THE USE OF BEHAVIORAL ASSESSMENT TO PRESCRIBE AND EVALUATE TREATMENTS FOR SEVERELY HANDICAPPED CHILDREN

Behavioral assessment procedures were used to prescribe and evaluate treatments of maladaptive behavior for 2 children with severe multiple handicaps. In Experiment 1, the results of an assessment of reinforcer preference were used in conjunction with a functional analysis of the conditions maintaining self-injurious behavior to prescribe a treatment for a child with severe disabilities. The treatment procedure involved the use of a pressure-sensitive microswitch to activate reinforcing stimuli during two solitary conditions, during which self-injurious behavior had occurred at high rates. The results were evaluated with a multiple baseline across settings design and indicated that self-injury decreased with concomitant increases in microswitch activation. Results were maintained at 6 weeks, 8 weeks, and 6 months. In Experiment 2, the results of behavioral assessments of reinforcer preference and self-injurious behavior were combined to develop a treatment for a second severely handicapped child, who exhibited high rates of self-injury in demand situations. This treatment was evaluated with a multiple baseline across tasks design and resulted in the elimination of self-injury for up to 15 months.     

CHANGING PROTECTIVE AND RISKY BEHAVIORS TO PREVENT CHILD-TO-PARENT TRANSMISSION OF CYTOMEGALOVIRUS

Child-to-parent transmission of cytomegalovirus may be reduced by increasing protective behaviors (handwashing and glove use) and decreasing risky behaviors (intimate contact between child and parent). This study showed that an educational intervention resulted in increases in reported and objective measures of protective behaviors and decreases in reported risky behaviors. Further study must determine if changes in protective and risky behavior are maintained and prevent cytomegalovirus transmission.     

BEHAVIORAL GERONTOLOGY: APPLICATION OF BEHAVIORAL METHODS TO THE PROBLEMS OF OLDER ADULTS

Elderly persons are under-represented in research and clinical applied behavior analysis, in spite of data suggesting that behavior problems are quite prevalent in both community dwelling and institutionalized elderly. Preliminary investigations suggest that behavioral procedures can be used effectively in treating various geriatric behavior problems. We discuss a number of areas within behavioral gerontology that would profit from additional research, including basic field study, self-management, community caregiver training, institutional staff training and management, and geriatric behavioral pharmacology. Special considerations for adapting behavioral procedures are discussed, and suggestions for expanding the role of behavior analysis in geriatric care are offered.     

THEORETICAL,PRACTICAL, AND SOCIAL ISSUES IN BEHAVIORAL TREATMENTS OF OBESITY

Although showing superior maintenance, behavioral treatments of obesity typically produce small weight losses at a decelerating rate. Rather than reflecting poor compliance with treatment, these findings are consistent with known compensatory metabolic changes that operate to slow weight loss and promote regain. Other problems associated with dieting include failure of caloric regulation, hyper-responsivity to food palatability, and hunger, which is greatest under conditions of moderate restriction and unpredictability of access to food. The inevitability of treatment failure in many instances must be faced and efforts made to prevent further worsening of the obese patient's self-esteem. Prognosis and treatment planning may be aided by consideration of the historical difficulties of weight loss, the degree of hunger experienced on diets, which may reflect important physiological differences among individuals, and the use of food to optimize arousal level. Full involvement of the patient in setting goals and planning treatment is recommended.     

CONSTRUCTING PARALLEL SIMULATION EXERCISES FOR ASSESSMENT CENTERS AND OTHER FORMS OF BEHAVIORAL ASSESSMENT

Assessment centers rely on multiple, carefully constructed behavioral simulation exercises to measure individuals on multiple performance dimensions. Although methods for establishing parallelism among alternate forms of paper-and-pencil tests have been well researched (i.e., to equate tests on difficulty such that the scores can be compared), little research has considered the why and how of parallel simulation exercises. This paper extends established procedures for constructing parallel test forms to dimension-based behavioral simulations. We discuss reasons for establishing comparable, alternate simulation forms and discuss the issues raised when applying traditional procedures to simulation exercises. After proposing a set of guidelines for establishing alternate forms among simulations, we apply these guidelines to simulations used in an operational assessment center.     

