COMPARISON OF STAFF TRAINING STRATEGIES TO PROMOTE GENERALIZED TEACHING SKILLS

Two studies compared the effectiveness of different strategies for promoting generalization of staff skills in teaching self-care routines to clients with developmental disabilities. In Study 1, 9 direct-care staff members of group homes were trained sequentially through four conditions: (a) the provision of written instructions, (b) performance-based training using a single client program exemplar and simulated clients (single case training), (c) performance-based training using actual developmentally delayed clients as trainees (common stimuli training), and (d) performance-based training using multiple client program exemplars with simulated clients (general case training). The results indicated that staff members did not reach all generalization criteria until general case training was provided. Because staff members had been trained sequentially through several conditions in Study 1, a second study controlled for potential sequence effects. In Study 2, 7 staff members were trained using only the general case strategy after baseline. All staff members reached generalization criteria with only general case training, replicating the findings of Study 1. Together, the two studies demonstrated that the general case training strategy was more effective at promoting generalized training effects across clients, settings, and client programs than other commonly used staff training approaches.     

PYRAMIDAL STAFF TRAINING IN THE EXTENSION OF TREATMENT FOR SEVERE BEHAVIOR DISORDERS

We implemented a pyramidal training procedure for staff working with individuals who exhibited self-injurious behavior (SIB), aggression, and disruption. Two adults with developmental disabilities and their direct-care staff and supervisors participated. Following successful treatment by the experimenters, two types of baselines were conducted with the clients and their direct-care staff. During an initial baseline, the staff implemented preexisting procedures. Staff members then received instruction on the new treatment procedures using training methods common throughout the institution, and data were collected during this “post-in-service” baseline. Experimenters then taught unit supervisors to implement treatment, collect and interpret data, and provide similar instructions and feedback to the staff members. The supervisor training was implemented in a multiple baseline design across subjects (clients and direct-care staff). Results showed little change following in-service training but noticeable improvements in direct-care staff behaviors and corresponding decreases in the clients' inappropriate behavior following the pyramidal training intervention with supervisors. Six additional clients (along with their direct-care staff and supervisors) participated in pre- and posttreatment replication designs, and their results provided additional support for the efficacy of the supervisor training procedures.     

THE EFFECTS OF VIDEO MODELING ON STAFF IMPLEMENTATION OF A PROBLEM‐SOLVING INTERVENTION WITH ADULTS WITH DEVELOPMENTAL DISABILITIES

We investigated the effects of video modeling on the percentage of correctly implemented problem‐solving steps by staff in a group home for adults with developmental disabilities, using a nonconcurrent multiple baseline design across participants. The treatment consisted of staff watching a video model demonstrating the correct implementation of a problem‐solving intervention (i.e., teaching clients to identify problems, possible solutions, and consequences to each solution, and to choose the best solution). The percentage of correctly implemented problem‐solving steps increased for all participants, and the effect was maintained over time, generalized to novel problems, and generalized from role play with a researcher to actual clients.     

THE GOOD PRODUCTIVITY GAME: INCREASING WORK PERFORMANCE IN A REHABILITATION SETTING1

Simple reinforcement systems have been used to improve performance in a broad range of settings. For example, in classrooms, the “Good Behavior Game” has been shown to be very effective (Barrish, Saunders, and Wolf, Journal of Applied Behavior Analysis, 1969, 2 , 119–124). In industry, small bonuses were used to increase the punctuality of workers (Hermann, deMontes, Dominquez, Montes, and Hopkins, Journal of Applied Behavior Analysis, 1973, 6 , 503–572). In a sheltered workshop setting, Shroeder (Journal of Applied Behavior Analysis, 1972, 5 , 45–52) examined work rates under varying frequencies and amounts of reinforcement and response force. The present study involved the utilization of simple group contingencies to increase productivity in a rehabilitation industry. Four state hospital residents who were trainees at a rehabilitation industry participated in the study which examined the effects of feedback, and feedback plus the “Good Productivity Game” to improve work output. The task, for which the employees were paid a wage, involved sorting boards by size. When the employees were provided with feedback on the number of boards sorted during the observation period, productivity increased slightly over baseline. After a return to baseline, the “Good Productivity Game” was played. For performance, the game afforded the employees pseudo-competition (in that teams were paired against each other, but both teams always “won”) and simple rewards such as candy and early work termination. The game improved performance by 104% over the second baseline and by 64% over the third baseline. Data gathered on rates of on-task behavior by the employees correlate with the productivity rates. Data gathered on rates of staff attention paid to employees show little difference across conditions, thus corroborating the function of the “Good Productivity Game” in increasing work output. Although no formal data were collected, the staff continued to use the game with considerable success after the formal termination of the study. The “Good Productivity Game” appears useful in increasing work output in a rehabilitation setting. Further research should concentrate on the utility of the game throughout longer periods of the workday and over extended periods of time.     

