Association for Behavior Analysis International

Non-pharmacological interventions, recommended as first-line treatment for various problems associated with cognitive decline in older adults, encompass a broad array of approaches (e.g. music therapy, memory boards, caregiver supported interventions, etc.) with ill-defined mechanisms of change. Interventions are often implemented haphazardly, based upon provider preferences. Behavior analysts, in contrast, deliver services that are conceptually consistent with behavior analytic principles, based upon scientific knowledge. This symposium will describe the rationale and the implementation of non-pharmacological interventions for problems that commonly occur when working with individuals aged 60 and older with neurocognitive disorders and their care partners, and provide behavior-analytic interpretations of their results. The first paper will describe the development of a tool designed to assess training experiences of care partners of older adults. The second paper will present the results of personalized music playlists on indices of happiness, vocalizations, and problem behaviour when compared to a social-visit without music control. The third paper will discuss the value of descriptive functional analyses in understanding behavior within a specialized dementia care unit. The final paper will describe the results of a multicomponent intervention to reduce calling out during mealtimes in a long-term care facility.

Care partners are tasked with the implementation of interventions to ensure the wellbeing and prevent excess disability of their family members with neurocognitive disorders. However, most care partners report that they are ill-prepared, and barriers to implementation are common. Multicomponent interventions are overwhelmingly recommended to remove barriers. Investigation into the various strategies used within multicomponent interventions for care partners suggests that behavioral skills training is most efficacious in decreasing care partner barriers, but it is unclear to what degree and how frequently care partners receive it. The present study describes the development of a tool, based on the Performance Diagnostic Checklist - Human Services (PDC-HS), designed to assess the training experiences of care partners of older adults with neurocognitive disorders. Relevant stakeholders, specifically, care partners of the target population participated in a focus group to provide feedback on the acceptability and feasibility of the tool. Results suggest that while the tool is feasible, further considerations for acceptability are required. Implications of the findings with respect to the dissemination of behavior-analytic principles to care partner training will be discussed.

Dementia is a significant global health concern. An estimated 35.6 million people lived with dementia worldwide in 2010, and that number is expected to double every 20 years. Rather than difficulties remembering, thinking, or problem-solving, behavioural problems associated with dementia such as agitation, wandering and aggression are the main reason for institutionalization. Non-pharmacological interventions are mandated as first-line interventions to prevent or manage the behavioural symptoms of dementia. Music-based interventions are one approach that has recently gained popularity. The purpose of this study was to identify whether personalized music playlists had any observable effect on participant indices of happiness, vocalizations, and problem behaviour when compared to a social-visit without music control. Four caregiver/participant dyads participated. Results suggest that the impact of music was not uniform across participants. Regardless of objective behaviour change observed, all caregivers reported high satisfaction with the study. Implications of these results within a behavior analytic framework will be discussed.