Category Archives: Uncategorized

Teaching Council of Ireland Public Consultation

Currently, the Teaching Council of Ireland (TCI) is hold two separate consultations and are inviting submissions from interested stakeholders.

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The first consultation is on the subject of the TCI’s draft strategic plan for 2015-2017.  The draft can be read here.  At a glance, the document seems promising in the sense that it seems to promise a new emphasis on CPD and on fitness to teach. However, I suspect that many ABA Ireland members will be disappointed with the absence of any reference to matters such as compulsory autism or special needs specific qualifications, supervision and training.

The second consultation is on the linked subject of Registration Regulations. Many ABA Ireland members have registered with the TCI recently. Some have expressed concern that their provisional recognition will lapse within a short space of time. Others have expressed concern that they have a second class form of registration that does not allow the parent of a child using the home tuition scheme to hire them until the parents can demonstrate that no teacher was available. If you have had positive or negative experience with regard to registration regulations, this is an opportunity to let the TCI know and hopefully your views will be reflected in the new regulations.

Behavioural Gerontology

(Michelle E. Kelly, BCBA-D)

Behavioural Gerontology is the application of behaviour analysis to ageing and age-related issues. Behavioural Gerontology is also a Special Interest Group (SIG) of the Association for Behavior Analysis International (ABAI). The BG-SIG’s mission is to foster interest among behaviour analysts in addressing and researching ageing-related issues. Their website is http://bgsig.wordpress.com/; Facebook https://www.facebook.com/behavioralgerontology.

I was recently contacted by Dr Miranda Trahan (BCBA), a member of the BG-SIG, as we both share an interest in the application of behaviour analysis to dementia populations. Miranda runs Trahan Behavioural Services, an ABA service in the U.S. that focuses on keeping older adults with dementia independent for as long as possible. Goals include (i) teaching older adults and their caregivers the skills necessary to improve their quality of life; (ii) increasing appropriate behaviours; and (iii) manage challenging behaviours with individualized non-pharmacological interventions. Miranda writes blogs on the practical applications of ABA for people with dementia – these are well worth a read. For more information, check out her website and blog pages at – http://marandatrahan.com/.

For those of you who may not be familiar with the benefits of behaviour analysis for people with dementia  and their families, here is a snapshot of how ABA can be readily applied and hugely beneficial in remediating a number of concerns throughout the dementia journey.Dementia 1

About Dementia

Dementia is an umbrella term that describes a range of conditions that cause damage to the brain. There are many different causes of dementia including vascular dementia, fronto-temporal dementia, and the most common cause, Alzheimer’s disease. These are the diseases that cause the symptoms.

Dementia 2

Over 35.6 million people are currently living with dementia worldwide. This is estimated to almost double by 2030 to 65.7 million. Currently in Ireland there are approximately 48,000 people living with dementia (4,066 aged under 65). This figure is also expected to double to around 96,000 in the next 20 years. This means that increasingly greater numbers of people will require interventions and services to ensure they can live well with their diagnosis. It is important therefore, that behaviour analysts can identify relevant applications of their skills for working with people with dementia; and that people with dementia, their families, and health and social care professionals recognise the potential of behavioural interventions.

Behaviour Analysis at Diagnosis

At diagnosis a behaviour analyst is well placed to advise individuals with dementia and their families on changes that may be required, such as the adaptation of living environments, implementing schedules or routines, or changes in how people carry out their daily tasks.

Behaviour therapists are also particularly important at this stage.  There is considerable evidence that assuming the role of caregiver is stressful and that, as a result, caregivers may be at an increased risk for psychological health problems. Research shows that both Cognitive Behaviour Therapy (CBT) and Acceptance and Commitment Therapy (ACT) can help. For example, a group of psychologists in Spain recently published a report in PSIGE (Faculty of Psychology for Older People) on CBT and ACT indicating promising results for both, although preliminary findings suggest ACT may result in the most positive outcomes for carers.

More focus is required on the potential applications and effects of CBT and ACT for people with dementia themselves however, particularly given that around 60% are thought to experience anxiety or depression post-dementia diagnosis. Although some research indicated that a modified version of CBT (CBT-AD) was beneficial for treating people with dementia, a lot more research is needed.

All fun and Games

Early Interventions

At the early stages of the disease, there should be an emphasis on maintenance of existing abilities to compensate for decline. Focus should not be on what has been lost but rather on maximising existing capabilities.

In my own work, I implemented an early intervention called “Cognitive Rehabilitation” or CR with three people with early stage dementia. The intervention focused on individualised personal rehabilitation goals and implemented practical interventions and strategies. I worked on a 1:1 basis with participants once a week for about 8 weeks on goals that they identified as important to them. Examples included remembering names, phone numbers, appointments, or using a mobile phone. I used strategies such as discrete trial training, precision teaching, spaced retrieval, and errorless learning. I also encouraged the use of memory aids and routines, adapted environments, and worked on relaxation skills. After the intervention, each participant’s ratings of goal performance and satisfaction improved, as did carer ratings of their loved ones performance. Importantly, quality of life and cognitive function (as measured by standardised cognitive tests; MoCA and RBANS) also improved for participants from baseline to follow-up.

