An analysis of stereotypy during prevocational instruction of an adolescent with severe mental retardation

An adolescent with severe retardation was observed during participation in several vocational tasks. The vocational tasks were comprised of repeating sequences of work-related responses. Across two experiments, conditions that are typical in the training of vocational tasks in special education and adult vocational programs were manipulated and the effects of these conditions on rates of vocational sequences completed and rates of stereotypic behavior were assessed. In Experiments 1 and 2, the adolescent was reinforced with a food item following the completion of vocational sequences under two alternating reinforcement contingencies. Under one contingency, the adolescent performed with frequent errors and under the other, often performed without errors. In Experiment 3, the adolescent participated with another student in a different vocational task on alternating days and in an alternating sequence of work conditions in each task. In one condition, both adolescents had vocational materials nearly continuously present and the teacher prompted and reinforced both adolescents as needed. In the other condition, the vocational materials were presented to the adolescents on an alternating basis, and the teacher prompted and reinforced first one and then the other. Across both experiments, increased competence reflected as high rate, error free, and consistent vocational performances were associated with low rates of stereotypic behavior when compared to conditions with less competent performances, and with leisure periods in Experiment 3. © 1997 John Wiley & Sons, Ltd.     

Teaching social play skills to adults and children with autism as an approach to building rapport

Adults with autism spectrum disorder (ASD) and no intellectual disabilities were taught to increase the social play skills of children with ASD as part of a vocational training program. Participants included 3 adults, aged 21 to 27 years, and 6 children with ASD. Probes conducted throughout the study evaluated whether play skills training affected a measure of rapport between the adult and child. Results demonstrated the effectiveness of behavioral skills training for teaching the adult participants the appropriate play skills. In addition, the children's social engagement increased. Finally, rapport probes showed that play skills training increased levels of proximity, our measure of rapport, between the adults and children.     

Community treatment for the seriously mentally ill: Is this community psychology?

Community treatment for seriously mentally ill individuals fits well into the philosophy of community psychology. Community psychologists have skills and experiences with other populations that represent assets in improving the ACT service model and producing richer and more useful research results for the future. Maybe we should ask ourselves why community psychologists have obviously avoided this intervention area and the population of seriously mentally ill individuals. Does this represent an adolescent reaction to the parent discipline — clinical psychology? Is the label “mentally ill” as stigmatizing to community psychologists as it is to the general population? Are these individuals written off as not worthy of or capable of benefiting from preventive interventions? Advocates for the seriously mentally ill are mounting a backlash against prevention services. We would be well advised at this time to become involved in community treatment and demonstrate that community psychology is forall vulnerable and at-risk population groups. If the truth of the matter is that “community psychology is not doing much of a job of empowering people” (Berkowitz, 1990), maybe the truth of the matter is also that we need to reach out to more disenfranchised populations with research to show that community psychologycan do the job of empowering some.     

Impulsivity in suicidal and nonsuicidal adolescents

Nonsuicidal and suicidal adolescent inpatients were compared to community high school students using behavioral measures of impulsivity. Measures of problem solving ability, hopelessness, and depression were also administered to all groups. The suicidal inpatients were characterized by greater impulsivity, hopelessness, and depression than both nonsuicidal inpatients and community high school students. There were no differences in problemsolving abilities found between the suicidal inpatients and either the nonsuicidal inpatients or the community controls.     

Behavioral skills workshop for staff and supervisor in a community residence for developmentally handicapped adults

A behavioral skills workshop for counselors and a supervisor in a community group home was developed and evaluated. The workshop included group skills training, individual supervised in vivo practice, and supervisor training. Supervisor training taught behavioral staff management skills that were delivered in a multiple baseline design across subjects. Positive changes in staff behavior occurred for each group only after supervisor intervention. Significant positive changes occurred by the end of the workshop and were maintained at follow-up for staff self-evaluations of expertise and confidence to resolve problems, severity of client problems, and behavioral observations of positive client behaviors.     

Evaluating the vermont system of care: Outcomes associated with community-based wraparound services

Evaluation of innovative community-based interventions is becoming a high priority for child and adolescent mental health service system research. The present study examined outcomes for a sample of Vermont children (N=27) experiencing emotional and behavioral problems and receiving individualized, wraparound services. One year after initiation of wraparound care, incidence of negative behaviors rated as placing a child at risk of removal from the community had decreased significantly, compliance behavior had increased, and a significant decline in Total Problem Behavior scores on the Child Behavior Checklist was observed. In addition, though 70% of the participants had previously required inpatient or residential treatment, 89% were maintained in the community after one year of services, and the total cost of services was less than that of out-of-state residential care. Although further comparative research is needed, this study suggests that for many of these children, wraparound services may be a more efficient intervention than long-term psychiatric hospitalization or residential treatment.     

