TRAINING MENTALLY RETARDED ADOLESCENTS TO BRUSH THEIR TEETH1

The need for self-care by retarded individuals in behaviors such as brushing teeth led to the development and evaluation of a comprehensive toothbrushing program that included a task analysis and training procedure specific to each component of the task analysis. Eight mentally retarded adolescents, in two groups, individually received acquisition training that included scheduled opportunities for independent performances, verbal instruction, modelling, demonstration, and physical assistance. The first group of four subjects received token plus social reinforcement; the second received only social reinforcement. All eight subjects showed improved toothbrushing behaviors when compared to baseline. Six of the eight subjects correctly performed all toothbrushing steps in two of three consecutive sessions. The study emphasizes the need for systematic program development and evaluation.     

THE EFFECTIVENESS OF REINFORCEMENT,RESPONSE COST,AND MIXED PROGRAMS ON CLASSROOM BEHAVIORS1

Six elementary school children served as subjects in an experiment comparing the relative effectiveness of (1) token reinforcement, in which children received tokens for attending and for correct arithmetic performance; (2) response cost, in which children received “free” tokens at the start of a period but lost them for inattention and for arithmetic performance below a specified level; and (3) a combination of both token reinforcement and response cost. During training, the six subjects received all three procedures in counterbalanced sequence. The effects of the three procedures were assessed by a within-subject comparison divided into three phases: (i) baseline, (ii) training, (iii) withdrawal of tokens. Introduction of the three token procedures markedly increased the two dependent measures. However, there were no differences across the procedures in the amount of change produced in either attending behavior or arithmetic performance. During baseline, the subjects averaged 29% attending behavior and 6.4 correct problems. These levels increased to 85% for attending behavior and 11.4 correct problems for arithmetic performance during training. Removal of all token procedures significantly decreased attending behavior (to an average of 65%), but produced a nonsignificant reduction in arithmetic performance (to an average of 7.6 correct problems). There was evidence that this lack of differential effects of the three token procedures was not due to an inability to discriminate among them. Furthermore, the subjects were evenly divided in their preference for the three procedures.     

A comparison of procedural variations in teaching behavior chains: manual guidance, trainer completion, and no completion of untrained steps

We compared variations for teaching a sequence of responses through forward chaining. Seven children who had been diagnosed with autism participated in a comparison of teacher completion (TC) of steps beyond the training step and manually guiding the student (SC) to complete steps beyond the training step. A no-completion (NC) condition, in which the steps beyond the training step were not completed, was added to the comparison with 4 of the participants. Results showed that learning occurred with all procedures, although 5 participants acquired the chains most efficiently in the SC condition and the other 2 learned most efficiently in the TC condition. Of the participants for whom an NC condition was included, the tasks were acquired with the shortest average session length and total training time. Despite the potential benefits of TC and SC procedures, NC is a viable option and may be preferable for some students.     

Teaching minority high school students to recruit helpers to attain personal and educational goals

Recruiting help from mentors and other potential helpers is a promising strategy for helping disadvantaged and minority youths meet their personal and educational goals. Three African-American high school seniors participated in a project designed to evaluate the effectiveness of training procedures that would allow them to ask for help in attaining educational and other personal goals. A behavioral training procedure that included instructional materials, role-play practice, praise, and feedback was used. Targeted skills included goal setting and 30 responses involved in the process of meeting with a potential helper. Role-play situations were used to evaluate participants' help-recruiting skills before and after training. Participants increased their help-recruiting skills from an average of 38% during baseline, to an average of 75% after training. Self-reported measures of goal attainment suggested that the students benefited from the training. Implications for mentoring programs designed to increase minority students' opportunities to reach educational goals were discussed.     

Individual Differences in Training Gains and Transfer Measures: An Investigation of Training Curves in Children with Attention‐Deficit/Hyperactivity Disorder