CONTINGENT REINFORCEMENT FOR BENZODIAZEPINE-FREE URINES: EVALUATION OF A DRUG ABUSE TREATMENT INTERVENTION

This study evaluated contingent reinforcement for benzodiazepine-free urines as a therapeutic intervention for promoting reduced use of supplemental benzodiazepine drugs among methadone maintenance outpatients. Ten methadone maintenance patients were selected for participation on the basis of positive urinalysis results. During a 12-week intervention period these patients were offered clinic privileges, including monetary payments or methadone take-home doses, contingent on benzodiazepine negative urinalysis test results. Eight of ten participants responded to the intervention with at least 2.5 weeks of consecutive clean urines. An increase in benzodiazepine-negative tests during the contingent reinforcement period was significant for the group as a whole. The results suggest that more widespread application of contingent reinforcement procedures may be warranted in drug abuse treatment clinics.     

BEHAVIORAL RESEARCH IN PREVENTIVE DENTISTRY: EDUCATIONAL AND CONTINGENCY MANAGEMENT APPROACHES TO THE PROBLEM OF PATIENT COMPLIANCE

This study examined the effects of reinforcement on compliance with an oral hygiene education program. Patients 18 years of age or older who enrolled in an ongoing program at a periodontal practice received 3–5 sessions of instruction in preventive dental care. Using a between-subjects design, patients who entered the program during alternating months also had a portion of their fees refunded contingent upon improvements in their dental plaque scores. Pre- and posttreatment data showed that all subjects exhibited lower plaque levels following the program, but that greater improvements were seen in patients who were exposed to the fee reduction contingency. Plaque scores taken at a 6-month follow-up revealed some relapse for the Fee Reduction subjects. However, their scores were still substantially better than pretreatment, and better than those of the Education only subjects, whose data differed little from untreated Controls. Methodological and practical issues related to behavioral research in preventive dentistry are discussed.     

LIVING RESEARCH: THE EXPERIENCE OF RESEARCHING SELF,OTHER, AND DISCOURSE

Although there is widespread agreement among psychologists that the self needs to be studied in context, how to actually study the interconnections between the self and environment can be challenging. This article describes a process of engaging in socially-embedded research by providing an inside view of the researcher's experience of working with such abstract concepts as culture, discourse, and the self. The background study consisted of three main layers of analysis, including (a) a narrative of one woman's reconstitution of self while recovering from anorexia nervosa, (b) an analysis of dominant discourses surrounding the discourse of recovery and treatment, and (c) a narrative of the research process including the discursive relationships of the researcher. This article focuses on this last phase and discusses the difficulties encountered when attempting to understand one's own relationship to various discourses. The researcher builds on constructivist conceptualizations of the self as the foundation for interpreting the texts selected as the data.     

OUTCOME EVALUATION OF BEHAVIORAL PARENT TRAINING AND CLIENT-CENTERED PARENT COUNSELING FOR CHILDREN WITH CONDUCT PROBLEMS1

The central question addressed was, how effective is parent training in reducing conduct problems in children in comparison to client-centered parent counseling? A secondary question was the relative effectiveness of the two treatment groups in comparison to a wait control group that when untreated during the 8-week period of treatment provided the other groups. Families of 36, 5- to 12-year-old conduct problem children were screened and assigned at random to treatment groups, but wait control group assignment depended upon therapist availability. Supervised graduate student therapists conducted 10 treatment sessions for each family. Parent reports and paper and pencil tests of child deviance and parent satisfaction showed a superior outcome for behavioral over the client-centered and wait control groups, and no differences between the latter two groups. At follow-up there was no maintenance of this superiority. Home observation data showed no advantage of behavioral over client-centered treatment, and these two groups did not improve significantly more than the wait control group. These results were discussed in the light of possible interactions between treatment and measurement, and methodological and sampling differences between this and other studies.     

