Jonathan C. Baker

Expanding the consumer base for behavior-analytic services: meeting the needs of consumers in the 21st century.

A growing workforce of behavior analysts provides services to individuals with autism and intellectual disabilities as legislative initiatives have spurred a growth of funding options to support these services. Though many opportunities currently exist for serving individuals with autism, the growing demand for these services may wane or, at some point, the growth in service providers will meet that demand. Other consumer groups could benefit from behavior analytic services, but typically have limited access to qualified providers. Individuals with dementia and traumatic brain injury are used as example consumer groups to illustrate the necessary tasks for a behavior analyst to expand their scope of practice to a new population. This paper provides strategies for developing competence and creating employment opportunities with new consumer groups.

Assessment and treatment of hoarding in an individual with dementia.

The authors used a reinforcer assessment to evaluate possible interventions for hoarding in an older individual with dementia. The most preferred condition from the assessment (sorting activity) was compared to a staff developed treatment involving item removal and redirection. Hoarding was reduced during both interventions with a greater reduction in the sorting condition. The behavioral reductions were maintained during schedule thinning of social interactions and follow-up.

Acceptability of interventions for aggressive behavior in long-term care settings: comparing ratings and hierarchical selection.

Fifty-six active treatment team members in long-term nursing care facilities completed an online survey assessing treatment acceptability of modern behavioral, pharmacological, and sensory interventions. A traditional treatment acceptability rating scale was compared to treatment selections in a paired-options format. Unlike earlier research, there were no significant differences in acceptability between the 3 interventions on the traditional rating scale. However, ratings and selections were significantly correlated for behavioral and pharmacological interventions. The clinical significance of such relations and the implications for the use of treatment ratings is discussed.

Teaching Mands to Older Adults with Dementia

Millions of Americans are diagnosed with dementia, and that number is only expected to rise. The diagnosis of dementia comes with impairments, especially in language. Furthermore, dementia-related functional declines appear to be moderated by environmental variables (Alzheimer’s Association, Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association 8:131–168 2012; American Psychiatric Association, 2000; Engelman et al., Journal of Applied Behavior Analysis 32:107–110, 1999; Engelman et al., Journal of Applied Behavior Analysis 36:129–132, 2003) Traditional language tests are not likely to assess or inform treatment for deficits in manding (Esch et al., The Journal of Speech-Language Pathology and Applied Behavior Analysis 5:166–191, 2010), and the mand is a verbal operant about which little is known among this population. The current study evaluated whether contriving an establishing operation within a preferred activity using a prompt-probe intermix procedure and a transfer of stimulus control procedure was effective in establishing mands in older adults with dementia. The procedure was demonstrated to be effective with one participant, but results were inconsistent with the second participant. Modifications were made throughout training for both participants, showing the importance of individualizing interventions.

Concurrent Validity of the Cognitive Assessment of Minnesota in Older Adults with and without Depressive Symptoms.

Cognitive impairment represents a common mental health problem in community-dwelling and institutionalized older adults, and the prevalence increases with age. Multidisciplinary teams are often asked to assess cognitive and functional impairment in this population. The Cognitive Assessment of Minnesota was created by occupational therapists for this purpose and is frequently used, but has not been extensively validated. This study examined the performance of the CAM and compared it to the MMSE with 113 outpatient clinic patients over the age of 60. Subgroups were established based on scores on a depression inventory to determine if the presence of depressed mood altered the relationship between the measures. Both measures demonstrated good internal consistency. The overall correlation between the two measures was high, statistically significant and remained high regardless of depression status. We offer recommendations about the utility of each measure in screening cognitive functioning for older adults.

Behavioral Gerontology: Research and Clinical Considerations

Abstract Behavior analysts have long recognized the importance of experimental research with and providing behavioral supports to older adults. While previous reviews have covered published literature associated with experimental and applied demonstrations of behavioral principles with older adults, relatively few have focused on how that published literature could guide research and clinical considerations for behavior analysts working with older adults. This chapter will focus on how behavior analysts might expand their research or clinical interests into aging settings.

Precursor manic behavior in the assessment and treatment of episodic problem behavior for a woman with a dual diagnosis

A functional analysis examined the relation between consequences that maintained episodic problem behavior (aggression, property destruction, and elopement) in the presence and absence of manic behaviors (MB). Results suggested that the presence of MB was correlated with the sensitivity of problem behavior to attention as a reinforcer during a functional analysis and that problem behaviors were maintained by attention. Noncontingent reinforcement was subsequently implemented and demonstrated to be effective in reducing problem behavior during the presence of manic behaviors.