A systematic review of physical guidance procedures as an open‐mouth prompt to increase acceptance for children with pediatric feeding disorders

This article reviews behavioral treatments of pediatric feeding disorders using physical guidance procedures as an open‐mouth prompt (i.e., jaw prompt, finger prompt, Nuk prompt, side deposit) to increase food acceptance. We identified 9 articles containing 35 systematic evaluations. We coded participant and study characteristics and assessed the experimental rigor, quality, and outcomes of each evaluation. Of the high‐quality research present, the finger prompt variation and side deposit reliably increased acceptance. We found mixed results on the efficacy of the jaw prompt, although it was the most widely researched procedure. Further, authors reported interobserver agreement for 100% of the participants, procedural integrity for 60%, social validity for 80%, fading for 5%, and follow‐up for 55%. Based on the invasive nature of physical guidance, we provide recommendations for researchers and clinicians to increase the quality of their treatment evaluations. We discuss limitations, implications for practice, and future research.     

A Playroom Observation Procedure to Assess Children with Mental Retardation and ADHD

Forty-two children (ages 6 to 12 years old) with moderate mental retardation to borderline intellectual functioning were studied in a laboratory playroom setting to determine whether children identified as ADHD (attention deficit hyperactivity disorder) or controls differed on activity and attentional measures. Children with ADHD were further divided into ADHD + conduct problems (ADHD + CD) and ADHD-only subgroups (with an ADHD-combined group comprising children of both subgroups). An interval recording system was used to code observations of independent play and a restricted academic task. Results indicated that the ADHD-combined group was significantly more vocal and engaged in a significantly greater number of toy changes than controls during independent play. Significant group differences were also noted during the restricted academic task, with the ADHD-combined and ADHD + CD groups more off-task and engaging in a greater number of toy touches than controls. Discriminant analyses found independent play measures to predict group membership in 70 percent of cases (ADHD-combined vs. controls), but in only 64 percent of cases using measures from the restricted academic task. No significant findings resulted when the ADHD subjects were further divided into two subgroups. Despite some inconsistent findings, such laboratory-based observations may be of value in the diagnosis of ADHD in children with moderate mental retardation to borderline intellectual functioning.     

轻度智力落后学生心理健康问题的研究

本研究使用心理健康诊断测验(MHT)手册对10-16岁(四至九年级)的轻度智力落后学生与智力正常学生间的心理健康水平进行比较研究,结果发现：轻度智力落后学生有不同程度的心理健康问题,随班就读轻度智力落后学生的心理健康问题尤为突出．有待相应有效的教育支持。     

Long-Term Follow-Up of Children with Mental Retardation/Borderline Intellectual Functioning and ADHD

Fifty-two children (ages 7 to 14 years) with moderate mental retardation to borderline intellectual functioning were recontacted 12 to 65 months following participation in a double-blind, placebo-controlled trial of methylphenidate (MPH). Sixty-nine percent of subjects continued to be prescribed medication for behavior control at follow-up. While 72% of the sample evidenced improvement, over two-thirds continued to be rated at or above the 98th percentile on the Hyperactivity Index of the Parent Conners. In fact, 22% of subjects had received inpatient psychiatric treatment between the time of the initial MPH trial and follow-up. Finally, subjects with high initial ratings on the Parent Conners Conduct Problems scale were more likely to be suspended from school or receive inpatient psychiatric treatment than subjects with low initial ratings. The results suggested that children with ADHD and mental retardation or borderline intellectual functioning continued to exhibit significant symptoms associated with attention deficit hyperactivity disorder (ADHD) at follow-up and that early conduct problems were predictive of continuing behavioral difficulties.     

全员参与学生发展性心理辅导研究

本研究借鉴美国、英国和我国香港地区的一些实践经验,力图发展和形成一种具有综合性的集体心理辅导模式,即学校教师全员参与学生的发展性心理辅导。研究提出了辅导模式的基本理念、操作步骤及主要内容,并采用教育实验的方法在金华南苑小学进行了实证研究,结果证明该模式有助于提高学生的心理健康水平,能促进学生更好地发展。     

Selectively ignoring locations does not modulate contingent involuntary orienting,but selectively attending does

Attending to a location in the visual field facilitates processing of objects in that location, and numerous studies have revealed processing benefits by precuing target locations. Recent studies have also demonstrated that precuing a location to ignore reduces distraction by items in that location; however, precuing a feature (colour) to ignore increases distractor interference, at least before a template for rejection is established. Thus, locations, not features, can be selectively ignored. The present study used a spatial cuing task to examine whether featurally-relevant items are selected when they appear in ignored locations. The results revealed contingent attentional capture by target-relevant cues (red cue when searching for red targets, but not for onset targets), even when the cue appeared in a location that was ignored. Importantly, this was equivalent to contingent capture elicited by cues in non-ignored locations. However, when observers were precued to the target location, contingent capture was largely eliminated. The results suggest salient items with target-relevant features are selected from selectively ignored locations, but focusing attention onto a location can preclude capture by salient and target-relevant items.     

