Further evaluation of latency measures in the assessment and treatment of severe self‐injurious behavior

Recent research has demonstrated the utility of latency measures during the functional analysis of problem behavior; however, few studies have evaluated the utility of latency measures during subsequent treatment analyses. The current study seeks to extend the literature on the use of latency measures during the treatment of severe self‐injurious behavior (SIB). Following a latency‐based functional analysis, a treatment analysis was conducted using a hybrid procedure in which baseline sessions were terminated following the first instance of SIB, and test sessions ended after a fixed length of time. Latency to SIB was compared across conditions, whereas latency and rate measures for both SIB and functional communication responses were compared for the functional communication training condition. Results suggest that latency measures may be too sensitive during treatment analyses and that it is beneficial to use a hybrid procedure that allows for both latency and rate comparisons.     

Effects of hypnosis and imagery training on naming behavior in aphasia

The effects of hypnosis and imagery training on the naming behavior of three subjects with Broca's aphasia were investigated using a multiple baseline design across subjects. Treatment consisted of the induction of hypnosis, followed by guided imagery focused on the physical and functional attributes of stimulus objects. Measures of naming ability on both trained and untrained items were taken at baseline, after every training session, and a few hours after training each day. Measures were also taken of imagery ability, hypnotic susceptibility, and psychological state. Results indicated that treatment facilitated improvement in naming ability, over baseline level, for two subjects. In the case of the third subject, the verbal label was incorporated into the imagery procedure following 10 training sessions. Subsequently, this subject's naming behavior improved over baseline level. The results are discussed in terms of current theory and research in neuropsychology and cognitive psychology.     

Brief report: Non-intrusive operant analysis of aggressive behavior in persons with mental retardation

A procedure for operant analysis of aggressive behavior was derived from multi-element assessment methods that have been previously applied to both self-injurious and stereotypic responding. Analog sessions included No Interaction Baseline, Social Disapproval, Demand, Social Reinforcement, and Discriminated Extinction conditions, repeatedly presented within a multi-element design. Three men with differing severity of mental retardation, communicative deficits and aggressive behavior were exposed to multiple brief analog sessions embedded within their normal meal-time routines in group home settings. Mean frequencies of aggressive behavior and concurrent eating indicate that, while aggressive behavior was negatively reinforced in all three participants, both social and non-social contingencies were also prominent. The same contingencies which have been demonstrated to maintain self-injury and stereotypic behavior can therefore also maintain aggression. Results suggest the feasibility of conducting relatively non-intrusive analog assessments in community residences, and support the-extension of functional analysis across differing classes of aberrant behavior.     

Effects of variable-interval value and amount of training on stimulus generalization.

In Experiment 1 pigeons pecked a key that was illuminated with a 501-nm light and obtained food by doing so according to a variable-interval (VI) schedule of reinforcement, the mean value of which differed across groups: either 30 s, 120 s, or 240 s. The pigeons in all three groups were trained for 10 50-min sessions. Generalization testing was conducted in extinction with different wavelengths of light. Absolute and relative generalization gradients were similar in shape for the three groups. Experiment 2 was a systematic replication of Experiment 1 using line orientation as the stimulus dimension and a mean VI value of either 30 s or 240 s. Again, gradients of generalization were similar for the two groups. In Experiment 3 pigeons pecked a key that was illuminated with a 501-nm light and obtained food reinforcers according to either a VI 30-s or a 240-s schedule. Training continued until response rates stabilized (> 30 sessions). For subjects trained with the 30-s schedule, generalization gradients were virtually identical regardless of whether training was for 10 sessions (Experiment 1) or until response rates stabilized. For subjects trained with the VI 240-s schedule, absolute generalization gradients for subjects trained to stability were displaced upward relative to gradients for subjects trained for only 10 sessions (Experiment 1), and relative generalization gradients were slightly flatter. These results indicate that the shape of a generalization gradient does not necessarily depend on the rate of reinforcement during 10-session single-stimulus training but that the effects of prolonged training on stimulus generalization may be schedule dependent.     

