Association for Behavior Analysis International

Behaviors that may be associated to higher perceived quality-of-life, such as the opportunity to participate in meaningful activities, expressing wants and needs, and socializing with others, may be negatively affected in individuals with a neurocognitive disorder (NCD, i.e., Alzheimer´s Disease). Due to deterioration of executive functions, such as taking initiative and lack of motivation, there is an increased risk of in-activity for individuals with NCD. Also, if the setting in which the person is does not actively support participation and activity engagement, in-activity may become even more apparent. Previous studies have shown that by training employees, activity attendance and engagement, and communication may be increased in NCD residents living in geriatric care units. The current study analyzed the effects of behavioral management skills training to increase positive communication and engagement of three certified nursing assistants (CNS) with residents with NCDs at the unit. Results from a multiple baseline across target participants showed an increase in positive communication and engagement with the residents by an average of 81.3% in CNA A, by 65.7% in CNA B, and 26.7% in CNA C. Both CNA A and CNA B had a notable increase in engagement with residents from baseline. However, CNA C had the least increase from baseline.

ABA providers who serve individuals that engage in severe problem behavior may be at particularly high risk of injury. However, there is little research on the prevalence or severity of staff injuries among these providers, nor on best-practice strategies to prevent or mitigate staff’s risk of injury. The Neurobehavioral Unit (NBU), at the Kennedy Krieger Institute, is the nation’s first ABA-based hospital program to assess and treat severe behavior disorders. The purpose of this study is to describe the NBU’s behavior-based safety approach to reporting and monitoring staff injuries and utilization of personal protective equipment (PPE) and share examples of ways to visually depict staff injuries through the use of body images to denote injury locations, cumulative records of injury severity across admission, as well as types of behaviors resulting in injury. A case example will be provided depicting how these graphs are utilized to more effectively monitor and enact plans to reduce injuries among staff. Future directions, such as modifying staff training and hospital practices, to wide-scale implications for other ABA providers will be discussed.