Psychodynamic counselling with parents of children with developmental disabilities

A joint treatment of parents and child can be the treatment of choice when dealing with developmental disabilities. In our clinical experience, we have observed that psychoanalytically oriented support (developmental guidance), which involves the child and the parents together, answers the needs and addresses the difficult dynamics that are characteristic of developmental disabilities.     

Further evaluation of emerging speech in children with developmental disabilities: training verbal behavior

The conceptual basis for many effective language-training programs are based on Skinner's (1957) analysis of verbal behavior. Skinner described several elementary verbal operants including mands, tacts, intraverbals, and echoics. According to Skinner, responses that are the same topography may actually be functionally independent. Previous research has supported Skinner's assertion of functional independence (e.g., Hall & Sundberg, 1987; Lamarre & Holland, 1985), and some research has suggested that specific programming must be incorporated to achieve generalization across verbal operants (e.g., Sigafoos, Reichle, & Doss, 1990). The present study provides further analysis of the independence of verbal operants when teaching language to children with autism and other developmental disabilities. In the current study, 3 participants' vocal responses were first assessed as mands or tacts. Generalization for each verbal operant across alternate conditions was then assessed and subsequent training provided as needed. Results indicated that generalization across verbal operants occurred across some, but not all, vocal responses. These results are discussed relative to the functional independence of verbal operants as described by Skinner.     

An evaluation of video-prompting procedures via telehealth to teach first aid skills to children with intellectual and developmental disabilities

Unintentional injuries are one of the leading causes of morbidity and mortality among children with intellectual and developmental disabilities (IDD). First aid training involves teaching critical first aid skills, some of which are designed to treat unintentional injuries. To date, no study has (a) evaluated the effects of a video-prompting procedure to teach first aid skills to children with IDD or (b) attempted to teach these skills to children by using a telehealth delivery format. We used a concurrent multiple-baseline-across-skills design to evaluate the efficacy of a video-prompting procedure via telehealth to teach five children with IDD to perform first aid on themselves for insect stings, minor cuts, and minor burns under simulated conditions. For all participants, our procedure produced large improvements that maintained for a minimum of 4 weeks. Furthermore, the effects of the training generalized to novel confederates for all participants, and these effects maintained for a minimum of 4 weeks.     

Basic numerical skills in children with mathematics learning disabilities: a comparison of symbolic vs non-symbolic number magnitude processing

Forty-five children with mathematics learning disabilities, with and without comorbid reading disabilities, were compared to 45 normally achieving peers in tasks assessing basic numerical skills. Children with mathematics disabilities were only impaired when comparing Arabic digits (i.e., symbolic number magnitude) but not when comparing collections (i.e., non-symbolic number magnitude). Moreover, they automatically processed number magnitude when comparing the physical size of Arabic digits in an Stroop paradigm adapted for processing speed differences. Finally, no evidence was found for differential patterns of performance between MD and MD/RD children in these tasks. These findings suggest that children with mathematics learning disabilities have difficulty in accessing number magnitude from symbols rather than in processing numerosity per se.     

Discrimination of picture requests for missing items among young children with developmental disabilities

Two experiments were conducted to assess discrimination of picture requests for missing items among young children with developmental disabilities. In Experiment 1, three children were first taught to request one object when it was missing from a set of two related leisure items. In Experiment 2, two children were taught to request one object belonging to a set of three leisure items. In both studies the requesting response consisted of pointing to a photograph of the missing item. After acquisition of the initial request, discrimination of picture requests was assessed when the second item (Experiment 1) and second or third item (Experiment 2) was missing. Requests for the untrained items emerged in the presence of natural maintaining contingencies and in the absence of instructional prompts for all but the third child in Experiment 1. This child required continued intervention on the initial request. The results suggest that for some children a sequence of intervention and the programming of natural maintaining contingencies may prove effective in promoting the discrimination of picture requests for missing items among young children with developmental disabilities.     

Assessment of the functions of vocal behavior in children with developmental disabilities: a replication

Although experimental analysis methodologies have been useful for identifying the function of a wide variety of target behaviors (e.g., Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994), only recently have such procedures been applied to verbal operants (Lerman et al., 2005). In the current study, we conducted a systematic replication of the methodology developed by Lerman et al. Participants were 4 children who had been diagnosed with developmental disabilities and who engaged in limited vocal behavior. The function of vocal behavior was assessed by exposing target vocal responses to experimental analyses. Results showed that experimental analyses were generally useful for identifying the functions of vocal behavior across all participants.     

A review of error correction procedures during instruction for children with developmental disabilities

Error correction procedures are remedial strategies presented following an incorrect response that increases the probability that a correct response will occur in the future. Error correction is commonly used during skill acquisition programs for children with developmental disabilities; however, the specific strategy used may differ considerably. Recent comparative studies have examined the effect of numerous error correction procedures on the efficiency of acquisition for children with developmental disabilities. Despite considerable merit, minor procedural differences and unique terms for similar procedures likely affect comparisons across studies. Here, we clarify the procedures and findings of these studies and suggest areas of future research.     

