Use of peer-mediated intervention in children with attention deficit hyperactivity disorder

The present experiment extended and replicated the use of functional analysis and a peer-mediated intervention to decrease disruptive behavior displayed by children diagnosed with attention deficit hyperactivity disorder in an afterschool program. After determining that the participants displayed off-task behavior maintained by peer attention via a functional analysis, peer-implemented differential reinforcement of other behavior with extinction was effective in reducing participants' off-task behaviors. The use of peers as behavior-change agents is discussed, as are avenues for future research.     

Brief functional anlaysis and treatment of elopement in preschoolers with autism

As a result of the impact of functional analysis methodologies in identifying maintaining variables of problem behavior, considerable research has been devoted to tailoring the methodologies to be practical for an outpatient setting. The purpose of this study was (a) to use brief functional analysis (BFA) methodologies to empirically demonstrate the function of elopement exhibited by two preschoolers diagnosed with autism and (b) to develop function‐based interventions derived from the results of the BFA. In phase one, a BFA consisting of 5‐min sessions with multiple repetitions of each condition was conducted with each participant. In phase two, the efficacy of function‐based interventions was assessed using a pairwise design. Both participants' rates of elopement were differentially lower during the implementation of the function‐based intervention relative to baseline. Collectively, these results demonstrated that brief functional methodologies could be applied successfully to the assessment and treatment of elopement. Moreover, the application of BFA and the ensuing treatment in an outpatient setting extend the existing research on functional analysis. Copyright © 2008 John Wiley & Sons, Ltd.     

When interventions harm. Peer groups and problem behavior.

This article explored developmental and intervention evidence relevant to iatrogenic effects in peer-group interventions. Longitudinal research revealed that "deviancy training" within adolescent friendships predicts increases in delinquency, substance use, violence, and adult maladjustment. Moreover, findings from 2 experimentally controlled intervention studies suggested that peer-group interventions increase adolescent problem behavior and negative life outcomes in adulthood, compared with control youth. The data from both experimental studies suggested that high-risk youth are particularly vulnerable to peer aggregations, compared with low-risk youth. We proposed that peer aggregation during early adolescence, under some circumstances, inadvertently reinforces problem behavior. Two developmental processes are discussed that might account for the powerful iatrogenic effects.     

Independent control of a pre-school child's aggression and peer interaction by contingent teacher attention

This study demonstrated the existent role of contingent teacher attention in maintaining a preschool child's aggression to his peers, as well as an imposed use of contingent teacher attention to increase his low peer interaction. Aggression and peer interaction were analyzed independently as two baselines of multiple baseline design; each was subjected to at least one reversal. The multiple baseline design was used to examine three possibilities: (1) that the high rate of aggressive behavior was in itself impeding the emergence of peer interaction; (2) that contingent teacher attention could be used to maintain a reduced rate of aggressive behavior; and (3) that a similar use of teacher attention could maintain an increased rate of peer interaction. The technique of largely ignoring the subject's aggressive behavior and attending instead to whatever child he was attacking decreased his aggressive behavior to an acceptable rate. Two reversals of this technique displayed experimental control, each recovering the high baseline rate of aggression. After the aggressive behavior was decreased for the final time, teachers attended to the subject only when he was involved in social interaction with peers, and they thus increased his social interaction to a high rate. Later, they withdrew their attention for social interaction and reversed the effect and finally then recovered it.     

DISCREPANCY IN FUNCTIONAL ANALYSIS RESULTS ACROSS TWO SETTINGS: IMPLICATIONS FOR INTERVENTION DESIGN

Functional analyses that were conducted in two settings (playground and classroom) indicated that problem behavior was sensitive to adult attention on the playground and tangible items in the classroom. Attention‐ and tangible‐based interventions were designed based on the results from each of the assessment environments and were compared. The attention‐based intervention was more effective on the playground, and the tangible‐based intervention was more effective in the classroom. Findings are discussed in regards to the generality of functional analysis results across environments.     