The effects of principal-implemented techniques on the behavior of pupils

Three investigations were conducted on the effects of various procedures initiated by a principal on the behavior of elementary school children. Seventy nine children including kindergarten, first, third, and fifth graders served as subjects. In Experiment I, when three chronically absent children attended school, the principal entered their classrooms and praised them for being present. In Experiment II, three low-achieving subjects were sent to the principal's office to receive praise contingent on meeting predetermined criteria in word-recognition and addition tutoring sessions. Experiment III assessed the effects that a procedure implemented by a principal had on the academic functioning of 74 third graders. Twice weekly in two classrooms the principal recognized both improving students and the highest performing students for their work on addition study sheets. In all three experiments, the target behaviors increased when the principal applied the treatment contingencies. The application of multiple baseline designs revealed a functional relationship between the children's behavior and the procedures implemented by the principal. Since the study was carried out in an overcrowded innercity public school, it was suggested that the treatment procedures might be widely applicable.     

An experimental analysis of peer social initiations on the behavior of withdrawn preschool children: Some training and generalization effects

In this study, positive social initiations by an age-peer was evaluated as an intervention for isolate preschool children in training and generalization sessions. During baseline, the confederate made few social approaches to the target subjects. The confederate greatly increased his rate of positive social initations during the first intervention, decreased social approaches during a second baseline, and increased social approaches again in a second intervention phase. Increases in confederate initiations resulted in an immediate acceleration in the frequency of subjects' positive social behavior during training sessions. Additionally, for two of the three subjects, positive social behaviors were also observed to increase during generalization sessions. The results suggest that (a) peers may be trained successfully to set the occasion for positive social behaviors by withdrawn classmates, (b) increased social responding by withdrawn children in the presence of frequent peer social initiations may also generalize beyond the training setting, and (c) the magnitude of direct and generalization effects appears to be related to the entry-level repertoire of target children.     

Multiple sessions of systolic blood pressure biofeedback: Its effects on ability to control systolic pressure during training,after training,and its effects on pulse rate

Seventy-one normotensive subjects participated in four training sessions in which they were either (a) instructed to increase their blood pressure, (b) instructed to decrease their blood pressure, or (c) not instructed to change their blood pressure. The subjects either (a) were provided with biofeedback concerning systolic blood pressure or (b) were not provided with biofeedback concerning systolic blood pressure. After the last training session, subjects participated in a transfer session in which they were again instructed concerning changes in pressure but were not provided with biofeedback. Analyses conducted on data from the training and transfer sessions indicated that subjects who were instructed to increase pressure and given biofeedback to aid them showed higher pressure than subjects in other conditions and that there were no differences among those other conditions; that is, biofeedback was effective for teaching subjects to increase pressure but was not effective for teaching subjects to decrease pressure. Additional training sessions did not add to the effect achieved in the first training session. During training sessions, subjects who were instructed to increase pressure showed higher heart rates than subjects in other conditions. The results raise questions concerning the interpretation of earlier experiments that did not include no-treatment, instructions-only, and attention control conditions.     

SELF-INSTRUCTIONAL TRAINING TO INCREASE INDEPENDENT WORK PERFORMANCE IN PRESCHOOLERS

The generalized effects of self-instructional training on the classroom performance of three “impulsive” preschool children were investigated using a multiple-baseline design across subjects. Measures of child and teacher behavior in the classroom were obtained through direct observations during a daily independent work period. Self-instructional training followed Meichenbaum and Goodman's (1971) approach, except that training materials consisted of naturalistic task worksheets rather than psychometric test items and training sessions were of shorter duration. For all three children, self-instructional training resulted in increased levels of accuracy on worksheets in the classroom that were similar to those used in training. Results related to several supplementary measures were less clear; however, they suggested that rates of on-task behavior may also have improved, and that a mild classroom intervention further strengthened on-task rates and effected consistent work completion for all three children. The findings suggested that generalized increases in accuracy on classroom worksheets were related to the naturalistic format of the self-instructional training sessions. The level of teacher attention was controlled to rule out its effect on changes in child behavior.     

