TEACHING A PARENT TO TRAIN A SPOUSE IN CHILD MANAGEMENT TECHNIQUES

This study analyzed several aspects of the training of a mother and father in child management techniques for use with their 6-year-old severely developmentally delayed son. The mother received clinic training in procedures for increasing her son's independent dressing skills; subsequently, she was asked to teach the same procedures to her husband with no assistance from the trainer. For both parents, procedures were introduced sequentially across two components of parent behavior in a multiple baseline design. Examinations were made of (a) the effectiveness of initial child management training on the mother's behaviors, (b) her ability to teach the same techniques to her husband independently, (c) the generalization of both parents' skills from the training setting (a dressing task) to two untrained activities (eating and toy use), and (d) the impact of training on the child's behavior. Results showed that the mother learned to implement the trained procedures and successfully communicated them to her husband, as evidenced by substantial positive changes in both parents' behaviors after being introduced to the child management skills. Both parents showed some generalization to the untrained activities, and their written comments following training indicated they understood the procedures. Clear-cut improvements were observed in the child's attending and independent performance of dressing and toy use skills concurrent with parent training. A 2-year follow-up report indicated that both parents retained their knowledge of skills taught, continued to use the procedures, and rated the training as very helpful in teaching the child self-help skills.     

Developing proper mealtime behaviors of the institutionalized retarded

The institutionalized mentally retarded display a variety of unsanitary, disruptive, and improper table manners. A program was developed that included (1) acquisition-training of a high standard of proper table manners and (2) maintenance procedures to provide continued motivation to maintain proper mealtime behaviors and decrease improper skills. Twelve retardates received acquisition training, individually, by a combination of verbal instruction, imitation, and manual guidance. The students then ate in their group dining arrangement where the staff supervisor provided continuing approval for proper manners and verbal correction and timeout for improper manners. The results were: (1) the trained retardates showed significant improvement, whereas those untrained did not; (2) the trained retardates ate as well in the institution as non-retarded customers did in a public restaurant; (3) proper eating was maintained in the group dining setting; (4) timeout was rarely needed; (5) the program was easily administered by regular staff in a regular dining setting. The rapidity, feasibility, and effectiveness of the program suggests the program as a solution to improper mealtime behaviors by the institutionalized mentally retarded.     

Control of the behavior of schizophrenic patients by food

Operant-conditioning principles using food as a reinforcer were applied to control the behavior of 45 chronic schizophrenic patients. The investigation was conducted in a psychiatric ward in which there was 24-hr environmental control.

In order to use food as a reinforcer for controlling psychotic behavior, it was necessary first to deal with the eating deficits in the patients. Approximately 50% of the ward population was selected because of a history of refusal to eat. Their refusal to eat had remained relatively unaffected by one or more of these treatments: spoonfeeding, tubefeeding, intravaneous feeding, and electroshock. These treatments were discontinued, and the patients were left alone at mealtimes. The results show that social reinforcement in such forms as coaxing, persuading, and feeding the patient tend to shape patients into eating problems so they are conditioned to eat only with assistance. When refusal to eat was no longer followed by social reinforcement, the patients soon started eating unassisted. When access to the dining room was made dependent upon a chain of responses including a motor and social component, all patients learned these responses.

     

Development of oral motor behavior related to the skill assisted spoon feeding

Milestones in the typical development of eating skills are considered to be nippling (breast or bottle), eating from a spoon, drinking from a cup, biting and chewing.The purpose of this research was to study the development and consolidation of oral motor behavior related to the skill assisted spoon feeding in young infants. The present study longitudinally investigated the development of this skill in 39 healthy children from the start of spoon feeding until the skill was acquired. The Observation List Spoon Feeding with 7 observation items for oral motor behavior and 6 items for abnormal behavior was used. Results showed that infants between 4 and 8 months of age needed 5.7 weeks (SD 2.1), with a range of 8 weeks (from 2 to 10 weeks) to acquire this skill. No significant correlation (p = .109) between age at start spoon feeding and weeks needed to develop the skill was found. During this period oral motor behavior consolidated and abnormal behavior diminished.With this study it is shown that the period in weeks needed to acquire the oral motor behavior for the skill assisted spoon feeding is important in case of feeding problems.     

Enhancing Treatment Integrity Maintenance Through Fading with Indiscriminable Contingencies

School psychologists are often asked to develop treatment to remediate students’ academic skills or social behavior problems. When teachers implement treatment recommendations with high levels of treatment integrity, students benefit. Treatment integrity has been enhanced by use of direct training, performance feedback, and negative reinforcement procedures. Still, maintenance of treatment integrity has received limited systematic inquiry. This study investigated maintenance of treatment integrity over time by utilizing a systemic fading procedure with indiscriminable contingencies. The results showed that the teachers continued to implement treatment protocols at a high level after performance feedback was faded. Students also fared better when treatment integrity was high.     

