Child- versus teacher-administered token programs in a psychiatric hospital school

The purpose of this study was to: (a) compare student-administered token programs with similar programs administered by professional teachers, (b) investigate the contribution of feedback to the success of token systems, (c) compare the effectiveness of peer and teacher feedback, and (d) test a sequence of withdrawal from token programs designed to increase generalization. Results indicated that (a) peers could do just as well as teachers in reducing disruptive behavior through a token program, (b) feedback is not solely responsible for the effectiveness of token reinforcement, (c) peer feedback may be more effective than teacher feedback, and (d) withdrawal from token reinforcement to feedback may be a successful method of retarding the increases in disruptive behavior usually found when backup reinforcers are eliminated.The project was supported by Grant OEG 0-71-2872 (607) from the U.S. Department of Education and Department of Health, Education, and Welfare. The opinions expressed herein, however, do not necessarily reflect the position or policy of the U.S. Office of Education, and no official endorsement by that Office should be inferred. The author would like to thank Drs. L. Krasner, A. O. Ross, and K. Feldman for their assistance throughout the study, and Dr. K. D. O'Leary for his invaluable help. Also gratefully acknowledged is the help of R. Spitalnik, R. Kent, M. Hageman. S. Ransom, W. Kaler, S. Golembeski and E. Howard.     

The token economy program in the psychiatric hospital: a review and analysis

Reports of token economy programs with hospitalized psychiatric patients are reviewed with emphasis on three general aspects of function :(1) effectiveness. (2) factors influencing effectiveness, and (3) experimental methodology. Token economies are effective in modifying a wide variety and range of patient behavior, but it is still unclear which variable or combination of variables operating in the program are primarily responsible for the changes effected. The methodological aspects of program evaluation were found to be less than adequate in most cases because of failure to control probable operational variables. A systems analysis of the token economy program was offered in which influential aspects of the program including feedback effects were recognized and accounted for in conceptualizing function and evaluation.     

Reward, cost, and self-evaluation procedures for disruptive adolescents in a psychiatric hospital school

Sixteen pupils in a psychiatric hospital were assigned to two tutorial reading classes and balanced on six pupil characteristics and teacher preferences for the children. The effects of reward and cost procedures in a token program were assessed using both within- and between-subject comparisons in the following phases: (1) Baseline; (2) Token I, teacher evaluated and reinforced children for appropriate behavior; (3) Withdrawal of Tokens; (4) Token II, same as Token I; (5) Token III, same as Token I and II, but switched order of class meeting time; and (6) Self-Evaluation, students rated their own behavior and received prizes based on their rating, rather than the teacher's rating. The token program was markedly successful in reducing disruptive behavior and in increasing reading skills in both the Reward and Cost Classes, but there were no significant differences in the effects of the reward versus the cost procedure. While cost may be seen as a punishment procedure, there were no adverse side effects observed in the Cost Class at any time when the token program was in effect. The order of the classes was unrelated to the level of disruptive behavior or academic progress. The Self-Evaluative Phase, in which the students rated their own behavior, was included as an alternative to the abrupt withdrawal of tokens. In this phase, disruptive behavior remained at the previous low level.     

A token reinforcement program in a public school: a replication and systematic analysis

A base rate of disruptive behavior was obtained for seven children in a second-grade class of 21 children. Rules, Educational Structure, and Praising Appropriate Behavior while Ignoring Disruptive Behavior were introduced successively; none of these procedures consistently reduced disruptive behavior. However, a combination of Rules, Educational Structure, and Praise and Ignoring nearly eliminated disruptive behavior of one child. When the Token Reinforcement Program was introduced, the frequency of disruptive behavior declined in five of the six remaining children. Withdrawal of the Token Reinforcement Program increased disruptive behavior in these five children, and reinstatement of the Token Reinforcement Program reduced disruptive behavior in four of these five. Follow-up data indicated that the teacher was able to transfer control from the token and back-up reinforcers to the reinforcers existing within the educational setting, such as stars and occasional pieces of candy. Improvements in academic achievement during the year may have been related to the Token Program, and attendance records appeared to be enhanced during the Token phases. The Token Program was utilized only in the afternoon, and the data did not indicate any generalization of appropriate behavior from the afternoon to the morning.     

Parent-child relationships of adopted adolescents in a psychiatric hospital

This study compared the parent-child relationships of 140 adopted and non-adopted adolescents treated in a psychiatric hospital through examination of information contained in the adolescents' medical records. Specifically, comparisons were made of the mention of parental contribution to the problems precipitating hospitalization, psychiatric restriction of parental visits to hospitalized offspring, and referral of parents to an adjunct parents' group. Data were gathered by uninformed research assistants, from the hospital charts of adolescents who had already been discharged from the hospital. Statistical analysis of the data yielded the following results. Adoptive parents were significantly more frequently restricted in their visits to their children. In addition, they were also more likely to have been involved in the precipitants to hospitalization and to have been referred subsequently for adjunctive treatment. It was concluded that parent-child relations may be more problematic among hospitalized adopted, as compared with non-adopted , adolescents. It was also suggested that psychiatric bias concerning "typical" adoptive family dynamics might have contributed to the observed differences.     

