SOME STRUCTURAL ASPECTS OF DEVIANT CHILD BEHAVIOR1

Covariation within behavior repertoires of problem children were examined. Two boys, referred for psychological help, were observed both at school and at home for about 3 yr. A coded observation system permitted scoring of 19 child-behavior categories and six social-environment categories. After a two-month baseline, behavior categories were intercorrelated, demonstrating that each child showed a group of behaviors that covaried. These groupings were specific to the home and school settings. Contingency management procedures were then applied to each child's problem behaviors in one setting. Next, a reversal phase was instituted, followed by resumption of the initial contingency management phase. These three phases lasted seven months, until the end of the children's public school terms. Results showed that the baseline group of covarying behaviors continued to covary over the three experimental phases. The children then entered a remedial education setting for three summer months, and then returned to schools and were observed in follow-up for 2 yr. The baseline group of behaviors continued to covary during both phases. The behavior covariations could not be accounted for on the basis of temporal relationships between the behaviors and social environment categories. Although no behavior covariations extended across either child's home and school settings, contingency management procedures produced across-setting effects.     

COVARIATION WITHIN FUNCTIONAL RESPONSE CLASSES: IMPLICATIONS FOR TREATMENT OF SEVERE PROBLEM BEHAVIOR

Two studies examined the effects of a reductive treatment versus instruction-based treatments on the generalized reduction of problem behaviors. Each study involved a detailed analysis of multiple problem behaviors performed by school-aged youth with severe intellectual disabilities. The analysis examined the contrasting effects of one of two different positive intervention procedures (teaching a positive alternative behavior or providing additional teacher assistance during instruction) versus blocking and/or verbally reprimanding a problem behavior. The focus of each analysis was on the covariation of multiple problem behaviors within functional response classes. Results of the investigation indicated that when only one member of the response class was blocked, a collateral increase was observed in one or more different problem behaviors from the same response class. Alternatively, when 1 participant was taught a functionally equivalent mand response, all problem behaviors in the response class were reduced. Problem behaviors also were reduced for the remaining participant by presenting antecedent teacher assistance. Implications of the research extend to analysis of covariation within response classes and to procedures that result in generalized reduction of problem behaviors within a response class.     

The collateral decrease of self-injurious behavior with teaching communicative gestures to individuals who are mentally retarded

The present study assessed the effect of teaching communicative gestures on the occurrence of self-injurious behavior and other behavior disorders with 14 individuals who are severely/ profoundly mentally retarded. Results show a statistically significant decrease of about 40% in self-injurious behavior as a collateral effect of an increased use of communicative gestures. Apart from a decrease in the occurrence of destructive behaviors, no other effects on other behavior disorders were found. Results are discussed in terms of the possible use of communicative gestures as a therapeutic supplement to standard procedures for decreasing self-injurious behavior with individuals who are nonverbal and mentally retarded.     

TELEPHONE CONVERSATIONAL SKILLS TRAINING WITH SOCIALLY ISOLATED,IMPAIRED NURSING HOME RESIDENTS

We evaluated the effectiveness of a comprehensive training program for enhancing the conversational skills of socially isolated, impaired elderly nursing home residents. A multiple baseline design across behaviors was used to train four subjects (aged 87, 85, 68, and 66), on four content-related conversational components: (a) expressing common courtesies, (b) making positive self-disclosures, (c) asking questions, and (d) making interjections and acknowledgments. Training procedures included instructions, modeling, behavior rehearsal, feedback, and reinforcement. Results showed positive effects with all four subjects; in two cases, changes were significant enough to affect untrained observers' perceptions of the elders' conversational skills.     

Social interaction patterns of geriatric home and community residents

Thirty elderly nursing home residents and ten community residing older adults were observed in group settings. Their behavior was assessed for dependent personal maintenance, independent personal maintenance, and appropriate and inappropriate behaviors. Responses by staff and peers to these behaviors were classified as positive, negative, or ignore. The frequency of occurrence of these behaviors as well as the relationship of resident to peer or staff behaviors were analyzed. Results indicate that community-residing elders' behaviors differ from nursing home residents' in quantity rather than quality of interactions. There was a lower frequency of behaviors in the nursing home residents. Though older adults respond differentially to various behaviors of other nursing home residents, staff responses were consistent regardless of residents' behavior. These results suggest that geriatric home residents' behavior can be characterized as withdrawn rather than dependent.     

