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.     

Independence training vs modeling procedures for teaching phone conversation skills to the mentally retarded

Forty-five mildly mentally retarded adults were assessed for deficits in telephone conversational skills. They were ranked on the basis of their pretest scores and matched into triplets on skill level. One member from each of these groups was then randomly assigned to either a no-treatment control group, a modeling condition or independence training—a treatment that incorporated social reinforcement, instructions, performance feedback, modeling, shaping by successive approximations and self-monitoring and evaluation. For the two latter conditions, treatment was provided three times weekly for 2 months in group sessions (N = 5) of 1 hr duration. The dependent variable, conversational skills of subjects was assessed at pretest, posttest and at a 3-month follow-up based on verbal responses that subjects made to nine questions asked by an experimenter and related social responses during a phone call. Independence training proved to be significantly more effective than the other two experimental conditions at posttest and follow-up. In addition, modeling proved to be significantly more effective than the no-treatment controls at both of these assessment points.     

The role of social and material reinforcers in increasing talking of a disadvantaged preschool child

Adult social reinforcement and access to materials in the preschool were made contingent on the verbalizations of a 4-yr-old Negro girl with an extremely low frequency of talking. Though the teachers' social attention was always given immediately for all spontaneous speech, if the child's spontaneous verbalizations were requests for materials, those materials were withheld until she had responded to the teachers' questions about those materials. When she was silent, the teachers withheld their attention and the materials. A high frequency of verbal behavior was quickly established. When both teacher attention and materials were provided only when the child was not verbalizing, the child's frequency of talking immediately decreased. When social attention and materials were again made contingent upon spontaneous speech and answering questions, the child's frequency of talking quickly increased to its previous high level. The content of the child's verbal behavior which increased was primarily a repetition of requests to the teachers with little change noted in the non-request verbalizations, or verbalizations to other children. A further experimental analysis demonstrated that social interaction per se was not the reinforcer which maintained the increased verbalization; rather, for this child, the material reinforcers which accompanied the social interaction appeared to be the effective components of teacher attention.     

Overcorrection,Modeling, and Reinforcement Procedures for Reinstating Speech in a Mute Boy

A 9-year old boy who had not spoken for three years was treated using overcorrection, modeling and reinforcement. The experimental design was a multiple baseline across five target behaviors with a reversal of treatment conditions which differed in terms of the therapist doing training and the environment in which trainging occured. This desing allowed for an analysis of the stimulus control of the treatment procedures as well as an analysis of changes in target behaviors due to variations in the treatment conditions. It was found that overcorrection, instructions, information feedback, modeling, and reinforcement were readily effective for reinstating speech, but that no generalization to other therapists occured until the second therapist began applying the treatment procedures. Additional generalization to speaking words not specifically trained, to persons who had not been providing treatment, occured in the latter stages of the study on the ward. These positive changes resulted after generalization to one additional therapist and treatment situation had been established. In addition, generalization and maintenance of results were still evident on the ward at the conclusion of a 2-month follow-up.     

USE OF SOCIAL-SKILLS TRAINING IN THE TREATMENT OF EXTREME ANXIETY AND DEFICIENT VERBAL SKILLS IN THE JOB-INTERVIEW SETTING

A 30-year-old recent college graduate, exhibiting extreme anxiety and deficient verbal skills in job interviews, was treated with a social-skills training procedure that included instructions, modelling, behavior rehearsal, and videotape feedback. Three target behaviors—focused responses, overt coping statements, and subject-generated questions—were presented using a multiple-baseline design. Galvanic skin-response activity was monitored during pre- and posttraining in vivo job interviews. In addition, independent judges unobstrusively rated the subject's social-communicative behaviors in his temporary work-setting before and after training. Training resulted in expected changes for all three target behaviors and a decrease in the rate of speech disturbances. Physiological data supported the subject's report that training enabled him to deal with his anxiety more effectively during job interviews. Training was found to generalize to novel interview questions and different interviewers. Furthermore, unobtrusive measures of eye contact, fluency of speech, appropriateness of verbal content, and composure supported the subject's report that training generalized to his daily social interactions on the job.     

