Acceptability of positive and reductive behavioral interventions: Factors that influence teachers'' decisions

Treatment acceptability refers to individuals' judgments as to whether psychological treatment procedures are appropriate, fair, and reasonable for a given problem. In the present two-experiment study, experienced teachers' ratings of acceptability for positive (i.e., praise, home-based reinforcement, and token economy) and reductive (i.e., ignoring, response-cost lottery, and seclusion time-out) behavioral interventions were investigated. Using the Intervention Rating Profile (IRP) and a case study methodology to manipulate variables of intervention complexity and problem behavior severity, it was established that (a) teachers' acceptability ratings of both positive and reductive interventions varied with the severity of a target behavior, (b) the complexity of an intervention influenced teachers' ratings of acceptability, less complex or time-consuming interventions being rated generally more acceptable, and (c) mean acceptability ratings were significantly more favorable for positive than reductive treatments. These findings are discussed in the context of previous acceptability research and future investigations.     

College students' acceptance of potential treatments for ADHD

The purpose of the current study was to investigate the influence that the professional occupation of a consultant making a treatment recommendation may have on college students' (82 women and 52 men) acceptance of a proposed treatment for a child displaying characteristics of Attention Deficit/Hyperactivity Disorder. Consultants were special education teachers, school psychologists, or physicians. The study also examined college students' ratings of treatment acceptability associated with three frequently implemented interventions of either nonspecific medication, token economy with response cost, or time-out for children with characteristics of Attention Deficit/Hyperactivity Disorder. Analysis indicated college students found a token economy intervention was the least acceptable recommendation by a physician.     

Consumers' and clients' pretreatment acceptability ratings of classroom group contingencies

Group contingencies are popular with teachers and have been demonstrated to be effective for managing children's classroom behavior. Children's views of the acceptability of such techniques, however, have not been assessed systematically and may have important consequences for long-term treatment effectiveness. In addition, little is known about psychologists' sense of the acceptability of such techniques. The present analog study investigated fifth graders', teachers', and school psychologists' assessment of the acceptability of three types of group contingencies (dependent, independent, and interdependent) that entail a consequence of positive reinforcement for appropriate behavior. Variables of treatment type, sex of rater, and the severity of a hypothetical classroom problem were examined to determine their influence on intervention acceptability scores on a child's and an adult's version of the Intervention Rating Profile. Fifth graders rated all three types of group contingencies mildly acceptable. Teachers and school psychologists rated the dependent form of the group contingency unacceptable, and the independent and interdependent forms acceptable.     

Effects of a Perseverative Interest-Based Token Economy on Challenging and On-Task Behavior in a Child with Autism

We compared the effects of a token economy intervention that either did or did not include the perseverative interests of a 7-year-old boy with autism. An alternating treatment design revealed that the perseverative interest-based tokens were more effective at decreasing challenging behavior and increasing on-task behavior than tokens absent the perseverative interest during an early literacy activity. The beneficial effects were then replicated in the child’s classroom. The results suggest that perseverative interest-based tokens might enhance the effectiveness of interventions based on token economies.     

Acceptability of aversive procedures and medication as treatment alternatives for deviant child behavior

The present investigation evaluated the acceptability of alternative treatments for deviant child behavior. Clinical cases of children who displayed severe behavioral problems at home and at school were described along with three different treatments. The treatments, time-out from reinforcement, locked seclusion, and medication, were rated by psychiatric inpatient children and parents in a 3 × 3 replicated Latin-square design. The investigation also evaluated whether acceptability ratings were influenced by the clinical effectiveness of treatment in altering behavior. Although children and parents did not differ overall in acceptability ratings, they differed in their ranking of different treatments. Children viewed medication as the most acceptable treatment, whereas parents viewed time out as the most acceptable treatment. For both children and parents, treatments described as producing marked effects were rated as more acceptable than treatments producing weaker effects. The results indicated that disturbed children and their parents can readily distinguish the acceptability of alternative treatments. The implications of treatment acceptability for clinical applications of treatment are discussed.Completion of this investigation was facilitated by a Research Scientist Development Award (MH00353) and a grant (MH35408) from the National Institute of Mental Health. The author is grateful for the assistance of the clinical research team of the Child Psychiatric Treatment Service, especially that of Irene Heidish, M.A., who assisted with the data analyses.     