Say something nice: A meta-analytic review of peer reporting interventions

Peer reporting interventions (i.e., Positive Peer Reporting and tootling) are commonly used peer-mediated interventions in schools. These interventions involve training students to make reports about peers' prosocial behaviors, whether in oral or written form. Although peer reporting interventions have been included in meta-analyses of group contingencies, this study is the first meta-analytic review of single-case research focusing exclusively on peer reporting interventions. The literature search and application of inclusion criteria yielded 21 studies examining the impact of a peer reporting intervention on student behavior compared to baseline conditions. All studies used single-case experimental designs including at least three demonstrations of an effect and at least three data points per phase. Several aspects of studies, participants, and interventions were coded. Log response ratios and Tau were calculated as effect size estimates. Effect size estimates were synthesized in a multi-level meta-analysis with random effects for (a) studies and (b) cases within studies. Overall results indicated peer reporting interventions had a non-zero and positive impact on student outcomes. This was also true when data were subset by outcome (i.e., disruptive behavior, academically engaged behavior, and social behavior). Results were suggestive of more between- than within-study variability. Moderator analyses were conducted to identify aspects of studies, participants, or peer reporting interventions associated with differential effectiveness. Moderator analyses suggested published studies were associated with higher effect sizes than unpublished studies (i.e., theses/dissertations). This meta-analysis suggests peer reporting interventions are effective in improving student behavior compared to baseline conditions. Implications and directions for future investigation are discussed.     

Functional Analysis and Treatment of Mealtime Problem Behavior for a Person with Developmental Disabilities

We conducted a functional analysis of problem behaviors (spitting and whining) during meals and tested an intervention based on that analysis. The participant was a 13-year-old young woman with severe mental retardation and cerebral palsy. She ate all food presented to her, and the hypotheses were tested that the problem behaviors were maintained either by contingent access to trainer attention or the pace of eating. An attention analysis examined the relationship between problem behavior and trainer attention during the meal. The effect of attention following problem behavior versus ignoring was inconclusive. An analysis of the effects of teacher paced eating, student paced eating (reinforce spoon grasping) and food presented for problem behavior was conducted next. Problem behavior rates were highest when access to food was made contingent on the performance of problem behavior and lowest when spoon grasping resulted in a bite of food. Following analysis, an intervention was designed to reduce the frequency of targeted problem behaviors during mealtime. Reinforcing spoon grasping and a 10s removal of food following problem behavior dramatically reduced spitting and whining during meals. The study provides a demonstration of an extended functional analysis and treatment of a complex behavior pattern.     

GENERATING HYPOTHESES ABOUT THE FUNCTION OF STUDENT PROBLEM BEHAVIOR BY OBSERVING TEACHER BEHAVIOR

We examined whether, as predicted by research on child effects, we could generate hypotheses about the function of student problem behavior by observing the amount of attention teachers provided to students. In the first phase of the study, we observed the amount of attention teachers distributed among small groups of students who exhibited problem behavior in individual or small-group instructional settings (problem behavior presumably maintained by attention or escape). Based on the amount of attention each student received, we generated hypotheses about the function of his or her problem behavior. In the second phase of the study, we determined the accuracy of these predictions by conducting a brief functional assessment with each student. Results confirmed that, for 14 of the 15 students, we were able to generate accurate hypotheses about the function of their problem behavior. These results suggest the potential efficacy of using the amount of attention teachers distribute among groups of students to generate empirically based hypotheses about the function of student problem behavior maintained by attention and/or escape. These results also illustrate the efficiency of this procedure; by observing teacher behavior, we were able to generate hypotheses about the function of problem behavior for several students at one time.     