I am currently working with clinical psychologists and geriatricians to develop a CR manual, designed for use by psychologists and healthcare professionals working with people with dementia. I will provide further information when the manual is complete.

Moderate to Later Stage Dementia

Over 50% of people with dementia experience Behavioural and Psychological Symptoms of Dementia (BPSD) at some point; with more difficult symptoms often occurring in moderate to later stages. BPSDs include depressive symptoms, anxiety, apathy, sleep problems, irritability, psychosis, wandering, elation and agitation. These symptoms can be highly distressing, and may result in challenging behaviour. BPSDs are also associated with a more rapid rate of cognitive decline, greater impairment in activities of daily living, diminished quality of life, and can often be a reason for placement into residential care. Although there is little or no evidence to suggest that traditional antipsychotic medications have any utility in treating BPSDs, these are still the ‘go-to’ solution in most cases.

Behaviour analysts won’t be surprised to hear that a recent Cochrane Review (one of the highest standards of reviews in evidence-based medicine) concluded that Functional Assessments (FAs) for the management of challenging behaviour are a promising alternative to traditional BPSD management. With FAs, the behaviour analyst can determine the function of the challenging behaviour, and develop and evaluate hypothesis driven strategies that can aid family and staff to reduce and resolve the person’s distress and associated behavioural manifestations.

 
Behaviour Analyst Results

Communication difficulties are another area where behaviour analysts might intervene, particularly given that communication interventions are so commonly implemented by behaviour analysts in applied practice. Aphasia (a reduction in the ability to express or comprehend language) is common in moderate to later stages of dementia, meaning that alternative methods of communication are often required. Talking Mats, very similar to what most of us behaviour analysts know as PECS, are often used with people with dementia, and have been shown to be an effective method of communication. Behaviour analysts can not only train the individual in the use of Talking Mats or PECS, but can also train staff and family members to use them effectively.

Finally, improving activity engagement in residential and long term care is an area that can be addressed by behaviour analysis. In a study of 27 nursing homes (observed for 13 hours per day), 65% of residents’ time was spent doing nothing and only 12% in social activities. Low activity engagement was shown to be a result of weak stimulus control of activities, and was quite easily remediated with reinforcer sampling, modelling, and the implementation of schedules of reinforcement for activity engagement.

Suggested Journal Articles

Dwyer-Moore & Dixon (2007) – Functional Analysis and Treatment of Problem Behavior of Elderly Adults in Long-Term Care: Functional analyses were conducted for the problem behaviour of 3 older adults in a long-term care setting. Two of the problem behaviours were maintained by attention, and a third was maintained by escape from demands. Function-based interventions were implemented that resulted in decreases in problem behaviour in each case. Implications for the use of functional analysis and function-based interventions in the field of gerontology are discussed – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2078575/

Trahan et al. (2011) – Behaviour Analytic Research on Dementia in Older Adults: It is estimated that 1 in 10 adults aged 65 years and older have been diagnosed with dementia, which is associated with numerous behavioral excesses and deficits. Despite the publication of a special section of the Journal of Applied Behavior Analysis (JABA) on behavioral gerontology (Iwata, 1986), there continues to be a paucity of behavior-analytic research with this population. This review compares the research published before and after the behavioral gerontology special section and evaluates the most recently published aging articles in JABAhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177357/

Sample Lecture Slides

1210 Applied Behavior Analysis as a Treatment Framework for Various Dementias (1)

Training Caregivers of Elders with Dementia who Exhibit Challenging Behaviours to Take a Functional Approach – http://bgsig.files.wordpress.com/2011/03/talk_gutterson.pdf

Behaviour Analysis and Dementia in Ireland (directly related to the content above) http://behaviouranalysisinireland.wordpress.com/2013/11/01/dr-michelle-kelly-behaviour-analysis-and-dementia/

*Thanks to the Alzheimer Society of Ireland for the infographics on dementia.

Top 5 Recent Posts 10/08/2014

Every week on our Facebook Page, members post dozens of post on topics related to Behaviour Analysis, its applications and related issues. One purpose of this blog is to highlight some of the most “liked” posts in order to make them available to a wider audience.

5. FREE Workshops from Penn State ASD Conference

Darragh O’Regan shared an excellent resource made available by the organisers of the Penn State ASD Conference. Videos of hundreds of presentations made at the conference are available online and will be of use to ASD professionals and parents.

4. Professor Neville Blampied’s Sleep Presentation

Prof Blampied’s tour of Ireland’s universities seems to have been a success with good attendance reported at all of his workshops and presentations.  For those who were unable to attend, the Centre for Behaviour Analysis at Queen’s University recorded and uploaded his talk.  There are several other excellent video presentations available at the above link.

3. Diploma in Applied Behaviour Analysis

Keith Lyons posted a link to a new Diploma course in ABA that is being run by City Colleges in Dublin.  The course can be taken in vivo or online and promises to provide a solid introduction to behaviour analysis and its applications.

2.  The Lion King and Evidence Based Approaches

ABA’s own Superhero Behavior Man posted the below meme. It was later shared to ABA Ireland and proved popular!

