Effects of Varying Levels of Treatment Integrity on Toddler Aggressive Behavior

Abstract

Effects of different levels of treatment integrity for a time-out intervention in relation to the aggressive behavior of an 18-month-old were investigated. The time-out intervention was composed of four steps and treatment integrity was systematically varied at 50%, 25%, 75%, and 100%. The results suggest that the 75% and 100% treatment integrity conditions were most effective for decreasing aggressive behavior. Further, there were only minor differences in aggressive behavior between the 25% and 50% treatment integrity conditions. Discussion focuses on the need for assessing optimal and minimum levels of treatment integrity for producing behavior change and the implications for classroom-based interventions.     

The Student Guided Functional Assessment Interview: An Analysis of Student and Teacher Agreement

Functional assessment strategies are used to guide the treatment of problem behavior with individuals who have severe disabilities. Also, researchers have extended functional assessment applications to individuals with emotional and behavioral disabilities. One such extension is the use of students as informants in the functional assessment process. The present study assessed an interview tool designed to elicit information directly from students regarding their problem behaviors. We examined agreement between students and their teachers. Results showed high agreement on the causes and functions of problem behavior with mixed agreement on support plan recommendations.     

Evaluation of a Targeted Intervention Within a Schoolwide System of Behavior Support

A recommended component of comprehensive behavior support in schools is a targeted intervention designed to efficiently and effectively meet the support needs of students who are not responding to preventive schoolwide intervention strategies (Sugai, Horner et al., 2000; Walker et al., 1996). This study provides a fine-grained analysis using a multiple baseline across students design with the targeted intervention as the independent variable, and both classroom problem behavior and academic engagement as dependent variables. The multiple baseline analysis documents a modest functional relationship between implementation of the intervention and reduction in problem behavior. Implications for the design of behavior support in schools and the development of future research are provided.     

An Investigation of Treatment Integrity and Outcomes in Wraparound Services

Research on wraparound services has been generally positive, but has failed to include data regarding treatment integrity. Without such data, conclusions drawn from such studies are weakened. This study followed 28 children and adolescents receiving wraparound services in rural central Pennsylvania. Treatment integrity was defined as the percentage of service hours prescribed vs. received, and behavioral outcomes were defined as Total Problem Behavior T Scores on the Child Behavior Checklist. Preliminary analyses failed to reveal significant differences in sample means between included subjects and those excluded due to missing data. Outcome behavior ratings were significantly improved over baseline ratings. Regression analyses, however, failed to find a significant effect for treatment integrity when used in an outcome prediction equation for Therapeutic Support Staff, Mobile Therapy services, or Behavioral Specialist wraparound services. These results suggest that adherence to prescribed treatment hours may not be related to behavioral outcomes in a wraparound service setting.     

Treatment for Youth in Short-Term Care Facilities: The Impact of a Comprehensive Behavior Management Intervention

We describe a comprehensive program to train emergency shelter staff in effective methods for dealing with youth who have behavioral and emotional problems; assess the degree to which staff implemented the treatment approach; measure the impact of the intervention on shelter-wide incidents such as out-of-control behavior, runaways, and violence against other youth; and examine pre-post changes in staff experiences at the shelter via anonymous surveys. Overall, the short-term shelter staff indicated adequate implementation of the intervention. The rate of youth incidents at the shelter significantly declined from pre to post assessment. Direct-care staff ratings of their satisfaction with their proficiency in behavior management and teaching youth skills increased significantly from pre to post implementation. These findings suggest that it is feasible to deliver an effective staff-training program to improve the behavior management and social skills of youth residing in short-term care facilities within the child welfare system.     

Using Brief Experimental Analysis to Select Oral Reading Interventions: An Investigation of Treatment Utility

This study examined the treatment utility of brief experimental analysis for selecting skill-based oral reading interventions that targeted acquisition and fluency. Two second and one third grade student served as participants. The potentially most and least effective instructional packages identified from the brief experimental analysis for each student were alternated during an extended analysis phase. The instructional components that were compared were based on an ease of implementation hierarchy, with the brief experimental analysis used to select the hypothesized most effective instructional package for oral reading. Visual analysis of extended analysis data revealed that the hypothesized most effective combination of instructional components identified from the brief analysis produced greater initial gains in reading for two children (i.e., over 29 and 21 intervention days) and greater gains in reading throughout the extended analysis phase for the third child. Thus, the investigation provided preliminary evidence for the treatment utility of using brief experimental analysis to select effective and efficient oral reading instructional interventions. Implications, limitations, and future research topics are discussed.     