INCREASING THE ACCURACY OF CORRECTIONS FOR RANGE RESTRICTION: IMPLICATIONS FOR SELECTION PROCEDURE VALIDITIES AND OTHER RESEARCH RESULTS

The common practice in meta-analyses and in individual studies of correcting for direct range restriction even though range restriction is actually indirect has long been known to lead to undercorrection, but this error has been assumed to be small. Using validity generalization data sets for 4 jobs, this study calibrated this error by comparing meta-analysis results based on corrections for direct range restriction with the more accurate results from a recently developed method of correcting for indirect range restriction. It was found that, on average, correction for direct range restriction resulted in substantial underestimation of operational validities for both job performance measures (21%) and training performance measures (28%). In addition, 90% credibility values were on average underestimated by 38%–40%. In addition to the implications for personnel selection, these findings suggest that similar underestimation of important relationships has occurred in other areas of research, with potential implications for theory development.     

BRIDGING THE DISCONNECTION BETWEEN APPLIED RESEARCH AND PRACTICE: A REVIEW OF TREATMENTS THAT WORK: EMPIRICALLY SUPPORTED STRATEGIES FOR MANAGING CHILD BEHAVIOR PROBLEMS BY ED CHRISTOPHERSEN AND SUSAN MORTWEET

In recent years, behavior analysts have lamented a disconnection between applied research and practice. In their book, Treatments That Work: Empirically Supported Strategies for Managing Child Behavior Problems, Christophersen and Mortweet (2001) have attempted to bridge this gap for medical and behavioral health providers alike by describing empirically supported treatments, derived from behavior therapy and its application, that are specifically designed for challenging problems commonly seen in typical children. The book is clearly intended for both primary care physicians and behavior therapists, and in this article, we review the extent to which the book meets the needs of each. Discussion centers on the extent to which the book can meet the need for both technical precision and conceptual breadth in training of behavior therapists. We conclude that, in making explicit the connections between research and practice, the authors have provided a useful clinical teaching tool and have also raised important questions about how best to establish collaborative relationships with physicians and promote the use of behavioral technology in primary care.     

EVALUATION OF BEHAVIORAL SKILLS TRAINING FOR TEACHING FUNCTIONAL ASSESSMENT AND TREATMENT SELECTION SKILLS TO PARENTS

Scant research has addressed the issue of teaching parents to conduct a functional assessment and design a treatment for problem behavior. The present study utilized behavioral skills training to teach parents how to conduct ABC recording, write a summary statement based on the data collected, and make appropriate treatment choices. Eight parents participated in one 3‐h class in which a trainer used instructions, modeling, rehearsal, and feedback to teach these three skill sets. Prior to class, during class, directly after class training, and 1 to 2 weeks following class, the participants viewed videos showing a problem behavior serving a different function in the context of a parent child interaction. The percentage of correct responding for each dependent variable (ABC recording, summary statement, and treatment choices) was calculated, and baseline and post‐treatment scores were compared via a multiple baseline across participants design. The results showed an increase in the percentage correct for most skills for most participants. These results show that it is possible to teach parents to conduct a functional assessment and choose proper treatment strategies. Copyright © 2012 John Wiley & Sons, Ltd.     

EFFECTS OF REINFORCER QUALITY ON BEHAVIORAL MOMENTUM: COORDINATED APPLIED AND BASIC RESEARCH

The high-probability (high-p) instructional sequence has been an effective treatment for noncompliance. However, treatment failures have also been reported. We hypothesized that the efficacy of the high-p treatment may be improved by using higher quality reinforcers for compliance to high-p instructions. The resistance of compliance to change was tested by varying reinforcer quality in two applied studies and a basic laboratory experiment. Experiment 1 tested the hypothesis that an increase in reinforcer quality for high-p compliance will increase the effectiveness of the high-p treatment when it fails to increase compliance. Experiment 2 assessed the effects of reinforcer quality on resistance of compliance to change by presenting successive low-p requests following the high-p treatment. A basic laboratory study (Experiment 3) was conducted to further isolate the relation between reinforcer quality and behavioral momentum. Two different liquid reinforcers (sucrose and citric acid solutions) were presented in a two-component multiple variable-interval variable-interval schedule followed by a single extinction test session. Results of all three experiments showed a generally consistent relationship between reinforcer quality and behavioral momentum.     

