Comparison of behavioral intervention and sensory integration therapy on challenging behavior of children with autism

The current study used an AB crossover design to directly compare the effects of sensory integration therapy (SIT) and behavioral intervention (BI) on the challenging behavior of 10 participants with autism spectrum disorder. During the intervention phase, all participants received both treatments. Follow‐up probes were conducted 1 month following intervention for 4 participants implementing the more effective intervention. The results showed that BI successfully reduced challenging behavior to low‐ or near‐zero levels. In contrast, SIT resulted in higher and more variable rates of challenging behavior. One exception was noted for Participant 4 who engaged in a decreased level of challenging behavior during SIT. The findings are discussed in relation to implication for practice and future research.     

Crisis prevention and intervention training for psychiatric hospital staff

A 5-day course designed to train psychiatric hospital staff verbal and physical methods of preventing violence and injury when dealing with upset patients was taught to 89 staff from maximum and less secure wards. Compared to no-treatment controls, experimental subjects improved significantly on four tests of crisis-related tests and knowledge. Questionnaire and self-report measures from staff and patients on the training wards also indicated positive course effects. Assault frequencies decreased immediately after the course and staff injuries on experimental wards were reduced after the course relative to control wards.     

Effects of immediate performance feedback on implementation of behavior support plans

Research has focused on increasing the treatment integrity of school-based interventions by utilizing performance feedback. The purpose of this study was to extend this literature by increasing special education teachers' treatment integrity for implementing antecedent and consequence procedures in an ongoing behavior support plan. A multiple baseline across teacher-student dyads (for two classrooms) design was used to evaluate the effects of performance feedback on the percentage of antecedent and consequence components implemented correctly during 1-hr observation sessions. Performance feedback was provided every other week for 8 to 22 weeks after a stable or decreasing trend in the percentage of antecedent or consequence components implemented correctly. Results suggested that performance feedback increased the treatment integrity of antecedent components for 4 of 5 teachers and consequence components for all 5 teachers. These results were maintained following feedback for all teachers across antecedent and consequence components. Teachers rated performance feedback favorably with respect to the purpose, procedures, and outcome, as indicated by a social validity rating measure.     

Function‐based replacement behavior interventions for students with challenging behavior

Using a concurrent multiple probe design, this study investigated the effects of function‐based replacement behavior interventions on the challenging behaviors of three students with or at risk of emotional and behavioral disorders who attended a rural elementary school. For all three students, interventions were effective at decreasing the occurrence of challenging and off‐task behavior. Effects were maintained for two participants. Maintenance and generalization effects in a replication setting in which replacement behaviors were loosely trained were also documented for two participants. Furthermore, teachers rated the interventions favorably. Implications for practice, study limitations, and areas for future research are discussed.     

Effects of training, prompting, and self-monitoring on staff behavior in a classroom for students with disabilities

This study extended the limited research on the utility of tactile prompts and examined the effects of a treatment package on implementation of a token economy by instructional assistants in a classroom for students with disabilities. During baseline, we measured how accurately the assistants implemented a classroom token economy based on the routine training they had received through the school system. Baseline was followed by brief in-service training, which resulted in no improvement of token-economy implementation for recently hired instructional assistants. A treatment package of prompting and self-monitoring with accuracy feedback was then introduced as a multiple baseline design across behaviors. The treatment package was successfully faded to a more manageable self-monitoring intervention. Results showed visually significant improvements for all participants during observation sessions.     

Cognitive representation of challenging behaviour among staff working with adults with learning disabilities

Cognitive representations of illness have been identified as a determinant of therapeutic outcomes in a variety of health care settings. This paper describes the development of a Likert-type questionnaire to assess how the concept of challenging behaviour is cognitively represented in staff working with adults with learning disabilities. The Challenging Behaviour Representation Questionnaire (CBRQ) was theoretically derived, drawing on two existing measures: the Illness Perception Questionnaire (IPQ) and the Challenging Behaviour Attributions Scale (CHABA). Items for the questionnaire were generated from responses by 300 direct care staff. The questionnaire shows acceptable levels of internal and external reliability. The questionnaire has face validity and a measure of concurrent validity. There is evidence that challenging behaviour is cognitively represented in care staff in a multi-dimensional way, consistent with other studies in health psychology. This has implications for future staff training in this area.     

Video games: support for the evolving family therapist

Video games are a growing part of USA and world culture. Gaming may have addictive effects on some gamers and may foster violent thoughts and behaviour in children and adults. Conversely, there are documented positive outcomes from playing video games. Through this growing media, family therapists have a new gateway to better understand the experience of a younger generation of clients. To keep up with a changing client base, family therapists must learn about video games, their contextual impacts, addictive aspects and possible uses in the therapeutic setting while ignoring the myth that all gaming is harmful.     

On the longevity of behavioral interventions for challenging behavior

The capacity for a treatment to maintain its effects over time may be the most critical component of behavioral interventions for challenging behavior as treatments that fail to persist are likely to be of little value to society. We reviewed the quality and quantity of different types of post-intervention data for the treatment of challenging behavior in studies published over the last 7 years. We found that for the majority of participants at least one measure of maintenance, fading, or follow-up was reported but with limited information regarding the quality of those measures. Reports of secondary variables related to post-intervention data (e.g., latency to measurement) were also uncommon. We discuss possible explanations for the paucity of post-intervention data, barriers to obtaining post-intervention data, strategies for obtaining these data, and implications for the external validity of behavioral interventions for challenging behavior. We provide recommendations for increasing the probability that post-intervention data are included in applied research on challenging behavior.     