Currently, evidence for the beneficial effects of working memory (WM) training on transfer measures in children with attention‐deficit/hyperactivity disorder (ADHD) is inconsistent. Although there is accumulating evidence for the role of individual differences in training and transfer gains of cognitive training, this area has been left unexplored for children with ADHD. In the current study, an advanced latent growth curve model analysis was used to investigate the individual differences in learning curves (training gains) of WM training tasks within a new cognitive intervention ‘Paying Attention in Class’. It was investigated whether certain baseline variables (age, intelligence quotient, externalizing behaviour problems and presence of learning disability) predicted the learning curves and how these individual learning curves influenced near‐transfer and far‐transfer measures. A total of 164 children diagnosed with ADHD, between the age of 8 and 12 years old, followed this new Paying Attention in Class intervention. WM (near‐transfer) and academic performance (far‐transfer) measures were assessed before treatment and directly after treatment. Results showed that individual differences at the start of training were predicted by age and intelligence quotient, but the individual differences in learning curves were not predicted by any of the baseline variables. Both for the verbal and the visuospatial WM training, children with larger training gains (i.e. steeper training curves) showed larger benefits on the near untrained transfer measures. These effects were absent for the far‐transfer measures. Current study shows that training WM is quite complex and has its limitations for children with ADHD. Nonetheless, it highlights that training and transfer gains are affected by many different factors and warrants the need of a more in‐depth investigation of individual differences in future studies.Copyright © 2017 John Wiley & Sons, Ltd.     

Action and coping planning with regard to dental brushing among Iranian adolescents

The aims of this study were two-fold: (i) to examine the validity of the proposed three-factor structure (intention, action-, and coping planning) in an Iranian sample of adolescents, and (ii) to assess the predictive ability of the Theory of Planned Behavior (TPB) measures of action planning and coping planning for dental brushing. Eight hundred adolescents were randomly selected to participate in the study. 90% (721) of adolescents agreed to participate. Perceived behavioral control, action and coping planning scales and a self-report questionnaire related to dental brushing behavior were completed by the adolescents at baseline. One month later (time-point 2), the adolescents were asked to reassess their frequency of dental brushing over the four week period. Data were analyzed by a confirmatory factor analysis (CFA) on an original three-factor structure (intention, action plan, and coping plan). A hierarchical linear regression analysis was also performed. The CFA for the original three-factor structure showed a good fit index (χ(2)?=?637.60, degrees of freedom df?=?116), goodness-of-fit index (GFI)?=?91, and root mean square error of approximation (RMSEA)?=?0.079. Adjusting for demographic variables, action- and coping planning together accounted for 7.9% of the variance associated with dental brushing behavior at one month. In conclusion, results suggest that action planning and coping planning are associated with higher frequency in dental brushing among Iranian adolescents.     

A Comparison of Behavioral Parent Training Programs for Fathers of Children With Attention-Deficit/Hyperactivity Disorder

Few behavioral parent training (BPT) treatment studies for attention-deficit/hyperactivity disorder (ADHD) have included and measured outcomes with fathers. In this study, fathers were randomly assigned to attend a standard BPT program or the Coaching Our Acting-Out Children: Heightening Essential Skills (COACHES) program. The COACHES program included BPT plus sports skills training for the children and parent-child interactions in the context of a soccer game. Groups did not differ at baseline, and father ratings of treatment outcome indicated improvement at posttreatment for both groups on measures of child behavior. There was no significant difference between groups on ADHD-related measures of child outcome. However, at posttreatment, fathers who participated in the COACHES program rated children as more improved, and they were significantly more engaged in the treatment process (e.g., greater attendance and arrival on time at sessions, more homework completion, greater consumer satisfaction). The implications for these findings and father-related treatment efforts are discussed.     

Teaching self-protection to young children

Self-protective behaviors were taught to three preschool children in order to prevent the opportunity for abduction. An analogue measure of self-protection was developed in which confederate adults approached and verbally attempted to lure each child from the setting, before, during, and after training. A multiple baseline design across subjects was used. During baseline, all the children displayed susceptibility to the lures. Training procedures included modeling, behavior rehearsal, and social reinforcement. Within 1 week after training began, all children displayed appropriate responses to all of the lures both in the training setting and in the community.     

SOCIAL SKILLS TRAINING WITH CHILDREN: PROCEED WITH CAUTION

Three learning disabled children, selected on the basis of peer sociometric ratings and teacher referral, received social skills training. A group training procedure consisting of coaching, modeling, behavior rehearsal, and feedback was used to teach children the target behaviors of eye contact and appropriate verbal responses. A multiple baseline analysis across target behaviors was used to demonstrate treatment effectiveness on role-play scenes trained during treatment sessions. Duration of speech was measured as an untrained, corollary measure. The following measures were also obtained during baseline, posttreatment, and 1-mo follow-up for the experimental subjects and three control subjects: (a) performance on role-play scenes not trained during treatment sessions; (b) behavioral observations in a free play setting, and (c) sociometric ratings. In addition, the trained and untrained role-play scenes were administered by novel experimenters following treatment. The results indicated that socially unskilled, learning disabled children can be taught to respond appropriately to role-play situations. However, improved performance did not generalize to the natural school setting and treatment did not effect ratings of peer acceptance. The implications of these findings for future social skills training with children are discussed.     

