Re-acquisition of a Recreation Skill by Adults with Cognitive Impairments: Implications to Self-Determination
Keywords:Cognitive Impairment, Self-Determination, Single Subject Research Methodology, System of Least Prompts
AbstractThe purpose of this study was determine if the leisure repertoire of adults with cognitive impairments who reside in a long term care facility could be expanded. The effectiveness of the system ofleast prompts (SLP), a concrete intervention strategy consisting ofa hierarchy of interventions from the least intrusive to the most intrusive, was examined. The six participants (ages>70) all scored in the severe cognitive impairment range of the Mini Mental Status Exam. A single subject multiple probe design across dyads was used to introduce the independent variable (SLP). The intervention phase required the application of a consistent sequence of instructional prompts: verbal, repeated verbal, gestural, model, and physical. Independence increased for each participant during the intervention. Results of social validity interviews indicated that family members and caregivers perceived the intervention to be valuable. Two of the three participants who received direct instruction increased independence in gardening and one member acquired independence prior to any intervention. Only one of the three participants acquired the skill during the observation and learning phase. Independence increased for the other two participants when they re-ceived the SLP. The findings provide evidence that a SLP in a dyad or individual setting can facilitate the re-acquisition of a recreation skin in adults with cognitive impairments.
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