The effects of staff self-management on positive social interactions in a group home setting

The purpose of this study was to evaluate the effectiveness of a participative management (self-management) procedure directed toward increasing the frequency of positive interactions between direct-care staff and group home residents. A component of the self-management procedure, goal setting, was also evaluated. This study took place in two group homes housing a total of 16 male and female adults with moderate to mild mental retardation. Ten direct-care staff served as subjects. It was found that self-management produced an increase in the frequency of positive interactions of staff and residents, but did not produce changes in other behaviors being measured (e.g., negative interactions, self-stimulation, etc.). Goal setting did not result in changes in positive interactions or other target behaviors. Reasons for the different results of self-management versus goal-setting are discussed and further research is suggested.     

Case study: Reinforcement control of severe aggression exhibited by a child with autism in a family home

This clinical case study describes in-home treatment of severe aggression and tantrum behavior exhibited by an 11 -year-old child with autism, using methods of differential reinforcement comparable to those of a case study by Luiselli (1990). No significant reductions in problem conduct occurred when a parent implemented differential reinforcement of other behavior (DRO) in conjunction with publicly posted ‘good behavior rules,’ physical management training, and redirection to relaxation. Control was established when the child was reinforced for compliance with task demands in conjunction with extinction, implemented directly by professional support staff working in the home. Despite demonstrable parental consistency, systematic training, and fading of supports, results were not maintained at follow-up. The generality of differential reinforcement as a practical intervention for severe aggression in family homes is questioned.     

Improving day-treatment services for adults with severe disabilities: a norm-referenced application of outcome management

We evaluated an outcome management program for working with staff to improve the performance of adults with severe disabilities in a congregate day-treatment setting. Initially, observations were conducted of student task involvement and staff distribution of teaching interactions across students in four program sites. Using recent normative data to establish objective goals for student performance, management intervention was warranted in two of the sites. A six-step outcome management program was then implemented in the two sites. The program involved defining desired student and staff outcomes, systematic monitoring of the outcomes, staff training, and supportive and corrective feedback. The outcome management program was accompanied by increases in student on-task behavior and staff distribution of teaching interactions in both sites. The increases brought the levels of on-task behavior above the normative average; on-task behavior was maintained above the baseline average for over 1 year in both sites. These results are discussed in terms of the benefits of relying on normative data for objectively evaluating and improving service delivery systems. Discussion of future research needs focuses on applying the outcome management program to other settings and services for people with disabilities.     

Telehealth for persons with severe functional disabilities and their caregivers: facilitating self-care management in the home setting

Persons with severe functional disabilities are the highest users of health care services. Caring for the needs of this population represents a significant percentage of our national health care costs. A growing body of research has demonstrated the efficacy of self-management strategies and caregiver engagement for effective long-term care for individuals with chronic medical conditions. Economic forces over the past decade have led to new challenges and resulted in major changes in health care delivery resulting in shortened length of inpatient stays and greater limits on the length of outpatient treatment. Telehealth is an innovative method for health care delivery and a means of meeting this new challenge. This article highlights the findings of 3 pilot studies on the use of telecommunications technologies in promoting self-care management and enhancing health care outcomes in persons with severe disabilities and their family caregivers. The importance of matching technology to the needs of this population, lessons learned from these investigations, and future directions for research are addressed.     

Improving the spelling performance of students with disabilities

The present study examined the effects of an error correction strategy on the spelling accuracy of students with emotional and/or learning disabilities. The strategy, which asked students to spell a word, view a correct model, and then correct their errors, was compared to a traditional strategy that asked students to write words three times each while viewing a correct model. Results showed that students learned more words in the error correction condition than in the traditional condition. The error correction treatment was shown to be an effective strategy that reduced the number of repetitive spelling practice trials, and was preferred by students.     

Functional analysis and treatment of the delusional statements of a man with multiple disabilities: a four-year follow-up

Although delusional statements in people with intellectual disabilities and traumatic brain injury can be treated using behavioral interventions, none have demonstrated long‐term treatment effects. In the current study, a functional analysis demonstrated that delusional statements were maintained by attention. Differential reinforcement of alternative behavior and extinction of delusional statements resulted in near elimination of delusional statements and an increase in nondelusional statements. Follow‐up at 6 months, 1, 2, and 4 years indicated that treatment gains were maintained with continued staff training.     

