Brain injury is a major public health concern affecting nearly 5 million Americans annually with a cost exceeding $60 billion in the United States. Acquired and traumatic brain injuries cause physical, cognitive and social deficits resulting in behavioral, affective, cognitive, and physical changes. Though the biomechanical injury may be the initial source of the behavioral changes, environmental factors frequently contribute to maintaining maladaptive behaviors. Behavioral and affective changes in the person with a brain injury are frequently cited as the most distressing issues for caregivers, and their need for education and training is well documented. Interactions between caregivers and persons with brain injury may play a critical role in the rehabilitation process, and coaching caregivers may decrease unwanted behaviors exhibited by the person with the brain injury and foster more positive functional outcomes for the individual.
This study utilized a multiple probe, multiple baseline across behaviors, single-case research design and examined the effects of caregiver behaviors on skill acquisition by a child with a traumatic brain injury. The caregiver-client dyad in this study was a mother and her 10-year-old adopted child. The researcher coached the caregiver using distance technology. Coaching consisted of in vivo feedback on the caregiver’s use of general behavior analytic skills, such as use of effective prompting and positive social consequences, while engaging with the child with a brain injury. Improvements in the client’s independent task completion across three functional tasks were observed, which correlated with changes in the caregiver’s skills following distance coaching
