Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention-deficit hyperactivity disorder

Twenty-four boys with attention deficit-hyperactivity disorder (ADHD) participating in an intensive summer treatment program each received b.i.d. placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed with two classroom settings: a behavior modification classroom including a token economy system, time out and daily home report card, and a regular classroom setting not using these procedures. Dependent variables included classroom observations of on-task and disruptive behavior, academic work completion and accuracy, and daily self-ratings of performance. Both MPH and behavior modification alone significantly improved children's classroom behavior, but only MPH improved children's academic productivity and accuracy. Singly, behavior therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted in maximal behavioral improvements, which were nearly identical to those obtained with 0.6 mg/kg MPH alone.The authors gratefully acknowledge the assistance of Patricia Donovan, Michelle Berry, Mary Ingram, Patricia Wells, Beth Gnagy, Karen Greenslade, Mary Hamilton, and the entire staff of the Western Psychiatric Institute and Clinic ADHD Summer Treatment Program.     

INCREASING APPOINTMENT KEEPING BY REDUCING THE CALL-APPOINTMENT INTERVAL

We examined the effect of reducing the interval between a patient's call for an appointment and the appointment itself. In Experiment 1, patients calling a family planning unit of a public health department were assigned appointments within either 1 or 3 weeks of their call. Data on patient “shows” and “no-shows” were recorded weekly for 6 weeks. Show rates for those in the 1-week appointment group were significantly higher than those in the 3-week group. In Experiment 2, patients were assigned to appointment dates either the next operating clinic day (next-day group) or 2 weeks from the call date (2-week group). Show rates for those in the next-day group were significantly better than show rates for patients in the 2-week group. Clinic productivity, time spent with patients, and consumer satisfaction were also assessed. Implications for appointment scheduling are discussed.     

Predictors of conflict over the household division of labor among women employed full-time

This empirical study examined predictors of conflict over the household division of labor among a group of 319 middle class, less traditional married women in order to examine the degree to which equity factors predicted conflict. Forty of the women were either African American, Hispanic, Native American, or Asian. An analysis of covariance indicated that there were no differences by race/ethnicity. The study explored the following: (1) the degree to which equity factors predict conflicts over household labor, (2) which equity factors best account for conflict, (3) the degree to which particular equity factors mediate the relationship of conflict with other variables, (4) whether equity factors are more compelling in predicting conflicts than practical or status variables, and (5) whether women's perceptions of the reasons for conflict put more emphasis on equity than on other issues. Results indicated that while both equity and practical factors predicted conflict, equity factors were more statistically significant. The best overall model of conflict suggested that it was predicted by lower satisfaction with the division of labor (which, in turn, was contingent upon time differentials between spouses and the time a womans' spouse spent on traditional women's tasks), a larger number of household members, a woman's younger age, and performing a greater number of overall household tasks. Equity is important to such women and constitutes a basis for making arguments about justice. However, these employed women devote twelve hours more per week to household labor than their partners and are relatively satisfied with the division. Chaeftz's theory of gender equity identifies where this sample of employed women may be located in the process of change.Thanks to Diane Blohowiak for statistical assistance and to Susan Jacquet, Laura Thieme, Annette Tierrien, and Mark Hoven Stohs for assistance with data gathering. Special thanks to the reviewers.     

The Impact of Procedural Justice on Opinions of Public Policy: Solid Waste Management as an Example1

This study assessed the applicability of Tyler and Lind's (1992) relational model of authority to the context of local government policies on solid waste management. Tests of the hypothesized relations proposed by Tyler and Lind, accomplished through structural equation modeling, revealed that our data supported the relations between the various constructs of the model. Perceptions of both process control and relational process were found to be positively related to procedural fairness judgments, while procedural fairness judgments were weakly related to evaluations of government entities. Contrary to our expectations, a similar structural equation model test of an extension of the Tyler and Lind model showed that the model constructs were unrelated to respondents' opinions of public policies. The results also indicated that respondents living in communities with different infrastructures and political climates differed slightly in their perceptions of procedural justice and related constructs, but did not differ in their endorsement of the various solid waste management policies.     

Counseling and screening for cystic fibrosis in patients with congenital bilateral absence of the vas deferens: Patient perceptions

Congenital bilateral absence of the vas deferens (CBAVD) occurs in approximately 1.3% of infertile males and is thought to be, in most cases, a primarily genital form of cystic fibrosis (CF). Fourteen males with CBAVD considering microsurgical sperm aspiration from the epididymis (MESA) and in vitro fertilization were seen for genetic counseling and screening for CF. To retrospectively evaluate these patients' perceptions of the counseling and screening information, we conducted structured telephone interviews to assess their recall of information about CF and its impact on their health concerns and reproductive plans. We found that, as the health implications of CF are abstract and not as important to patients as the diagnosis of CBAVD itself, patients tend to view their CF status primarily in terms of their reproductive potential. Retrospective analysis afforded us an opportunity to identify the psychosocial issues of most concern to this unique patient population.     

Assessing social competencies in lower income preschool children

This study examined social competencies in 4-year-old, lower income, nonwhite preschool children in a replication of work by Shure, Spivack, and Jaeger. Age differential interpersonal cognitive problem-solving skills were investigated, i.e., ability to generate alternative solutions to interpersonal problems, consequential thinking, and school achievement as they relate to behavioral adjustment ratings by teachers and independent observers. A teacher's rating of a child as aberrant or adjusted predicted an independent observer's rating of that child in a naturalistic setting. Children who were rated as adjusted by their teachers had significantly higher scores on an achievement inventory than those children who were rated aberrant, but the study did not find the predicted relationship between problem-solving thinking and adjustment. A version of this paper was presented at the annual meeting of the American Psychological Association, New York, September 1979. The study was supported by grants from the McGregor Fund, the Eloise and Richard Webber Foundation, the David M. Whitney Fund and by the Detroit Public Schools Region 7, for which the authors express grateful appreciation. The authors also wish to thank Myrna B. Shure for her help in carrying out this replication.     

COLLATERAL GAINS AND SHORT-TERM MAINTENANCE IN READING AND ON-TASK RESPONSES BY INNER-CITY ADOLESCENTS AS A FUNCTION OF THEIR USE OF SOCIAL REINFORCEMENT WHILE TUTORING

Two experiments are reported concerning the effects of the differential use of verbal approval by problematic adolescents serving as tutors in a remedial reading program for an inner-city school. The experiments, each with 3 tutors and 15 tutees, used a combined multiple baseline and ABCBC design. Data showed that tutors' approvals as well as tutors' and tutees' on-task and reading responses were low and stable during baseline. Tutors were trained to use verbal approval for tutees' on-task behavior. Tokens were presented and withdrawn to control the tutors' use of approval. During phases in which tutors' approvals were raised via token dispensation, tutor reading and on-task scores increased in a nonexperimental setting. Tutee reading scores also increased as a function of tutor approvals. The second experiment replicated these findings and, in addition, (a) tested the validity of changes in reading responses via standardized tests, (b) isolated and compared the covariance between variables in all phases, and (c) provided data on tutee attention to tutors as a possible natural reinforcer for the short-term maintenance found in both studies. Data are discussed as evidence that tutors had acquired the ability to recruit reinforcement from the classroom for appropriate behavior.