TEACHING THE HANDICAPPED TO EAT IN PUBLIC PLACES: ACQUISITION,GENERALIZATION AND MAINTENANCE OF RESTAURANT SKILLS

This study examined classroom-based instruction in restauranting skills for handicapped persons. Three male students were taught each of four skill components in sequential order: locating, ordering, paying, and eating and exiting. Training was implemented in a multiple baseline design across subjects and consisted of modeling and role playing in conjunction with photo slide sequences and a simulated ordering counter. The use of a menu containing general item classes and a finger matching procedure for identifying errors in the delivery of change greatly reduced the reading and math skills necessary to enter and complete the program. Periodic probes were conducted in a McDonald's restaurant prior to, during, and up to one-year following the termination of training. In addition, two probes (overt and covert observation) were conducted in a Burger King restaurant to assess further generalization to a location different from the one depicted throughout training. Results showed that students' performance on restaurant probes improved as a result of training, generalized to novel settings, maintained over an extended period of time, and was comparable to that of a normative sample of nonretarded persons.     

Peer tutoring to prevent firearm play acquisition, generalization, and long-term maintenance of safety skills

Hundreds of accidental injuries and deaths to children occur annually in the United States as a result of firearm play. Behavioral skills training (BST) and in situ training have been found to be effective in teaching children the skills to use if they find a firearm, but training requires substantial time and effort. The current study examined the use of peers as tutors as a potential way to decrease the time and resources needed to teach these safety skills to youngsters. Peer trainers conducted BST and in situ training with other children. Children taught by the peer trainers acquired the safety skills and demonstrated them in naturalistic situations in which the skills were needed. Furthermore, all of the peer trainers acquired and maintained the skills. These results support the use of peer tutoring for teaching safety skills to other children.     

IN VIVO VERSUS SIMULATION TRAINING: AN INTERACTIONAL ANALYSIS OF RANGE AND TYPE OF TRAINING EXEMPLARS

We analyzed the role of the range of variation in training exemplars as a contextual variable influencing the effects of in vivo versus simulation training in producing generalized responding. Four mentally retarded adults received single case instruction, followed by general case instruction, on washing machine and dryer use; one task was taught using actual appliances (in vivo) and the other using simulation. In vivo and simulation training were counterbalanced across the two tasks for the 2 subject pairs, using a within-subjects Latin square design. With both paradigms, more errors were made after single case than after general case instruction during probe sessions with untrained washing machines and dryers. These results suggest that generalization errors were affected by the range of training exemplars and not by the use of simulated versus natural training stimuli. Although both general case simulation and general case in vivo training facilitated generalized performance of laundry skills, an analysis of training time and costs indicated that the former approach was more efficient. The study illustrates a methodology for studying complex interactions and guiding decisions on the optimal use of instructional alternatives.     

Using Direct Skills Teaching to Improve Job Skills for Persons With Disabilities

This study evaluated whether a direct skills training (DST) approach for persons with disabilities can better prepare participants for job interviews. Twenty graduate students in a master's program in rehabilitation counseling at various agency internship sites were trained in a 4‐session Presenting Qualifications curriculum based on DST administered to 126 participants in 20 group settings. Participants reported greater confidence and preparedness in the interview process, in answering difficult questions, and in highlighting past accomplishments after the group. Results support the feasibility of training entry‐level rehabilitation counselors in the DST approach to teach job interview skills to individuals with disabilities.     

Social validation of a conversational skills-training program

This study sought to demonstrate the social validity of a conversational skills-training program administered to two male clinical cases. Multiple-baseline, single-subject experimental designs were used to evaluate the effects of training on nonverbal and verbal behavior as assessed in unstructured dyadic interactions with experimentally naive peers. The interpersonal attractiveness of subjects also was rated by conversational partners following assessment interactions. Behavioral measures and attraction ratings were converted toT scores relative to means and standard deviations derived from normal subjects. Subject 1 demonstrated posttreatment behavioral skills which were between one and two standard deviations above the norm. Behavioral improvement was associated with comparable improvement in rated interpersonal attractiveness. Following treatment, Subject 2 demonstrated average behavioral competence, but interpersonal attractiveness was not notably enhanced by skills training. These findings are discussed relative to experimental and therapeutic criteria for evaluating treatment outcome.Portions of this research were completed while the authors were affiliated with the University of Georgia. Special thanks are extended to Michael Breakwell for his assistance in completing behavior ratings.     