Using consumer preference information to increase the reach and impact of media-based parenting interventions in a public health approach to parenting support

Within a public health approach to improving parenting, the mass media offer a potentially more efficient and affordable format for directly reaching a large number of parents with evidence-based parenting information than do traditional approaches to parenting interventions that require delivery by a practitioner. Little is known, however, about factors associated with parents' interest in and willingness to watch video messages about parenting. Knowledge of consumer preferences could inform the effective design of media interventions to maximize parental engagement in the parenting messages. This study examined parents' preferred formats for receiving parenting information, as well as family sociodemographic and child behavior factors that predict parents' ratings of acceptability of a media-based parenting intervention. An ethnically diverse sample of 162 parents of children ages 3-6 years reported their preferences for various delivery formats for parenting information and provided feedback on a prototype episode of a video-format parenting program based on the Triple P Positive Parenting Program. Parents reported the strongest preference for self-administered delivery formats such as television, online programs, and written materials; the least preferred formats were home visits, therapists, and multiweek parenting groups. Parents' ratings of engagement, watchability, and realism of the prototype parenting episode were quite strong. Parents whose children exhibited clinical levels of problem behaviors rated the episode as more watchable, engaging, and realistic. Mothers also rated the episodes as more engaging and realistic than did fathers. Lower income marginally predicted higher watchability ratings. Minority status and expectations of future problems did not predict acceptability ratings. The results suggest that the episode had broad appeal across groups.     

Factor structure of the Treatment Evaluation Inventory: Implications for measurement of treatment acceptability

The Treatment Evaluation Inventory (TEI), a frequently used measure of treatment acceptability, was used by 164 undergraduates to rate the acceptability of each of the following treatments: differential reinforcement of other behavior, exclusionary time-out, overcorrection, medical restraint, contingent electric shock, and physical restraint. TEI ratings of each treatment type were grouped separately, variance-covariance matrices were formed and compared, and data were subjected to factor analysis. The results indicated that the factor structure of the TEI varied with the treatment it was used to evaluate. Item analysis of the TEI indicated a high degree of internal consistency, although item-total correlations varied between rated treatments. The findings suggest that although the TEI is a reliable instrument, sensitive assessment of the treatment acceptability construct probably requires multidimensional measurement.     

Understanding teachers' perceptions of the motor difficulties of children with developmental coordination disorder (DCD)

Background. Children with developmental coordination disorder (DCD) are often identified by classroom teachers and the identification process relies heavily on teachers' perceptions. The literature would suggest that teachers' perceptions may be influenced by a child's gender, behaviour and the type of motor problem they demonstrate. To date, the influence of these factors on teachers' perceptions of children with DCD has not been empirically tested. Aim. This study investigated whether child gender, behaviour and type of motor problem influenced teachers' ratings of concern and importance of intervening for children with motor difficulties. Sample. One hundred and forty‐seven teachers of children from 6 to 9 years of age participated in this study. Method. Hypothetical case scenarios were developed that experimentally manipulated the factors of child gender (male/female), behaviour (disruptive/non‐disruptive) and type of motor problem (fine motor/gross motor). Teachers were given two case scenarios of the same gender (that varied by behaviour) and rated: (a) their degree of concern about children's motor problems and (b) how important they thought it was for the child to receive intervention for that problem. Results. The effect of child gender on teachers' perceptions depends upon the type of motor problem. While child behaviour had a marginal influence on teachers' perceptions, interestingly, teachers appeared to recognize motor problems only in the absence of disruptive behaviour. The type of motor problem demonstrated also influenced teachers' perceptions. Conclusion. This study provides preliminary insight into factors that influence teachers' perceptions of children with DCD with clear implications for the classroom identification of children with DCD.     

Treatment acceptability among mexican american parents

There is a void in the literature with regard to Hispanic parents' views about common interventions for children with behavior problems. The purpose of this study was to examine the treatment acceptability of child management techniques in a Mexican American sample. Parents' acculturation was also examined to determine if it would account for differences in treatment acceptability. Mexican American parents found response cost, a punishment-based technique, more acceptable than positive reinforcement-based techniques (e.g., differential attention). Results suggest that Mexican American parents' acculturation has little impact on acceptability of child management interventions. No association was found between mothers' acculturation and treatment acceptability. However, more acculturated Mexican American fathers viewed token economy as more acceptable than less acculturated fathers. Results are discussed in the context of clinical work and research with Mexican Americans.     

Treatment Acceptability

The present study assessed mothers' and fathers' acceptance of six interventions frequently used to alter children's problem behavior. This is the first study to assess fathers' perceptions of behavioral interventions for children. Positive reinforcement, response cost, medication, room timeout, chair timeout and spanking were rated by parents using the Treatment Evaluation Inventory (TEI). In addition, parents' perceptions of their children's behavior and own marital adjustment were measured using standardized checklists. Parents' acceptability ratings differed significantly across treatment conditions depending on parent gender, child behavior problems, and marital adjustment. Treatment preference order was equivalent for all groups.     

