Functional analysis and treatment of social-communicative behavior of adolescents with developmental disabilities.

This investigation used functional analyses to identify the social variables that maintained the inappropriate social-communicative behaviors of 2 adolescent students with mental retardation. Analyses were performed in the students' classrooms with the assistance of peers and teachers. The results of these assessments were used to identify appropriate, functionally equivalent behaviors that the students were taught to self-monitor. Findings showed substantial decreases in inappropriate social responding and increases in the use of appropriate social skills.     

Reducing the serious behavior problems of people with developmental disabilities living in the community

Trends and issues regarding the community-based support of people with developmental disabilities who exhibit severe behavior problems are discussed. Living in the community provides a unique framework within which behavior change programs are developed, implemented, and monitored. Support models for people with challenging behavior need to: (a) program for diversity across people, settings, and activities; (b) plan for high levels of integration in community settings among typical community members; and (c) meet guidelines regarding restrictions in intervention typologies. Increasingly, behavior analysts are conducting analog and in vivo assessments prior to intervening in order to develop an understanding of why behavior problems are occurring. Along with the increase in assessing the functions of behavior, is a greater attention to the contexts in which interventions are applied. The rearranging of contexts, communication training, choice-making, matching people's competence to their settings, the use of novelty, and proactive programing reflect these concerns.     

Environmental toxicants and developmental disabilities: a challenge for psychologists

Developmental, learning, and behavioral disabilities are a significant public health problem. Environmental chemicals can interfere with brain development during critical periods, thereby impacting sensory, motor, and cognitive function. Because regulation in the United States is based on limited testing protocols and essentially requires proof of harm rather than proof of lack of harm, some undefined fraction of these disabilities may reflect adverse impacts of this "vast toxicological experiment" (H. L. Needleman, as quoted in B. Weiss & P. J. Landrigan, 2000, p. 373). Yet the hazards of environmental pollutants are inherently preventable. Psychologists can help prevent developmental disabilities by mobilizing and affecting public policy, educating and informing consumers, contributing to interdisciplinary research efforts, and taking action within their own homes and communities to reduce the toxic threat to children.     

Parts and wholes in person recognition: developmental trends

This study's aim is the investigation of short-term visual person recognition in 8- and 10-year-olds and adults, within the part-whole paradigm introduced by. Natural unfamiliar whole persons were contrasted with natural unfamiliar faces to test for differences between person processing and face processing. Two experiments showed advantages of whole face recognition over isolated face feature recognition. Also, these was a complete over part probe advantage (CPA, ) for person recognition in all age groups. Thus, recognition became more accurate between 8 years and adulthood, but no developmental shift in visual information processing was observable with face and whole person recognition. I conclude that person recognition does not rely on processes completely different from those of face recognition and that this holds for 8- and 10-year-olds as well as for adults.     

Recognizing the role of parents in developmental outcomes: a systems approach to evaluating the child with developmental disabilities

When developmental concerns arise in children, a clinical assessment focuses on the child's developmental profile to achieve three goals (1) determine diagnosis, (2) develop interventions, and (3) evaluate progress. Parents often have needs during this time that are not addressed by professionals because of the exclusive focus on the child during the evaluation. In this article, we suggest that clinicians take a "systems" approach to the assessment process by recognizing how the well being of family members can impact a child with a developmental disability. We review systems theory and its conceptualization of individual functioning and discuss how parental well-being differs according to child diagnosis. Finally we suggest a systems-based model to use during the assessment process.     

Enmeshed lives: adult children with developmental disabilities and their aging mothers

This article uses equity theory to examine the ways in which aging mothers and their adult children with developmental disabilities support each other and the effects that this exchange has on the caregiving satisfaction and burden of the mothers. Data from 305 mothers revealed that exchange flows both from mother to child and from child to mother. Results indicate that caregiving satisfaction increased when affection from child to mother was greater. Caregiving burden was not affected by either functional support or affection from child to mother.     