Heterogeneity of biofeedback training effects in spasmodic torticollis: a single-case approach

Data from 184 biofeedback sessions are presented, in which 10 subjects with spasmodic torticollis had been trained to reduce pathologic activity in the hypertrophied sternocleidomastoid muscle. Each session was conducted as a single case experiment with nine successive trials. Attempts were made to distinguish motor learning processes which can be elicited independently from the biofeedback-condition from the effects of specific biofeedback information. Results showed dramatic decreases of muscle activity under biofeedback. Contrary to expectation, action potentials did not decrease across a course of 14 training sessions. Instead, effects were exhibited in an all-or-none fashion early in the training. Single-case ARIMA intervention analysis has shown that in 59% of the sessions EMG decreases demonstrated under biofeedback could be elicited prior to biofeedback in a condition of instructed control. Case studies revealed complex interactions of instructed control, specific biofeedback effects, unspecific effects of the biofeedback setting, and cognitive processes. Effects obtained within experimental sessions varied highly between subjects. Results are discussed in terms of newer concepts of basal ganglia dysfunction, and conclusions for the use of biofeedback paradigms in torticollis subjects are outlined.     

Training Public School Special Educators to Implement Two Functional Analysis Models

The purpose of this study was to investigate the efficacy and efficiency of a training package to teach public school special educators to conduct functional analyses of challenging behavior. Six public school educators were divided into two cohorts of three and were taught two models of functional analysis of challenging behavior: traditional and trial-based functional analysis. The effect of the training package on functional analysis implementation was evaluated using multiple-baseline designs across participants for each functional analysis model. The sequence of functional analysis models taught was counterbalanced across cohorts. Following the training package, all participants reached 100 % implementation fidelity during role-plays and classroom sessions with students, and maintained high fidelity at follow-up role-play sessions. Data on training duration, trials to criterion, and social validity revealed that trial-based functional analysis training had a shorter duration and was rated as the more favorable functional analysis model.     

The effect of couples training and partner co-operativeness in the behavioral treatment of obesity

To evaluate the influence of spouse co-operativeness and couples training in the treatment of obesity, 29 obese men and women were assigned to three experimental conditions: (1) Co-operative spouse-couples training: subjects attended all meetings with spouses. Spouses were trained in modeling, monitoring, and reinforcement techniques; (2) Co-operative spouse-subject alone: subjects attended meetings alone even though their partners had agreed to become involved in treatment; (3) Non-cooperative spouse: subjects had spouses refusing to participate in the program, and attended sessions alone. At the 3-month and 6-month maintenance assessments. subjects in the spouse training condition lost significantly more weight than subjects in the other two conditions. Weight losses compared favorably to those of any controlled study with subjects in the couples training group averaging nearly 30 lbs lost after 8$\text{1}\text{2}$ months of treatment. In the absence of spouse training, subjects with co-operative spouses did no better than subjects with non-co-operative spouses. The findings suggest that spouse training may have a potent facilitative effect in weight reduction, and that this effect may promote long-term maintenance of weight loss.     

The effects of context change on long-term habituation of the orienting response in humans

Four experiments examined the effects of context change (Experiments 1-3) and context extinction (Experiment 4) on long-term habituation of the skin conductance response. In all experiments, subjects received 15 presentations of a target stimulus in each of two sessions. In Experiment 1 (N=60) there was a 15-min interval between training and test sessions. This interval was extended to 24 hours in Experiments 2 (N=60) and 3 (N=60). The experimental treatment in each of these studies involved a change in context between the two training sessions. None of the experiments provided evidence of context dependency in measures of long-term habituation. In Experiment 4 (N=60) experimental subjects received a period of context extinction during which they remained in the laboratory environment between two series of habituation trials. Again, however, there was no evidence that long-term habituation was contextually mediated. Thus, the results fail uniformly to support theories that argue that long-term habituation is context-dependent.     