The Siblings of Individuals with Mental Retardation: A Quantitative Integration of the Literature

The sibling relationship has recently become the focus of much research in developmental psychology. The family system perspective implies the presence of a sibling with mental retardation will impact on the psychological development and functioning of their typically developing siblings. Past reviews of the literature have found this impact to be negative but there is the suggestion of positive consequences to having a sibling with mental retardation. The present meta-analysis sought to quantitatively integrate 25 studies and 79 effect sizes from the literature on the siblings of individuals with mental retardation. A small negative effect for having a sibling with mental retardation was discovered that could not be attributed to a publication bias or some other artifact. This negative effect was greatest for direct observation measures, measures of psychological functioning, especially depression, and for children. Limitations to this meta-analysis and directions for future research are discussed.     

Attentional capture by irrelevant emotional distractor faces is contingent on implicit attentional settings

Although expressions of facial emotion hold a special status in attention relative to other complex objects, whether they summon our attention automatically and against our intentions remains a debated issue. Studies supporting the strong view that attentional capture by facial expressions of emotion is entirely automatic reported that a unique (singleton) emotional face distractor interfered with search for a target that was also unique on a different dimension. Participants could therefore search for the odd-one out face to locate the target and attentional capture by irrelevant emotional faces might be contingent on the adoption of an implicit set for singletons. Here, confirming this hypothesis, an irrelevant emotional face captured attention when the target was the unique face with a discrepant orientation, both when this orientation was unpredictable and when it remained constant. By contrast, no such capture was observed when the target could not be found by monitoring displays for a discrepant face and participants had to search for a face with a specific orientation. Our findings show that attentional capture by emotional faces is not purely stimulus driven and thereby resolve the apparent inconsistency that prevails in the literature on the automaticity of attentional capture by emotional faces.     

Well-being of mothers of children with mental retardation: An evaluation of the Double ABCX model in a cross-cultural context

The present study was designed to compare the psychological well-being of mothers of children with mental retardation in the USA and Korea. The Double ABCX model of stress proposed by McCubbin and Patterson (1983) was evaluated for the two national groups. Thirty-eight American and 40 Korean mothers participated in the home-visit interview. The path models in the present study partially supported the ABCX model, but different path models for the two national groups provided important explanations for the well-being of mothers from the two nations. The cause of stress for the American mothers was specific to the individual variables. For Korean mothers, cultural values that carry social influence were more strongly associated with their attitudes towards the child and their experience of stress.     

Acculturation in Women with Mental Retardation and Its Impact on Genetic Counseling

The provision of genetic counseling to women with mild mental retardation poses many challenges, some directly related to their developmental and cognitive disabilities. Traditional genetic counseling models, in which decision-making is largely based on the understanding of factual information, are particularly affected by the intellectual limitations which characterize this population. Equally important, however, are these women's attitudes, perceptions, and behaviors related to their involuntary inclusion into a highly stigmatized social group. Common themes among these women which surface in the genetic counseling setting include the denial of mental retardation, a hierarchical perception of their own and others' disabilities, and a strong motivation to conceive and parent a child. Such attitudes and behaviors may be symptomatic of acculturation, as these women struggle to take on accepted social roles while rejecting the stigma of intellectual disability. In contrast to factual information, the counselee's ability to discuss emotions and perceptions is not necessarily hampered by her intellectual limitations. A focus on the recognition and discussion of psychosocial issues provides a more meaningful approach than traditional genetic counseling models for facilitating informed reproductive decisions among women with mental retardation.     

A contingent perspective on the advantages of stores' strategic philanthropy for influencing consumer behaviour

The importance and implications of organisational‐level charitable giving, or strategic philanthropy, are often overlooked in international consumer literature. Drawing on the utilitarian human capital perspective from economics, the social norm theory from sociology, motivation theory from psychology and the strategy–environment coalignment paradigm in organisational science, this research develops a contingent framework for strategic philanthropy. The empirical results indicate that if drug stores put more emphasis on strategic philanthropy as perceived by customers in the community, customers will have stronger social ties with the store and be more loyal to the store. In addition, it was found that the impact of strategic philanthropy on patronage loyalty is moderated by customer characteristics (gender and ethnicity) and context factors (service quality and cause severity). Copyright © 2005 John Wiley & Sons, Ltd.     