Building a bridge of trust: collaborative assessment with a person with serious mental illness

Collaborative assessment utilizes psychological testing to help people make positive changes in their lives. Limited research has evaluated the utility of collaborative assessment for persons with serious mental illness. This case example uses the Personality Assessment Inventory to illustrate the usefulness of collaborative assessment with a person with serious mental illness. This approach informed not only diagnostic considerations but also revealed the client's current level of distress, contributed to enhanced therapeutic alliance, and directly pointed to psychiatric rehabilitation strategies.     

Improving instruction for adults with developmental disabilities: Evaluation of a staff training package

Improvements in adaptive behavior among adults with developmental disabilities often depends on the quality of instruction delivered by direct-care staff. The present study evaluated the effectiveness of a multifaceted package for improving the quality of instructional interactions among three staff/adult dyads. Instructional interactions were first analyzed to identify areas for improvement. A multifaceted intervention package consisting of inservice training, participative management, and on-going feedback was then implemented in a multiple-baseline design across dyads. The package trained staff to increase their use of time delay and reinforcement strategies and these changes were associated with greater independence in a sandwich making task among two of the three participating adults. The results suggest direct observation of existing instructional interactions may provide valuable information when training staff to implement effective habilitative programs for adults with developmental disabilities.     

Assessment of anger and aggression in male offenders with developmental disabilities

Systematic assessment of anger among people with developmental disabilities has been lacking, especially for hospital inpatients. Reliability and validity of anger self-report psychometric scales were investigated with 129 male patients, mostly forensic. Anger prevalence and its relationship to demographic, cognitive, and personality variables and to hospital assaultive behavior were examined. High internal and intermeasure consistency, and some concurrent validity with staff ratings, were found. Retrospective validity regarding physically assaultive behavior in the hospital was obtained. Hierarchical regressions revealed that patient-reported anger was a significant predictor of assaults postadmission, controlling for age, length of stay, IQ, violence offense history, and personality variables.     

Suicidal ideation in adolescent psychiatric inpatients as associated with depression and attachment relationships

Examined suicidal ideation in adolescent psychiatric inpatients as associated with depressive symptoms and attachment to mother, father, and peers. Fifty-nine adolescent psychiatric inpatients (25 male, 34 female) completed self-report measures of suicidal ideation, depressive symptoms, and attachment. Attachment to mother accounted for significant variation in levels of depressive symptoms and suicidal ideation. In addition, attachment to peers accounted for significant variation in suicidal ideation and girls' (but not boys') depressive symptoms. However, after adjusting for depressive symptoms, attachment variables failed to contribute additional variance in suicidal ideation. Self-reported depressive symptomatology remained the strongest predictor of suicidal ideation, regardless of its order in the regression analyses. Prevention and treatment efforts may focus on mother-adolescent attachment and peer attachment (particularly in girls) to reduce risk for depression and suicidal ideation.     

Verbal rehearsal and selective attention in children with learning disabilities: A developmental lag

To investigate the development of verbal rehearsal strategies and selective attention in learning disabled children, Hagen's Central-Incidental task was administered to younger learning disabled (M CA = 8.68 years) and normal (M CA = 8.62 years) boys in Experiment 1 and to intermediate (M CA = 10.18 years) and older (M CA = 13.48 years) learning disabled boys in Experiment 2. Also, in Experiment 2, an experimentally induced verbal rehearsal condition was included to determine its effects on serial recall and selective attention performance. In Experiment 1, the serial postion curve of the normals revealed both a primacy and a recency effect, whereas that of the learning disabled revealed a recency effect only. In Experiment 2, both the intermediate and the older learning disabled exhibited both primacy and recency effects under both standard and rehearsal conditions. A developmental analysis of central recall for the three learning disabled groups revealed constant age-related increases in overall central recall and in primacy recall. That the normals recalled more central, but not more incidental, information than the learning disabled in Experiment 1 suggests that the learning disabled are deficient in selective attention. Correlational findings suggest that the selective attention of the learning disabled improves with age. The results were interpreted as support for the hypothesis of a developmental lag in the learning disabled population.     

