Improving functional skills using behavioral procedures in a child with anoxic brain injury

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Study using a multiple baseline design to evaluate the efficacy of a behavioral treatment program for improving the functional skills of a child with anoxic brain injury. The subject was a 12 year old girl who experienced prolonged anoxia during a near drowning accident. A neuropsychological evaluation performed 3 months postinjury showed moderate agitation, amnesia, and pervasive cognitive impairment. She could perform self care tasks such as grooming, dressing, and toileting, but only with verbal cues and moderate physical assistance. A behavioral intervention using monetary rewards was implemented targeting two categories of activities of daily living: dressing and undressing/toileting. Following intervention, decreases of 80% and 70% were observed in the number of verbal cues and instances of physical assistance, respectively, required to complete dressing. For toileting/undressing, reductions of 92% and 75% were observed in the number of verbal cues and instances of physical assistance. The time to completion also was reduced for both tasks. A six month follow up indicated that treatment gains had been maintained.

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