A study in the founding of applied behavior analysis through its publications.

This article reports a study of the founding of applied behavior analysis through its publications. Our methods included hand searches of sources (e.g., journals, reference lists), search terms (i.e., early, applied, behavioral, research, literature), inclusion criteria (e.g., the field's applied dimension), and (d) challenges to their face and content validity. Our results were 36 articles published between 1959 and 1967 that we organized into 4 groups: 12 in 3 programs of research and 24 others. Our discussion addresses (a) limitations in our method (e.g., the completeness of our search), (b) challenges to the validity of our methods and results (e.g., convergent validity), and (c) priority claims about the field's founding. We conclude that the claims are irresolvable because identification of the founding publications depends significantly on methods and because the field's founding was an evolutionary process. We close with suggestions for future research.

B. F. Skinner's Utopian Vision: Behind and Beyond Walden Two.

This paper addresses B. F. Skinner's utopian vision for enhancing social justice and human well-being in his 1948 novel, Walden Two. In the first part, we situate the book in its historical, intellectual, and social context of the utopian genre, address critiques of the book's premises and practices, and discuss the fate of intentional communities patterned on the book. The central point here is that Skinner's utopian vision was not any of Walden Two's practices, except one: the use of empirical methods to search for and discover practices that worked. In the second part, we describe practices in Skinner's book that advance social justice and human well-being under the themes of health, wealth, and wisdom, and then show how the subsequent literature in applied behavior analysis supports Skinner's prescience. Applied behavior analysis is a measure of the success of Skinner's utopian vision: to experiment.

B. F. Skinner's contributions to applied behavior analysis.

Our paper reviews and analyzes B. F. Skinner's contributions to applied behavior analysis in order to assess his role as the field's originator and founder. We found, first, that his contributions fall into five categorizes: the style and content of his science, his interpretations of typical and atypical human behavior, the implications he drew from his science for application, his descriptions of possible applications, and his own applications to nonhuman and human behavior. Second, we found that he explicitly or implicitly addressed all seven dimensions of applied behavior analysis. These contributions and the dimensions notwithstanding, he neither incorporated the field's scientific (e.g., analytic) and social dimensions (e.g., applied) into any program of published research such that he was its originator, nor did he systematically integrate, advance, and promote the dimensions so to have been its founder. As the founder of behavior analysis, however, he was the father of applied behavior analysis.

Brief training to promote the use of less intrusive prompts by nursing assistants in a dementia care unit.

We evaluated the efficacy of a brief staff-training procedure to increase the use of graduated prompting by 2 certified nursing assistants (CNAs) while they helped to dress 3 persons with dementia in a seven-bed dementia care unit. The multiple baseline design across participants showed that CNAs dressed residents with minimal resident involvement during baseline observations. Following brief in-service training, CNAs provided graduated prompts and praise appropriately, suggesting that CNAs can promote active involvement in personal care routines by older adults with dementia.

Using family-style meals to increase participation and communication in persons with dementia.

Although researchers stress the importance of encouraging independent behavior in persons with dementia, institutional practices often foster dependence. This study took place in a six-resident locked dementia care unit that followed the common institutional practice of serving meals on prepared plates. The purpose of this study was to examine if changing the mode of meal delivery to "family-style," where residents were presented with serving bowls and empty plates, would increase resident communication and participation in mealtime tasks. An ABAB' reversal design revealed very low rates of appropriate communication (5% of intervals) and mealtime participation (10% of tasks) during baseline, when residents received prepared plates (A). Communication and participation doubled when family-style meal delivery was introduced (B) and dropped back to baseline levels when it was withdrawn (A). Because the levels of communication and participation during family-style meals were still low, the nursing assistant was provided with instruction on prompting and praising appropriate mealtime behaviors (B'). After instruction was provided and family-style meals were reintroduced, resident participation rose to 65% of tasks and appropriate communication increased to 18% of observations. This study suggests family-style meals may result in modest increases in mealtime participation and communication of residents with dementia, but staff training in prompting and praising may be necessary to see large changes in these behaviors.

Finding a practical method to increase engagement of residents on a dementia care unit.

Previous research has shown that it is possible to increase the engagement of residents with dementia in daily activities by making changes in institutional care practices. However, these changes often require expensive and cumbersome staff training programs that long-term care facilities may be unlikely to adopt and maintain. This study evaluates a simple, inexpensive recording and feedback procedure to increase resident engagement in a way that may be more amenable to adoption by long-term care facilities. Nursing assistants working in a locked dementia care unit were asked to complete a daily activity record on which they recorded the amount and quality of resident engagement. The facility's activity director was asked to read these activity records each day and give immediate, positive feedback to the nursing assistants. This procedure was evaluated by using a control series design. Results revealed baseline engagement observations with a mean of 11 percent, which increased to a mean of 44 percent during observations under treatment conditions. This study suggests that simple, inexpensive changes in institutional practices can make meaningful improvements in the level of engagement of residents with dementia.

Restoring dressing independence in persons with Alzheimer's disease: a pilot study.

PURPOSE: Well meaning nursing facility staff may compromise the independence of older adults with dementia by performing activities of daily living for residents. We assessed the impact of teaching certified nursing assistants (CNAs) to use a graduated prompting procedure to increase dressing independence of persons with dementia. DESIGN AND METHODS: This study was conducted in a seven-bed dementia care unit. Three residents and two CNAs participated in the study. We used a repeated-measures experimental design to evaluate the effect of a training workshop for CNAs on a strategy for increasing resident engagement in self-care activities. RESULTS: During a series of baseline observations, we found that CNAs typically dressed residents with minimal resident involvement. Results showed that, following the training workshop for CNAs, resident independence in dressing increased and range of motion improved. IMPLICATIONS: CNAs can provide restorative care that increases dressing independence and range of motion of older adults with dementia.