Evaluation of Progressive Muscle Relaxation with Conduct-Problem,Learning-Disabled Children

Four learning-disabled, conduct-problem children were trained in the use of progressive muscle relaxation to determine the effect of subsequent relaxation practice on behavior in the classroom. After three initial sessions of relaxation training, the children performed in 21 daily classroom periods. Each period was 12 minutes in length. Prior to each classroom period, the children engaged in one of two activities with the relaxation trainer for 15 minutes, i.e., either practice at relaxation with the trainer or card-playing. Measures of disruption, on-task, academic rate, and academic accuracy were gathered in the classroom. In addition, a relaxation checklist was employed to determine the extent to which the child was relaxed in the relaxation practice sessions. The results gave no evidence of differential effects as a consequence of the relaxation procedures or any of the classroom measures. These results suggest that the overzealous use of progressive relaxation training as a setting event or as a non-specific treatment procedure with school children may be unwarranted at this time.     

Control of echolalic speech in psychotic children

Immediate echolalia, a common language disorder in psychotic children, was studied in a series of replicated single-subject designs across six schizophrenic and five normal children. In Experiment 1, each child was presented with several questions and commands, some of which set the occasion for specific, appropriate responses and some of which did not. The former were referred to as discriminative stimuli and the latter, as neutral stimuli. The psychotic children tended to echo the neutral stimuli while responding appropriately to the discriminative stimuli; the normal children, in contrast, typically echoed neither type of stimulus. In Experiment 2, three psychotic children were taught appropriate responses to each of several neutral stimuli. Following this training, the children generally responded appropriately to these stimuli without echoing. A plausible interpretation of these results is that the neutral stimuli were initially incomprehensible or meaningless to the children (whereas the discriminative stimuli were comprehensible or meaningful) and that verbal incomprehensibility may be one important determinant of immediate echolalia. Finally, the results are noteworthy in that they isolate a sufficient treatment variable (i.e., the reinforcement of alternative, nonecholalic responses) for eliminating instances of this language anomaly.     

SELF-INSTRUCTIONAL TRAINING TO INCREASE INDEPENDENT WORK PERFORMANCE IN PRESCHOOLERS

The generalized effects of self-instructional training on the classroom performance of three “impulsive” preschool children were investigated using a multiple-baseline design across subjects. Measures of child and teacher behavior in the classroom were obtained through direct observations during a daily independent work period. Self-instructional training followed Meichenbaum and Goodman's (1971) approach, except that training materials consisted of naturalistic task worksheets rather than psychometric test items and training sessions were of shorter duration. For all three children, self-instructional training resulted in increased levels of accuracy on worksheets in the classroom that were similar to those used in training. Results related to several supplementary measures were less clear; however, they suggested that rates of on-task behavior may also have improved, and that a mild classroom intervention further strengthened on-task rates and effected consistent work completion for all three children. The findings suggested that generalized increases in accuracy on classroom worksheets were related to the naturalistic format of the self-instructional training sessions. The level of teacher attention was controlled to rule out its effect on changes in child behavior.     

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.     

GENERALIZED IMITATION AND RESPONSE-CLASS FORMATION IN CHILDREN WITH AUTISM

An experimental analysis of imitation was conducted to examine the influence of response topography on generalization of imitation across three response types. Four children with autism were presented with both reinforced training trials and nonreinforced probe trials of models from vocal, toy-play, and pantomime response types. The probe trials were used to examine generalization within each response type. A multiple baseline design was used to analyze percentage of matching and nonmatching responses to models across response types. This study, the first to analyze imitative response classes in children with autism, showed that imitation generalized from reinforced training models to nonreinforced probe models within a response type, but it did not generalize across response types. Thus, functional response classes determined by topographical boundaries were exhibited within generalized imitation.     

The Effects of Relaxation and Postural Training on External Perception: Improvement of Visual Acuity, Visual Field, and Hearing Acuity

This study examined the effects of muscular relaxation and postural training on external perception using a visual acuity test, a visual field test, and a hearing acuity test. Eighteen undergraduate students were randomly assigned to experimental and control groups. The experimental group underwent muscular relaxation and postural training. Each subject in this group was administered the tests before and after the training. Each subject in the control group carried out the tests before and after participating in a 30-min conversation with the experimenter. On all three tests, the experimental group improved significantly more than the control group.     