Effects of reinforcement and guidance procedures on instruction-following behavior of severely retarded children

Positive reinforcement, physical guidance, and fading procedures were used to teach two severely retarded children motor responses to a variety of verbal instructions. Subjects' responses to one set of instructions provided the focus for the training procedures. Their responses to a second set of instructions were used to assess the generalized effects of training. The frequency of responses to both sets of instructions was evaluated during Baseline 1, Training 1, Baseline 2, and Training 2 periods. During the training periods, this evaluation was made after the daily training sessions when no training procedures were in effect. Results indicated that the subjects showed pronounced increases in instruction-following behaviors (both trained and untrained) during training periods with decreases in such behavior occurring during the Baseline 2 period. The general findings demonstrate the applicability of the training procedures for producing and maintaining instruction-following behaviors in severely retarded children and for facilitating appropriate responding to instructions not directly involved in training.     

Training of conversational skills with institutionalized elderly: a preliminary study

16 residents in a Residential Care Home for elderly people volunteered and were trained in a social skills program aimed at increasing conversational skills. Subjects were assigned randomly to three groups, one experimental and two control groups (placebo and waiting list). The techniques used in the experimental group were behavior rehearsal, feedback, modeling, discriminative reinforcement, verbal instructions, and homework. Relative to control groups, experimental subjects showed significant increases in conversational skills, such as receiving information, speaking-up, and giving information. They also showed a significant decrease in their scores on Zung's Self-rating Scale of Depression compared with the two control groups. They showed an increase in assertive responses and a decrease in aggressive and inhibited responses. These changes remained when follow-up was made 3 mo. later, suggesting the potential utility of this training program with elderly persons residing in old people's homes.     

Training interpersonal skills among mentally retarded and socially dysfunctional children

Two moderately retarded boys, ages 11 and 12 yr, who resided in an inpatient unit for emotionally disturbed children, were treated for deficits in social skills. The deficits included physical gestures, facial mannerisms, eye contact, words spoken, and intonation and content of speech. The treatment package consisted of instructions, performance feedback, social reinforcement, modeling, and role-playing. The effects of the treatment in developing appropriate social performance were evaluated in separate multiple-baseline designs across behaviors for each child. The training improved social skills and brought children up to or beyond the level of normal control subjects who were the same age and gender.     

A comparison of intervention for problematic speech using reinforcement with and without preferred topics

Previous research has shown that responding to the appropriate and problematic speech of individuals diagnosed with developmental disabilities with interested and uninterested listener responses, respectively, can promote more appropriate conversational engagement. However, Fisher et al. (2013) also responded to appropriate speech with access to preferred conversational topics. This study examined the influence of listener interest on the problematic speech of 8 participants and tested the additive effects of (Study 1) and participant preference for (Study 2) delivering preferred topics as reinforcement for appropriate speech. Interventions were equally effective with or without arranging access to preferred topics, but a majority of participants demonstrated a preference for intervention with contingent access to preferred topics. Caregivers and speech‐language pathologists rated the intervention procedures as acceptable and changes in participants' speech satisfactory.     

TEACHING AUTISTIC CHILDREN CONVERSATIONAL SPEECH USING VIDEO MODELING

We assessed the effects of video modeling on acquisition and generalization of conversational skills among autistic children. Three autistic boys observed videotaped conversations consisting of two people discussing specific toys. When criterion for learning was met, generalization of conversational skills was assessed with untrained topics of conversation; new stimuli (toys); unfamiliar persons, siblings, and autistic peers; and other settings. The results indicated that the children learned through video modeling, generalized their conversational skills, and maintained conversational speech over a 15-month period. Video modeling shows much promise as a rapid and effective procedure for teaching complex verbal skills such as conversational speech.     

Preschoolers’ Motor and Verbal Self-Control Strategies During a Resistance-to-Temptation Task

Although prior research has shown that young children exhibit enhanced self-control when they use verbal strategies provided through adult instructions, little work has examined the role of children's spontaneous verbalizations or motor behavior as strategies for enhancing self-control. The present study examined the usefulness of spontaneous verbal and motor strategies for 39 3- and 4-year-old children's ability to exercise self-control during a resistance-to-temptation task. After a 2-min play period, participants were asked by an experimenter not to touch an attractive train set while he was out of the room. Children were videotaped during the 3-min waiting period and videos were coded for frequency and duration of touches, motor movements, and verbalizations. Results indicated that self-control was improved by using both motor and verbal strategies. Children who were unable to resist touching the forbidden toy used limited motor or verbal strategies. These findings add to the growing literature demonstrating the positive role of verbalizations on cognitive control and draw attention to motor behaviors as additional strategies used by young children to exercise self-control.     