TRAINING PROSOCIAL BEHAVIORS TO YOUNG CHILDREN: AN ANALYSIS OF RECIPROCITY WITH UNTRAINED PEERS

We examined the effects of a social skills training package on the play behaviors of three young girls. Two children were taught to invite their peers to play and to use social amenities during their conversations with other children. A combined reversal and multiple baseline across responses design demonstrated that both children directed more social behaviors to their classroom peers after training and that these two children's play invitations were maintained in the later absence of experimental contingencies. In addition, both target children received a greater number of play invitations from their peers during the free play periods. In contrast, a third child's play invitations were not reciprocated by peers; her invitations subsequently decreased in rate after training was discontinued. An interdependent group contingency produced a reciprocal exchange of invitations between this child and her classroom peers. A reversal design demonstrated partial maintenance of subject-peer exchanges after the group intervention was discontinued. The results obtained with the three target children suggest that peer reciprocity may facilitate the maintenance of children's play invitations over time.     

Visually discriminated behavior in a "blind" adolescent retardate

A 16-yr-old retarded male, diagnosed organically blind and treated by those around him as a blind person, was given practice in discriminating visual stimuli. After training, he responded with significantly better than chance accuracy in a choice situation in which stimuli were as small as 18 pt Futura Medium type. In addition, he was trained to look at the experimenter's eyes when instructed to do so. Control procedures revealed that it was the reinforcement contingency that functioned to establish and maintain eye contact. Eye contact with the experimenter generalized in a limited way to situations in which this behavior was not reinforced, though not to a neutral individual. When the boy was required to use visual cues to help himself in a cafeteria line, he soon emitted the necessary behaviors, where formerly he had been assisted by others. Resumption of assistance markedly decreased self-help, suggesting that continued use of any newly learned skills would depend on the response of the individuals in his environment. The boy also learned eating behavior that appeared to require the use of visual cues.     

Prerequisite vs. in vivo acquisition of self-feeding skill

Separating the acquisition of prerequisite skills from the learning of skills in vivo may be a more efficacious procedure for self-help training of low functioning developmentally delayed children. Two procedures for training independent use of a fork at meals were compared using two equivalent groups of three subjects each, in multiple baseline design. Using previously accepted procedures, one group was trained during meals while the experimental group received prerequisite training making use of simulated food (styrofoam pieces). Data during training, generalization-to-meal, and follow-up were collected. For 6 months following training, the efficacy of prerequisite training was upheld. The complexity of individual responses to the singular or conjunctive use of social and edible reinforcement for the purpose of self-feeding skill generalization and maintenance, is discussed.     

EFFECTS OF SELF-EVALUATION ON PRESCHOOL CHILDREN'S USE OF SOCIAL INTERACTION STRATEGIES WITH THEIR CLASSMATES WITH AUTISM

This study investigated effects of a self-evaluation procedure on preschool children's use of social interaction strategies among their classmates with autism. Three triads of children (comprised of 1 trained normally developing peer, 1 untrained peer, and 1 child with autism) participated. A multiple baseline design across subjects was used to demonstrate that peers who were taught facilitative strategies increased their use of strategies only after the self-evaluation intervention was introduced. Improvements in social behavior of children with autism was associated with peers' increased strategy use. Untrained peers demonstrated little change in their social behavior. Treatment effects were replicated when trained peers were asked to use self-evaluation with other children with autism during other play times. Self-evaluation procedures enhanced the use of social interaction strategies on the part of normally developing peers during social skills interventions.     

Nothing gained: An explorative study of the long‐term effects of perceived maternal feeding practices on women's and men's adult BMI,body image dissatisfaction,and disordered eating

The objective of the studies presented here was the prediction of adult body mass index (BMI), body image dissatisfaction, and disordered eating from recalled maternal child feeding practices. Studies 1 and 2 sampled women from the community, and found that recalled childhood feeding practices predicted both current BMI and current disordered eating. Daughters whose mothers pressured them to eat as children had lower BMIs as adults. The more a mother was concerned about her daughter's weight as a child, and the more she restricted fatty food intake, the less the woman was satisfied with her current body image. Disordered eating of adult women was positively related to their mothers' restriction of their fatty food intake as children, and negatively related to the mothers' monitoring of their food intake as children. Combining the samples and subdividing them into four BMI intervals showed that the obese women were higher on all but one of the recalled maternal child feeding practices, as well as on disordered eating and body dissatisfaction. Age was found to be positively related to BMI and drive for thinness, but not to body dissatisfaction or disordered eating, with older women having higher BMI and more drive for thinness. Study 3 sampled adult men from the community and found that recalled maternal child feeding practices predicted adult BMI and disordered eating for men, as well as for women. Considerable sex differences were found for all study variables. Recollection of maternal child feeding practices may have a formative role in the development of body image, disordered eating, and BMI for men and women, even into adulthood.     