简算策略教学提高小学四年级儿童的计算水平及延迟效应

采用3组平衡组实验设计对小学四年级171名学生进行教学实验,两组实验班学生分别采用讲授式和探究式教学方法进行简算策略计算教学,对照班教师自主进行计算教学。结果揭示：通过专门开设简算策略教学训练课,实验班学生的的计算成绩、计算速度和计算兴趣显著高于对照班学生;实验班的延迟提示与不提示测验无显著差异,未出现策略“利用性缺陷”现象;讲授式和探究式教学方法进行策略教学的效果无明显差异。本研究表明：专门开设策略训练课能提高学生的计算水平和学习兴趣,是有效的和必要的;只要教学方法得当,策略“利用性缺陷”可以避免     

Social problem solving training: A follow-up study of cognitive and behavioral effects

The long term effects of Spivack and Shures' social problem-solving training were assessed and compared to an attention-placebo control. Thirty-seven preschool age children were involved in this year's long intervention project and six month follow-up. All subjects received 46 sessions of intervention by specially trained assistants. Support was found for the cognitive effectiveness of social problem-solving training with aberrant children at post test in that they gained significantly in their ability to generate alternative solutions to interpersonal problems. This differential effect was not sustained at follow-up. Blind teacher ratings of behavioral adjustment and independent observers' ratings of behavior (using a naturalistic observation scale developed for this study) revealed no significant behavioral training effects at post test or at follow-up. Findings are discussed with the suggestion that behavior change in young children may not be mediated through a strictly cognitive intervention, and may more logically require an integration of behavioral and cognitve techniques.     

THE DEVELOPMENT AND GENERALIZATION OF DELAYED IMITATION1

An individual's behavior can be identified as imitative if it temporally follows the behavior of another individual and if its topography is controlled by the demonstrated behavior [Baer, Peterson, and Sherman (Journal of the Experimental Analysis of Behavior, 1967, 10 , 405–416)]. This definition takes into account both temporal and topographical characteristics of the behavior in question. More recent research in the area of imitation has interpreted the temporal component of the above definition differentially by limiting imitation to those topographically similar responses occurring within 3, 5, or 10 sec after a model's demonstration. Yet, Gewirtz and Stingle (Psychological Review, 1968, 75 , 375–397) pointed out that much of the imitation seen in young children is not of this immediate nature, but instead occurs sometime after a model's response. They further suggest that this type of imitative behavior can be characterized as a response class and is susceptible to development and modification as a function of consequences delivered to subjects contingent on this type of delayed responding. Four retarded children, three initially imitative and one nonimitative, were individually trained to imitate a number of motor responses in an immediate and a delayed fashion. Immediate imitation was defined as a response similar to a model's demonstration occurring within 5 sec after the model's demonstration; delayed imitation was defined as a response similar to a model's demonstration occurring more than 5 sec, but not more than 25 sec, after the model's demonstration. A reversal (ABAB) design was employed to examine the experimental development of a generalized delayed imitative repertoire. Untrained probe responses were demonstrated to subjects systematically through the ongoing training. Generalized immediate and delayed imitation were observed in each subject; this generalization was restricted to the type of imitation currently undergoing training. This development of a generalized imitation repertoire was observed in each subject. That is, these subjects imitated some responses that had never been specifically trained. More importantly, a training package consisting of prompting, fading, and consequences for delayed imitation functioned to develop generalized delayed imitation. These data exemplify a special case of generalization that was a function of the most recent training history of immediate or delayed imitation. The reversal design demonstrated that imitations of nontrained models were either delayed or immediate, depending upon which form of imitation was currently receiving training. Therefore, for each form of imitation trained, delayed or immediate, a corresponding response class was demonstrated. These data relate to data reported by Garcia, Baer, and Firestone (Journal of Applied Behavior Analysis, 1971, 4 , 101–112). The association lies in the proposition that there are identifiable boundaries of generalized imitation and that these boundaries are functionally related to previous training histories.     