Enhancing job-site training of supported workers with autism: a reemphasis on simulation

Currently recommended practice in supported work emphasizes training job skills to workers with severe disabilities while on the job. Early behavioral research indicated that skills needed in natural environments could also be trained in simulated settings. We compared job-site plus simulation training for teaching job skills to supported workers with autism to provision of training exclusively on the job. Job-site training occurred in a small publishing company during the regular work routine, and simulation training occurred in an adult education site for people with severe disabilities. Two pairs of workers received training on two job skills; one skill was trained at the job site and the other was trained using job-site plus simulation training. Results indicated that for 3 of the 4 comparisons, job-site plus simulation training resulted in a higher level of skill or more rapid skill acquisition than did job-site-only training. Results suggested that job-site training, the assumed best practice for teaching vocational skills, is likely to be more effective if supplemented with simulation training. Directions for future research include expanding applications of behavioral technologies to other aspects of the current support paradigm.     

A Meta-Analysis of Behavioral Interventions for Adolescents and Adults with Autism Spectrum Disorders

Evaluation of evidence-based treatments is important for adolescents and adults with autism spectrum disorders (ASD) given the increasing number of interventions available and the prevalence of ASD. In this study, we sought to evaluate the effectiveness of behavioral interventions for this population by conducting a meta-analysis of published single-case research studies. A new metric for calculating effect size in single-case research, nonoverlap of all pairs, was utilized. In addition, the certainty of evidence, a system to evaluate research methodology, was applied to the reviewed articles. Forty-three articles were identified in the study. Results suggested that the behavioral interventions in the areas of academic skills, adaptive skills, problem behavior, phobic avoidance, social skills, and vocational skills have medium-to-strong effect sizes. Medium-to-high confidence in findings was noted for 81 % of the studies in the meta-analysis; however, three-fourths of the reviewed studies did not include treatment integrity, which may affect the ability to draw conclusions about the effectiveness of the interventions. Overall, the evidence is promising for the use of behavioral interventions for this population; however, additional research and dissemination are needed to fill the gap between research and practice in order for practitioners to meet the increasing demand as individuals with ASD age.     

Mitigating aggression and promoting prosocial behavior in aggressive elementary schoolboys

The effects of four school-based interventions designed to decrease children's aggression and promote prosocial behavior were assessed. One hundred and four aggressive boys, ages 8–13, from ‘Behavior Disorder’ classrooms, were assigned to one of four training conditions: cognitive (self-control) training, behavioral (prosocial skills) training, combined cognitive-behavioral training, or attention/play training. School psychologists trained the boys in small groups for 10 1-h sessions. It was hypothesized that training in both cognitive and behavioral competencies would lead to the most behavioral improvement. Results indicated that, according to teacher report, those children receiving the cognitive-behavioral and attention/play interventions improved significantly more than those exposed to cognitive and behavioral training by decreasing their aggression and increasing their prosocial behavior immediately following the intervention. At 6-month follow-up, only those children exposed to the attention/play intervention remained significantly improved.     

Children's social problem-solving skills, behavioral adjustment, and interventions: A meta-analysis evaluating theory and practice

Meta-analyses were performed to examine reported relations between children's interpersonal cognitive problem-solving (ICPS) skills and adjustment, and to specify the effects of ICPS training. In general, the relation between ICPS and adjustment appears robust, and interventions yield clear increases in ICPS skills. Intervention effects on behavioral adjustment are somewhat more equivocal; meta-analytic results differ depending on whether behavioral ratings or observations are the dependent variables. Age of subject, source of publication, and expertise of investigator are boundary conditions for the meta-analysis regarding ICPS and adjustment; teacher/child dialogues on ICPS principles in real-life situations, expertise of investigator, source and quality of publication, and length of interventions mediate magnitude of certain intervention effects. Further research is needed where data were sparse, as in follow-up data and effects of intervention for various special populations.     

A Career Awareness Program for High School Dropouts

The Career Awareness Program for High School Dropouts was an experimentally funded project to determine the effect of a concentrated vocational assessment and vocational counseling program on the employability of high school dropouts. Various aspects of CAP included individual and group counseling, vocational-educational assessment and diagnosis, job attitude training, vocational guidance, and career exploration. The results of a follow-up survey showed that approximately 60% of the dropouts were still employed six months after completion of the program. In addition, the dropouts reported benefiting from the program through increased awareness of their own needs, abilities, and interests as well as through better awareness of the types of skills and behaviors desired by employers.     

