Enhancing Physical Therapy Exercises in Persons with Acquired Brain Injury through a Self-Control Training Procedure

Abstract

The purpose of the present study was to increase engagement in physical therapy tasks with two adults with acquired traumatic brain injuries while promoting self-control choices. Participants were directed to engage in a designated physical therapy task without programmed reinforcement. Next, participants were presented with two choices: a small amount of a preferred reinforcer delivered immediately and a larger portion of the same reinforcer delivered after a specified level of task engagement. When the participants still exhibited impulsive behavior, a third condition was introduced that involved an additional choice of a large progressively delayed reinforcer. With one of the participants, additional manipulations were required in order to bring about self-control responding. These included modifications of delay values and the implementation of a series of forced choices while the delay associated with the choice was systematically increased. Both participants eventually exhibited a preference for the progressive delay option even as the duration of the delay surpassed that of the fixed delay option. Results are discussed in terms of teaching life enhancing skills and the enhancement of optimal choice making.