Outcomes of a practical approach for improving conversation skills in adults with autism

Many individuals with autism spectrum disorder (ASD) have deficits in conversation skills that can interfere with the development of personal and professional relationships. Further research is needed on efficient interventions for targeting conversation skills in adults with ASD and for evaluating the social validity of the outcomes. In this study, 2 practitioners implemented a 4‐week training program for 5 adults with ASD that combined individualized computer‐based instruction (CBI) and practice with peers to promote the acquisition, maintenance, and generalization of conversation skills. Training was associated with improvements in 12 of 13 skills across participants. These findings, along with peer ratings of the participants' conversation skills, suggest that this model is a promising, socially valid approach for improving conversation skills in adults with ASD.     

Evaluation of a telehealth parent training program in teaching self-care skills to children with autism

The present study used synchronous video conferencing to remotely deliver a behavioral skills training-based (BST) parent training program to 3 parents of children with autism in the family home. Parents were taught to implement graduated guidance to teach their children several important self-care skills. Parents did not correctly implement graduated guidance after receiving detailed written instructions only. After parents received the BST parent training package, however, all parents implemented graduated guidance with near-perfect levels of fidelity, and all children completed the targeted self-care skills with substantially higher levels of accuracy and independence. Furthermore, parents reported high levels of satisfaction with graduated guidance, the telehealth BST training package, and their children's ability to complete self-care skills.     

Evaluating the Effectiveness of an Abduction Prevention Program for Young Adults With Intellectual Disabilities

The purpose of this study was to evaluate the effectiveness of behavioral skills training (BST) and in situ training (IST) for teaching abduction prevention skills to young adults with intellectual disabilities. Four individuals, ages 18–24, participated. Five BST sessions were conducted for each participant. Following BST, in situ assessments took place at the participants’ school to assess acquisition of the skills. The data show that none of the participants reached criterion level following BST although some of the participants improved their score from baseline. IST was then implemented with two of the participants achieving criterion level and two participants exhibiting two of the three safety skills.     

Assessing and teaching job‐related social skills to adults with autism spectrum disorder

Few studies have evaluated interventions to improve the job‐related social skills of adults with autism spectrum disorder. In this study, we examined the efficacy of a treatment package for teaching several social skills that are critical to job success, such as responding appropriately to feedback and asking for a task model from the supervisor. Three adults, aged 19 to 27 years, participated. Initial training of each skill consisted of verbal explanations, modeling, and role‐play with feedback, along with stimulus prompts to promote generalization to a different setting. The trainer introduced additional intervention components as needed. We also evaluated generalization across different social skills and evocative situations. Results indicated that the treatment package was generally effective in improving the targeted social skills, and that stimulus prompts may be necessary for generalization to a job setting. However, generalized responding across social skills rarely emerged. These findings have important implications for preparing individuals with autism to function successfully on the job.     

Parent‐implemented behavioral skills training of social skills

Impairment in social skills is a primary feature of Autism Spectrum Disorders (ASDs). Research indicates that social skills are intimately tied to social development and negative social consequences can persist if specific social behaviors are not acquired. The present study evaluated the effects of behavioral skills training (BST) on teaching four parents of children with ASDs to be social skills trainers. A nonconcurrent multiple baseline design across parent–child dyads was employed and direct observation was used to assess parent and child behaviors Results demonstrated substantial improvement in social skills teaching for all participants for trained and untrained skills. Ancillary measures of child performance indicated improvement in skills as well. High levels of correct teaching responses were maintained at a 1 month follow‐up. This study extends current literature on BST while also providing a helpful, low‐effort strategy to modify how parents can work with their children to improve their social skills.     

Enhancing the training integrity of human service staff using pyramidal behavioral skills training

This experiment used a pyramidal training model to evaluate the effects of behavioral skills training (BST), delivered in a 1-time group-training format, on the extent to which 25 human service staff implemented BST when training others how to implement behavioral procedures. Results indicated that (a) the training workshop increased BST integrity to mastery levels for the majority of participants with varying levels of education, organizational positions, and training experience, (b) the training effects generalized to teaching an untrained skill, and (c) high levels of BST integrity maintained at follow-up 4 to 6 weeks after training for all 3 participants with whom probes were conducted. Moreover, participants indicated high levels of satisfaction with both the training workshop and BST as a training procedure.     