BEHAVIORAL ASSESSMENT FOR PEDIATRIC INTENSIVE CARE UNITS1

Two studies were conducted to analyze behaviors of staff and patients on a Pediatric Intensive Care Unit (PICU). In the first study, behavioral observation procedures were employed to assess patient state, physical position, affect, verbal behaviors, visual attention and activity engagement, and staff verbal behavior. On the average, one-third of the patients were judged to be conscious and alert but markedly nonengaged with their environment. In the second study, a member of the hospital staff provided alert patients with individual activities to determine whether a simple environmental manipulation could positively affect behavior of children in intensive care. Employing a reversal design, the activity intervention was found to increase attention and engagement and positive affect, and to decrease inappropriate behavior. Both studies demonstrate that behavioral assessment procedures can provide an empirical basis for designing PICU routines affecting children's psychosocial status, and, thus, complement current procedures designed to provide quality medical care.     

Developing proper mealtime behaviors of the institutionalized retarded

The institutionalized mentally retarded display a variety of unsanitary, disruptive, and improper table manners. A program was developed that included (1) acquisition-training of a high standard of proper table manners and (2) maintenance procedures to provide continued motivation to maintain proper mealtime behaviors and decrease improper skills. Twelve retardates received acquisition training, individually, by a combination of verbal instruction, imitation, and manual guidance. The students then ate in their group dining arrangement where the staff supervisor provided continuing approval for proper manners and verbal correction and timeout for improper manners. The results were: (1) the trained retardates showed significant improvement, whereas those untrained did not; (2) the trained retardates ate as well in the institution as non-retarded customers did in a public restaurant; (3) proper eating was maintained in the group dining setting; (4) timeout was rarely needed; (5) the program was easily administered by regular staff in a regular dining setting. The rapidity, feasibility, and effectiveness of the program suggests the program as a solution to improper mealtime behaviors by the institutionalized mentally retarded.     

Forgiveness in marriage: putting the benefits into context.

The current longitudinal study examined the consequences of spouses' tendencies to forgive their partners over the first 2 years of 72 new marriages. Though positive main effects between forgiveness and marital outcomes emerged cross-sectionally, spouses' tendencies to forgive their partners interacted with the frequency of those partners' negative verbal behaviors to predict changes in marital outcomes longitudinally. Specifically, whereas spouses married to partners who rarely behaved negatively tended to remain more satisfied over time to the extent that they were more forgiving, spouses married to partners who frequently behaved negatively tended to experience steeper declines in satisfaction to the extent that they were more forgiving. Similar patterns emerged for changes in the severity of husbands' problems, such that husbands married to wives who frequently behaved negatively reported sharper increases in problem severity to the extent that they were more forgiving but reported more stable problem severity to the extent that they were less forgiving. These findings question whether all spouses should benefit from forgiveness interventions and thus highlight the need for further research on the most appropriate targets for such interventions.     

ONGOING CONSULTATION AS A METHOD OF IMPROVING PERFORMANCE OF STAFF MEMBERS IN A GROUP HOME

A model of ongoing consultation was implemented in a community group home for 8 adults with severe and profound mental retardation. Two consultants, highly experienced in working with people with mental retardation and in the procedures used in group homes, taught staff members to use a token reinforcement system, to engage the adults in a variety of activities, and to improve the content and style of the staff members' interactions with the adults. The consultants taught skills to 9 staff members through brief mini-workshops, direct observation of the staff members' use of the skills during regular activities in the group home, and individual verbal feedback regarding a staff member's performance of the skills. Evaluation of the ongoing consultation process by the 2 consultants showed it to be effective in improving the performance of the staff members and in changing the behaviors of the adults who lived in the home. Continued implementation of the process, however, appeared to be necessary for the behavior changes of staff members to be maintained at high levels.     

THE EFFECTS OF A CHILD'S SELF-EVALUATION PROGRAM ON COMPLIANCE WITH PARENTAL INSTRUCTIONS IN THE HOME

A self-evaluation program was implemented with a kindergarten-aged boy in the home to increase compliance with parent instructions and decrease inappropriate verbal behavior. The self-evaluation package included the child's assessing the appropriateness of his behavior in 5-min intervals, receiving chips for positive self-evaluations, and exchanging chips for a reward following experimental sessions. In a reversal design, analyses were conducted of the effectiveness of the self-evaluation program, the requisite conditions for effective child behavior change with a self-evaluation approach, and the parent's efficiency in using the self-evaluation package. The self-evaluation procedures typically resulted in increased compliant behavior and decreased inappropriate behavior, although the effects generally weakened with time. Behavioral gains were greater and better maintained when the self-evaluation procedures were preceded by a phase of external evaluation via the mother than by baseline, suggesting that self-evaluation procedures may serve more to maintain the effects of external evaluation rather than to induce their own changes. The parent generally was efficient in implementing the procedures. Research and clinical implications for using self-evaluation procedures in a home setting are discussed.     