A multiple-schedule evaluation of immediate and subsequent effects of fixed-time food presentation on automatically maintained mouthing

The purpose of this study was to evaluate the immediate and subsequent effects of fixed-time (FT) food presentations on mouthing. The effects of FT food presentations were analyzed within a three-component multiple schedule in which baseline conditions were implemented during the first and third components and treatment conditions were implemented during the second component. Results indicated that FT food reduced mouthing and that levels of mouthing during post-FT components were reliably lower than pre-FT components. Behavioral mechanisms responsible for treatment effects are discussed.     

USE OF A SELF-RECORDING AND SUPERVISION PROGRAM TO CHANGE INSTITUTIONAL STAFF BEHAVIOR

The use of a self-recording and supervision program to increase interactions between direct care staff and profoundly retarded persons in a state residential facility was investigated. Following baseline, staff were provided with instructions regarding what to self-record, criteria for how many interactions to record, and a prepared card on which to make the recordings. Throughout the study, the staff supervisor monitored intermittently staff-client interactions. Observations indicated that when the staff recorded their interactions with clients in a loosely structured dayroom setting, the rate of interactions increased noticeably for each staff person. Behavioral ecology measures indicated that other staff responsibilities, such as maintaining the cleanliness of residents and the physical area, were not affected detrimentally when social interactions increased and actually showed small improvements. Additionally, small decreases in resident self-stimulatory and disruptive/aggressive behaviors occurred when the rate of social interactions from staff persons increased. Follow-up measures indicated that the rate of staff self-recording was variable, but when staff did self-record, the increased rate of staff-client interactions maintained.     

Behavioral contrast and response independent reinforcement

Four pigeons received pre-training that included presentation of the reinforcer independently of behavior and then baseline training on a variable-interval schedule of reinforcement. With the introduction of a multiple schedule, in which the first stimulus was associated with a response contingent and a second stimulus with a response independent, 1-min variable-interval schedule, a reduction in response rate was obtained in the second component, which was not accompanied by a behavioral contrast effect in the first component. A further three pigeons were given the same pre-training and baseline training before the introduction of an otherwise identical multiple schedule, in which no reinforcement occured in the second component. Behavioral contrast was obtained from all three subjects. The results indicated that under conditions of constant reinforcement density a reduction in responding is not a sufficient condition for the occurrence of behavioral contrast.     

Effects of structured social interaction with geriatric mentally retarded clients: an exploratory study

In this study, using an observation-based inferred self-concept (social competency measure), I examined a structured program of client-staff interaction reinforcing self- and environmental awareness in institutionalized geriatric mentally retarded clients. Results indicate significant improvement over successive sessions. Subjects in structured interaction had a more positive self-concept in the post-treatment period when compared either to pretreatment baseline or to a control group that had not been in structured interaction with staff. Results support the use of structured interaction--which serves as a reinforcer for improved functioning--to increase staff contact with clients.     

THE EFFECTS OF PERFORMANCE FEEDBACK ON THE SAFETY OF CLIENT LIFTING AND TRANSFER

Individual written and verbal performance feedback was examined to determine its influence on the safety with which physically disabled clients were transferred. Two client-transfer techniques were task analyzed and six direct service providers' on-the-job performance was measured weekly. A multiple baseline across settings and subjects was used to evaluate effects of the feedback. Consumer satisfaction and the costs of the procedures were also assessed. Results showed that feedback was consistently followed by improvements in safe performance. These improvements tended to maintain as feedback was faded. Participants favorably rated the feedback procedure and consistently recommended its use with other staff.     

Behavioral momentum and resistance to extinction across repeated extinction tests

The present experiments assessed whether resistance to extinction of pigeons' key pecking decreased across repeated extinction tests. An additional impetus for this research was to determine how the quantitative framework provided by behavioral momentum theory might be used to describe any such changes across tests. Pigeons pecked keys in two‐component multiple schedules (one component associated with a higher reinforcer rate and the other with a lower rate) in which baseline and extinction conditions alternated. In Experiment 1, baseline and extinction conditions alternated every session, and, in Experiment 2, these conditions lasted for 10 and 7 sessions, respectively. Resistance to extinction decreased across successive extinction conditions in both experiments. Fits of the behavioral‐momentum based model of extinction to the data returned uncertain results in Experiment 1 but implicated both generalization decrement and response–reinforcer contingency termination as the possible mechanisms responsible for behavior change in Experiment 2. Thus, these data suggest that experimental manipulations that affect discrimination of changes in reinforcement contingencies may influence resistance to extinction by modulating the disruptive impacts of removing reinforcers from the experimental context and of suspending response–reinforcer contingencies.     