Increasing the happiness of individuals with profound multiple disabilities: replication and extension

A multielement design was used to compare the effects of three treatments on the happiness of 3 individuals with profound multiple disabilities. The conditions were typical programming using materials selected by staff, presentation of preferred materials plus social interaction, and social interaction alone with no materials present. Both the presentation of the preferred items with social interaction and social interaction alone resulted in higher happiness indicators than typical programming. The combination of preferred items and social interactions was somewhat superior to social interaction alone.     

Improving instruction for adults with developmental disabilities: Evaluation of a staff training package

Improvements in adaptive behavior among adults with developmental disabilities often depends on the quality of instruction delivered by direct-care staff. The present study evaluated the effectiveness of a multifaceted package for improving the quality of instructional interactions among three staff/adult dyads. Instructional interactions were first analyzed to identify areas for improvement. A multifaceted intervention package consisting of inservice training, participative management, and on-going feedback was then implemented in a multiple-baseline design across dyads. The package trained staff to increase their use of time delay and reinforcement strategies and these changes were associated with greater independence in a sandwich making task among two of the three participating adults. The results suggest direct observation of existing instructional interactions may provide valuable information when training staff to implement effective habilitative programs for adults with developmental disabilities.     

Intensive cognitive behavioural group treatment for social phobia: a pilot study

The aim of this pilot study was to examine the effectiveness of an intensive form of cognitive behavioural group treatment practised routinely in a psychiatric clinic. A total of 27 outpatients with social phobia of long duration were assigned to a 41-hour treatment administered over 2 periods of 3.5 and 4.5 days, 1 week apart. Four groups, each comprising 6-8 patients, participated in the study. All except 1 patient (26/27) completed the treatment and 20 patients participated in all follow-up sessions after 3, 6 and 12 months. Treatment significantly reduced fear and avoidance of social interaction and performance, anticipatory anxiety and symptoms' influence on daily life. Follow-up assessments indicated maintained or increased improvement from post-test to 1 year and large sensitivity to treatment at both post-test and 1 year. Of the patients in the study, 85% were taking a prescribed drug, and 70% had taken medication for at least 1 year before they entered the treatment. At 1-year follow-up 52% had discontinued medication.     

Writing program with word prediction for a young man with multiple disabilities: a preliminary assessment

This study assessed a writing program with word prediction, which completed the writing of a word and spoke it out only when there was certainty that such a word was the correct one. The assessment was carried out with a young man with multiple disabilities, who typically used a word-processing program without word prediction. The two programs were compared on the time required by the participant for writing general sentences, through a social validation assessment, and eventually a check on the participant's preference. Analysis showed the program with word prediction was significantly more effective in terms of the writing time, which was halved, and was deemed preferable by 40 raters (psychology students) involved in the social validation assessment and by the participant himself. Implications of the findings are discussed.     

Case study: Examining the relationship between self-initiations of an individual with disabilities and directive behavior of staff persons in a residential setting

This case study examines the relationship between self-initiations of an adult woman with severe disabilities and the directive behavior of staff persons in a community residential setting. Hypotheses generated from functional assessment procedures indicated that (a) Susan's low self-initiations were very likely related to high directive behavior of staff persons, and (b) infrequent problem behaviors during the morning routine were maintained by escape from repeated staff demands. An intervention was implemented to enable Susan to increase self-initiation in choice and sequence of activities and simultaneously decrease staff directives. Results and discussion focus on the need for a contextual approach for addressing problematic situations and an affirmation of the effectiveness of the positive behavioral support technology for increasing adaptive behaviors in individuals with severe disabilities.     