The effects of verbal operant training and response interruption and redirection on appropriate and inappropriate vocalizations

Past research has shown that response interruption and redirection (RIRD) can effectively decrease automatically reinforced motor behavior (Hagopian & Adelinis, 2001). Ahearn, Clark, MacDonald, and Chung (2007) found that a procedural adaptation of RIRD reduced vocal stereotypy and increased appropriate vocalizations for some children, although appropriate vocalizations were not targeted directly. The purpose of the current study was to examine the effects of directly targeting appropriate language (i.e., verbal operant training) on vocal stereotypy and appropriate speech in 3 children with an autism spectrum disorder. The effects of verbal operant (i.e., tact) training were evaluated in a nonconcurrent multiple baseline design across participants. In addition, RIRD was implemented with 2 of the 3 participants to further decrease levels of vocal stereotypy. Verbal operant training alone produced slightly lower levels of stereotypy and increased appropriate vocalizations for all 3 participants; however, RIRD was required to produce acceptably low levels of stereotypy for 2 of the 3 participants.     

Effects of preference on performing a self-care skill among children with autism spectrum disorder

In this study, four children with autism were assessed to determine their preference choices for toothbrushes and toothpastes included during self-care skills teaching sessions. For two of the children, the presence of high-preference (HP) materials was associated with improved independent tooth brushing when compared to the presence of low-preference (LP) materials. There was no difference in independent tooth brushing between HP/LP conditions for the other two children. These findings suggest that preference and choice of materials alone can be a helpful instructional strategy for care providers serving children who have neurodevelopmental disorders and skill deficits.     

Predicting the Performance of Dental Hygiene Behaviors: An Examination of the Fishbein and Ajzen Model and Self-Efficacy Expectations1

This study examined the value of the Fishbein and Ajzen model of behavioral intentions and Bandura's concept of self-efficacy expectations as prospective predictors of the dental hygiene behaviors of young adults. All participants (73 males and 58 females) completed self-report measures of the predictor variables and 60% of that group (N = 77) then recorded brushing and flossing behaviors over a four-week period. The Fishbein and Ajzen model accounted for a significant proportion of the variance in intentions to brush (R²= .32) and intentions to floss (R²= .30). Intentions were in turn related to self-monitoring records of brushing and flossing frequency (rs= .52 and .61). Introducing self-efficacy expectations into the Fishbein and Ajzen model failed to improve the prediction of brushing and flossing frequency. However, self-efficacy was predictive of behavioral intentions, adding significantly to the variance accounted for by the attitudinal and subjective norm components of the Fishbein and Ajzen model. These data suggest that self-efficacy expectations are important in understanding protective health behaviors and that the inclusion of a self-efficacy component in the Fishbein and Ajzen model deserves consideration.     

Gains in fluid intelligence after training non-verbal reasoning in 4-year-old children: a controlled, randomized study

Fluid intelligence (Gf) predicts performance on a wide range of cognitive activities, and children with impaired Gf often experience academic difficulties. Previous attempts to improve Gf have been hampered by poor control conditions and single outcome measures. It is thus still an open question whether Gf can be improved by training. This study included 4-year-old children (N = 101) who performed computerized training (15 min/day for 25 days) of either non-verbal reasoning, working memory, a combination of both, or a placebo version of the combined training. Compared to the placebo group, the non-verbal reasoning training group improved significantly on Gf when analysed as a latent variable of several reasoning tasks. Smaller gains on problem solving tests were seen in the combination training group. The group training working memory improved on measures of working memory, but not on problem solving tests. This study shows that it is possible to improve Gf with training, which could have implications for early interventions in children.     

Increasing Behavioral Variability and Social Skill Accuracy in Children with Autism Spectrum Disorder

Although social skills training for children with autism spectrum disorder (ASD) often addresses deficits in social communication, restricted and repetitive social behaviors are less frequently targeted in the literature. The present study evaluated a manualized social skills training program, modified to incorporate lag schedules of reinforcement, to promote appropriate and variable responding in three children in a school setting. Participants attended social skills once weekly, with probes of social skills taking place daily. A multiple baseline design across target skills was used to determine intervention efficacy. Results of the study indicated that the social skills curriculum incorporating lag schedules of reinforcement resulted in substantial increases in the number of appropriate and variable responses demonstrated by participants during each probe session, as well as the number of appropriate and variable responses demonstrated overall.     

