Visual acuity improvement following fading and feedback training—II. Relationship to changes in refractive error

The present study evaluated the effects of behavioral training on visual acuity and refractive error in myopic adults. Twenty volunteers were matched on the basis of refractive error and one member of each matched pair was randomly assigned to either Fading and Feedback training or a no-treatment control condition. Visual acuity was measured with both recognition and resolution measures. Refractive error was measured subjectively using the LaserSpec optometer, and objectively by two retinoscopic examinations performed by an ophthalmologist with and without cycloplegia. The results indicated significant increases in recognition visual acuity, but not resolution visual acuity for trained subjects compared to the no-treatment controls. Trained subjects did not show improvement in refractive error on any measure, and refractive error changes were not correlated with changes in either measure of visual acuity. These data suggest that the visual acuity improvements typically found with behavioral training are not associated with changes in refractive error.     

PROMOTING AUTOMOBILE SAFETY BELT USE BY YOUNG CHILDREN

A program using behavioral practice, assertiveness training, and social and contrived reinforcers was developed to establish and maintain automobile safety belt use by young children. Sixteen children (ages 4.8 to 7 years) who never used their safety belts during a 5-day preexperimental observation period were randomly assigned to two groups of eight each. A multiple baseline design across groups was used to evaluate the effectiveness of the training program. During the 8-day baseline period for Group 1, no children used their safety belts when unobtrusively observed while being driven from school. During the 26-day intervention period, the children were buckled up on 96% of the observations. Follow-up probes conducted 2–3 months after program discontinuance found safety belt use to range from 86% to 100%. For Group 2, the 14-day baseline safety belt use averaged 6% and increased to a mean of 81% during the 20-day training and maintenance program. Follow-up probes 2–3 months later found safety belt use to occur during 75% to 96% of the observations. Parent questionnaires indicated the generalizability and social validity of the program.     

Behavioral training for myopia: generalization of effects

The present study assessed generalization of training effects using a video computer system (VCS) as a training medium for modifying acuity. Eighteen myopic volunteers were matched according to pre-training acuity and assigned to either fading and feedback training group or a practice only control. Subjects were pre- and post-tested on three measures: the Snellen Letter Chart, a Behavioral Acuity Test and a performance test with the VCS. Compared to controls, trained subjects displayed significant improvements in acuity on the Behavioral Acuity Test. These results suggest that training effects generalize to untrained stimuli. Implications for the clinical implementation of behavioral training procedures for modifying myopia are discussed.     

Telehealth parent training for a young child at risk for autism spectrum disorder

The global pandemic has highlighted the importance of telehealth to access behavioral interventions. Face-to-face parent training improves the development and behaviors of young children at risk for autism spectrum disorder (ASD). We evaluated a telehealth parent training intervention for a child at risk for ASD. Two parents identified possible early ASD symptoms in their 30-month-old son (lack of imitation, pointing, and vocal manding). Both parents simultaneously received telehealth behavioral skills training on the Parent Intervention for Children at Risk for Autism program for 1 hour per week over 29 weeks. Multiple baseline designs across parent and child behaviors showed that both parents improved their parent teaching fidelity above 80% and the child improved on all trained behaviors. This study expands the utility of telehealth behavioral parent training to young children at risk for ASD to mitigate early symptoms of ASD.     

Using Behavioral Skills Training to Promote the Generalization of Parenting Skills to Problematic Routines

Research has demonstrated the efficacy of a behavioral parent training program for skills acquisition; however, few studies have examined the extent to which those skills generalize to the home or the effect that they have on child behavior. A multiple baseline across participants design was used to assess (a) caregiver accuracy with implementation of three parenting skills, and (b) the effects of the parenting skills on child behavior. Results demonstrated that three caregiver participants successfully generalized parenting skills taught during behavioral skills training (BST) to naturally occurring routines, and the behavior of each caregiver's child improved following BST.     