Sequenced neurocognitive and behavioral parent training for the treatment of ADHD in school-age children

The present study examines the potential of sequencing a neurocognitive intervention with behavioral parent training (BPT) to improve executive functions (EFs), psychiatric symptoms, and multiple indices of functional impairment in school-age children aged 7 to 11 years who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Specifically, in a randomized controlled trial design, 85 children were assigned to either Cogmed Working Memory Training (CWMT) followed by an empirically supported, manualized BPT intervention, or to a placebo version of CWMT followed by the same BPT intervention. Working memory maintenance (i.e., attention control/short-term memory), working memory processing and manipulation, ADHD and oppositional defiant disorder (ODD) symptoms, impairment in parent–child dynamics, familial impairment, and overall functional compromise were evaluated as outcomes. The results suggest specific effects of the combined CWMT and BPT program on verbal and nonverbal working memory storage and nonverbal working memory processing and manipulation but no incremental benefits in regard to ADHD symptoms, ODD symptoms, and functional outcomes. The present findings do not support the hypothesis regarding the complementary and augmentative benefits of sequenced neurocognitive and BPT interventions for the treatment of ADHD. These results, the study’s limitations, and future directions for research are further discussed.     

EFFECTS OF SELF-EVALUATION ON PRESCHOOL CHILDREN'S USE OF SOCIAL INTERACTION STRATEGIES WITH THEIR CLASSMATES WITH AUTISM

This study investigated effects of a self-evaluation procedure on preschool children's use of social interaction strategies among their classmates with autism. Three triads of children (comprised of 1 trained normally developing peer, 1 untrained peer, and 1 child with autism) participated. A multiple baseline design across subjects was used to demonstrate that peers who were taught facilitative strategies increased their use of strategies only after the self-evaluation intervention was introduced. Improvements in social behavior of children with autism was associated with peers' increased strategy use. Untrained peers demonstrated little change in their social behavior. Treatment effects were replicated when trained peers were asked to use self-evaluation with other children with autism during other play times. Self-evaluation procedures enhanced the use of social interaction strategies on the part of normally developing peers during social skills interventions.     

Object manipulation and the use of tools by infant baboons (Papio cynocephalus anubis).

Infant baboons (Papio cynocephalus anubis) in a captive peer group used objects as containers, drinking utensils, and sponges in the context of play. The baboons later used paper, browse, and other materials as tools to extract sweet liquids from apparatus designed to accommodate sponging and probing behavior. The results of this study demonstrate flexible combinatorial manipulation and spontaneous use of tools by infant baboons. These data are consistent with hypotheses that (a) an evolutionary history of omnivorous extractive foraging is associated with the use of tools and (b) free play in an object-enriched captive environment may facilitate combinatorial manipulation in nonhuman primates.     

The Effects of a Daily Behavior Report Card Intervention: Inclusion of a Peer Mediator

Daily Behavior Report Cards (DBRCs) have been found to decrease disruptive behaviors of children with attention-deficit/hyperactivity disorder, intellectual and developmental disorders, and typically developing students. However, although previous studies indicate that peers can assist with the implementation of a variety of interventions (e.g., Check in check out), teachers are often the implementer of DBRCs. In addition, it appears that no studies evaluating DBRCs have included a functional assessment. Thus, the purposes of this study were to assess the effects of a peer-mediated DBRC on disruptive classroom behaviors, determine whether peers could implement their portion of the intervention procedures with high integrity, and assess whether DBRC was effective independent of the functional reinforcer for disruptive behavior. In this study, peer-mediated DBRC led to a decrease in disruptive behavior and an increase in on-task behavior for all three target students who were at risk for EBD. The peer mediators also implemented the DBRC procedures with high integrity. Furthermore, DBRC was effective at suppressing disruptive behavior independent of their presumed functional reinforcer. However, it does appear that different portions of the intervention likely addressed the hypothesized functions of problem behaviors of all three participants.

     

Decreasing Self-Injurious Behavior in a Student with Autism and Tourette Syndrome through Positive Attention and Extinction

This case study was conducted with a student diagnosed with autism and Tourette syndrome who displayed severe self-injurious behavior (SIB). We conducted a functional behavioral assessment which indicated that SIB was maintained by multiple functions using an ABAC design to determine the effect of positive social attention and extinction. Results show a considerable decrease in SIB incidents, particularly when session duration was reduced from 10 minutes to 5 minutes during the second intervention phase. Thus, the combination of contingent social attention formulated from the functional assessment and extinction was successful in bringing about significant decreases in SIB. This combination holds great promise as a nonintrusive positive strategy for SIB.     