ANALYSIS OF A SIMPLIFIED TREATMENT FOR STUTTERING IN CHILDREN

We investigated the effectiveness of a simplified program for the treatment of stuttering in children. The simplified treatment included awareness training, in which the subjects learned to detect every occurrence of stuttering; training a response incompatible with stuttering, which involved relaxation and regulation of air flow over the larynx when speaking; and social support, which involved parent-delivered prompts and praise of children's use of the techniques in everyday environments. Eight children were treated in their homes with the simplified treatment, in a multiple baseline across subjects design, and all reached the criterion level of less than 3% words stuttered. In addition, the reduction in stuttering generalized to the school setting and was maintained at posttreatment (10 to 13 months). The subjects' rates of speech remained stable throughout baseline and treatment. Pretreatment and posttreatment ratings by the parents showed that they found treatment to be both acceptable and credible. Finally, social validity measures revealed a noticeable improvement in the subjects' speech to parents and speech pathologists.     

SEQUENTIAL APPLICATION OF MAJOR HABIT-REVERSAL COMPONENTS TO TREAT MOTOR TICS IN CHILDREN

In this study, we sequentially administered up to four components of the habit-reversal treatment to 4 children with motor tics within a multiple baseline design. The habit-reversal components included (a) awareness training; (b) awareness training and self-monitoring; (c) awareness training, self-monitoring, and social support; and (d) awareness training, social support, and the use of a competing response. Results demonstrated that the combined use of awareness training, social support, and competing response training was effective in eliminating motor tics in 2 of 4 children, that awareness training alone was effective for 1 child, and that a combination of awareness training and self-monitoring was effective for the 4th child. The treatment and ensuing improvement were found to be socially valid. We discuss possible explanations for these results and recommend directions for future research.     

Increasing Single‐Word Requests to Multiword Requests in Children with Autism and Related Disabilities

Initial language training with children with autism often focuses on the production of single‐word requests (i.e., mands). As a child progresses in treatment, it is desirable to increase the mean length of utterance (MLU) of requests. The present study examined treatment outcomes of behavioral intervention designed to increase the MLU of requests in a larger sample of children with language delays (n = 30). Intervention consisted of prompts and differential reinforcement for lengthier requests, and trials were conducted flexibly throughout the treatment session. A non‐concurrent multiple baseline across participants design was utilized to establish experimental control, and MLU intervention consisted of a baseline and treatment phase for each participant. Nonoverlap of all pairs (NAP) was employed to estimate an effect size. Overall treatment effects were medium to large (average NAP = 0.89; average d = 2.36), and the majority of the sample (70%) demonstrated strong treatment effects. Results suggest that targeted behavioral intervention to increase the length of requests can be effective for children with autism and associated language delays. Copyright © 2015 John Wiley & Sons, Ltd.     

The implementation and adoptability of behavioral skills training in a university career center

We evaluated the extent to which staff at a university career center (a) already used, (b) could be taught to use, and (c) might continue to use behavioral skills training (BST) when teaching interview answers to college students. We used a nonconcurrent multiple baseline design across three staff‐student dyads to assess the extent to which staff implemented BST and students provided appropriate answers before and after training. Results showed that interview training at the career center typically consisted of few BST steps, but staff could be taught on how to implement BST. All staff rated BST as an acceptable and effective form of interview training, but only one indicated that he or she was likely to adopt BST at the career center.     

Intervention-based school psychology services: Training for child-level accountability; preparing for program-level accountability

This research evaluated the outcomes of a school psychology training practicum by replicating intervention-based service delivery procedures established in prior research. The key components include describing a service delivery model, teaching the model, deriving practice guidelines that fit the model, supporting trainees in carrying out the steps, and evaluating the outcomes. Procedures to determine outcomes were based on single-case design facets including accountability design (A-B), visual analysis of graphic data, and social validity ratings. Meta-analysis techniques included calculation of effect sizes and percent of nonoverlapping data (PND). Goal attainment scaling (GAS) also was used to summarize outcomes. The analyses indicated that the interventions led to positive changes for most children. For example, the median effect size was 1.42 across cases. Social validity evidence showed that consumers judged the outcomes positively. Achieving ideal baseline and technical adequacy checks (e.g., observer agreement, intervention adherence) represented challenges for many consultations. The contributions of the study include describing methods for child- and program-level accountability in training and areas for improvement including further supporting the completion of technical checks for intervention services.