A pharmacological examination of the resistance-to-change hypothesis of response strength.

The effects of d-amphetamine sulfate, sodium pentobarbital, haloperidol, and cholecystokinin-octapeptide were examined within the context of Nevin's (1974, 1979) resistance-to-change hypothesis of response strength. In three experiments, rats' responding was reinforced by delivery of food under chained random-interval 30-s random-interval 30-s, multiple fixed-interval 30-s fixed-interval 120-s, or multiple random-interval 30-s random-interval 120-s schedules. Each rat received several doses of each drug and changes in response rate were measured. The resistance-to-change hypothesis predicts greater disruption of response rate relative to baseline in the initial component of the chained schedule and in the 120-s component of the multiple schedules. In the chained schedule cholecystokinin-octapeptide produced greater reductions in response rate relative to baseline in the initial component. However, no differences between components were observed with haloperidol or sodium pentobarbital, and high doses of d-amphetamine reduced response rate in the terminal component relatively more than in the initial component. In the multiple schedules either no differences were observed between components or response rate was reduced more relative to baseline in the 30-s component. The data fail to support the notion that drugs may be viewed within the same context as other response disruptors such as extinction, satiation, and the presentation of alternative reinforcement.     

Effects of Public Posting and Goal Setting on Team Performance in a Residential Setting

Treatment integrity has been shown to be of critical importance in behavioral programming. The extent to which tasks are completed as designed often has a direct effect on the quality of care provided to clients. Most research on treatment integrity has focused on implementation of interventions. The current study used a multiple baseline design across behaviors to evaluate the effects of public posting of team performance data and goal setting on data collection by direct‐care staff. Results of the current study suggest that public posting and goal setting may be effective strategies to improve staff data collection. Copyright © 2016 John Wiley & Sons, Ltd.     

EVALUATING A SUPERVISION PROGRAM FOR DEVELOPING AND MAINTAINING THERAPEUTIC STAFF-RESIDENT INTERACTIONS DURING INSTITUTIONAL CARE ROUTINES

This study evaluated a program to teach and maintain language training interactions between institutional staff and profoundly handicapped children during a routine care task. Following baseline observations of bath sessions, staff were sequentially taught in multiple baseline fashion to vocalize more during the bath, praise child vocalizations, imitate sounds, and provide sound prompts. Procedures included a brief in-service meeting followed by a series of supervisory prompts and feedback. Results indicated that staff acquired the interaction skills in the bath sessions and that the skills generalized to another direct care task, dressing. The number of days on which components of supervision were implemented decreased from 47% of all days during the experimental conditions to 19% of the days during a 19-week maintenance period with no decrease in staff behavior. The interactions were shown not to interfere with the quality of the direct care task nor to increase the amount of time necessary to complete it. Also, some increases were noted for child vocalization frequencies. The advantages of providing therapeutic interactions during care routines are discussed along with the need for staff management techniques with long-term maintenance value.     

Clinical use of the Quick Test with sheltered workshop clients

The purpose of this note is to provide clinical reference data on the Quick Test responses of 48 adult sheltered workshop clients. The mean IQs for Forms 1, 2, and 3 were 66.3, 67.6, and 69.7, respectively. The mean IQ for combined Form 1 + 2 + 3 was 68.4. Standard deviations of IQs for the three forms were 13.68, 13.99, and 15.31, respectively, and for Form 1 + 2 + 3 was 13.65. There were 17 females and 31 males ranging in age from 18-2 to 61-1. These data provide tentative local norms for psychologists to use when the Quick Test is given to evaluate mentally subnormal clients of these sheltered workshops for placement or to predict their success in work programs. Future norms should be checked and updated for workshop clients.     

Evaluation of increasing antecedent specificity in goal statements on adherence to positive behavior‐management strategies

We evaluated the impact of antecedent specificity in goal statements on adherence to positive behavior‐management strategies. Teaching staff were recruited from 2 different school settings where there were routine expectations to use behavior‐specific praise in the classroom, but adherence was poor. In a concurrent multiple baseline design, the use of behavior‐specific praise by 4 participants was found to be unaffected by goal statements that increasingly specified the behavior to be used and the conditions under which the behavior should occur. However, adherence by 3 of the 4 participants did change when goal statements included teacher‐specified frequencies with which the behavior should occur. Results were systematically replicated in a second study in which, in a concurrent multiple baseline design, 3 participants showed marked increases in adherence when goal statements specified the target behavior, the conditions under which it should occur, and the frequency with which it should occur.     

