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

Using a multiple baseline design, a behavioral treatment program was used to improve the functional abilities of a 12-year-old child with anoxic brain injury. Neuropsychological testing indicated marked amnesia and global cognitive deficits. Functionally, self-care tasks could be performed, but only with verbal cues and moderate physical assistance. Introduction of a monetary reward system significantly reduced the number of verbal cues and the amount of physical assistance necessary to perform two categories of activities of daily living: toileting/undressing and dressing. Results indicated decreases of 80% and 70% in the number of verbal cues and instances of physical assistance required to complete dressing, and reductions of 92% and 75% in the number of verbal cues and the amount of physical assistance necessary to complete toileting/undressing, respectively. Time to task completion was also decreased for both activity categories. A 6-month follow-up revealed that treatment gains had been maintained.