ACCEPTABILITY OF ALTERNATIVE TREATMENTS FOR SCHOOL REFUSAL: EVALUATIONS BY STUDENTS,CAREGIVERS, AND PROFESSIONALS

Summary . School refusal is a debilitating condition that may be treated in various ways. This study examined the acceptability and perceived effectiveness of alternative treatments for school refusal. A total of 376 people comprising students, parents, and professionals, were required to evaluate several treatment options in relation to a vignette. Despite its potential aversiveness, behavioural management was the most acceptable treatment approach followed, in order, by home tuition with psychotherapy, hospitalisation, and medication. A strong positive relationship was found between acceptability and perceived effectiveness.     

THE LOCAL ORGANIZATION OF BEHAVIOR: DISCRIMINATION OF AND MEMORY FOR SIMPLE BEHAVIORAL PATTERNS

A procedure was developed to enable nonverbal organisms to report what they remember of the temporal organization of their recent behavior. A baseline behavior with known temporal structure was established by a concurrent variable-interval variable-interval schedule for two temporal patterns of behavior (two different classes of reinforced interresponse times). The five pigeon subjects emitted these two temporal patterns on a center key and were occasionally given a short-term memory probe for their most-recently-emitted pattern. The probes consisted of symbolic delayed matching-to-sample tests, in which a response on a green side key was reinforced if the most recent pattern belonged to the shorter reinforced class, and a response to a red side key was reinforced if the most recent pattern belonged to the longer reinforced class. All subjects could report with over ninety percent accuracy what their most recently emitted behavioral pattern was when a retention interval separating the pattern from the memory probe was only .1 seconds. The retention interval was then manipulated, and it was found that recall for a pattern was frequently above chance after a delay of as much as eight seconds. Thus, pigeons can remember their most recent interresponse time not only right after it is emitted, but for several seconds thereafter. In other conditions, the patterns themselves were manipulated. It was found that as the patterns became more similar, discrimination became poorer. These results agree with the view that reinforcement tends to organize and integrate the local structure of behavior to the extent to which that structure is remembered.     

DISCIPLINED DECISION MAKING IN AN INTERDISCIPLINARY ENVIRONMENT: SOME IMPLICATIONS FOR CLINICAL APPLICATIONS OF STATISTICAL PROCESS CONTROL

This paper explores some of the implications the statistical process control (SPC) methodology described by Pfadt and Wheeler (1995) may have for analyzing more complex performances and contingencies in human services or health care environments at an organizational level. Service delivery usually occurs in an organizational system that is characterized by functional structures, high levels of professionalism, subunit optimization, and organizational suboptimization. By providing a standard set of criteria and decision rules, SPC may provide a common interface for data-based decision making, may bring decision making under the control of the contingencies that are established by these rules rather than the immediate contingencies of data fluctuation, and may attenuate escalation of failing treatments. SPC is culturally consistent with behavior analysis, sharing an emphasis on data-based decisions, measurement over time, and graphic analysis of data, as well as a systemic view of organizations.     

THE FUNCTIONS OF ASSESSMENT: IMPLICATIONS FOR SELECTION AND DEVELOPMENT OF DEVICES FOR ASSESSING REPERTOIRES IN CLINICAL,EDUCATIONAL, AND OTHER SETTINGS

An attempt is made to identify the many different functions that assessment of an individual's repertoire can serve. Implications of these functions for the character of and evidence about assessment devices are suggested. The functions fall into two general groups, those which influence decisions regarding an individual learner, and those which influence policy, program development, and scientific knowledge. The first group of functions is presented in a rough chronological sequence such that they form a “behavioral assessment funnel,” beginning with functions involving broad-band assessment to identify likely persons and skill areas, and narrowing to the precise pinpointing, monitoring, and follow-up functions. The contribution of behavior analysis and behavior therapy to assessment methodology in this sequence is identified as well as the areas where more traditionally conceived methods are still useful. The second group of functions and behavioral contributions to it are then discussed.