Bully Busters: A Psychoeducational Intervention for Reducing Bullying Behavior in Middle School Students

The present study examined the effectiveness of a bully prevention program counselors may use to modify teachers' knowledge/use of bullying intervention skills, teachers' self‐efficacy, and students' classroom bullying behaviors. Participants attended 3 training sessions and participated on a support team. The findings indicated that the treatment program effectively increased teachers' knowledge/use of intervention skills, teachers' personal self‐efficacy, and self‐efficacy related to working with specific types of children and reduced classroom bullying as measured by disciplinary referrals.     

SOCIOMETRIC AND DISRUPTIVE BEHAVIOR AS A FUNCTION OF FOUR TYPES OF TOKEN REINFORCEMENT PROGRAMS1

Children in a first-grade classroom were divided into four groups. Baseline measures of disruptive classroom behavior were taken on a well-behaved and disruptive child in each group. Following baseline, four types of token economies were simultaneously introduced and rotated every 10 days within a Latin Square design. The token economies were: (1) individual reinforcement determined by individual performance; (2) group reinforcement determined by the behavior of the most disruptive child; (3) group reinforcement determined by the behavior of the least disruptive child; (4) group reinforcement determined by the behavior of a randomly chosen child. The token economies were compared on their effectiveness in changing target behavior, preference by the targets, ease of use, and cost. Additionally, sociometric responses were taken on questions of responsibility, friendship, and funniness. Results showed a significant decrease of inappropriate behavior for the disruptive children and no difference between the effectiveness of the four types of token economies in producing behavior change. However, there were other differences that indicated that the system in which group reinforcement was determined by a randomly selected child would be desirable for most teachers. Results also showed changes in the sociometric status of the disruptive children. As predicted, disruptive children were rated as more responsible when they were in the group reinforcement determined by the most disruptive child in the group token economy. Using behavior modification techniques indirectly to change sociometric status is suggested as offering a new potential technique for behavior change agents.     

Outpatient Treatment of Pica in a Developmentally Delayed Child

A multiple baseline design was employed to evaluate the effectiveness of over correction and differential reinforcement to reduce pica in a 4-year-old developmentally delayed boy. Parents and classroom staff were trained as mediators of treatment by a behavioral consultant. Despite the effectiveness of the procedure, treatment mediators terminated intervention, therefore, an alternative program consisting of positive reinforcement and time-out was implemented according to a reversal design. Pica was measured via direct observation and parental monitoring during a variety of activities, including fine motor tasks, gross motor play, and independent play. Results indicated clear reductions in pica as a result of both interventions. Implications for future clinical practice and research are discussed.     

Maternal Treatment Acceptability and Preference of Room Time-Out and Deferred Time-Out Escape Contingencies

ABSTRACT

Maternal preference and acceptability were examined for two methods of addressing time-out escape behavior: room time-out (RTO) and deferred time-out (DTO). With respect to preference, mothers were split about evenly. Spanking frequency and previous effectiveness using privilege removal were associated with preference for DTO while previous effectiveness using RTO was associated with preference for RTO. Child age was negatively associated with acceptability for either treatment and lax parenting style was negatively associated with acceptability for DTO. Results suggest that DTO could provide an alternative escape contingency for mothers who spank their children or who have been unsuccessful using RTO.     

In-vivo rating of treatment acceptability by children: Effects of probability instruction on student's spelling performance under group contingency conditions

In prior studies, Shapiro and Goldberg (1986, 1990) failed to find a relationship between in-vivo ratings by children of treatment acceptability and treatment effectiveness. These studies involved the use of interdependent and dependent group contingencies designed to improve the spelling performance of sixth grade students. To investigate whether the failure to link treatment acceptability and effectiveness may have been due to the subjects' inability to understand the differences in treatment conditions, this study utilized a pre-intervention training package to enhance salient differences between two types of group contingencies. Results of this study showed that both group contingencies were successful at improving the spelling performance of students, particularly the poorer spellers. Prior to treatment, students preferred the interdependent condition, with the higher-achieving students expressing the strongest preference. After implementation of the training package, both conditions were now rated as equally acceptable. Pre- and post-test acceptability ratings of each condition tended to be significantly correlated but correlations between acceptability ratings and treatment effectiveness were negligible at all points in the study. Limitations of the present study and suggestions for further research are discussed.