Behavioural training during acute brain trauma rehabilitation: an empirical case study

Operant conditioning-based behavioural interventions are commonly used for the behavioural problems of individuals with mental retardation. There is also growing evidence of the benefits of these interventions for treating some of the behavioural problems of individuals with acquired cognitive deficits resulting from brain trauma. However, the effects of behavioural interventions on behavioural problems occurring during acute neurorehabilitation, when orientation and memory are most impaired, have not been studied. In this empirical case study, operant conditioning-based procedures were applied with an 8-year-old girl recovering from brain trauma and related neurosurgery. Screaming, non-compliance and aggression, which were disrupting rehabilitation therapies and follow-up neuroimaging, were treated using differential positive reinforcement techniques. Beneficial behavioural intervention effects were demonstrated using single-subject experimental methods. Aberrant behaviour during physical and occupational therapies was reduced, and cooperation with a computerized tomography (CT) scan without sedation was accomplished using operant behavioural intervention. Results support the use of operant interventions early in recovery from brain trauma, and highlight the importance of interdisciplinary collaboration for the implementation and further study of early behavioural interventions.