A reinforcement plus interruption method of eliminating behavioral stereotypy of profoundly retarded persons

Stereotyped responses have been shown to be eliminated by an overcorrection-reinforcement program. The present study evaluated response-interruption as an alternative to the overcorrection component with seven profoundly retarded adults. During the baseline praise condition, stereotypy occurred during 66% of the observations for the seven profoundly retarded adults but decreased to less than one response per half hour in a mean of two sessions of individual training. In the subsequent class situation, stereotypy was reduced to less than 5% on the first day of class, to less than 1% by the fourth day and less than one stereotypy per hour after the third day. The interruption method seems preferable to postural overcorrection because of its apparent and relative nonaversiveness.     

Dry-bed training: rapid elimination of childhood enuresis

Enuresis has been treated with moderate effectiveness by the urine-alarm method which requires many weeks of training. The present procedure used a urine-alarm apparatus but added such features as training in inhibiting urination, positive reinforcement for correct urinations, training in rapid awakening, increased fluid intake, increased social motivation to be nonenuretic, self-correction of accidents, and practice in toileting. After one all-night training session, the 24 enuretic children averaged only two bedwettings before achieving fourteen consecutive dry nights and had no major relapses. Little or no reduction in bedwetting occurred within the first two weeks for matched-control enuretics who were given the standard urine-alarm training. The results of a control-procedure showed that the new procedure did not involve Pavlovian conditioning. The new method appears to be a more rapid, effective and different type of treatment for enuresis.     

Required relaxation: a method of inhibiting agitative-disruptive behavior of retardates

Institutionalized retardates frequently exhibit agitative-disruptive behavior. Recent experiments have shown that overcorrective training in specific types of behavior can inhibit inappropriate behavior. A procedure was developed in which overcorrective practice in relaxation was given to each of eight adult retardates for their disruptions. The agitated resident was required to spend a fixed period of time in relaxation in his own bed upon each occurrence of agitation. This overcorrective relaxation resulted in a rapid, enduring and almost complete reduction in such behavior as self-injury, threats, physical aggression, screaming, crying, cursing and tantrums. Ward attendants strongly preferred the required relaxation procedure to the time-out technique and other inhibition procedures they had used. The procedure appears to be about as effective as alternative techniques and to have the advantages of ease of implementation and acceptability by ward staff and retardates as a ‘reasonable’ reaction to agitation.     

Eliminating nail-biting by the habit reversal procedure

Fingernail-biting is prevalent among children and adults alike. About 43% of children bite their nails during the puberty ages (Wechsler, 1931); 25% of college students are nail-biters (Coleman and McCalley, 1948), and 10% of adults bite their nails (Pennington, 1945).A variety of treatments including negative practice, operant procedures and psychotherapy have been used in treating nail-biting but no single treatment has been generally effective in eliminating nail-biting. Smith (1957) using negative practice reported that 21 of 57 (39%) of his nail-biting clients were cured. 9 improved and 27 (47%) were unimproved. Bucher (1968) reported that 13 of 20 (65%) college students stopped nail-biting by using a self-administered operant shock procedure. However, he reported many relapses after the withdrawal of shock for nail-biting. No evaluation of psychoanalytic treatment for nail-biting appears to have been made.     

A rapid method of eliminating stuttering by a regulated breathing approach

The Habit Reversal Procedure for eliminating nervous habits was applied to the problem of stuttering. In the new procedure the speaker interrupted his speech at moments of actual or anticipated stuttering and at natural pause points, and resumed speaking immediately after breathing deeply during the pause. In addition to this regularized pausing and breathing, the program included other factors such as formulation of one's thoughts prior to speaking, identification of stutter-prone situations, identification of mannerisms associated with stuttering, speaking for short durations when tense or nervous, daily breathing exercises, relaxation procedures for anxiety, immediate display of improved speaking, and enlisting family support for progress. Fourteen stutterers were given training in the program during a single counseling session of about two hours duration. The next day, the average number of stuttering episodes decreased by 94 per cent, by 97 per cent at the end of one month, and by 99 per cent during the extended follow-up. Each of the clients was improved by at least 93 per cent. The new procedure appears to be more rapid and effective than alternative procedures.     

Habit reversal vs. negative practice treatment of nailbiting

A previous study of the habit reversal treatment of nailbiting was extended by using more subjects (97) and a comparison with an alternative method (negative practice). Negative practice reduced nailbiting episodes by about 60% whereas habit reversal reduced nailbiting episodes by about 99% throughout the 5-month follow-up.     

Evaluation of a parent's manual for training enuretic children

An operant method of training enuretic children had previously been evaluated by direct training of the child and parent. A manual describing the method was used by 13 parents in the present study with no professional assistance. Bedwetting was reduced from its pre-treatment level of 68% of the nights to 27% during the first week. 10% during the third month and 7% the sixth month. These results closely approximated those obtained previously with direct training.     

