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The impact of stroke on the lives of individuals and the health-care system is considerable. Damage from stroke can be limited if the treatment is administered at the appropriate time, so early recognition is essential. Some common interventions (e.g., FAST) designed to help potential stroke victims discriminate stroke symptoms often result in false negatives. Strokes can present with a wide variety of symptoms, making it difficult to discriminate stroke symptoms from non-stroke symptoms. Because the probability that a given set of symptoms are stroke symptoms is typically unknown to the victim, the problem is a decision under conditions of uncertainty. Signal detection methodology allows us to consider the ability of an individual or group to discriminate between stroke symptoms and non-stroke symptoms, as well as measure the motivation or bias toward a particular decision. We examined the effects of levels of feedback on performance of a random sample of participants from Amazon Mechanical Turk. We found that feedback designed to generate liberal bias toward stroke detection yielded fewer misses than FAST while maintaining a false alarm rate below 50%. Given that strokes are difficult to discriminate, this suggests that interventions should be focused on incentivizing help-seeking behaviors in conditions of uncertainty for those most at risk. Keywords Stroke * Signal detection * FAST * Decisions under uncertainty, There are at least 700,000 individuals who experience a stroke for the first time each year in the United States (Alpert, 2011). When a patient is experiencing stroke symptoms, rapid [...]

In the current study, nursing home staff were taught to administer functional analyses to determine the variables maintaining aggression by an elder with dementia. The results indicated that aggression was evoked during bathroom routines and that escape maintained aggression. Staff then reduced aggression to near-zero levels with noncontingent escape. Implications for the assessment and treatment of problem behaviors in nursing home settings are discussed. (Contains 1 figure.)

Millions of Americans are diagnosed with dementia, and that number is only expected to rise. The diagnosis of dementia comes with impairments, especially in language. Furthermore, dementia-related functional declines appear to be moderated by environmental variables (Alzheimer's Association, "Alzheimer's & Dementia: The Journal of the Alzheimer's Association" 8:131-168 2012; American Psychiatric Association, 2000; Engelman et al., "Journal of Applied Behavior Analysis" 32:107-110, 1999; Engelman et al., "Journal of Applied Behavior Analysis" 36:129-132, 2003) Traditional language tests are not likely to assess or inform treatment for deficits in manding (Esch et al., "The Journal of Speech-Language Pathology and Applied Behavior Analysis" 5:166-191, 2010), and the mand is a verbal operant about which little is known among this population. The current study evaluated whether contriving an establishing operation within a preferred activity using a prompt-probe intermix procedure and a transfer of stimulus control procedure was effective in establishing mands in older adults with dementia. The procedure was demonstrated to be effective with one participant, but results were inconsistent with the second participant. Modifications were made throughout training for both participants, showing the importance of individualizing interventions.

Skinner's 1957 analysis of verbal behavior has demonstrated a fair amount of utility to teach language to children with autism and other various disorders. However, the learning of language can be forgotten, as is the case for many elderly suffering from dementia or other degenerative diseases. It appears possible that Skinner's operants may facilitate not only acquisition of language but also the ability to recall items or objects that may have appeared to be "forgotten." The present study examined the utility of having a series of adults in long-term care emit tacts, echoics, or intraverbals upon presentation of various visual stimuli. Compared to a no-verbal response condition, it appears that the incorporation of Skinner's verbal operants can in fact improve recall for this population. Implications for the retraining of lost language are presented. (Contains 1 figure.)

Aphasia is an acquired language impairment that affects over 1 million individuals, the majority of whom are over age 65 (Groher, 1989). This disorder has typically been conceptualized within a cognitive neuroscience framework, but a behavioral interpretation of aphasia is also possible. Skinner's (1957) analysis of verbal behavior proposes a framework of verbal operants that can be integrated with the work of Sidman (1971) and Haughton (1980) to describe the language difficulties individuals with aphasia experience. Using this synthesis of models, we propose a new taxonomy of aphasia based on the observed deficit relations. Assessment and treatment implications are also discussed. (Contains 5 tables.)