Teaching social perception skills to adolescents with autism and intellectual disabilities using video‐based group instruction

Few interventions focus on teaching social skills to adolescents with autism spectrum disorder (ASD) and intellectual disabilities (ID) that are consistently used during interactions with peers ( Carter et al., 2014). The present study evaluated the effects of video‐based group instruction (VGI) on the acquisition of social perception skills of five adolescents with ASD or ID in a public school setting. Social perception involves observing affective behaviors of others, discriminating relevant environmental stimuli, and differentially reinforcing the affective behavior of another person. Typically developing peers supported VGI implementation as social partners for participants. A multiple probe design across behaviors demonstrated the effectiveness of VGI for teaching social perception skills. Four of five participants acquired and maintained the targeted social perception skills, and we observed some transfer to a nontreatment setting. Results of this study suggest VGI may support the acquisition of social perception among adolescents with ASD or ID.     

Perceptions on well-being at home of families with people with disabilities: A psycho-environmental perspective

Introduction

Although the home is of major importance in the lives of people with disabilities, few studies address disability in the literature on home and health. Moreover, people with disabilities and their family members’ perceptions of their homes has rarely been explored.

On the variation of the structure of a social group with time

A case studied in a previous paper, concerning the changes of the relative number of individuals of different types in a social group, is treated under more general assumptions. It is shown that under those more general conditions periodical fluctuations in the structure of the social group may occur.     

A focus group study on the potential of autonomous vehicles as a viable transportation option: Perspectives from people with disabilities and public transit agencies

Autonomous vehicle (AV) technology is becoming one of the most promising alternatives to improve mobility for people with disabilities. Nevertheless, how people with disabilities perceive AV as transportation services has not been explored. Also, limited information exists about how public transit agencies comprehend and perceive autonomous vehicle transportation (AVT) services. This study discusses mobility issues for people with disabilities and explores the potential of AVT to serve that population, particularly those with visual impairments or physical disabilities. Researchers conducted six focus groups comprising people with disabilities (N = 23) and public transit service experts (N = 10) in Austin, Texas and Houston, Texas. Each session was audio-recorded and analyzed using conventional content analysis. This study identified people with disabilities’ mobility issues related to: (1) current transit services (including fixed-route and paratransit services) and (2) the quality of neighborhood built environments. Both people with disabilities and transit experts expected that AVT could mitigate current mobility issues, especially in improved built environments. However, participants with disabilities also expressed concerns and anxieties regarding AVT. Transit experts agreed that more targeted strategies would be needed to overcome possible barriers to AVT for people with disabilities. This study provides insights on shaping AVT strategies and policies relevant to improving mobility for people with disabilities.     

Multiple microswitches for persons with multiple disabilities: a basic procedure to examine the persons' choice behavior

This study examined a basic choice-analysis procedure to clarify choice between two responses and related stimuli by five persons with multiple disabilities ages 17.1 to 50.2 yr. The procedure was based on reversing the links between responses and stimuli to assess whether the stimuli accounted for differences in response levels. When this was not the case, the procedure added extra stimuli for the less preferred response to judge whether such an increase would compensate for the apparent disadvantage of that response, e.g., its higher physical cost. Analysis showed that the choice of three of the five participants seemed motivated by the stimuli following the responses. The choice of the other two persons seemed related to a preference for one of the responses which was partially or largely modified when extra stimuli were added.     

Effectiveness of cognitive behavioural group therapy for social phobia in a community clinic: a benchmarking study

This study used a benchmarking strategy to investigate the transportability of cognitive behavioural group therapy (CBGT) for social phobia to a community mental health clinic. The influence of common exclusion criteria on effect sizes was also examined. Patients (N=153) attended seven 4-h sessions of CBGT, which resulted in significant reductions in symptoms of social anxiety and depression. Effect sizes compared favourably to previous efficacy and effectiveness studies of both group and individual treatment. More than half of the treatment completers achieved reliable change. One-third achieved clinically significant change (CSC) on the Social Phobia Scale and the Beck Depression Inventory, but fewer achieved CSC on the Social Interaction and Anxiety Scale. Restricting the sample on the basis of depression symptoms, age above or below 50 years, comorbidity, alcohol problems, or student status did not significantly moderate effect sizes for social anxiety. It is concluded that CBGT is effective within community mental health clinics.