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

Previous Page


Symposium #440
Research and Practice in Brain Injury Rehabilitation
Monday, May 27, 2024
10:00 AM–11:50 AM
Marriott Downtown, Level 4, Franklin Hall 9-10
Area: CBM; Domain: Translational
Chair: Marla Baltazar-Mars (Collage Rehabilitation Partners; University of North Texas)
Discussant: Megan R. Heinicke (California State University, Sacramento)
Abstract: Board Certified Behavior Analysts (BCBA) have an ethical responsibility to ensure they practice within their scope of competence and provide evidence based services, (Behavior Analyst Certification Board, 2020, Sections 1.05, 2.13), however BCBAs practicing within a unique and/or underserved population, such as brain injury rehabilitation, have limited resources to meet these expectations. This symposium will demonstrate how behavior analysts working within the continuum of brain injury rehabilitation apply the science and practices of ABA to explore the re-acquisition of skills and address complex/challenging sequelae of acquired brain injury (ABI). The first two presentations will focus on the extension of research on behavior analytic techniques with individuals with ABI and the last two presentations will demonstrate the application of behavior analytic principles in a neurorehabilitation setting. We invite students interested in working in brain injury and practitioners providing services to individuals with ABI to attend and participate in discussion about the research and service delivery to this population.
Instruction Level: Basic
Keyword(s): brain injury, Multiple-exemplar training, neurobehavioral, verbal operants
Concurrent vs. Serial Multiple Exemplar Training in Equivalence-Based Instruction Following Acquired Brain Injury: A Translational Study
(Applied Research)
Lucia Orozco (California State University, Sacramento), Megan R. Heinicke (California State University, Sacramento), EMILY STELLHORN (CSU Sacramento), Ava Minolli (California State University, Sacramento )
Abstract: Only one study within the behavior analytic literature (Cowley et al., 1992) has evaluated equivalence-based instruction (EBI) to re-teach name-face relations following acquired brain injury, but the effectiveness of stimulus generalization procedures embedded within EBI remains unknown. The purpose of the current study was to compare the efficacy and efficiency of serial and concurrent multiple exemplar training (MET) within an equivalence paradigm in promoting generalized equivalence classes. We taught unfamiliar name-face relations using a simultaneous matching-to-sample procedure to neurotypical adults as a stand-in population and compared serial and concurrent MET using an adapted alternating treatments design embedded within a nonconcurrent multiple baseline across dyads. All participants demonstrated generalized equivalence classes for name-face relations, and most participants only required direct training for one of three exemplars used in the serial MET condition. Although both methods were efficacious, results suggested that the most efficient method varied depending on the measure used for comparison (e.g., sessions to mastery, exposures to mastery, total training time). We will discuss the procedural parameters of EBI and MET as well as stimulus features that may require modification prior to extending this protocol to include acquired brain injury survivors.

Reestablishing Verbal Behavior in Individuals With Traumatic Brain Injury - An Extension

(Applied Research)
STEPHON PRIMOUS II (University of North Texas), Marla Baltazar-Mars (Collage Rehabilitation Partners; University of North Texas), April M. Becker (University of North Texas; University of Texas Southwestern Medical Center)

Aphasia, a communication disorder stemming from acquired brain injuries (ABI), profoundly impacts verbal abilities. Research on verbal operants has shown that direct training of one verbal operant can result in the emergence of untrained relations (i.e., tact training could lead to the emergence of previously lost mand and intraverbal relations). In the context of language rehabilitation, this feature could potentially maximize the efficiency of rehabilitation gains. In this series of studies, we evaluated the transfer from tact to mand and intraverbal skills in patients with aphasia. Results from the first study demonstrated some mand and intraverbal emergence; however, patient preference for the training methods was low. For the second study, we adjusted prompting procedures and implemented a point-based reinforcement system in efforts to enhance training efficiency, efficacy, and participant retention. The results from this study will be discussed, with a focus on the effectiveness of language rehabilitation and the overall experience for everyone involved.


Interventions for Hygiene and Medication Adherence for Individuals With Acquired Brain Injury in a Long Term Setting

(Service Delivery)
MARLA BALTAZAR-MARS (Collage Rehabilitation Partners; University of North Texas), Chris M. Schaub (ReMed), Mitchell Meyers (Collage Rehabilitation Partners)

Over the course of recovery, individuals with acquired brain injury (ABI) may have difficulties completing activities of daily living (ADLs) and adhering to medical recommendations. Prolonged issues with ADLs and following medical recommendations can present multiple challenges in caring for individuals with ABI, such as complicating rehabilitation processes, increased susceptibility to high-risk behavior, and increased risk of medical crisis. Behavior analysts working with individuals with ABI have the opportunity to target these areas and improve quality of life and support staff/caregivers assisting the individual. This presentation will showcase two case studies from a post-acute neurorehabilitation facility. The first provides an example of how the use of a visual aid resulted in establishing a client-led shower routine. The second shows the results of a "see picture of medication - say reason for medication" intervention for a gentleman with a history of medication refusals. Barriers associated with these interventions and recommendations for other practitioners will be discussed.


The Role of Applied Behavior Analysis (ABA) in Addressing Complex and Co-Occurring Issues After an Acquired Brain Injury

(Service Delivery)
CHRIS M. SCHAUB (ReMed), Marla Baltazar-Mars (Collage Rehabilitation Partners; University of North Texas), Mitchell Meyers (Collage Rehabilitation Partners)

Acquired brain injuries (ABI) can result in sequelae across multiple systems and domains that disrupt and impact the individual’s interactions with the environment, thus affecting behavioral relations. The term “neurobehavioral” is used to classify a wide array of challenging excesses and/or deficits of behavior resulting from ABI, that impact or impede an individual’s progress in rehabilitation and/or their recovery, and can ultimately pose safety concerns for the individual and caregivers. The behavioral history of adults with ABI may include challenging behaviors prior to their injury, which can be exacerbated post-injury and complicate treatment planning and programming. The subject of this case study had a pre-injury history of physical and emotional trauma, as well as a borderline personality disorder diagnosis, that required both inpatient and outpatient treatment. Following an ABI at the age of 23, resulting from a rollover car accident at high speed, pre-injury repertoires and sensitivities were profoundly disrupted and at-risk behavior occurred at high levels across all dimensions and settings. This case presentation will describe and discuss treatment efforts to address these behaviors and complications in an intensive, residential, neurobehavioral facility, highlighting the combination of neuropsychiatric and behavior analytic interventions that resulted in stabilization and transition to home.




Back to Top
Modifed by Eddie Soh