ASSESSING AND PROGRAMMING GENERALIZED BEHAVIORAL REDUCTION ACROSS MULTIPLE STIMULUS PARAMETERS

Generalization across three stimulus parameters was examined for 5 individuals whose self-injurious behavior was maintained by escape from task demands. Prior to treatment, three stimulus parameters (therapist, setting, and demands) were systematically varied across baseline sessions. These variables were held constant during treatment, which consisted of escape extinction. When treatment was completed, three novel stimulus parameters were probed. If the rate of self-injury was high during this probe, treatment was reimplemented with one new stimulus parameter (the other two were the same as in the original treatment condition). Following this second treatment, another probe with three novel stimuli was conducted. If the rate of self-injury was again high, treatment was implemented again while a second stimulus parameter was changed. This sequence continued until generalization was observed across the three parameters. Results showed idiosyncratic differences in generalization. The behavior of 2 subjects showed complete generalization during the first novel probe. A 3rd subject's behavior showed generalization following treatment across two stimulus parameters (setting and therapist). The behavior of the 2 remaining subjects showed a complete lack of generalization across the three parameters; both subjects required training for novelty by randomly varying the stimulus parameters for a substantial number of sessions.     

EMG biofeedback training, relaxation training, and placebo for the relief of chronic back pain

24 patients with chronic low back pain were randomly assigned to three treatment conditions: EMG biofeedback, relaxation training, and a placebo condition. Patients were seen for eight sessions and were evaluated before Session 1 and after Session 8. Eight analyses of covariance which were adjusted for age and pretest scores were computed on the final scores to find which variables could detect significant difference between treatments. Age was included as a covariate because the differences in age between conditions were significant. Four variables with significant and nearly significant differences were chosen for analysis. The second set of analyses identified the nature of the differences among the three conditions. These included a priori planned comparisons among conditions, and paired t tests. Relaxation-trained subjects were significantly superior to subjects in the placebo condition, in decreasing pain during the function test, increasing relaxation, and decreasing Upper Trapezius EMG. They were superior to EMG Biofeedback training in increasing reported activity. Both Relaxation and EMG trained subjects were able to reduce Upper Trapezius EMG by Session 8. Relaxation-trained subjects showed significant change on eight of the 14 possible comparisons for each treatment condition. EMG biofeedback training showed significant favorable results in only one condition; the placebo condition showed no significant results. Relaxation training gave better results in reducing EMG and pain, and in increasing relaxation and activity than either EMG biofeedback alone or a placebo condition.     

The effects of beta-noradrenergic receptor blockade on acquisition of eyeblink conditioning in 3-month-old F344 rats

There is evidence that blocking beta-noradrenergic receptors will cause deficits in some forms of learning. We investigated the effects of systemic injections of 1, 5, and 10 mg/kg doses of propranolol on acquisition of delay eyeblink conditioning in 3-month-old Fischer 344 rats. We presented a 3-kHz, 90-dB tone as a conditioning stimulus and a 6 psi airpuff as our unconditioned stimulus to freely moving rats. We monitored eyelid activity using EMG signals. The treatment subjects were injected with either propranolol or saline 0.5 h prior to daily training sessions. Two groups of control subjects, one receiving injections of saline and one receiving injections of 5 mg/kg propranolol, received daily training sessions with unpaired and randomized presentation of the tone and airpuff. Each daily training session for the treatment groups consisted of 27 paired training trials and 3 conditioned stimulus-alone training trials. Rats injected with saline vehicle or with 1 mg/kg propranolol achieved a 60% or better learned response rate within two training sessions. Rats injected with 5 or 10 mg/kg propranolol never achieved a response rate significantly different from animals that received unpaired, random presentations of the tone and airpuff stimuli. These results agree with prior studies from our lab that have shown a dose-dependent effect of beta-noradrenergic receptor blockade on learning in rabbit eyeblink conditioning as well as in a runway, motor learning paradigm. We believe that the beta-noradrenergic system plays an important role in learning and memory in more than one cerebellar-dependent learning paradigm.     