Teaching social‐learning procedures to paraprofessionals working with individuals with severe mental illness in a maximum‐security forensic hospital

This study describes an integrated technical method for teaching learning‐based interventions to paraprofessionals working in a maximum‐security psychiatric facility as a social‐learning program was implemented. This training approach combines brief didactic instruction with live demonstration and guided practice in specific procedures. Comparisons between baseline and post‐training functioning of staff were made using ongoing direct observational assessment data. Results revealed that following training and program implementation staff were much more active overall, interacted with clients far more often, and engaged in much lower rates of job‐irrelevant activity. Moreover, following training direct observational data of the patterns of staff–client interactions showed that staff were much more likely to demonstrate interactions reflective of learning‐based interventions than at baseline. These results have important implications for clinicians and administrators attempting to implement behavioral rehabilitation programs. Copyright © 2001 John Wiley & Sons, Ltd.     

Primary Care Behavioral Health Provider Training: Systematic Development and Implementation in a Large Medical System

The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense’s experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed.     

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.     

Anxiety and heart rate under psychological stress: The effects of exercise-training

Abstract The effects of a 12-week exercise-training program on cognitive, somatic, and behavioral anxiety and on heart rate responses to evaluative stress were scrutinized in 89 subjects randomly assigned to an experimental (exercise) or a control group. The training program consisted of exercises that were aimed to the improvement of the general physical fitness (i.e., strength, flexibility, and endurance). Following the 12-week training period, exercising subjects showed improved motor skill capacity as well as higher VO(2) max. In an anxiety inciting test situation, that consisted of the video-taped delivery of a 5-min speech, a mental arithmetic and a fine motor task, exercising subjects showed more favourable responses than control subjects in three ways: (a) they exhibited lower behavioral anxiety during the anticipation phase of the three stressors, (b) they reported lower cognitive and somatic anxiety during the anxiety provoking situation, and (c) their heart rate recovered faster, in contrast to both their baseline heart rate and the control subjects' heart rate, from the stress episode. These results demonstrate that a fitness-oriented exercise program has anxiolytic properties. They also provide a primary evidence that overt behavioral anxiety, as opposed to the usually measured self-reported anxiety, may be affected by exercise.     

In situ Training for Increasing Head Start After-Care Teachers’ Use of Praise

This study tested the effects of the direct behavioral consultation in situ training procedure for increasing Head Start teachers’ praise during an after-school program. Participants included four Head Start teachers in one Head Start center. A multiple baseline design across teachers was employed to test the effects of in situ training on teachers’ praise rate. Maintenance of the training procedure was evaluated 1 week following termination of training and again at 1-month follow-up. Results indicated that all teachers delivered praise below the expected rate (i.e., 1 praise statement per minute) during baseline, and in situ training resulted in an immediate and substantial increase in praise for all four teachers. Three of four teachers maintained increased praise during the maintenance phase and again at 1-month follow-up. One teacher’s praise decelerated during maintenance, and that teacher received additional in situ training. However, for that teacher, praise rate again decelerated following the second in situ training phase, and additional consultation procedures were necessary for increasing praise rate. Results are discussed in terms of the consultation research and applied practice.     

Training paraprofessionals to use behavioral strategies when educating learners with autism spectrum disorders across environments

Although the use of paraprofessionals in the education of young children with autism spectrum disorders (ASD) is a common practice, research on effective training procedures is scarce. The following study used a multiple‐baseline design across settings replicated by five paraprofessionals to evaluate their use of behavioral strategies with young children with, or at risk for, autism spectrum disorder. A training package consisting of a workshop and performance feedback by their supervising special education teacher served as the intervention. Results revealed that even though the paraprofessionals demonstrated skills in the use of behavioral strategies at the workshop, there was either no transfer or generalization to the preschool or home environments where they worked, or their use of skills decreased over time. When performance feedback was provided to all participants, their correct use of strategies increased. The training model evaluated in this study provides an example of one that could be employed in a typical public school classroom or early intervention program. Copyright © 2009 John Wiley & Sons, Ltd.     

INCREASING CALORIE CONSUMPTION IN CHILDREN WITH CYSTIC FIBROSIS: REPLICATION WITH 2-YEAR FOLLOW-UP

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.     

EVALUATION OF A TRAINING MANUAL FOR THE ACQUISITION OF BEHAVIORAL ASSESSMENT INTERVIEWING SKILLS

Two procedures were used to teach behavioral assessment interviewing skills: a training manual and one-to-one instruction that included modeling, rehearsal, and feedback. Two graduate students and two advanced undergraduates were trained with each procedure. Interviewing skills were recorded in simulated assessment interviews conducted by each student across baseline and treatment conditions. Each training procedure was evaluated in a multiple baseline across students design. The results showed that both procedures were effective for training behavioral interviewing skills, with all students reaching a level of 90%-100% correct responding. Finally, a group of experts in behavior analysis rated each interviewing skill as relevant to the conduct of an assessment interview and a group of behavioral clinicians socially validated the outcomes of the two procedures.     

