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COGNITIVE-BEHAVIOR MODIFICATION FOR PLANNING SEQUENTIAL ACTIONS IN A PATIENT WITH AN IDEATORY APRAXIA

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  • 観念失行症患者の系列行為の再学習に対する認知的行動療法

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Abstract

VI, Therapeutic tranining for ideatory apraxia has not been established as well as its nature.Lehnikuhl and Poek (1981), using tasks in which patients had to arrange pictures in correct order suggested that ideatory apraxia was characterized by a disturbance in the conceptual organization of actions. A 42 year old right-handed patient with an ideatory apraxia was taught to arrange 9 sets of photographs in correct order. A multiple baseline design across behaviors was used to assess the effect of training variables on learning to arrange photographs correctly, and to assess the effect of the learning on performing the sequential actions. Training variable consisted of giving social reinforcement contingent to a correct arrangement, and pointing to a correct photograph in the case of an incorrect choice or a severe hesitation. The pacient could learn consequently how to arrange every set of photographs correctly in a day. For first five actions, the learning to arrange photographs correctly was followed on the first day by improvement in carrying out the sequential action. For other four actions, improvement emerged before the application of training variables. The effect of learning correct arrangement on performing the sequential actions and generalization to other actions were discussed.

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