SOCIAL SKILLS TRAINING WITH CHILDREN: PROCEED WITH CAUTION

Three learning disabled children, selected on the basis of peer sociometric ratings and teacher referral, received social skills training. A group training procedure consisting of coaching, modeling, behavior rehearsal, and feedback was used to teach children the target behaviors of eye contact and appropriate verbal responses. A multiple baseline analysis across target behaviors was used to demonstrate treatment effectiveness on role-play scenes trained during treatment sessions. Duration of speech was measured as an untrained, corollary measure. The following measures were also obtained during baseline, posttreatment, and 1-mo follow-up for the experimental subjects and three control subjects: (a) performance on role-play scenes not trained during treatment sessions; (b) behavioral observations in a free play setting, and (c) sociometric ratings. In addition, the trained and untrained role-play scenes were administered by novel experimenters following treatment. The results indicated that socially unskilled, learning disabled children can be taught to respond appropriately to role-play situations. However, improved performance did not generalize to the natural school setting and treatment did not effect ratings of peer acceptance. The implications of these findings for future social skills training with children are discussed.     

ARTIFACTUAL EFFECTS OF SENSORY-INTEGRATIVE THERAPY ON SELF-INJURIOUS BEHAVIOR

Three individuals who exhibited self-injurious behavior (SIB) were exposed to sensory-integrative therapy. Prior to treatment, a functional analysis baseline was conducted to identify the motivational features of their SIB. One subject's SIB appeared to be an attention-getting response (maintained by positive reinforcement), which varied subsequently as a function of attention being either withheld or provided noncontingently during sensory-integration sessions. The 2nd subject displayed a pattern of responding suggestive of stereotypic SIB (maintained by automatic reinforcement), which paradoxically increased during sensory-integration sessions. The 3rd subject's SIB appeared to function as an escape response (maintained by negative reinforcement), and his behavior during sensory-integration sessions was similar to that observed during baseline sessions in which demands were not present. The SIB of all 3 subjects later was reduced when behavioral interventions were applied. The data presented raise questions about the active components of sensory-integrative therapy and the functional types of SIB for which it might be appropriate.     

The effects of videotape modeling on staff acquisition of functional analysis methodology

Lectures and two types of video modeling were compared to determine their relative effectiveness in training 3 staff members to conduct functional analysis sessions. Video modeling that contained a larger number of therapist exemplars resulted in mastery-level performance eight of the nine times it was introduced, whereas neither lectures nor partial video modeling produced significant improvements in performance. Results demonstrated that video modeling provided an effective training strategy but only when a wide range of exemplars of potential therapist behaviors were depicted in the videotape.     

The flexible application of a manualized treatment for PTSD symptoms and functional impairment related to the 9/11 World Trade Center attack

The purpose of this treatment effectiveness study was to evaluate the flexible application of a manualized cognitive behavioral treatment (CBT) for PTSD and related symptoms in survivors of the 9/11 terrorist attack on the World Trade Center. Treatment delivery ranged from 12 to 25 sessions; therapist experience ranged from no prior training to extensive training in CBT; and training and supervision of clinicians in the treatment manual was considerably less than that required in a randomized clinical trial (RCT). Paired t-tests demonstrated significant pre-post reductions in symptoms of PTSD and depression for the flexible application of the treatment. A benchmarking analysis revealed that the moderate-to-large effect sizes found for these variables were similar to those obtained in an RCT of the same treatment. Furthermore, effect sizes on measures of outcomes particularly relevant to this population of mass violence survivors such as functional impairment, use of alcohol and drugs to cope, and use of social support to cope, were also medium to large.     

Utilizing in-vivo feedback for caregiver training of pediatric feeding protocols

Researchers have used multicomponent behavioral skills training packages including written and verbal instructions, modeling, rehearsal, and feedback when teaching caregivers to implement pediatric feeding treatment protocols (e.g., Anderson & McMillan, 2001; Seiverling et al., 2012). Some investigators have shown that fewer behavioral skills training components may be necessary for effective training (e.g., Mueller et al., 2003; Pangborn et al., 2013). We examined the use of in-vivo feedback following written instructions to train caregivers to implement pediatric feeding treatment protocols using a multiple baseline design across 3 caregiver dyads. Correct implementation of the feeding treatment procedures was low during baseline (written instructions only), increased with only the addition of in-vivo feedback, and remained high during follow-up sessions for all caregivers. Results are discussed in terms of clinical implications and caregiver satisfaction.