Behaviour Man

1. Vince Carbone – ABA in Action

One of the most valuable and popular links posted over the past few weeks is a 1997 video featuring Vince Carbone of the Carbone Clinic working with a young child with autism. Over 7 weeks, the child moves from uncooperative and non-verbal to cooperative and verbal. It also shows Vincent working with the child’s mother to transfer the required skills to the child’s mother.

That’s all for this week.

All comments welcome.

While ABA Ireland has taken all reasonable steps to ensure the accuracy of the contents of this blog, it accepts no liability for the accuracy or quality of the information provided and no liability for this information being up-to-date or complete. Information is provided for educational and general purposes only and is not intended as a substitute for professional advice. Where ABA Ireland provides links to third-party websites, it accepts no liability for the content of these websites. The views of authors are their own and do not necessarily reflect the views of ABA Ireland or any organisations associated with the authors of posts.

 

Top 5 Posts of Last Week (20/07/2014)

Every week on our Facebook Page, members post dozens of post on topics related to Behaviour Analysis, its applications and related issues. One purpose of this blog is to highlight some of the most “liked” posts in order to make them available to a wider audience.

This week our top 5 posts are:

5. Cuts to St. Catherine’s Association

st cats

There have been a number of posts this week related to cuts to St. Catherine’s Association in Wicklow. The HSE is reported to have made cuts of 500,000 euro to the service without warning. St. Catherine’s is well known to ABA supporters in Ireland. It was the centre of a protracted High Court challenge on the subject of providing ABA to children with autism and remains one of the few centres in Ireland where the families of children with autism and intellectual disabilities can access ABA.

Keith posted a link to this petition which aims to pressure the HSE into reversing the funding cuts. Readers are encouraged to sign and share it.

4. A Behaviour View of Sleep Throughout the Lifetime

An upcoming workshop by Professor Neville Blampied of the University of Canterbury in Christchurch on the topic of sleep seems to be of interest to many ABA Ireland members. Professor Blampied will be presenting workshops and lectures on the topic in TCD, NUIM and at QUB.

3. RASID Call for Papers

Louise McHugh posted this link to a call for papers from Research in Autism Spectrum Disorders on the subject of Derived Relational Responding in Autism Spectrum Disorders. This is a popular area of research in Ireland so hopefully we will see lots of Irish researchers featured when the special issue of the journal is published.

2.  Science Versus Pseudoscience

Louise shared a photo from IFLS:

IFLS Pseudoscience

One member related the image back to the provision of services for people with autism noting that interventions that lack an evidence base are widely funded in Ireland while ABA is not. IFLS is highly recommended and deserves great credit for encouraging people to learn more about science and how it differs from pseudoscience.

1. Labour Committed to Funding and Recognising Autistic SchoolsJan O'Sullivan

Ruairi Quinn has left the Department of Education and Skills and been replaced by Labour’s Jan O’Sullivan. Michelle shared a link (originally posted by QUART) to a 2007 press release from the then opposition TD.

On the subject of the costs of providing ABA to children with autism Jan stated:

This is an extremely small price to pay for giving autistic children the best possible start by providing education directly catered towards their needs

Some posters were skeptical about the possibility of the Minister changing her new department’s policy. One noted that tendency of her predecessors to conveniently forget their pre-election positions when power while another pointed out that words are cheap when in opposition. At least one member felt that we should “give her a chance and wait and see what she does” as ” its all about measuring behaviour in the end, even the behaviour of Ministers.”

That’s all for this week. All comments welcome.

While ABA Ireland has taken all reasonable steps to ensure the accuracy of the contents of this blog, it accepts no liability for the accuracy or quality of the information provided and no liability for this information being up-to-date or complete. Information is provided for educational and general purposes only and is not intended as a substitute for professional advice. Where ABA Ireland provides links to third-party websites, it accepts no liability for the content of these websites. The views of authors are their own and do not necessarily reflect the views of ABA Ireland or any organisations associated with the authors of posts.

Hello & Welcome to the ABA Ireland Blog

ABA Ireland is a voluntary group of academics, professionals, parents and students dedicated to providing ABA information and educational services to members of the community who would derive benefit from the science, such as parents of typically developing children with challenging behaviour, individuals with acquired brain injuries and people with autism.

Since our formation in 2011, we have sought to achieve our goals in a variety of ways. For example, we have organsied free Family Fun Days  and Autism Friendly cinema screenings for the families of people with disabilities,  facilitated parent and professional training workshops in conjunction with partner organisations and made submissions to government on the future of disability policy. One of the most powerful ways in which we have managed to connect with people who could benefit from ABA is through the internet and social media.

In 2013, we launched our website. It allows us to direct provide useful information to all our stakeholders with ease.   Our Facebook group now has over 2,500 members and continues to grow at a rapid pace. To mark this new milestone, we are launching this blog.

Every day, numerous members of our group provide links to materials that are of interest to our community. One purpose of this blog is to compile and share those links and materials in a way that makes them more acessible to people who are not members of our group. In time, we also hope that we can use it to share original contributions and materials that are not available elsewhere.

If you have any questions or queries, please feel free to Contact Us.

Niall