Instruction-following behavior of a retarded child and its controlling stimuli

A combination of positive reinforcement and fading of physical guidance was used to teach a profoundly retarded boy specific responses to specific verbal instructions. The design consisted of a multiple baseline of probe data across different verbal instructions. The subject started responding correctly to each verbal instruction as that item was trained in a multiple-baseline order. Generalization did not occur to items that had not yet been trained, nor did it occur to items included to assess generalization. Probes of variations in the verbal instructions, conducted after training was completed, revealed that generalization was minimal except in those cases where the variation consisted of the verb only, the noun only, the noun plus preposition, or where the verb of the instruction was presented last. Training a profoundly retarded 11-yr-old subject to respond to specific verbal instructions did not adequately facilitate the development of a generative instruction-following capability, nor did all verbal elements of the instruction control a specific response.     

The social validation and training of conversational skills

Three reliably measured components of conversation-questioning, providing positive feedback, and proportion of time spent talking-were identified and validated as to their social importance. The social validity of the three conversational behaviors was established with five female university students and five female junior-high students. Each was videotaped in conversations with previously unknown adults. The conversational ability of each girl was evaluated by a group of 13 adult judges who viewed each tape and rated each conversant "poor" to "excellent" on a seven-point rating scale. The average ratings of the girls correlated at r = 0.85 with the specified behavioral measures. These procedures were replicated with additional subjects and judges and yielded a correlation of r = 0.84. The high correlations between ratings and the objective measures suggested that the specified conversational behaviors were socially important aspects of conversational ability. Employing a multiple-baseline design across the behaviors of asking questions and providing positive feedback, an attempt was made to train four girls who used these behaviors minimally to engage in the behaviors in conversations with adults. Adult judges were again employed to rate randomly selected samples of the girls' skills in pre- and posttraining conversations. The average ratings of the girls before training were lower than both the university girls and the junior high-school girls. After training, the girls' conversational abilities were rated substantially higher than those of their junior high-school peers. These rating data validated the benefits of the training and the social importance of the behavioral components of questions and feedback in conversation. The authors suggest that it may be necessary for traditional behavior analysis measurement systems to be supplemented by social-validation procedures in order to establish the relationship between "objectively" measured behaviors and complex classes of behavior of interest to society.     

Inappropriate speech in a severely retarded child: a case study in language conditioning and generalization

The modification of inappropriate speech, a class of behaviors rather than a limited number of specific examples, is little known in the severely retarded. In this study, operant techniques were used to modify the strikingly bizarre and inappropriate speech of a severely retarded boy. The boy's appropriate verbal responses to questions about magazine pictures were reinforced with candy. When he responded inappropriately, the magazine was withdrawn, and social interaction was discontinued for a 10-sec timeout period. Negative responses were ignored, the next picture displayed, and the next question asked immediately. In 10 sessions, appropriate responses increased from 26% to 86% of all responses. A reversal of reinforcement was then introduced, in which inappropriate responses were reinforced, appropriate responses resulted in timeout, and negative responses were treated as before. This reduced the percentage of appropriate responses to 24%. Subsequent sessions of reinforcement for appropriate responses increased appropriate responses to 96% of all responses. At significant stages in the experiment, a measure of possible generalization was attempted. Although some generalization was recorded, it was minimal: some explanations are discussed.     

Functional analysis and intervention of perseverative speech in students with high-functioning autism and related neurodevelopmental disabilities

Although perseverative speech is a common characteristic of individuals with high-functioning neurodevelopmental disabilities, little is known about the operant functions of these verbalizations. We conducted analogue functional analyses of perseverative speech for 2 students using reinforcement contingencies that included alone, attention, control, escape, and tangible conditions. Results showed the following patterns: attention only (Charlotte) or multiply determined including an attention function (Paul). We then tested an intervention for perseverative speech maintained by social positive reinforcement that included differential reinforcement of alternative behavior and extinction of perseverative speech for 1 participant. The intervention reduced perseverative speech, but did not increase appropriate speech until we added a prompting component. We then replicated this three-component intervention with Paul. The results showed moderate to high decreases in levels of perseverative speech and increased appropriate verbalizations in both cases. The results systematically replicated the interventions of previous studies by adding a prompting component to the intervention.     