Preparing children to cope with earthquakes: Building emotional competence

Natural disasters, including earthquakes, can have a traumatic impact on children's psychological wellbeing and development. The efficacy of interventions aimed at enhancing children's socio-emotional learning has been documented in the literature. At the same time, these techniques are the key for training children for possible future disasters by enhancing their knowledge about behavioural preparedness and emotional competence. However, research on evidence-based training programs on earthquakes combining digital and traditional activities is scarce. We tested the efficacy of a 10-unit training program for primary school children, developed within the Emotional Prevention and Earthquakes in Primary School (PrEmT) project. The program aimed at increasing knowledge of and metacognition about earthquakes, safety behaviours, emotions, and coping strategies, through digital (using the web-application HEMOT^®, Helmet for EMOTions, developed ad-hoc) and traditional activities (completing paper-and-pencil tasks). The participants were 548 second and fourth-graders from Italian schools. They were divided into an experimental group (participating in the training program) and a control group. Both groups participated in pretests and posttests to evaluate changes in their knowledge of training-related contents. For ethical reasons, we also measured children's wellbeing. Generalized linear mixed models indicated an improvement in the experimental group's knowledge and metacognition about earthquakes, safety behaviours, emotions, and coping strategies after the training program, compared to the control group. Children's general wellbeing did not deteriorate during participation in the project. The results documented the efficacy of the evidence-based training program developed within the PrEmT project. The program provides a preventive method for enhancing earthquake-related resilience that could be generalized to other kinds of disasters.     

NORMAL CHILDREN AS TUTORS TO TEACH SOCIAL RESPONSES TO WITHDRAWN MENTALLY RETARDED SCHOOLMATES: TRAINING,MAINTENANCE, AND GENERALIZATION

The findings of the three experiments reported herein indicate that normal children can successfully teach social responses (i.e., delayed imitation, cooperative play, and verbalization of positive comments) to withdrawn mentally retarded peers. The effects of the intervention generalized across stimulus and response conditions, while the trained and generalized levels of responding were maintained after the end of the intervention. Moreover, the subjects developed social responding within their classrooms and play areas parallel to the intervention and continued to increase such responding after the interruption of the intervention. Direct edible reinforcement appeared to be necessary at least during the initial period of the intervention. Vicarious edible reinforcement seemed useful to prompt the appearance of responding. Vicarious social reinforcement was ineffective at the beginning of the intervention, but apparently acquired prompting power at a later stage of training. Generalization results indicated that the similarity between the response occasions used for training and those used for testing generalization played an important role. Yet, the extensiveness of training and the development of responding within the classrooms and play areas may also have had a relevant effect. The development of social responding within the classrooms and play areas appeared to be mainly the effect of new learning. This was perhaps due to vicarious and direct social reinforcement.     

An Evidence-Based,Community-Engaged Approach to Develop an Interactive Deliberation Tool for Pediatric Neuromuscular Trials

Duchenne/Becker muscular dystrophy (DBMD) and spinal muscular atrophy (SMA) are rare neuromuscular disorders that present challenges to therapeutic and clinical trial decision making. We developed an interactive, evidence-based online tool designed to encourage thoughtful deliberation of the pros and cons of trial participation and to inform meaningful discussions with healthcare providers. Prior research demonstrates the importance of tool availability at the time each family is considering trial participation, which may be prior to the informed consent process. The tool is intended to be easily modified to other pediatric disease communities. Tool development was informed by prior qualitative research, literature reviews, and stakeholder input. Specific items were derived based on an online exploratory questionnaire of parents whose children participated in a trial for DBMD or SMA to understand motivations for participation. Parent participants in the exploratory survey reported strong impact of altruistic and individual benefit motivations and placed much greater emphasis on anticipated trial benefits than on harms when making participation decisions. We used this data to develop the evidence-based deliberation tool using a community-engaged approach. We initially targeted the tool for DBMD while using SMA survey data to evaluate ease of transition to that population. We conducted two iterative sets of activities to inform development and refinement of the tool: (1) community engagement of key stakeholders and (2) user experience testing. These activities suggest that the tool may increase deliberation and the weighing of benefits and harms. Ongoing evaluation will determine the acceptability and efficacy of this online intervention.     