心内科处理心理障碍患者治疗方案的可行性分析

为了探讨在心内科治疗心理障碍患者的可行性,我们应用汉密尔顿量表评估400例到心内科就诊的患者,对诊断为焦虑或抑郁状态的患者分为两组（心内科干预组,心理科治疗组）,随访半年,观察焦虑或抑郁状态的缓解情况。结果显示,本研究共入选符合心理障碍诊断者71例,占就诊人数的17．75％。到心理科治疗患者30例,在心内科门诊治疗患者41例,半年随访评估,治疗有效率分别为16．7％和79．4％（16．7％vs79．4％,P〈0．05）。因此,在心内科门诊对就诊的心理障碍患者进行治疗,是一种可行的方案。     

Effects of reinforced directed rehearsal on expressive sign language learning by persons with mental retardation

This study used a multielement design to compare standard training (prompting and reinforcement) with and without reinforced directed rehearsal as a correction procedure in teaching expressive sign language to 10 nonverbal students with moderate to severe mental retardation. Standard training consisted of either sequential prompting or graduated guidance and 5 students were randomly assigned to each condition. Directed rehearsal involved 10 practices of the correct sign contingent on an error or no response; praise was given during directed rehearsal for cooperation and attempted signing. A stimulus control analysis revealed that only 6 of the 10 students (3 from each standard training condition) completely discriminated the trained signs within the maximum training period of 160 trials (3 of the 4 students who failed the stimulus control test were hearing impaired; the remaining 6 who showed stimulus control were not). Using only these six students' data, we found that directed rehearsal increased: (a) accuracy (percent correct), (b) speed of learning (required fewer trials to criterion), (c) efficiency (decreased total instruction time), and (d) generalization (across trainers, objects, and settings). There were no obvious interactions between directed rehearsal and the type of prompting strategy employed. Very little agitated behavior occurred in any of the sessions, and a treatment acceptability survey indicated that 10 of 14 direct-care staff and the trainers in this study preferred corrective directed rehearsal (as used in this study) over standard training alone. The results indicate that directed rehearsal may be a valuable adjunct to sign language training with nonverbal students with mental retardation.     

An evaluation of in vivo desensitization and video modeling to increase compliance with dental procedures in persons with mental retardation

Fear of dental procedures deters many individuals with mental retardation from accepting dental treatment. This study was conducted to assess the effectiveness of two procedures, in vivo desensitization and video modeling, for increasing compliance with dental procedures in participants with severe or profound mental retardation. Desensitization increased compliance for all 5 participants, whereas video modeling increased compliance for only 1 of 3 participants.     

Evaluation of two physical guidance procedures in the treatment of pediatric feeding disorder

Children with pediatric feeding disorder may refuse to consume an adequate variety and/or volume of food to maintain expected growth. They can consume food but may actively or passively refuse, resulting in escape or avoidance of eating. Behavioral interventions like positive reinforcement with escape extinction can increase consumption. However, sometimes these interventions are insufficient, especially in treating passive refusal. In these cases, physical guidance may be used to prompt an open mouth to deposit food. Research indicates open-mouth prompts are effective and rated as acceptable. This study replicated an existing physical guidance procedure, the finger prompt, and compared its efficacy and acceptability with that of a spoon prompt. This study extended research by defining and measuring passive refusal as a dependent variable and assessing social validity among different stakeholders and times. Both prompts were effective in treating food refusal, and caregivers rated the finger prompt as more preferred.     

Establishing derived requesting skills in adults with severe developmental disabilities

This project examined whether a history of reinforced relational responding would result in derived requesting skills in 3 adults with disabilities. Participants were first taught to request preferred items using pictures; they were then taught conditional discriminations between pictures and their dictated names and between dictated names and their corresponding text. Finally, requests for preferred items using corresponding text were evaluated. All 3 participants demonstrated derived requesting skills.     

SELF-MONITORING AND WORK PRODUCTIVITY WITH MENTALLY RETARDED ADULTS

We examined the use of self-monitoring to increase the productivity of five mentally retarded adults in a sheltered workshop. Data were collected daily during a 30-minute intervention and 30-minute generalization period. Following baseline, verbal praise, prompts, and physical encouragement were administered contingent on productive behavior on a specific task during the intervention period. In the next phase, self-monitoring was trained during the intervention period. During both phases, baseline conditions prevailed in the generalization periods. In the final phase, self-monitoring was extended across the intervention and generalization periods. Results showed that increased productivity levels, evident when praise and prompting were being administered, maintained with self-monitoring alone. Minimal generalization across time was observed until self-monitoring was begun in the generalization period.     

Career guidance of adolescents in their sociocultural development and modern technologies

RelevanceThe creation of a system of work with schoolchildren focused on choosing a profession taking into account possible success in a specific professional field is relevant.AimThe article is aimed at analysis of the situation of adolescents’ susceptibility to such guidance basing on different components.Materials and MethodsThe methodology of creating and implementing a special course is focused on the formation of basic elements of readiness for professional activities.ResultsThe authors of the study developed long-term projects that are considered to improve socio-economic development and increase the quality of work in various industries and at the personal level–socio-cultural development and socialization of adolescents.ConclusionThe career guidance for adolescents should include information about the means of communication. The development of the definition of technological means to provide information on the choice of profession is a significant part of the career guidance program.