Self-administered written prompts to teach home accident prevention skills to adults with brain injuries.
A written checklist often teaches adults with brain injuries to fix home hazards; if not, add a brief task analysis and fade it out.
01Research in Context
What this study did
Three adults with brain injuries lived in their own apartments. Each person picked five real home hazards, like a frayed cord or a hot pan left on the stove.
The researchers gave each adult a simple written checklist of the hazards. If the checklist was not enough, they added a short step-by-step card that showed exactly what to do. They tracked how many hazards the adults fixed before and after the tools were introduced.
What they found
The checklists alone worked for two participants. They spotted and fixed every hazard on their list.
The third adult missed some hazards with the checklist alone. When the step-by-step card was added, that person also reached 100 % correct. Two weeks later, all three adults still fixed hazards, and they even found new problems that were not on the original lists.
How this fits with other research
Exline et al. (2024) extends this idea into telehealth. They showed that caregivers can teach and fade prompts over Zoom, just like the step-by-step cards were faded in person.
Dugan et al. (1995) used the same prompt-and-fade logic, but for feeding instead of safety. Both studies got big gains with one-to-one fading, proving the method works across very different skills.
Parsons et al. (1981) looks different on the surface—flextime at work—but both papers trust adults to track their own behavior with simple logs or checklists and still see real-life gains.
Why it matters
You do not need fancy tech to keep adults with brain injuries safe. Start with a plain-language checklist taped near the hazard zone. If they miss items, add a short task analysis and fade it once performance is steady. The tools are cheap, the data are easy to take, and the skills last after you leave.
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02At a glance
03Original abstract
This study evaluated the use of written checklists and task analyses as self-administered prompts to teach home accident prevention skills to 4 adults with brain injuries. Subsequent to baseline, participants used written checklists that identified potential in-home hazards but did not prompt behaviors necessary for hazard remediation. Written individualized task analyses, incorporating specific behavioral steps for correcting hazards that participants had failed to remediate during the checklist phase, were used to prompt appropriate responding when necessary. These were subsequently faded to transfer stimulus control to the natural conditions. A multiple probe technique across participants and settings was used. Results indicated that the checklist alone was sufficient to increase appropriate responses to many of the potential hazards. Individualized task analyses, when needed, resulted in appropriate remediation of all potential hazards. Generalization to untrained potential hazards occurred to some degree for all participants. Follow-up results showed that most skills trained were maintained over a 1-month period.
Journal of applied behavior analysis, 1990 · doi:10.1901/jaba.1990.23-431