The effects of token reinforcement and feedback on the delusional verbal behavior of chronic paranoid schizophrenics

Prior research with token reinforcement in the psychiatric population has been directed at work adjustment, more than at major symptomatic behaviors. The purpose of the present research, on the other hand, was to investigate the effects of feedback and token reinforcement on the modification of delusional verbal behavior in chronic psychotics. Six male and four female paranoid schizophrenic patients participated in the study. The results indicated that the effects of feedback were effective about half the time in reducing percentage delusional talk, but in at least three cases produced adverse reactions. Token reinforcement, however, showed more consistency and reduced the percentage of delusional verbal behavior in seven of the nine subjects exposed to this procedure. The effects of both feedback and token reinforcement were quite specific to the environment in which they were applied and showed little generalization to other situations. It would appear that using token reinforcement can reduce the percentage delusional speech of chronic paranoid schizophrenics.     

A BEHAVIORAL INTERVENTION FOR IMPROVING VERBAL BEHAVIORS OF HEROIN ADDICTS IN A TREATMENT CLINIC

Positively reinforcing appropriate behaviors improved verbal behaviors of opioid-dependent patients in a buprenorphine treatment clinic. During B phases of an ABAB design, clients received stickers for engaging in appropriate verbal or nonverbal behaviors. Each sticker provided a chance of winning $25. No reinforcement was provided during the A phases. Appropriate verbal behaviors increased during reinforcement periods, and inappropriate verbal behaviors decreased.     

Reinforcing effects of prerecorded words and delayed speech feedback on the verbal behavior of a neologistic schizophrenic

The possibility of using prerecorded words and 2-sec. delayed speech feedback as reinforcement in the reconditioning of intelligible verbal responses in a chronic, neologistic schizophrenic patient was investigated. A test situation was devised which involved daily presentation of 100 stimulus word-picture cards to elicit verbal responses. The results indicated that both singly presented prerecorded words and delayed speech feedback apparently strengthened correct and intelligible verbal responding.     

Coordinated interpersonal timing in the conversations of children who stutter and their mothers and fathers

Coordinated interpersonal timing (CIT) is a measure of "conversational congruence," or "attunement," and refers to the degree to which the temporal aspects of the vocal behaviors of co-conversationalists are correlated over the course of a conversation [Jasnow, M., & Feldstein, S. (1986). Adult-like temporal characteristics of mother-infant vocal interaction. Child Development, 57, 754-761]. In the present study, CIT was examined in a group of children who stutter (CWS), and a matched group of nonstuttering children (CWDNS; children who do not stutter), during conversations with either their mother or father recorded in two separate sessions (i.e., mother-child, father-child). Separate audio signals for both the child and parent (mother or father) were analyzed using AVTA software, which allowed for the quantification of sound and silence patterns in simultaneous speech. Squared cross-correlations (i.e., coefficients of CIT) for the durations of five vocal behavior states were obtained for each subject, through time series regression analysis using lag procedures. Vocal state behaviors within conversational turns included: vocalization, pauses, turn switching pauses, and interruptive and noninterruptive simultaneous speech. Results indicated that CWS and their parents showed mutual influence (i.e., CIT in both directions, child to parent and parent to child, or bi-directional influence) for more vocal state behaviors than did CWDNS and their parents. In addition, the CWS exhibited CIT with their parents for the durations of more vocal state behaviors than did the CWDNS (i.e., unidirectional influence). Findings suggest that children who stutter may be more easily influenced by the subtle timing aspects of conversation. Taken further, some of these children may perceive conversations with their parents as either challenging or difficult because of an element of unpredictability brought into conversations by the production of stuttering, the social skills of the child, and the nature of the parent-child relationship. Consequently, these children may be engaging in more pervasive coordination of the temporal characteristics of their speech to those of their conversational partner, as a mechanism by which to more effectively manage verbal interaction. EDUCATIONAL OBJECTIVES: After reading this paper, the learner will be able to: (1) describe the phenomenon of coordinated interpersonal timing (CIT); (2) summarize research findings in CIT as they apply to the verbal interactions of children and their parents; (3) summarize research findings in parent-stuttering child interaction, especially those related to the temporal aspects of both parent and child conversational speech, and (4) discuss the applicability of the findings from the present study to the treatment of childhood stuttering.     

Application of social skills training in a group of institutionalized aggressive elderly subjects

A social skills training program consisting of instructions, modeling, role playing, and feedback was carried out with a group of 6 verbally aggressive institutionalized elderly patients. Dependent measures included confirmed incidents of verbal aggressive behavior monitored across an ABAB design with a 5-month follow-up period. Results indicated that verbally aggressive behavior can be significantly decreased in a group-training setting and subsequently generalized to ward and other socialized behavior. Ancillary aspects of the study include the role of social reinforcement, participant modeling, and staff attitude, perception, and motivation. Implications for future research are discussed.