Perceptual training strongly improves visual motion perception in schizophrenia

Schizophrenia patients exhibit perceptual and cognitive deficits, including in visual motion processing. Given that cognitive systems depend upon perceptual inputs, improving patients’ perceptual abilities may be an effective means of cognitive intervention. In healthy people, motion perception can be enhanced through perceptual learning, but it is unknown whether this perceptual plasticity remains in schizophrenia patients. The present study examined the degree to which patients’ performance on visual motion discrimination can be improved, using a perceptual learning procedure. While both schizophrenia patients and healthy controls showed decreased direction discrimination thresholds (improved performance) with training, the magnitude of the improvement was greater in patients (47% improvement) than in controls (21% improvement). Both groups also improved moderately but non-significantly on an untrained task—speed discrimination. The large perceptual training effect in patients on the trained task suggests that perceptual plasticity is robust in schizophrenia and can be applied to develop bottom-up behavioral interventions.     

Increased Jump Height with an External Focus Due to Enhanced Lower Extremity Joint Kinetics

Sensorimotor abilities are crucial for performance in athletic, military, and other occupational activities, and there is great interest in understanding learning in these skills. Here, behavioral performance was measured over three days as twenty-seven participants practiced multiple sessions on the Nike SPARQ Sensory Station (Nike, Inc., Beaverton, Oregon), a computerized visual and motor assessment battery. Wrist-worn actigraphy was recorded to monitor sleep–wake cycles. Significant learning was observed in tasks with high visuomotor control demands but not in tasks of visual sensitivity. Learning was primarily linear, with up to 60% improvement, but did not relate to sleep quality in this normal-sleeping population. These results demonstrate differences in the rate and capacity for learning across perceptual and motor domains, indicating potential targets for sensorimotor training interventions.     

Behavioral Problems in Taiwanese Children of Adolescent and Adult Mothers

The purpose of this study was to estimate child behavioral problems over time and determine gender differences in behavioral problems between children born to adolescent and adult mothers in Taiwan. The consistency between parent’s and teacher’s reports was also examined. Secondary analysis of a longitudinal dataset from Taiwan was conducted. A matched sample of 107 children born to adolescent mothers and 111 children born to adult mothers were recruited. Child behavioral problems were assessed by parents at Time 1 (1^st and 2^nd grades) and by teachers at both Time 1 and Time 2 (5^th and 6^th grades). Generalized estimating equations and paired t-test were used. At Time 1, compared to children of adult mothers, children of adolescent mothers had had more behavioral problems by both parental and teacher’s reports. Both parents and teachers reported that boys had more behavioral problems than girls. Moreover, according to teacher reports, children of adolescent mothers and boys had more behavioral problems and these differences persisted over time, even controlling for sociodemographic characteristics. In addition, parents reported higher scores of behavioral problems than teachers. In conclusion, child behavioral problems in Taiwan are associated with maternal age at child birth and child’s gender. Interventions may profitably focus on determining the mechanisms that lead to behavior problems in children of adolescent mothers, and/or reducing adolescent pregnancy as a way of decreasing child behavioral problems. Screening and preventive interventions for child behavior problems may need to be gender-specific.     

Development of a parent training program for children with pervasive developmental disorders

Parent delivered interventions based on applied behavior analysis (ABA) for children with Pervasive Developmental Disorders (PDDs) have been evaluated using primarily single‐subject design methodology or small case series. While the results of these evaluations are encouraging, an important next step is to standardize the interventions to allow for replication across sites, in studies with large samples and measures of long‐term, clinically meaningful outcomes such as improvements in children's functioning and their relationships with parents. Accordingly, the Research Units on Pediatric Psychopharmacology and Psychosocial Interventions (RUPP Autism Network) assembled a detailed manual for a structured behavioral parent training (PT) program, developed treatment fidelity and training procedures, and conducted a pilot, feasibility study. The PT program is part of a large scale, multisite study intended to determine the efficacy of combined pharmacological treatment and behavioral intervention to improve behavior and adaptive functioning in children with PDD. This paper discusses the rationale for this project. A companion paper provides the results of our feasibility study on the PT program. Copyright © 2007 John Wiley & Sons, Ltd.     

Participation in decision-making by staff in community mental health programs

Staff participation in decision-making was examined in 22 community mental health programs in Michigan. A questionnaire was completed by 164 practitioners employed at least half time. The response rate was 94%. For virtually every work-related decision examined, the practitioners wanted significantly greater participation in decision-making than they currently have. Also, those working in programs where practitioner participation was high reported greater job satisfaction, less role ambiguity, greater use of their skills, better communication among staff, and greater goal clarity and attainability. Practitioner participation was lowest in programs serving more disturbed, less successful populations, such as inpatient, mental retardation, and drug-abuse programs. Para-professional practitioners in all programs reported less participation in their jobs than professional practitioners. Finally, practitioners who typically interact more with clients also reported lower levels of participation.     

