OCCUPATIONAL THERAPY FRAMES OF REFERENCES AND MODELS

BEHAVIORAL FRAME OF REFERENCE

Theoretical Base

  • The central assumption of behavioral theories is that learning is the basis of all behavior

  • Learning is always inferred from behavior, and it leads either to more effective behavior, known as adaptive behavior, or to maladaptive behavior


Repertoire of Behaviors

  • Behaviors both adaptive and maladaptive

  • Determines ability to function in activities of daily living, work, and leisure


Learning Theory

Parismony

  1. Differentiates learning theory approach from other approaches

  2. Emphasizes on external environment, and its focus on the situational specificity of human behavior

  3. Learning theory looks to the environment, rather within the individual for the determinants of behavior

  • Behavior can be best predicted and controlled by attending to environmental influences

Situational Specificity

  1. It is believed that people behave the way they do in response to the characteristics of the particular situation that they are in at the moment

  2. As a result, a person’s behavior is usually not consistent across situations

  3. Aggressive response would be understood in relation to the specific situation


Two Main Approaches in Behaviorism

Classical Conditioning

  • Also known as respondent approach

  • Focuses on how people learn new responses by coming to associate a set of circumstances that previously did not elicit a particular reaction with another set of circumstances      that already led to that reaction

  • Limited to reflexive or involuntary behaviors

  • Important in understanding the relationship between stress and the functioning of the autonomic nervous system

Operant Conditioning

  • Also  known as instrumental approach

  • Affects all voluntary behavior, as well as that of the autonomic nervous system

  • Behavior is learned as a result of the environmental consequences a person receives when performing the behavior


Maladaptive Behaviors

  • Learned through selective reinforcement from the environment in the same way that adaptive behaviors have been learned


Operant

  • A behavior resulting reinforcement

  • Environment is seen to cause and to control behavior by teaching the person to behave as he or she does

  • The person emits a response that results in an environmental event, which is a rewarding event, which is a rewarding consequence


Environmental Reincforcement

Usually one of three types

  1. Consumable

  2. Social

  3. Participatory


Schedule

  • Initially, an immediate reward schedule of reinforcement is necessary to elicit the desired behavioral response

  • Intermittent reinforcement

  • § Reinforcing for every nth response

  • § used effectively stabilize the response


Backward Chaining

  • A variation of shaping wherein components of the task are learned by starting with the final step and working backward to the first step


Token Economy Systems

  • Tokens are received that can be traded for something they desire if they can produce certain types of behavioral responses


Biofeedback

  • The person is given reinforcement for emitting some type of physiologic response


Function-Dysfunction Continua

Function

  • A state of function exists when the person has the requisite kinds and amounts of functional skills to attain maximal independence within his or her environment

Dysfunction

  • Conceptualized as a low incidence of adaptive behaviors required within the person’s environment and a high incidence of maladaptive behaviors



Function-Dysfunction Continua

  • Specific, definable, and observable behaviors that compromise functional abilities are targeted for change in the behavioral FOR

  • The frequency with which these behaviors occurs within the environment is indicative of the degree of function and dysfunction

  • Task situations are used as naturalistic setting to observe typical behaviors and the environmental reinforcers that serve to maintain those behaviors

  • Evaluate activities are conceptualized in terms of their potential for providing opportunities to elicit and observe specific, behaviors targeted for change


Postulates Regarding Change and Intervention

  • After functional and dysfunctional behaviors are identified, the client is provided with opportunities to learn the specific behaviors necessary to maximize functional independence within the environment

  • Dysfunctional behaviors can be changed by manipulating environmental variables so that adaptive behaviors can be changed by manipulating environmental variables so that adaptive behaviors are reinforced and maladaptive behaviors are not reinforced

  • Activities are analyzed in terms of their potential for eliciting and providing reinforcement for behaviors targeted for change through the following steps, Seig (1976)

  1. Identify the terminal behavior, or operationally defined treatment goal. Note that in order for the behavior to be assessed, it must be observable and quantified

  2. Determine the baseline performance, that is, the frequency of occurrence of the behavior before the onset of the occupational therapy program. The baseline performance is used to measure changes in behavior

  3. Design a data collection format. The occupational therapist selects an objective procedure for counting and recording the behavior such as the use of a counterm or charting behavior on a graph

  4. Select reinforcer. The therapist identifies the principal reinforcers that are supporting the behavior. Positive reinforcers to be presented are most often consumable items, social reinforcements, or activity opportunities

  5. Determine the reinforcement schedule. The therapist determines when the patient should be reinforced, that is, immediately, intermittently, or after each activity session

Chart the data. This provides clear information about the rate over a period of time