Does the two-chair dialogue intervention facilitate processing of emotions more efficiently than basic Rogerian conditions?

Processing difficult emotions is assumed to be of importance in therapeutic change. In this study, we examine whether a two-chair dialogue in Emotion-focused Therapy (EFT) is associated with a change in emotional processing, measured as changes in emotional arousal and emotional experiencing. In a multiple baseline design, 20 clients in treatment for depression or anxiety first received five, seven or nine weekly sessions of baseline treatment providing Rogerian conditions and affect attunement. In the second phase, two-chair intervention was added for the five consecutive sessions. All sessions were subdivided into 2 min segments which were rated using the Client Emotional Arousal Scale III and the Experiencing Scale. Analyses indicated a significantly higher number of high-arousal segment in the latter phase. Individual clients’ change trajectories were not significantly steeper in the second phase. Experiencing increased throughout both phases of treatment. However, after introducing the two-chair dialogue the Experiencing change trajectory was not significantly steeper than in the baseline phase. Findings suggest that both the two-chair dialogue and the Rogerian conditions with affect attunement focus are effective in facilitating emotional processing. Results are consistent with previous research, suggesting that the two-chair dialogue is an emotionally evocative intervention. Implications and limitations are discussed.     

Independent use of activity materials by the elderly in a residential setting

A lottery was implemented to encourage the elderly clients of a residential home to use activity materials any time they wished, independently of staff intervention and the institutional routine of the home. During baseline, there were minimal levels of independent use of activity materials by residents. Various conditions were implemented but only the introduction of a £20 lottery prize brought about a significant increase in the frequency of independent use of activity materials. A follow‐up suggested that the reinforcing properties of the activity materials themselves eventually maintained the target behavior.     

Training direct service staff in congregate settings to interact with people with severe disabilities: A quick,effective and acceptable program

An area of traditional as well as recent concern in congregate settings for people with severe disabilities is ensuring frequent social interactions between direct service staff and individuals who live in the residences. This study evaluated a program for training staff to interact frequently and positively across clients while in group situations in living units. The program involved a short classroom instructional session encompassing less than 1 h, followed by a maximum of 4 brief on-the-job observations and feedback sessions. Results indicated interaction rates of all 9 participating direct service staff increased above a normative criterion rate while participating in the training program. All staff also increased the proportion of their social interactions with clients that were positive in nature, and 6 of the 9 staff increased their distribution of interactions across clients. The improved interaction performances occurred when staff were provided with immediate on-the-job feedback regarding their performances as well as when provided with delayed feedback. Acceptability measures indicated the training program was well received by staff, although program components also were noted that may have affected staff acceptance differentially. Directions for future research are suggested in regard to further evaluating and increasing staff acceptance of effective training procedures.     

Teaching social‐learning procedures to paraprofessionals working with individuals with severe mental illness in a maximum‐security forensic hospital

This study describes an integrated technical method for teaching learning‐based interventions to paraprofessionals working in a maximum‐security psychiatric facility as a social‐learning program was implemented. This training approach combines brief didactic instruction with live demonstration and guided practice in specific procedures. Comparisons between baseline and post‐training functioning of staff were made using ongoing direct observational assessment data. Results revealed that following training and program implementation staff were much more active overall, interacted with clients far more often, and engaged in much lower rates of job‐irrelevant activity. Moreover, following training direct observational data of the patterns of staff–client interactions showed that staff were much more likely to demonstrate interactions reflective of learning‐based interventions than at baseline. These results have important implications for clinicians and administrators attempting to implement behavioral rehabilitation programs. Copyright © 2001 John Wiley & Sons, Ltd.     

Multicultural web-based motivational interviewing for clients with a first-time DUI offense

Culturally and linguistically appropriate interventions are needed to reduce the risk of driving under the influence (DUI) recidivism among diverse populations. Using core elements of Motivational Interviewing, we developed a culturally relevant web-MI intervention (web-MI) in English and Spanish to serve as a standalone or adjunctive program in DUI educational settings and evaluated its feasibility and acceptability among clients with first-time DUI offenses. We conducted an iterative formative assessment using focus groups with staff (n = 8) and clients (n = 27), and usability interviews with clients (n = 21). Adapting MI for the web was widely accepted by staff and clients. Clients stated the web-MI was engaging, interactive and personal, and felt more comfortable than past classes and programs. Spanish-speaking clients felt less shame, embarrassment, and discomfort with the web-MI compared to other in-person groups. Results support the viability of web-MI for DUI clients at risk for recidivism and highlight the importance of adapting the intervention for diverse populations. Key decisions used to develop the web-MI are discussed.