Follow-up on welfare benefits received by Job Club clients

A follow-up was made of the welfare payments received by AFDC clients who had received job-finding counseling. At the 6th-month follow-up, welfare payments had been reduced by about one-half for the Job Club clients vs 15% for the control group.     

Interaction-priming: a method of reinstating patient-family relationships

The probability of successful discharge for long-term mental hospital patients has been found to depend on strong family and social relationships (Chapman, Day and Burstein, 1961 ; Chase and Silverman, 1943; Paul, 1969; Meichenbaum, 1966; Ullmann, 1967). Yet, long-term institutionalization often results in the weakening of these relationships. These findings suggest that successful discharge would be facilitated by procedures that maintained or restored these social relationships. The present study attempted to develop such a procedure, based on the principles of Response Priming (O'Brien, Azrin and Henson, 1969) and Reinforcer Sampling (Ayllon and Azrin, 1968). Response Priming views complex behavior such as family visits as chains of responses and states that the probability of the completion of the chain (visit) increases during later portions of the chain. The present procedure applies this principle by not requiring visitors to engage in those behaviors remote from the completion of the chain, but rather, by making visits available to them at the terminal portion of the chain. This was done by not requiring visitors to come to the hospital to visit the patient, but rather, by directly transporting the patient to the visitor's home. The Reinforcer Sampling rationale (Ayllon and Azrin, 1968) suggests that future visits would likely increase if visits were reinforcing to the family and the patient. Thus, the patients' behavior was analyzed during visits in the families' homes. Between visits, instruction was given to the patients for improving the reinforcing quality of these types of behavior for subsequent visits. The rationale was that the Response Priming Procedure would produce visits and the Reinforcer Sampling Procedure would show the families and patients that being together was enjoyable. The relationships should, therefore, be maintained and, hopefully, thereby increase the likelihood of successful discharge for the long-term hospitalized patients.     

Control of selective echolalia via the instatement of a general alternative response

Treatment for echolalic responding has been limited to the training of a small number of correct responses and limited stimulus verbalizations by the experimenter, leaving the possibility that the introduction of novel stimuli could result in the reoccurrence of echolalia. In the present study an 11-year-old severely retarded male's echolalic responding to questions that he could not answer correctly was controlled by instating a general alternative response, “I don't know.” The subject continued to respond correctly to questions that he could answer. indicating that the general alternative response had been appropriately discriminated. A Baseline. Treatment. DRO. Treatment design indicated that the subject's echolalic responding, as well as the appropriate use of the general alternative response, was under experimental control. Generalization of the experimental results to the subject's regular day-care setting was accomplished by having the staff verbally punish all echolalic responses and then restate the question to the subject until a non-echolalic answer had been emitted. Implications of these findings and suggestions for combining previous treatment procedures for echolalia with the general alternative response procedure were offered.     

Tic-Tac-Toe performance as a function of maturational level of retarded adolescents and nonretarded children

Two groups of retarded adolescents, differing from each other primarily in IQ (and mental age), were compared with two groups of nonretarded children, differing from each other in chronological age (and mental age), on a modified tic-tac-toe game. The mental ages of the retarded and nonretarded groups were approximately the same. It was found that the slope of performance improvement with increasing maturational level was the same for both subject groups, but the performance of the retarded adolescents was approximately 1.5 years behind mental age expectations, as derived from the performance levels of the normal children. These findings support previous suggestions of a major retardate deficit in tasks requiring logical foresight.     

Conditioned inhibition of fear: Evidence for a competing response mechanism

In two experiments, inhibitory conditioning was attempted by presenting a discrete CS in a neutral stimulus environment shortly following the termination of either shock (Experiment 1) or a second discrete CS which had been paired in a forward manner with shock (Experiment 2). Evidence of successful inhibitory conditioning was mixed in Experiment 1, where the properties of the CS were assessed within an escape-from-fear procedure. Postresponse presentations of the CS enhanced performance, whereas the presentation of the CS prior to responding did not have the expected degrading effect on performance. In Experiment 2, the inhibitory properties of the CS were assessed by combining this stimulus with an excitatory CS and presenting the compound to rats engaged in a water-reinforced licking response. Less response suppression was found in reaction to this compound relative to three separate comparison conditions, thus witnessing the success of the inhibitory-conditioning procedure used. The common assumption that inhibitory conditioning results from the nonreinforcement of a CS in a situation where reinforcement is expected, i.e., one which contains previously reinforced cues, is not supported by these data, for no previously reinforced cues were simultaneously presented with the CS during inhibitory training. The data are in agreement with a conditioned antagonistic-response interpretation of inhibitory conditioning.