Peer tutoring with ESL and below-average readers

A multiple baseline research design across subjects (pairs) was used to examine the effectiveness of a peer tutoring reading intervention which involved the systematic use of delayed attention, prompting and praise. Eight, fourteen year old, below average readers were trained to tutor eight students of similar age for whom English was a Second Language (ESL). Continuous data collection indicated that peers were effective in their use of the tutoring behaviors while both peer tutors and ESL readers made statistically significant gains in reading accuracy and comprehension over the course of the intervention.     

Effects of Classwide Positive Peer “Tootling” to Reduce the Disruptive Classroom Behaviors of Elementary Students with and without Disabilities

The purpose of this study was to examine the use of a classwide positive peer reporting intervention known as “tootling” in conjunction with a group contingency procedure to reduce the number of disruptive behaviors in a third-grade inclusive classroom. Nineteen elementary students including four students with disabilities (i.e., specific learning disabilities and/or attention deficit hyperactivity disorder) were taught how to report their classmates’ positive behaviors using the “tootling” intervention. Results indicated that the use of the “tootling” intervention in combination with a group contingency procedure decreased students’ disruptive classroom behaviors, establishing a functional relation. Limitations of the study, implications for using tootling as a classwide positive behavior support, and future research questions are discussed.     

Current research on the influence of establishing operations on behavior in applied settings

This article provides commentary on research published in the special section of the Journal of Applied Behavior Analysis devoted to establishing operations (EOs). Three major themes are highlighted: (a) identification of the influence of EOs on behavior in applied settings, (b) the use of EO manipulation as an assessment tool, and (c) the development of interventions based on the alteration of EO influences. Methodological issues pertaining to research on EOs are addressed, and suggestions for future investigation are provided.     

APPLIED BEHAVIOR ANALYSIS IN ACQUIRED BRAIN INJURY REHABILITATION: A META‐ANALYSIS OF SINGLE‐CASE DESIGN INTERVENTION RESEARCH

The purpose of this meta‐analysis was to complete a systematic evidence‐based review of published behavioral treatment studies employing single‐case designs with both children and adults with acquired brain injury. Peer‐reviewed journals were searched using PsycINFO, Medline, and ERIC databases with combinations of terms such as brain injury, behavior disorder, behavior therapy, behavior modification, behavior analysis, and verbal behavior. A total of 112 acquisition and reduction studies met the established inclusion criteria. The data extracted from each study included specific details about the participants, target responses, intervention characteristics, use of functional assessment, and outcome characteristics. A data extraction software program was also used to extract data from graphs to calculate percentage of nonoverlapping data as an effect size_. The studies were then evaluated along several dimensions from multiple evidence‐based practice frameworks. Collectively, interventions targeted a wide range of behaviors for acquisition and reduction, but only five interventions were classified as well established according to the American Psychological Association Division 12 criteria. Furthermore, methodology of the identified studies was found to be relatively poor. A variety of methodological concerns are discussed. Copyright © 2014 John Wiley & Sons, Ltd.     

Conceptualizing changes in behavior in intervention research: the range of possible changes model

An international movement has focused on identifying evidence-based interventions that were developed to change psychological constructs and that are supported by controlled studies. However, inconsistent findings within individual intervention studies and among multiple studies raise critical problems in interpreting the evidence, and deciding when and whether an intervention is evidence-based. A theoretical and methodological framework (Range of Possible Changes [RPC] Model) is proposed to guide the study of change in intervention research. The authors recommend that future quantitative reviews of the research literature use the RPC Model to conceptualize, examine, and classify the available evidence for interventions. Future research should adopt the RPC Model to both develop theory-driven hypotheses and conduct examinations of the instances in which interventions may or may not change psychological constructs.