Placebo effects in developmental disabilities: implications for research and practice

Recent clinical trials of secretin in children with autism showed robust placebo effects and no benefit of secretin over placebo. This article explores the reasons for the observed placebo effects, focusing on the heightening of positive expectancy by media attention and by the sensory experiences associated with intravenous injections. Comparisons are drawn with research involving other novel treatments and other clinical populations of children with developmental disabilities and neurobehavioral disorders. Research regarding mechanisms of placebo effects is reviewed, including patient and clinician attributes, expectancy effects, participation effects, changes in caregiver behavior, and conditioning. New evidence regarding the biological basis of placebo effects is briefly presented. Since placebo effects are ubiquitous and may operate by a variety of mechanisms, research design is critical in designing clinical trials and in evaluating other outcomes research. Measurement issues important for research in developmental disabilities are emphasized. Ethical concerns have been raised regarding the use of placebo in clinical research, but current analysis suggests that placebo controls are necessary and defensible on ethical grounds, if certain conditions are met. The study of placebo effects ("placebology") holds great promise as a new area of research in therapeutics. The author's research in the potential augmentation of stimulant effects in children with attention deficit/hyperactivity disorder (ADHD) by adding placebo in open label is briefly presented. The placebo has always been integral to the practice of medicine, but advances in scientific medicine and medical ethics have diminished the role and use of placebo in practice. An innovative approach to the ethical use of placebo is proposed.     

A multimodal behavior analytic model for evaluating the effects of medical problems on nonspecific behavioral symptoms in persons with developmental disabilities

A relationship between various medical illnesses and the frequency and severity of nonspecific behavioral symptoms such as aggression and self-injury has been described by a number of writers. None, however, provides a clinical case formulation model that articulates the specific nature of this relationship or the manner in which potential biomedical influences interact with psychological and socioenvironmental ones to determine the occurrence and strength of behavioral symptoms. A model is described in this paper that suggests possible contributions of medical illnesses or conditions to occurrence of nonspecific behavioral symptoms and provides a diagnostic basis for selecting and evaluation related interventions. © 1997 John Wiley & Sons, Ltd.     

Writing program with word prediction for a young man with multiple disabilities: a preliminary assessment

This study assessed a writing program with word prediction, which completed the writing of a word and spoke it out only when there was certainty that such a word was the correct one. The assessment was carried out with a young man with multiple disabilities, who typically used a word-processing program without word prediction. The two programs were compared on the time required by the participant for writing general sentences, through a social validation assessment, and eventually a check on the participant's preference. Analysis showed the program with word prediction was significantly more effective in terms of the writing time, which was halved, and was deemed preferable by 40 raters (psychology students) involved in the social validation assessment and by the participant himself. Implications of the findings are discussed.     

Effects of deprivation on engagement in preferred activities by persons with developmental disabilities

This study examined the effects of deprivation on engagement in activities for 3 adult men with developmental disabilities. First, an assessment was conducted to identify a high- and a low-preference activity for each participant. Second, the high-preference activity was made available following three amounts of deprivation of the activity (15 min, 2 hr, and 1 to 4 days); the low-preference activity was made available following the schedule of deprivation that produced the highest level of engagement by each participant in the high-preference activity. The results were that 1 to 4 days of deprivation produced the highest average amounts of engagement in the high-preference activity for each participant; this amount of deprivation did not produce high engagement in the low-preference activities. Third, the deprivation procedures and results were replicated when high-preference activities were presented by teachers during the participants' daily activities when their engagement had been quite low.     

Quality care in residential placement for children and youth with developmental disabilities

There is a growing concern for quality care in residential placements outside of the natural family for children and youth with developmental disabilities. Ideally, children with developmental disabilities should remain with their natural parent or parents of parents with appropriate supports until the age when children typically leave home. In reality, parents of children and youth with development disabilities are not always able or willing to care for their children at home, and alternate residential placements must be found. This paper will discuss some of the issues surrounding the provision of quality care in out-of-home residential placements for children and youth with developmental disabilities.