Behavioral management of a neurologically impaired pediatric inpatient.
Neurologically-impaired pediatric inpatients often require behavioral management to facilitate attendance and performance in physical, occupational, and speech therapies. Nursing management of such patients can be simplified by the use of behavioral analysis techniques. This paper reports a case in which the patient's own behaviors along with verbal reinforcement were used to reinforce appropriate behavior patterns in a child who presented several management problems. There was improvement during behavioral sessions with generalization of desired behavior to the nursing floor and to therapy sessions. Analysis of desired or target behaviors and the levels of consciousness schema facilitated behavioral programming. This case study demonstrates how careful attention to behavioral details can improve the behavioral repertoire of a patient who would otherwise be very disruptive and not a good rehabilitation candidate. A behavioral analysis system using the Premack principle and levels of consciousness schema can be applied more generally to the behavioral management of neurologically impaired inpatients.
D001521:Behavior Therapy; D002648:Child; D002653:Child Behavior Disorders / Q000628:therapy*; D002673:Child, Hospitalized; D006801:Humans