The lateral effects of Dohsa-method relaxation on visual and auditory responses

The effects of relaxation training, using the Dohsa method, on visual and auditory responses were examined. Twelve college students underwent relaxation training either to the left shoulder, left side of the waist, and the left foot, or to the right side. The measures used in this study were weight-bearing, body perception and external perception, visual field, and visual and hearing acuity. Weight-bearing significantly increased for the foot undergoing relaxation training, compared with the untreated foot, indicating that the subjects stood more firmly on the ground on the relaxed foot. Subjects could also perceive positive changes in their "sense of standing firmly on the ground,""sense of activity in the body,""sense of muscular relaxation," and "sense of fullness in the abdomen" on the side of the body receiving relaxation training. There were positive changes in external perception such as "vividness of the external world,""breadth of the visual field," and "active impression of the external world" for subjects' vision on the side receiving relaxation training. Furthermore, visual and hearing acuity on the side on which relaxation training was administered improved significantly.     

Sharing in preschool children: Facilitation, stimulus generalization, response generalization, and maintenance

Three approaches to facilitating verbal and physical sharing and of the generalizability and durability of the behaviors that were trained were investigated. During a free play period, groups of preschool children were taught to share verbally, to share physically, or to share verbally and physically; another group was not trained. Immediately following free play, the children were observed in a different setting. Follow-up was conducted 4 weeks after training ended. Physical sharing that was durable and generalizable resulted only when children were taught to share verbally. Increases in physical sharing produced by training children to share only physically were not durable and did not generalize. Training both verbal and physical sharing produced results with a magnitude slightly greater than teaching just verbal sharing. Despite a lack of special programming, some of the treatment effects generalized to another setting and were maintained during the Follow-up. There was response generalization of the effects of training verbal sharing to physical sharing but not vice versa. Problems with the concept of response class, a methodological suggestion for studying response generalization, and possibilities concerning why generalization and maintenance occurred without specific programming are discussed.     

Frontal lobe epilepsy presenting as a psychotic disorder with delusions and hallucinations: a case study

Although psychotic symptoms are a recognized manifestation of epilepsy, these are more often associated with seizures of the temporal lobe type. While 10% of children with temporal lobe epilepsy develop a psychotic disorder by adulthood, the literature does not report any cases of psychotic disorders associated with frontal lobe seizures in children. This article presents a unique case of a girl whose frontal lobe seizures were associated with delusional psychotic symptoms. Once her seizure disorder was identified through electroencephalography (EEG) and appropriate anticonvulsant therapy was initiated, her associated psychotic symptoms resolved.     

THE ROLE OF SUBJECT VERBALIZATION IN GENERALIZED CORRESPONDENCE

We examined the role of subject verbalization in the generalization of verbal-nonverbal correspondence. Twelve kindergarten children underwent correspondence training (subject verbalization) or received reinforcement for performing an experimenter-selected behavior (experimenter verbalization). A reversal design, along with the introduction of a multiple baseline design across behaviors, was used to assess functional relations. Pupils who received correspondence training demonstrated greater generalization. Our findings suggest that subject verbalization may be necessary to accomplish generalized correspondence.     

Psychotic symptoms in posttraumatic stress disorder

Recent data suggest that the presence of psychotic symptoms in patients suffering from posttraumatic stress disorder (PTSD) may represent an underrecognized and unique subtype of PTSD. Among combat veterans with PTSD, 30% to 40% report auditory or visual hallucinations and/or delusions. The presence of psychotic symptoms in PTSD is associated with a more severe level of psychopathology, similar to that of chronic schizophrenia. In this review, the differential diagnosis of psychotic symptoms in PTSD is discussed, including possible comorbid schizophrenia, psychotic depression, substance-induced psychosis, and personality disorder. A recent biologic study supporting the existence of a unique subtype of PTSD with psychotic features is also addressed, as are the similarities between PTSD with psychotic features and psychotic depression disorder. Finally, data on the treatment implications of psychotic symptoms in PTSD are presented. The intriguing recent findings on psychotic symptoms in PTSD need further investigation in noncombat-related PTSD populations before findings can be generalized to all individuals with PTSD.