Some experiments on reinforcement principles within a psychiatric ward for delinquent soldiers

Several experiments exploring the effects of certain behavioral procedures were performed on a psychiatric ward for delinquent soldiers. Within the context of a point economy, the behavioral procedures were examined for their applicability to this patient group in a hospital-ward setting. The following procedures were studied: (1) use of points as consequences for specific behaviors compared with demonstration of "model" behavior by a ward officer; (2) punishment by a point-fine to control undesired behavior; (3) use of a chaining-type reinforcement contingency to increase desired behavior; (4) differential reinforcement of the individual versus the group to increase the frequency of a verbal performance; and (5) reinforcement of reports of personal problems versus impersonal problems.     

CONTINGENT EXERCISE: A MILD BUT POWERFUL PROCEDURE FOR SUPPRESSING INAPPROPRIATE VERBAL AND AGGRESSIVE BEHAVIOR

Two single-subject experiments were conducted in public school classrooms for severely emotionally disturbed children. Both experiments investigated the effects of a treatment requiring a child to exhibit a simple exercise task after a verbal or aggressive response, using reversal and multiple-baseline designs. The independent variable, contingent exercise, required standing up and sitting on the floor five to ten times contingent on an inappropriate behavior. It was found that contingent exercise was easy to carry out, and following it, the child quickly returned to the learning task that had been interrupted by the inappropriate behavior. The contingent exercise procedure required a minimum of prompting or manual guidance. Although contingent exercise was not topographically related to the inappropriate response, it decreased those responses dramatically. The results suggested that contingent exercise was not only more powerful than DRO but also could be administered independently. It was concluded that contingent exercise may constitute an alternative procedure that can be used by therapists confronted with severely abnormal behaviors. It would appear to be particularly relevant in settings where procedures such as timeout and painful consequences find restricted use. Finally, a number of guidelines have been proposed as a safeguard against the misuse of this mild but powerful procedure.     

Application of timeout from positive reinforcement for increasing the efficiency of speech training

Language training procedures, which involved positive reinforcement for verbal imitation, were applied to increase the appropriate verbal behavior of an almost non-verbal, brain damaged, 5-yr-old boy. Two experiments assessed the effectiveness of timeout from positive reinforcement as a training procedure viewed as having potential punishing and negatively reinforcing functions. In both experiments, timein, termination of timeout and resumption of training, was arranged to have reinforcing properties in that it presented an opportunity to receive positive reinforcers. In Exp. I, the procedure consisted of temporarily halting language training (timeout) following verbal jargon and resuming it (timein) contingent upon the boy sitting quietly in his chair for approximately 30 sec. The jargon declined to almost zero for an extended period each time the procedure was employed. In Exp. II, the procedure consisted of halting language training (timeout) after emission of undesired verbal responses which previously had been reinforced as the desired approximation to the target verbal behavior. Resumption of training (timein) was made contingent upon the emission of the then-desired approximation of the target verbal behavior. In each experiment, the contingent timeout and timein of the language training that involved positive reinforcement effectively reduced the undesired and increased the desired responses.     

STIMULUS VARIATION AS A MEANS OF ENHANCING PUNISHMENT EFFECTS

We compared the effects of varied punishers (presentation of one of three available punishers) with the single presentation of one of the punishers on the occurrence of inappropriate behaviors with three developmentally delayed children. Two children were presented with varied-punisher conditions in which either overcorrection, time-out, or a verbal “no” was presented contingent upon inappropiate behavior. A loud noise was substituted for overcorrection for a third child. Results of the multielement with reversal design indicated that both punishment formats produced a decrease in the target behaviors with the varied-punisher format slightly more effective than the single presentations of the punishers. The results suggest the use of varied punishers as a means of enhancing the effects of less intrusive procedures to effectively reduce inappropriate behaviors.     

Identification of environmental determinants of behavior disorders through functional analysis of precursor behaviors

Experimental analysis procedures have been shown to be effective means for identifying the environmental determinants of problem behaviors. A potential limitation of these procedures is that it is necessary to produce and document patterns in the occurrence of the problem behavior during the assessment. In the case of severe behavior disorders, this may place the participant or therapist at such risk as to preclude the analysis. The current study arranged experimental analysis contingencies for precursor behaviors that had been observed to reliably precede the occurrence of problem behaviors targeted for reduction. For each of the 4 participants, it was possible to infer the maintaining variables for problem behaviors based on the outcomes of precursor analysis. These results suggest that the current procedures represent a promising alternative method for reducing risk during functional analysis of problem behaviors.     

