect
Proactive or Consequence based approaches: change behavior

Question 9

Provide examples of indirect assessment

Answer 9

interviews, checklists. less objective 2/2 retrospection

Question 10

What does a functional assessment ID?

Answer 10

example of direct assessment. it IDs the potential purpose or function of a behvaior

Question 11

How can a functionally equivalent alternative be implemented in behavior change?

Answer 11

a safer substitute , more appropriate but has the same function

Question 12

An operational definition includes topography and intensity, how are these important in defining a behavior

Answer 12

topography=what a behavior looks like
intensity=description or measure of force
they allow for the most objective observation of the behavior, most inter-rater reliability

Question 13

provide examples of positive and negative punishment

Answer 13

+ bark collar to decrease barking
-removal of TV or phone for teenager privileges

Question 14

provide examples of positive and negative reinforcement

Answer 14

+treats for eye contact when Otis sees dogs
- scheduled breaks to increase participation

Question 15

Examples of intermittent reinforcement and continuous reinforcement; benefits?

Answer 15

slot machine and soda machine respectively
intermittent is used for generalization and is resistant to extinction
continuous promotes behavior acquisition but sensitive to extinction

Question 16

List 4 de-escalation techniques

Answer 16

active listening and eye contact
orientation including purpose of activity
redirection-return to well known lower demand task
setting limits, outline expectations and consequences