Treating Depression Among Adolescent Perinatal Women With a Dialectical Behavior Therapy–Informed Skills Group

Depression is a prevalent and impairing problem affecting both women and offspring during the perinatal (pregnancy and the postpartum) period. Despite this, few studies have examined treatments for perinatal adolescents with depressive symptoms. The present study examined the feasibility and preliminary outcomes of a dialectical behavioral therapy (DBT) informed skills group among depressed adolescent perinatal women (N = 25) recruited from both a public health parent education program and an adolescent obstetric clinic. A brief composite case example is included to illustrate how DBT skills were taught, practiced, and applied. Findings suggest the intervention was credible, acceptable, and associated with improvement in depression. Challenges with feasibility of enrolling and retaining adolescent perinatal women were evident, as approximately half of the enrolled participants did not complete the study. This study provides preliminary evidence that a DBT-informed skills group may be a promising intervention for depressed adolescent perinatal women and points to important directions for clinical practice and research, including treatment engagement and retention.     

Building a Theoretical Model for Supporting Teens’ Autonomy Daily (STAND): A Network Analysis of Family-Perceived Changes

Little is known about processes through which behavior therapy (BT) for adolescent ADHD improves outcomes. The purpose of this study was to build a theoretical model for the processes through which a BT for adolescent ADHD (Supporting Teens’ Autonomy Daily; STAND) impacts functioning. Seventy-eight audio recordings from a standard therapeutic task in the final STAND session were analyzed as parents and adolescents (ages 11–16) reflected upon what changed during STAND and why. Qualitative coding sorted parent and teen statements into orthogonal categories of perceived changes. Network analysis examined inter-relations between categories. Results indicated twenty-one categories of perceived change areas. Parent use of behavioral strategies, adolescent motivation, and adolescent organization skills were central nodes in the network of perceived changes, with strong relations to academic and parent-teen relationship outcomes. A model is proposed in which skills training in STAND increases parent behavioral strategy use and teen organization skills, while Motivational Interviewing (MI) in STAND increase parent behavioral strategy use and initial adolescent motivation. In turn, parent behavioral strategy use is proposed to further reinforce teen motivation through contingency management, thereby increasing teen application of organization skills to daily life. As a result of improved teen motivation and organization skills, the model proposes that ADHD symptoms, academic problems, and parent-teen conflict abate. We discuss secondary mechanisms and outcomes in this model, the possibility of person-specific processes, implications for community-based adaptation of STAND, and plans to validate this conceptual model using sophisticated mediational models.     

Social interactions as predictors of children's likability and friendship patterns: A multiple regression analysis

The concurrent and predictive validity of four qualitative behavioral classes of social interaction (initiating and receiving positive and negative social interaction) was investigated using sociometric measures of peer acceptance (ratings) and friendship (nominations). Correlational analyses showed significant relationships between behavioral and sociometric measures supporting previous work with preschool populations. Stepwise multiple regression analyses suggested that receiving social interaction from peers best predicted overall acceptance, whereas initiating social interactions best predicted children's friendship patterns. Tentative implications for the behavioral assessment of children's social skills were discussed.The current data were gathered as part of a larger research project concerning social skills assessment and training in children.     

The effectiveness of psychological skills training and behavioral interventions in sport using single-case designs: A meta regression analysis of the peer-reviewed studies

We used a novel meta regression analysis approach to examine the effectiveness of psychological skills training and behavioral interventions in sport assessed using single-case experimental designs (SCEDs). One hundred and twenty-one papers met the inclusion criteria applied to eight database searches and key sport psychology journals. Seventy-one studies reported sufficient detail for effect sizes to be calculated for the effects of psychological skills training on psychological, behavioral, and performance variables. The unconditional mean effect size for weighted (Δ = 2.40) and unweighted (Δ = 2.83) models suggested large improvements in psychological, behavioral, and performance outcomes associated with implementing cognitive-behavioral psychological skills training and behavioral interventions with a SCED. However, meta-regression analysis revealed important heterogeneities and sources of bias within this literature. First, studies using a group-based approach reported lower effect sizes compared to studies using single-case approaches. Second, the single-case studies, (over 90 per cent the effect sizes), revealed upwardly biased effect sizes arising from: (i) positive publication bias such that studies using lower numbers of baseline observations reported larger effects, while studies using larger numbers of baseline observations reported smaller – but still substantial – effects; (ii) not adopting a multiple baseline design; and (iii) not establishing procedural reliability. We recommend that future researchers using SCED’s should consider these methodological issues.