Training kindergarten students lockdown drill procedures using behavioral skills training

During situations in which a gunman is present on a school campus, lockdowns are initiated until the threat is removed. However, there are no data demonstrating an effective teaching strategy to increase students’ correct responding during a lockdown. We evaluated the effectiveness of behavioral skills training (BST) to teach three groups of kindergarten students how to respond during lockdown drills. Results showed that participant groups displayed increases in correct steps and decreases in noise levels after BST was implemented; these effects maintained following training.     

Improving the interview skills of college students using behavioral skills training

Obtaining a job as a college graduate is partly dependent on interview performance. We used a multiple baseline design across skills to evaluate the effects of behavioral skills training with self‐evaluation for five college students. Training effects were evaluated using simulated interviews as baseline and posttraining assessments. All participants acquired targeted skills, but we observed some individual differences. Participants were satisfied with training outcomes and rated the procedures as acceptable. Furthermore, ratings from university staff who provide interview training indicated that training improved performance across several skills for the majority of participants.     

The use of behavioral skills training to improve staff performance of discrete trial training

Well‐trained staff are a prerequisite for successful implementation of treatment plans when working in human service contexts. The high rate of turnover makes the use of efficient and effective staff training all the more important. Previous research has used behavioral skills training to train teachers in correct implementation of discrete trial training of children with autism. They showed that a brief 10‐min procedure could effectively train staff and result in improved performance. The current study elaborated on previous work by using participants without prior exposure to the method, including treatment integrity data and testing for maintenance 1 month after training ended. The mean percentage of correct teaching responses for the three participants increased from 70%, 58%, and 66% during baseline to 97%, 96%, and 99%, respectively, following training. Results indicated that the training package was effective and the results were maintained 30 days later.     

Teaching safety skills to children to prevent gun play

Research has shown that children often engage in gun play when they find a firearm and that this behavior is often involved in unintentional firearm injuries. Previous research has shown existing programs to be ineffective for teaching children safety skills to reduce gun play. This study examined the effectiveness of a behavioral skills training (BST) program supplemented with in situ training for teaching children safety skills to use when they find a gun (i.e., don't touch, leave the area, tell an adult). Eight 4- to 5-year-old children were trained and assessed in a naturalistic setting and in a generalized setting in a multiple baseline across subjects design. Results showed that 3 of the children performed the skills after receiving BST, whereas 5 of the children required supplemental in situ training. All children in the study learned to perform the skills when assessed in a naturalistic setting and when assessed in a generalization setting. Performance was maintained at 2- to 8-week follow-up assessments.     

Teaching safety skills to children to prevent gun play: an evaluation of in situ training

This study evaluated behavioral skills training with added in situ training for teaching safety skills to prevent gun play. Following baseline, each child received two sessions of behavioral skills training and one in situ training session. Additional in situ training sessions were conducted until the child exhibited the safety skills (don't touch the gun, get away, and tell an adult). All children acquired and maintained the safety skills at a 3-month follow-up. In addition, of the 7 children assessed in a dyad situation, all exhibited the correct skills in the presence of another child.     

浅谈妇外科医生手术操作的四个层次

手术是处理妇科疾病的主要手段之一。本文从作者的经历和感触出发,就妇外科医师的成长过程中的共性规律进行总结。对于住院医师,熟悉解剖结构、练习基本操作是主要目标;对于主治医师,归纳手术套路、学会独立操作是主要任务;对于主任医师,承担常规工作的同时,条件和能力许可应有所创新。只有将手术从工作变为创作,将技术升华为艺术时,才能完成从“手术匠”到“大师”的飞跃。     

Skills Training for Spouses of Patients with Alzheimer's Disease: Outcomes of an Intervention Study

The effects of a 12-week intervention on a patient-focused skills training group and a caregiver-focused skills training group were compared with those on a control group that received comparable attention, but no training. Intervention effects were monitored at the completion of the treatment phase and at 3- and 6-months postintervention. Treatment implementation was documented in a comprehensive fashion to ensure replicability. Both training groups acquired skills that enabled them to improve targeted behaviors (patient problem behaviors and caregiver mood, respectively). Weaker effects were found for more distal outcomes, such as depression, perceived stress, caregiver strain, and self-efficacy.