A component analysis of behavioral skills training with volunteers teaching motor skills to individuals with developmental disabilities

This study included a component analysis of behavioral skills training (BST) for teaching volunteers how to use this training method to support individuals with developmental disabilities in a physical education program. In an alternating treatment design embedded within a multiple baseline design across five participants, the number of BST steps that volunteers completed correctly while teaching four motor skills was measured. In the initial training phase, each motor skill was taught to volunteers using a specific component of BST (i.e., instructions, modeling, rehearsal, or feedback). In subsequent training phases, BST components were combined to teach the volunteers the motor skills for which they did not reach a predetermined mastery criterion (a score of four correct responses across two consecutive trials). Maintenance was assessed. Results indicated that individual components of BST alone were sufficient for volunteers to meet the mastery criterion; however, the full BST framework was necessary for skill maintenance. Strengths, limitations, and recommendations for future research are discussed.     

A component analysis of job interview training for young adults with autism spectrum disorder

The job interview is a vital component to acquire employment. Individuals with autism spectrum disorder may experience difficulties with job interviews due to notable deficits in social and communication skills. We evaluated the relative impact of several components of a job interview training package on six participants' responses to commonly asked interview questions. We used a multiple baseline design across participants to present the following components: written instructions, rehearsal and video self‐feedback with a commercially available training program, and verbal feedback delivered by the experimenter. Results demonstrated that all participants required an additional behavioral skills training session to meet our mastery criterion. However, once training was complete, all participants showed generalized performance when the interview questions were presented in a varied format and by a novel interviewer outside of the training environment. In addition, their performance was maintained at follow‐up.     

TRAINED,GENERALIZED, AND COLLATERAL BEHAVIOR CHANGES OF PRESCHOOL CHILDREN RECEIVING GROSS-MOTOR SKILLS TRAINING

Three preschool children participated in a behavioral training program to improve their gross-motor skills. Ten target behaviors were measured in the training setting to assess direct effects of the program. Generalization probes for two gross-motor behaviors, one fine-motor skill, and two social behaviors were conducted in other settings. Results indicated that the training program improved the gross-motor skills trained and that improvements sometimes generalized to other settings. Contrary to suggestions in educational literature, the gross-motor training program did not produce changes in fine-motor skills or social behaviors. Implications for educators and for the development of the technology of generalization are outlined.     

An Intensive Summer Treatment Program for ADHD Reduces Parent–Adolescent Conflict

There are currently almost no treatment efforts to reduce parent–adolescent conflict in adolescents with ADHD. As such, this study investigated the effect of an intensive Summer Treatment Program for Adolescents with ADHD (STP-A) on parent–adolescent conflict. Twenty adolescents and their parents completed the 8 week behavioral treatment program, which included 320 hours of adolescent-directed treatment, 15 hours of parent behavior management training, and daily feedback from staff on parent implementation of a home-based behavioral contract. Results indicated that 70–85 % of adolescents who attended the STP-A demonstrated reliable improvement in parent–adolescent conflict from baseline to post-treatment. Treatment response was associated with higher levels of conflict at baseline, but not adolescent ODD severity or parent ADHD severity. Several patterns of treatment non-response were detected through visual examination of weekly conflict scores during the STP-A. Discussion suggests that intensive, parent-involved treatment programs may be necessary to improve home-conflict in adolescents with ADHD.     

Behavioral skills workshop for staff and supervisor in a community residence for developmentally handicapped adults

A behavioral skills workshop for counselors and a supervisor in a community group home was developed and evaluated. The workshop included group skills training, individual supervised in vivo practice, and supervisor training. Supervisor training taught behavioral staff management skills that were delivered in a multiple baseline design across subjects. Positive changes in staff behavior occurred for each group only after supervisor intervention. Significant positive changes occurred by the end of the workshop and were maintained at follow-up for staff self-evaluations of expertise and confidence to resolve problems, severity of client problems, and behavioral observations of positive client behaviors.