Assessing the efficacy of pictorial preference assessments for children with developmental disabilities

Past research has demonstrated that pictorial preference assessments can predict subsequent reinforcement effects for individuals with developmental disabilities only when access to the selected stimulus is provided contingent on a pictorial selection. The purpose of the present investigation was to assess more comprehensively the feasibility of the pictorial format with children with developmental disabilities. In Experiment 1, prerequisite skill assessments were conducted, and the role of a contingent reinforcer was assessed by comparing the results from the pictorial assessment without contingent access to a reinforcer assessment. If contingent access was found to be necessary, the effects of schedule thinning were evaluated to determine whether a pictorial format could be made more practical in Experiment 2. The pictorial format without contingent access was successful with only some participants. However, schedule thinning was found to be an effective method to establish conditioned reinforcement properties for pictorial stimuli to create a more practical assessment for a subset of participants.     

A pilot study exploring the use of a telephone-assisted planning intervention to promote parental support for physical activity among children and youth with disabilities

Parent support is an important contributor to physical activity (PA) among children and youth with disabilities (CYD). Although many parents of CYD are motivated to provide parent PA support, CYD remain insufficiently active. The multi-process action control model has been applied to understand parent PA support and highlights behavioral regulation strategies such as action and coping planning as critical for translating intentions into behavior. Parents may struggle to create and carryout planning without support. There is no known research examining telephone support as a tool to promote planning and subsequent parent PA support behavior.MethodParents (43 mothers and 6 fathers) of CYD (child M_age = 12.53 years ± 5.53; 75% male; 38.6% developmental disability) completed a baseline questionnaire and were subsequently randomized to a telephone-assisted planning experimental group twice over four weeks (n = 23) or a control group who had access to planning tools but no telephone assistance (n = 26).ResultsNo significant main or interaction effects emerged for parent PA support behavior. However, a significant time × condition interaction was found for behavioral regulation strategies (i.e., action and coping planning and self-monitoring; F(1,44) = 5.05, p = 0.03) indicating a significant increase in the use of behavioral regulation strategies for parent PA support from baseline, for parents assigned to the telephone-assisted intervention.ConclusionThese findings suggest potential for planning support as a tool to enhance behavioral regulation strategies related to parent PA support among parents of CYD.     

A microswitch‐based program for promoting initial ambulation responses: An evaluation with two girls with multiple disabilities

We assessed the use of a microswitch‐based program for promoting ambulation responses by two children with multiple disabilities. The goals of the study were to: (a) evaluate the importance of the contingency between the target behavior (forward step) and the programmed consequence (preferred stimuli), (b) measure effects of the intervention on indices of happiness, and (c) assess the social validation of the procedure using 20 physiotherapists as external raters. The intervention involved the automatic delivery of preferred stimuli contingent on forward steps. Results showed that both participants improved their performance (forward steps and indices of happiness) during contingent reinforcement phases compared to baseline and noncontingent reinforcement phases. Moreover, physiotherapists rated the intervention as socially valid.     

The developmental course of processing speed in children with and without learning disabilities

This study contrasted the development of processing speed in children with and without learning disabilities. We examined whether the same global mechanism presumed to be responsible for the normal developmental improvement in processing speed might also be associated with the processing speed deficiencies observed in children with learning impairments. One hundred and twenty-two children with learning disabilities in reading and/or math and 206 non-disabled community controls participated. There were no differences in relation of age to the development of processing speed for children with and without learning disabilities. We interpreted these results as suggesting that the underlying etiologies for the normal developmental change in processing speed and for the relative deficiencies in processing speed seen among children with learning disabilities were different.     

Microswitch programs for persons with multiple disabilities: an overview of the responses adopted for microswitch activation

Background: To introduce a person with multiple disabilities to a microswitch-aided program, one has to select a plausible response(s), that is, a response(s) that can be performed reliably and without excessive effort by the person and can successfully activate the microswitch(es) available (producing preferred stimuli). This paper provides an overview of the responses adopted for microswitch activation in research studies during the last 20 years. Method: Computerized and manual searches were carried out to identify the studies published between 1986 and 2005. Forty-eight research studies were identified. They concerned the use of (1) a single (typical) response, (2) a single (non-typical) response, (3) multiple (typical and non-typical) responses, and (4) multiple (vocal) responses. Results and discussion: The results showed that 151 of the 190 participants involved in the studies had a positive outcome (i.e., clear increases in their responding, which suggested that they had learned the association between responding and consequent preferred stimuli). Failures were largely concentrated in the first group of studies. The discussion focused on (a) the importance of selecting plausible responses for increasing the chances of success, (b) the need of non-typical responses for persons with minimal motor behavior, (c) implications of programs with multiple responses on engagement and choice, and (d) relevance of using vocal utterances. Some suggestions for future research concerning these points were also examined.     