Symptomatology of adopted and nonadopted adolescents in a psychiatric hospital

This study compared the symptomatology and diagnoses of adopted and nonadopted adolescents in a psychiatric hospital. Data were gathered from the hospital charts of adolescents who already had been discharged from the hospital. Contrary to expectations, adoptees were no more likely than nonadoptees to have received personality disorder diagnoses, nor were they more likely to be hospitalized as the result of antisocial behavior. However, in comparison with nonadopted adolescents, the adopted adolescents were younger upon admission to the hospital, significantly less often diagnosed psychotic, and significantly more often diagnosed adjustment reaction. It was suggested that adopted adolescents may be less likely than nonadopted adolescents to require severe or prolonged pathology in order to be admitted to a psychiatric hospital. It was also suggested that the antisocial symptomatology so frequently observed in adopted children in mental health settings does not account for the hospitalizations of those receiving inpatient treatment.     

Management of chronic psychiatric patients by a token reinforcement system

A token reinforcement system for the reduction of institutionalized behavior in a chronic psychiatric ward is described. Quantitative assessments were made of the effects of the system on five types of positively reinforced behavior, two types of unreinforced behavior, and two types of fined behavior. To assess whether these effects were a function of the token procedures, three experiments were carried out, the first removing tokens for a brief period, the second making tokens non-contingent on behavior, and the third removing fines in one area while maintaining them in another. The token procedures were found to be the source of the observed improvements.     

An appeals system for fines received by adolescents in a token economy

A system is described wherein adolescents participating in a token economy at a state hospital were allowed to appeal fines received from staff. Appeals were heard by a board composed of three residents and a psychology intern. The board met weekly and had full power to rescind or uphold fines. Before initiation of the appeal system, residents complained vigorously about fines received and about the "unfairness" of the staff and the token system, frequently denying responsibility for the infractions involved. Although almost half the fines were upheld, there were practically no more complaints of unfairness, and denials of responsibility declined drastically. The number of residents appealing fines fell from an average of four per week to less than one per week after the system had been in effect for one and one-half months. When asked why the system was not being used more often, residents grudgingly volunteered that most of the fines received were fair. It was not possible to determine whether this was due to changes in residents' attitudes or to actual changes in fining behavior by staff. Results are discussed in terms of effects on residents, acceptance by staff, and implications for further research.     

Maintenance of appropriate behavior in a token program

Following a baseline period, a token reinforcement program was instituted in three resource-room classes for very disruptive children where the children spent 1 hour per day. The only reinforcers used in the token program were those available to any classroom teacher, viz., free time in an activity area. The effects of the token program were evaluated in the three resource-room classes as well as in the homerooms of all students participating in the resource-room program. Following 4 months of the token program, a return to baseline was made in one resource classroom. As assessed by standard classroom observations, the token program was effective in reducing disruptive behavior in all three resource-room classes; and when it was withdrawn in one resource-room class, the disruptive behavior remained at a very low level in the resource room. Ratings by teachers in the homerooms showed a significant reduction in disruptive behavior, but recordings by homeroom observers showed no such reduction. Possible reasons for maintenance of low rates of disruptive behavior after withdrawal of tokens were discussed in terms of the type of reinforcers used.     

Weekly variations in performance on a token economy psychiatric ward

Seven types of behavior of thirteen chronic schizophrenic female patients, who were transferred to an existing male token economy ward, were rated during four experimental phases. During Conditions I and III the patients were given a token allowance in the morning on a noncontingent basis. During Conditions II and IV tokens were paid on a contingent basis; that is, the patients received tokens commensurate with their behavior ratings. Their ratings were higher during Conditions II and IV than during Conditions I and III. The results supported the expectation that the contingent tokens were controlling the behavior of the patients.     

Motivating adolescents to reduce their fines in a token economy

Adolescents on a 16-bed token economy ward of a state hospital were subjected to four interventions in a seven-phase experiment to reduce the number of fines they received each day. Phase I was a four-week baseline period. Phases II and III were four- and five-week periods, respectively, in which residents were awarded tickets for a weekly $10 lottery each day they were at or below a changing criterion of daily fines. In Phase IV, residents received coupons, exchangeable for money, for days with zero fines. Phase V was a return to baseline. Phase VI was a one-week period in which daily lotteries for $1 were held, with the criterion for receiving a ticket being zero fines on the previous day. Phase VII was a one-week return to baseline. No significant differences in average fines per day, number of residents meeting criteria, or mean number of zero-fine days per week were found across phases. Results are discussed in terms of amount and immediacy of reinforcement, other opportunities to gain money, possible rebelliousness of the residents against the increased aversiveness of fines, and implications for further research.     

A system for recording individualized behavioral data in a token program

A data matrix system used to record and summarize individual behavioral data is described. The major characteristics of the system are: (1) it provides a place to record and summarize all patient token exchanges, whether for standard contingencies or for idiosyncratic behavior; (2) it serves as a record and summary for time samples observed during a 24-hr period and as a record of reliability data on time sample measures; (3) it provides a place where the new token balance for each patient can be calculated and recorded for use the next day; (4) it provides for calculation of an individual patient's token balance at any given moment; and (5) it is a permanent record of each patient's daily participation in the program and documents progress in terms of his economic status as well as in changes in critical target behaviors.     

A longitudinal study of school adjustment in urban,minority adolescents: Effects of a high school transition program

Described an intervention program designed to prepare elementary school (K-8) eighth-grade students for their transition to high school the following year. Participants in the study were 145, predominantly Hispanic, inner-city public school adolescents. The experimental group received an augmented condition, consisting of Education and Peer Support Components. The control group received a minimal condition consisting of only the Education Component. While no group effects were observed, time effects indicated experimental and control students' improved perceptions of school readiness, but deteriorated perceptions of support from both home and school and diminished grade-point averages and attendance. Time effects also revealed variable changes in school perceptions. Findings are discussed in terms of a developmental perspective of the school transition process. Implications for high school transition programming with the target population and directions for future research are also addressed.