Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


50th Annual Convention; Philadelphia, PA; 2024

Event Details

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Symposium #198
CE Offered: BACB
Clinical Applications of Behavioral Gerontology for Older Adults With Neurocognitive Disorders
Sunday, May 26, 2024
8:00 AM–8:50 AM
Marriott Downtown, Level 4, Franklin Hall 1-2
Area: DEV; Domain: Service Delivery
Chair: Alexandra Doran (Western Michigan University)
Discussant: Hanna Steinunn Steingrimsdottir (Reykjavik University)
CE Instructor: Hanna Steinunn Steingrimsdottir, M.S.

The growing aging population in the United States is accompanied by an increase in both number of older adults with neurocognitive disorder and the number of people experiencing behaviors changes associated with neurocognitive disorder (NCD). Behavioral Gerontology is the "application of behavior analysis and therapy to older adults, ranging from basic behavioral research to clinical applications to organizational issues in service delivery (Adkins & Mathews, 1999; Burgio & Burgio, 1986)" (LeBlanc et al., 2011, p. 472). This symposium will focus on the practice of behavioral gerontology with older adults with NCD, including talks covering data-based interventions to support older adults with NCD, as well as discuss models for behavioral consultation and for informed consent/assent. Intervention studies will include caregiver implemented trial-based functional analysis and function-based treatment, as well as an individualized antecedent-based interventions to increase showering. The importance and future directions for clinical applications with adults with NCD, as well as needs for future research, will be discussed.

Instruction Level: Advanced
Keyword(s): Assent, behavioral gerontology, Consultation, neurocognitive disorder
Target Audience:

Masters level practitioner experience, BCBAs considering expanding into different practice areas

Learning Objectives: (1) participants will learn to apply a decision model for dissent and assent; (2) participants will learn how to adjust a behavioral consultation model for aging settings; (3) participants will learn how to individualize antecedent-based interventions and functional assessments in aging settings

Behavioral Consultation in Nursing Homes: A Model Adaptation and Considerations

SANDRA WAGNER (Western Michigan University), andrea perez (Western Michigan University), Jonathan C. Baker (Western Michigan University)

Up to 80% of older adults with neurocognitive disorder engage in behavioral and psychological symptoms of dementia (BPSD; e.g., verbal or physical aggression, wandering) in nursing home facilities (Toot et al., 2017). In nursing home facilities, health professionals often use a medical model to provide behavioral support. The medical model, however, does not consider the environmental factors that may be evoking and maintaining behaviors; it is also likely that pharmacological interventions are often prescribed to manage the behaviors (Baker et al., 2015). Given the adverse effects of pharmacological interventions, researchers have advocated for behavioral and function-based interventions for the management and treatment of BPSD (Dyer et al., 2017). Unfortunately, the behavioral approach to treatment is not widely adopted in nursing home settings. Thus, behavioral gerontologists are faced with having to provide behavioral consultation in a medical model setting. The purpose of the current study is twofold: 1) to provide a framework for providing behavioral consultation in these settings and 2) to provide examples and data related to the different decision points in the model.


Teaching an 81-Year-Old to Use Subtle Prompts to Increase Showering by His Spouse With Dementia

ZOE LUCOCK (Positive Ageing Consultancy & Training )

The behavioral gerontology literature to date has focused heavily on research with participants living in long term care facilities, yet the vast majority of people diagnosed with dementia live at home in the community. The purpose of this talk is to share the process and results from clinical work conducted in the home of a 79 year old woman living with Alzheimer’s disease who was supported by her 81 year old spouse. The client was referred for behavioral services due to a failure to shower for multiple months. Her spouse was supported to implement a simple and effective prompting procedure that utilised subtle verbal discriminative stimuli that resulted in increased showering behavior and preserved the client’s dignity. Maintenance probes demonstrated that the changes were generalized over time. I will discuss the changes that were made to data collection procedure and the method to ensure good contextual fit along with the importance of flexible and compassionate practice when working clients in the community living with dementia. This research demonstrates real-life behavior-analytic practice with older adults with dementia living in their own homes with a focus on practice that has strong contextual fit.


CANCELLED: Caregiver-Implemented Trial-Based Functional Analysis With Individuals Diagnosed With Alzheimer's Disease or Other Dementias

Maleni Carrillo-Gomez (California State University, Fresno), Marianne L. Jackson (California State University, Fresno), SHAYLEE EDE (California State University, Fresno)

Alzheimer's disease is the most common form of dementia. It accounts for 60% to 80% of all dementia cases. Over 80% of dementia sufferers exhibit at least one or more troublesome behaviors. Individuals are frequently medicated to manage such behavioral problems or agitation. These medications often come with severe side effects and risks of mortality that may make their use contraindicated and often do not address the need served by behavioral problems. Initial research suggests that functional assessment methodology may be viable for assessing problem behavior, leading to nonpharmacological treatment and more effective function-based intervention with this population. Additionally, many problem behaviors only occur in the presence of caregivers and staff. Therefore, the current study aimed to extend the Trial-Based Functional Analysis (TBFA) procedures to challenging behaviors in older adults with Alzheimer’s disease or other dementias. Caregivers were trained to implement the TBFA procedures and received in situ feedback as needed. The results suggest that caregiver training in TBFA procedures was effective and demonstrated behavioral functions for the challenging behavior of all four participants. This study adds to the small but growing body of evidence supporting the use of functional analysis technology with adults with dementia, specifically Alzheimer’s disease.

Respecting Dissent and Seeking Assent in Behavioral Gerontology: The Application of a Decision-Making Model
AMY WHITTEN SHAW (Western Michigan University), Jonathan C. Baker (Western Michigan University)
Abstract: Behavioral gerontologists may work with individuals with neurocognitive disorder (NCD) who may or may not be able to provide informed consent. As such, capacity assessments may be relevant. When participants in research or clients receiving treatment do not have the capacity for informed consent proxy decision makers provide consent and assent must be also be sought. Recent articles highlighted the need for behavior analysts to seek assent for research (Morris et al., 2021) and explored researchers’ comfort and current practices (Jasperse et al., 2023). While assent is recognized as affirmative agreement, participants and clients may also express dissent. Of informed consent, assent, and dissent, dissent is the least discussed and reported on measure. This talk explores current issues in the field of behavioral gerontology through the framework of a decision-making model that was originally published by Black et al. (2010) in the field of geriatric psychiatry. The model assesses for both dissent and assent separately. The authors use of this decision-making model while conducting research on manding will be discussed. Participants in the study were older adults with NCD living in a memory care unit. Data will encompass assent and dissent to sessions, session completion, and session termination.



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