Maximising the learning potential of brain injured patients
Maximising the learning potential of brain injured patients
Behaviour problems after severe brain injury may constitute a major barrier to rehabilitation. Recent reports in the literature emphasise the use of a wide range of procedures, especially those of reinforcement, extinction and time-out. However, some brain injured people do not respond to these and may remain inaccessible to rehabilitation input.
In this thesis, reasons underlying poor response are considered and alternative treatment strategies discussed. In Chapter Two, the application of differential reinforcement is reported. In Chapter Three, negative reinforcement of avoidance and escape behaviour is highlighted in the context of brain injury as one reason underlying poor response. The use of an alternative strategy, satiation training, is discussed. In Chapter Four the results of an experimental study are reported which suggest that in some cases the ability to respond to reinforcement, extinction and time-out procedures is limited because of deficits in specific information processing skills. Impairment of the central executive component of working memory may also account for the presence of some inappropriate behaviours. In Chapters Five to Seven the use of an alternative behaviour modification procedure, response cost, is evaluated. It is argued that this approach encourages greater inhibitory control of inappropriate behaviour in such cases by circumventing the neuropsychological impairments that prevent this happening when other techniques are used. The development of an innovative approach that also achieves this aim, while minimising ethical and practical constraints, is discussed in Chapter Nine. In Chapter Ten, the results of a pilot study investigating the validity of alternative test procedures for assessing deficits in executive functioning believed to underlie poor response is reported. Finally, some aspects of current practice are discussed with reference to both learning and neuropsychological theory, and implications for future work in this field discussed.
University of Southampton
Alderman, Nicholas
dfe8ce6f-12d1-4337-b9ea-7787bc82f2b5
1994
Alderman, Nicholas
dfe8ce6f-12d1-4337-b9ea-7787bc82f2b5
Alderman, Nicholas
(1994)
Maximising the learning potential of brain injured patients.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
Behaviour problems after severe brain injury may constitute a major barrier to rehabilitation. Recent reports in the literature emphasise the use of a wide range of procedures, especially those of reinforcement, extinction and time-out. However, some brain injured people do not respond to these and may remain inaccessible to rehabilitation input.
In this thesis, reasons underlying poor response are considered and alternative treatment strategies discussed. In Chapter Two, the application of differential reinforcement is reported. In Chapter Three, negative reinforcement of avoidance and escape behaviour is highlighted in the context of brain injury as one reason underlying poor response. The use of an alternative strategy, satiation training, is discussed. In Chapter Four the results of an experimental study are reported which suggest that in some cases the ability to respond to reinforcement, extinction and time-out procedures is limited because of deficits in specific information processing skills. Impairment of the central executive component of working memory may also account for the presence of some inappropriate behaviours. In Chapters Five to Seven the use of an alternative behaviour modification procedure, response cost, is evaluated. It is argued that this approach encourages greater inhibitory control of inappropriate behaviour in such cases by circumventing the neuropsychological impairments that prevent this happening when other techniques are used. The development of an innovative approach that also achieves this aim, while minimising ethical and practical constraints, is discussed in Chapter Nine. In Chapter Ten, the results of a pilot study investigating the validity of alternative test procedures for assessing deficits in executive functioning believed to underlie poor response is reported. Finally, some aspects of current practice are discussed with reference to both learning and neuropsychological theory, and implications for future work in this field discussed.
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Published date: 1994
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Local EPrints ID: 458510
URI: http://eprints.soton.ac.uk/id/eprint/458510
PURE UUID: 695f4e50-bcee-48df-84ac-94e6e237d3b8
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Date deposited: 04 Jul 2022 16:50
Last modified: 04 Jul 2022 16:50
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Author:
Nicholas Alderman
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