THE EFFECTIVENESS OF VERBAL INSTRUCTION ON TEACHING BEHAVIOR-MODIFICATION SKILLS TO NONPROFESSIONALS1

The effectiveness of a mastery criterion, lecture-based training program for teaching behavior modification to sheltered workshop personnel was evaluated. Staff performance was assessed in terms of: (1) verbal proficiency, as determined from a pre- and posttraining written exam, and (2) application proficiency, as measured by the frequency and appropriateness of staff responses to client behaviors. A direct count was made of the number of positive, negative, and neutral statements following client appropriate and inappropriate behaviors, and the number and type of client behaviors ignored. Thus, it was possible to determine the extent of generalization from classroom to applied settings, as well as the appropriateness of lectures for training specific performance skills. Lecture units introduced stimulus control procedures, shaping-chaining, and contingency management. Characteristic features of the training program were frequent testing, study objectives, immediate remediation, and contingent reinforcement. Verbal instruction was shown to be effective in improving subjects' verbal skills concerning behavior-modification principles, while only partially effective in improving application skills. There was an increase in the total number of staff-client interactions observed for all subjects, but only two of the response classes emphasized in the training program (reinforcing desirable client behavior and ignoring undesirable behavior) showed considerable improvement over pretraining levels. Despite this partial improvement, verbal instruction alone was shown to be insufficient for teaching the full range of behavior-modification skills required to function effectively in applied settings.     

Development of verbal control over bizarre gestures of retardates through imitative and nonimitative reinforcement procedures

Two retardates, manifesting hand gestures and minimal instructional control, were trained by imitative reinforcement procedures to imitate a response that was in contrast to gesturing. Next, with the contrast response continuing to be imitatively reinforced, gesturing was reduced by nonimitative reinforcement procedures; while providing facial and gesture cues, the adult said, "Do not do this". Imitative and nonimitative procedures were found to have the same effects on the contrast response as on the gesturing response, such that imitative procedures increased both responses, whereas nonimitative procedures decreased both. Nonperformance of gesturing was further maintained when (1) explicit verbal directions for nongesturing were superimposed upon the demonstrational-facial-verbal cues as these collective stimuli were faded out and (2) food reinforcers for nongesturing were gradually removed while social consequences continued to be administered.     

OVERCORRECTION: GENERALIZATION AND MAINTENANCE1

The present study examined the effects of one component of overcorrection—verbal reprimands—and compared them with the effects of the entire overcorrection procedure. Generalization and maintenance of effects were also evaluated. A combined reversal and multiple-baseline experimental design was used to evaluate the effect of the various contingencies on the inappropriate searching behavior of a severely and profoundly mentally retarded adult living in a group home. Searching was defined as carefully and thoroughly touching floors, sofas, cabinets, etc. Data were collected by group-home personnel during three separate observation periods each day of the 115-day study: before breakfast, after breakfast, and after dinner. Observers also served as experimenters. Following an initial baseline phase, verbal reprimands followed searching behavior during two daily experimental periods in multiple-baseline fashion. An immediate reduction of searching during experimental periods occurred with the onset of verbal reprimands. No reduction was observed in the third daily observation period, the control session. After a second baseline phase, during which searching behavior was not shown to return to the original baseline levels, overcorrection procedures (washing hands) were instituted. Overcorrection virtually eliminated inappropriate searching during both daily experimental periods. Further, the effects generalized to the daily control session. In a final experimental phase, decreased searching behavior was maintained with verbal reprimands alone.     

Cues-pause-point language training: Structuring trainer statements to provide students with correct answers to questions

This study assessed the applicability of Cues-Pause-Point language training procedures in teaching students to obtain information from the statements of others. Two mentally retarded subjects, one of whom was echolalic, received training on one set of stimuli but not on another. During training the subjects were encouraged to remain quiet before, during, and briefly after the presentation of statements and then verbalize (i.e., answer a question) using the verbal cue(s) that had been presented in the statement. Correct responding reached 100% to the trained stimuli and both subjects' responding improved to the untrained stimuli. Posttests revealed that subjects used the trainer's statements to answer novel questions. The results suggest that Cues-Pause-Point procedures may be useful in teaching severely retarded individuals the functional use of observing and listening to others' verbal behavior.