An evaluation of parent preference for prompting procedures

Parent participation in intervention can enhance intervention efficacy and promote generalization of skills across settings. Thus, parents should be trained to implement behavioral interventions. The purpose of the current investigation was to evaluate parent preference for and acceptability of 3 commonly used prompting procedures. We trained parents of children with disabilities to use 3 empirically validated prompting strategies (i.e., least-to-most, most-to-least, and a progressive-prompt delay). Once the parent reached the mastery criteria with each prompting procedure, we evaluated his/her preference for each of the procedures using a concurrent-chains arrangement. We also measured treatment acceptability of all procedures throughout the study. All participants met the mastery criteria for each of the prompting procedures and showed a preference for least-to-most prompting. Results suggest parents' acceptability of procedures prior to training were different than posttraining/post-child practice. In addition, acceptability rating scores obtained at the end of the investigation corresponded to preference of intervention during the concurrent-chains arrangement. The results demonstrate the benefits of objective measures for studying preference for behavioral, skill-acquisition procedures.     

Use of a Side Deposit to Increase Consumption in Children with Food Refusal

Research has shown that nonremoval of the spoon and physical guidance procedures can be effective in treating active food refusal (e.g., head turning and spoon pushing) and increasing food consumption. These procedures alone may not be effective in treating more passive food refusal (e.g., sitting still without opening mouth). We defined and evaluated the use of a side deposit procedure using a reversal design. Results showed that this procedure, when added to a treatment package including other components (e.g., nonremoval of the spoon and physical guidance), was effective in increasing food consumption and treating passive food refusal. Copyright © 2015 John Wiley & Sons, Ltd.     

Children Exposed to Marital Conflict Exhibit More Disordered Eating Behaviors: Child Emotional Insecurity and Anxiety as Mechanisms of Risk

Disordered eating in children is a major public health concern, as it is precursor to clinical eating disorders and obesity. However, little is known about the potential causes of child disordered eating. The current study examined marital conflict as a predictor of disordered eating in a sample of children aged 5–12 years, from the perspective of emotional security theory. Ninety five children and their parents in the Southeast United States participated in the study. We found that marital conflict was associated with higher levels of restrained eating, emotional eating and external eating behaviors controlling for demographics and parental feeding practices. Further, we examined the possible pathways between marital conflict and child disordered eating and found that marital conflict was related to greater child emotional insecurity about the family, which was associated with greater child anxiety, which were then related to disordered eating. In addition to serving as a secondary pathway linking emotional insecurity to child disordered eating, anxiety also significantly directly mediated the association between marital conflict and all three types of disordered eating: restrained eating, emotional eating and external eating in children. Next we examined if parental feeding practices (food monitoring, food restriction and parental pressure to eat) moderate the relation between marital conflict and child disordered eating. Parental pressure to eat was negatively associated with child disordered eating under higher marital conflict. The current study highlights the importance of marital conflict and child emotional security as precursors of child disordered eating.     

Functional Analysis and Treatment of Mealtime Problem Behavior for a Person with Developmental Disabilities

We conducted a functional analysis of problem behaviors (spitting and whining) during meals and tested an intervention based on that analysis. The participant was a 13-year-old young woman with severe mental retardation and cerebral palsy. She ate all food presented to her, and the hypotheses were tested that the problem behaviors were maintained either by contingent access to trainer attention or the pace of eating. An attention analysis examined the relationship between problem behavior and trainer attention during the meal. The effect of attention following problem behavior versus ignoring was inconclusive. An analysis of the effects of teacher paced eating, student paced eating (reinforce spoon grasping) and food presented for problem behavior was conducted next. Problem behavior rates were highest when access to food was made contingent on the performance of problem behavior and lowest when spoon grasping resulted in a bite of food. Following analysis, an intervention was designed to reduce the frequency of targeted problem behaviors during mealtime. Reinforcing spoon grasping and a 10s removal of food following problem behavior dramatically reduced spitting and whining during meals. The study provides a demonstration of an extended functional analysis and treatment of a complex behavior pattern.     