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.     

Video training of imagery for mature adults

To examine the effectiveness of videotaped memory training, two groups of middle-aged and older adults were given imagery training that included videotaped presentation of interactive imagery for object location recall and linking items on a list, and the image-name match method for name recall. The training group performed significantly better than the waiting list on the initial post-test, and the two groups were comparable after both groups had received training. Evidence for both maintenance and generalization was found. Videotaped presentation of imagery training is effective for mature adults as a self-paced at-home intervention, and has cost-saving advantages over the predominant training methodology.     

Provision of leisure activities for the reduction of challenging behavior

Behavioral treatment of challenging behaviors, such as aggression, self-injury, property destruction, and stereotyped movement is often a priority in residential facilities for persons with developmental disabilities. If these behaviors occur when the client is otherwise unengaged, a potentially effective treatment may be to provide alternative activities. In the present study, 3 adults with severe disabilities were observed. During baseline, these 3 individuals frequently displayed challenging behavior at times when they were otherwise unengaged. Opportunities to participate in leisure activities were then provided to each client in a multiple-baseline design. Provision of leisure opportunities was associated with increased adaptive behavior and collateral reductions in problem behaviors. The effectiveness of the intervention procedures suggest that these challenging behaviors may have been related to the lack of alternative activities.     

Case manager: A clinical tool for training residential treatment staff

Various behavioral approaches to institution staff training have appeared in the literature, with some showing that traditional didactic-type instruction or tangible extrinsic reinforcement is not always necessary for effective training. The system described here used principles of modeling and feedback to teach institution staff behavior management skills. In addition, staff were assigned special titles, i.e., “case manager.” Results indicate that this individualized system was associated with improvements in the target behaviors in question, and also increased the amount of time staff properly interacted with assigned residents. Implications are with regard to using this efficient approach as a clinical tool for training staff to be effective behavioral technicians.     

An intervention program for adolescents with behavior problems

Adolescents with behavior problems (aged 12 to 14) attending a regular public high school were in need of an intervention program. The purpose was to enhance their personal and interpersonal functioning as well as to structure a stimulating learning environment. In order to improve their social, educational, and psychological functioning, program objectives were established to help students develop the ability to listen to one another, respect others as well as their opinions, become aware of their own emotions and those of their peers, and recognize and minimize derogatory remarks toward one another. To attain these objectives, relaxation sessions, magic circle activities, art sessions, future planning groups, and decision-making groups were used. Meetings with teachers enabled them to examine and improve their attitudes and relationship with students. Upon completion of the program, the adolescents manifested less disruptive classroom behavior, increased their class participation, and displayed a more positive attitude toward school. The achievement of these behavioral changes indicates that a psychologically oriented intervention program is a feasible addition to a conventional curriculum. Teachers learned the basic skills of program formation, implementation, and evaluation, and most importantly, revitalized their attitude toward troubled students and their profession.     

Stress management training for law students: Cognitive-behavioral intervention

The practice of law has created chronic and, at times, severe psychological stress both in law school and subsequent practice. In the current study, students volunteered to participate in a six-session seminar on personal stress management skills including self-relaxation training, schedule planning, priority-setting, leisure time planning, and cognitive modification techniques. Subjects showed pre- to posttreatment improvement on a variety of measures that included their knowledge about stress, personal ratings of stressful situations, and their daily activity schedules. In contrast, a control group showed no improvement and worsened in reported levels of personal stress. The importance of providing law students with personal stress management skills is discussed.     

Pyramidal training for families of children with problem behavior

The pyramidal training model was extended to multiple family members of children with behavior disorders. Three primary caregivers were taught to implement individualized treatments for problem behavior. They were then taught how to use various instructional strategies (e.g., prompting, feedback) to teach 2 other family members to implement the treatment. Results showed that pyramidal training was effective in increasing caregiver implementation of treatments across three families.     

The creative porpoise: training for novel behavior

Two rough-toothed porpoises (Steno bredanensis) were individually trained to emit novel responses, which were not developed by shaping and which were not previously known to occur in the species, by reinforcing a different response to the same set of stimuli in each of a series of training sessions. A technique was developed for transcribing a complex series of behaviors on to a single cumulative record so that the training sessions of the second animal could be fully recorded. Cumulative records are presented for a session in which the criterion that only novel behaviors would be reinforced was abruptly met with four new types of responses, and for typical preceding and subsequent sessions. Some analogous techniques in the training of pigeons, horses, and humans are discussed.     

Feedback for improving staff training and performance in behavioral treatment programs

This paper reviewed observational studies that examined feedback for changing staff performance in behavioral treatment programs for clients with cognitive, developmental, or psychiatric disorders. The research findings were integrated into the main stages of staff training and management: pretraining, training, and posttraining. Specific recommendations for using feedback are made including defining process and outcome form and content before training, providing on‐the‐job supervisory feedback while staff practice self‐generated outcome feedback until competency is demonstrated, and after training, maintaining self‐generated feedback with emphasis on evaluating staff and client interactions with social validity measures. Copyright © 2008 John Wiley & Sons, Ltd.     

Comparison of single and multiple functional communication training responses for the treatment of problem behavior

Two functional communication training (FCT) conditions without extinction were compared to treat the problem behavior of a child with developmental disabilities. The individual was taught to emit a single FCT response to obtain one of six items delivered in a randomized order or multiple FCT responses that specified the exact item. Results showed that only the FCT-multiple condition reduced problem behavior and maintained alternative mands.