A systematic evaluation of preferences identified through person-centered planning for people with profound multiple disabilities

Person-centered planning is becoming a popular means of designing supports for people with disabilities. However, very little research evaluating person-centered planning exists. We evaluated the degree to which items and activities reported to be preferred in person-centered plans represented accurate preferences based on how individuals responded when presented with the items and activities. Person-centered planning meetings were conducted with 4 individuals with profound multiple disabilities to develop preference maps and to identify leisure-related preferences. A sample of the reported preferences in the plans was then systematically assessed by observing each participant's approach and avoidance responses to the items and activities. Of the sampled items and activities reported to be preferred in the plans, 42% represented moderate preferences based on the latter assessment process and 33% represented strong preferences. With 2 participants, several preferences identified in the plans were nonpreferred items and activities based on the preference assessments, and some were frequently avoided. These results suggested that although person-centered plans may identify some accurate preferences for people with profound multiple disabilities, this approach should be used cautiously. Results also suggested that such plans should be supplemented with systematic preference assessments to ensure the accuracy of identified preferences. Future research areas focus on evaluating other aspects of person-centered planning.     

Embedded evaluation of preferences sampled from person-centered plans for people with profound multiple disabilities

We investigated a brief, embedded assessment for evaluating preferences sampled from person-centered plans. After developing person-centered plans for individuals with multiple disabilities, systematic assessments were conducted with preferences sampled from the plans. An assessment of sampled preferences was then embedded within the participants' daily routines. The two assessments identified similar preferences based on participant approach responses. Both assessments also indicated inconsistencies with reported preferences in the person-centered plans. Overall, results suggested the embedded assessment may be an alternative means of evaluating some preferences reported through person-centered planning.     

A methodology for assessing the functions of emerging speech in children with developmental disabilities

An approach based on Skinner's (1957) theory of verbal behavior has been developed to understand and teach elementary communication skills to children with autism and developmental disabilities (Sundberg & Partington, 1998). However, few studies have directly examined the characteristics of emerging language in children with developmental disabilities. The purpose of this study was to develop and evaluate an assessment for identifying the elementary functions of vocal speech in children. Participants were 4 children with developmental disabilities, aged 6 years to 12 years, who exhibited at least one distinguishable vocal response (word or phrase) frequently in the natural environment. The assessment focused on three verbal operants delineated by Skinner (mand, tact, and intraverbal). One or more functions were identified for at least one vocal response of each child. Results suggested that this assessment would be useful for (a) evaluating Skinner's theory, (b) guiding decisions about language training for individual children, and (c) studying the nature of expressive language development in children with developmental disabilities.     

Effects of deprivation on engagement in preferred activities by persons with developmental disabilities

This study examined the effects of deprivation on engagement in activities for 3 adult men with developmental disabilities. First, an assessment was conducted to identify a high- and a low-preference activity for each participant. Second, the high-preference activity was made available following three amounts of deprivation of the activity (15 min, 2 hr, and 1 to 4 days); the low-preference activity was made available following the schedule of deprivation that produced the highest level of engagement by each participant in the high-preference activity. The results were that 1 to 4 days of deprivation produced the highest average amounts of engagement in the high-preference activity for each participant; this amount of deprivation did not produce high engagement in the low-preference activities. Third, the deprivation procedures and results were replicated when high-preference activities were presented by teachers during the participants' daily activities when their engagement had been quite low.     

Increasing the happiness of individuals with profound multiple disabilities: replication and extension

A multielement design was used to compare the effects of three treatments on the happiness of 3 individuals with profound multiple disabilities. The conditions were typical programming using materials selected by staff, presentation of preferred materials plus social interaction, and social interaction alone with no materials present. Both the presentation of the preferred items with social interaction and social interaction alone resulted in higher happiness indicators than typical programming. The combination of preferred items and social interactions was somewhat superior to social interaction alone.     

The effects of different mastery criteria on the skill maintenance of children with developmental disabilities

The acquisition of skills by individuals with developmental disabilities typically includes the attainment of a certain mastery criterion. We conducted a survey of practitioners who indicated the most commonly used mastery criterion as 80% accuracy across three consecutive sessions. Based on these results, we conducted a series of three experiments to evaluate the relation between mastery criterion and subsequent skill maintenance with 4 individuals with various developmental disabilities. Results suggest that 80% accuracy across three consecutive sessions may be insufficient for producing maintenance in some cases.     

The influence of working memory on reading growth in subgroups of children with reading disabilities

This 3-year longitudinal study determined whether (a) subgroups of children with reading disabilities (RD) (children with RD only, children with both reading and arithmetic deficits, and low verbal IQ readers) and skilled readers varied in working memory (WM) and short-term memory (STM) growth and (b) whether growth in an executive system and/or a phonological storage system mediated growth in reading performance. A battery of memory and reading measures was administered to 84 children (11-17 years of age) across three testing waves spaced 1 year apart. The results showed that skilled readers yielded higher WM growth estimates than did the RD groups. No significant differentiation among subgroups of children with RD on growth measures emerged. Hierarchical linear modeling showed that WM (controlled attention), rather than STM (phonological loop), was related to growth in reading comprehension and reading fluency. The results support the notion that deficient growth in the executive component of WM underlies RD.