Continuation of training as a variable influencing the generalization of speech in a retarded child

Imitation and differential reinforcement were applied in training a speech-deficient retarded child 4 separate verbal answers to 4 “everyday” questions. Training was provided in only one setting with one experimenter. After the subject had acquired each answer-response in the training situation, probes for stimulus generalization were given by both the trainer and nontrainers. These probes tested the usage of both trained and nontrained question-answering responses under nontraining conditions. Use of the separately trained responses in nontraining contexts increased as training continued beyond the established learning criteria. A concurrent reinforcement procedure for all 4 answerresponses increased the overall generalization effects across individuals and settings; the use of differential reinforcement of nonverbal responses in the training setting decreased the overall generalization effects.     

THE TIMEOUT RIBBON: A NONEXCLUSIONARY TIMEOUT PROCEDURE1

Recently, the use of timeout rooms has been questioned by various agencies, and some have adopted policies that prohibit or greatly restrict exclusionary timeout. The present study developed a timeout procedure that did not require removal of the misbehaver from the learning environment. The procedure was applied to the disruptive behaviors of five severely retarded children in an institutional special-education classroom. An observer prompted all teacher behaviors related to the procedures to assure their precise implementation. After baseline, a reinforcement-only condition was implemented. Each child was given a different colored ribbon to wear as a tie and received edibles and praise every few minutes for good behavior and for wearing the ribbon. When timeout was added, a child's ribbon was removed for any instance of misbehavior and teacher attention and participation in activities ceased for three minutes or until the misbehavior stopped. Reinforcement continued at other times for appropriate behavior. An ABCBC reversal design was used to demonstrate control of the behavior by the conditions applied. On average, the children misbehaved 42% and 32% of the time during the baseline and reinforcement conditions respectively but only 6% of the time during the timeout conditions. A followup probe during the new school year revealed that the teacher was able to conduct the procedure independently and that the children's disruptive behaviors were maintained at low levels. The practicality and acceptability of the procedure were supported further by the successful implementation of the procedure by a teacher in another state and by responses to a questionnaire given to 40 mental health professionals. The ribbon procedure appears to be a viable form of timeout, provided that disruptive behaviors during timeout can be tolerated within the setting, or a backup procedure such as exclusionary timeout is available when needed.     

Training profoundly retarded children to stop crawling

Many profoundly retarded children continue to crawl even though they can walk. Crawling and walking were viewed as two alternative response modes, both reinforced by movement. Children choose the one mode that is easier and faster for them. A training program was designed to increase the ease and speed of walking relative to that of crawling, and consisted of restraint-for-crawling and priming-of-walking. With the program, four retarded children reduced crawling and began to walk instead. When training was discontinued, two children with moderate walking impairment continued to walk rather than crawl. Two children with severe impairment of walking, however, required the occasional use of the restraint procedure to maintain walking as the dominant mode of locomotion. The program was easily administered, required little time, and was effective for all four children.     

Adverse effects of differential parental attention

In two independent parent training projects (Kansas and Mississippi), mothers of deviant young children were observed to follow almost all child behaviors with attention. The mothers were then trained to use differential attention procedures to increase their child's appropriate behaviors and to decrease deviant behaviors. Contrary to expectations, the differential attention procedure produced substantial increases in deviant behavior for four of the children. This adverse effect was maintained over many sessions and was replicated in single organism, reversal designs. A fifth child showed no change. A sixth child showed some improvement. However, this effect was not recovered in a second application of differential attention, and the child became worse. The results underline the importance of subject generality in applied behavior analysis and strongly suggest that service programs using operant techniques must carefully evaluate their effects on behavior.     

The Effects of Warned Versus Unwarned Time-Out Procedures on Child Noncompliance

Mothers of twenty-four noncompliant, clinic-referred, preschool children were trained to use either a warned or unwarned time-out procedure in a clinic analog setting to suppress child noncompliance to commands. Warnings respecified the command to be followed and labeled the time-out procedures were equally effective at increasing child compliance. However, warned time-out procedures were associated with fewer actual time-outs than unwarned time-out procedures. The potential benefits of warned time-out procedures are discussed and future research needs are indicated.     

The rate and amount of food intake as determinants of vomiting

Vomiting of nonmedical origin by retarded persons has been found to be greatly influenced by reinforcement procedures. To explicate the possible influence of the rate and amount of food intake, a satiation procedure and a spaced-eating procedure were provided to three profoundly retarded adults with this problem. Vomiting was found to double or triple after satiation for each subject, and to decrease during spaced eating for each subject; the decrease was especially great for the two subjects who learned to eat most slowly after extended spaced eating training. These results suggest that vomiting is caused in large part by excessive stomach loading and can be effectively treated by reducing the eating rate and/or amount of food intake. This generalization may also apply to infants and to the bulimic binge-purge cycle of nonretarded adults.