Understanding Mechanisms of Change in the Development of Antisocial Behavior: The Impact of a Universal Intervention

The association between the development of antisocial behavior, affiliation with deviant friends, and peer rejection was tested with a preventive intervention; 664 boys and girls were randomly assigned to a universal classroom-based intervention targeting disruptive behavior or a control condition. Peer nominations of antisocial behavior, friends' antisocial behavior, and peer rejection were assessed annually for 4 years. A high, a moderate, and a stable low antisocial behavior trajectory were identified. Large reductions in antisocial behavior were found among intervention children who followed the high trajectory. These reductions coincided with affiliations with nondeviant peers and with decreases in peer rejection. The affiliation between deviant and nondeviant peers was initiated by nondeviant children. The results support a causal role of deviant friends and peer rejection in the development of antisocial behavior. The implications for our understanding of the mechanisms leading to reductions in antisocial behavior are discussed.     

Incremental Benefits of a Daily Report Card Intervention Over Time for Youth With Disruptive Behavior

This study examined the percentage of children who respond positively to a daily report card (DRC) intervention and the extent to which students achieve incremental benefits with each month of intervention in a general education classroom. Participants were 66 children (87% male) with attention-deficit hyperactivity disorder or disruptive behavior problems who were enrolled in a school-based intervention program in rural, low-income school districts in a Midwest state. The DRC was implemented by each child's teacher, who received consultation from a graduate student clinician, school district counselor, or school district social worker. A latent class analysis using growth-mixture modeling identified two classes of response patterns (i.e., significant improvement and significant decline). Results indicated that 72% of the sample had all of their target behaviors classified as improved, 8% had all of their targets classified as declining, and 20% had one target behavior in each class. To examine the monthly incremental benefit of the DRC, individual effect sizes were calculated. Results for the overall sample indicated that most children experience a benefit of large magnitude (.78) within the first month, with continued incremental benefits through Month 4. The differential pattern of effect sizes for the group of improvers and the group of decliners offer data to determine when and if the DRC should be discontinued and an alternative strategy attempted. Evidence-based guidelines for practical implementation of the DRC are discussed.     

The Role of Teacher Behavior Management in the Development of Disruptive Behaviors: An Intervention Study with the Good Behavior Game

The role of teacher behavior management for children’s disruptive behavior development (hyperactive and oppositional behavior) was investigated using a universal classroom preventive intervention study. Five-hundred seventy children were followed from second to third grade of elementary school. Observations of teacher behavior management and children’s on-task and off-task classroom behavior and peer reports of hyperactive and oppositional behavior were available. Results showed that the reduced use of negative remarks of intervention teachers predicted children’s increase in on-task behavior and decrease in talking-out behavior. These improved children’s classroom behaviors in turn mediated the impact of the intervention on the development of hyperactive and oppositional behavior over the studied period. These results were similar for girls and boys. The results underscore the role of teachers’ classroom management strategies in improving children’s classroom behavior, which, in turn is an important component in the reduction of disruptive behavior development.     

The Analysis of Intervention Change in Children and Families: Methodological and Conceptual Issues Embedded in Intervention Studies

This article provides an overview of methodological and conceptual issues underlying the assessment of change during psychotherapy with children and families. Three central considerations are discussed: (1) What changes do we measure? (2) When do we measure change? (3) How do we measure change? The difficulties with the traditional methods of assessing change are highlighted, and suggestions for a new paradigm that calls for expansion of the nomological network relevant to the analysis of change, as well as the inclusion of more assessment points and more reliable and valid measures of the change process, are presented. Illustrations of key points are provided from the Adolescent Transitions Program, a theoretically based intervention program targeting high-risk youth.     

社会两难行为理性特点的实验分析

本研究运用定量和定性的方法探讨了动态适应性学习条件下两难行为的理性特点及其影响因素。72名杭州本科生参加了本实验,结果发现:1、在有限次重复的两难博弈实验中,人们的两难行为不符合纳什博弈理论,进一步的定性分析指出,这种两难行为体现出“社会理性”的特征;2、在高奖罚的条件下,人们更容易做出接近“纳什均衡点”决策;3、群体规模和反馈方式对人们的对策行为影响不显著,但是,进一步的定性分析部分支持了群体规模的社会理性解释。     

School-Based Intervention for Adolescents with Social Anxiety Disorder: Results of a Controlled Study

Social anxiety disorder, whose onset peaks in adolescence, is associated with significant impairment. Despite the availability of effective treatments, few affected youth receive services. Transporting interventions into schools may circumvent barriers to treatment. The efficacy of a school-based intervention for social anxiety disorder was examined in a randomized wait-list control trial of 35 adolescents (26 females). Independent evaluators, blind to treatment condition, evaluated participants at preintervention, postintervention, and 9 months later. Adolescents in the intervention group demonstrated significantly greater reductions than controls in social anxiety and avoidance, as well as significantly improved overall functioning. In addition, 67% of treated subjects, compared to 6% of wait-list participants, no longer met criteria for social phobia following treatment. Findings support the possible efficacy of school-based intervention for facilitating access to treatment for socially anxious adolescents.     

Self- and cross-citations in the Journal of Applied Behavior Analysis and the Journal of the Experimental Analysis of Behavior: 1983-1992

We examined self- and cross-citation practices in JABA and JEAB from 1983 through 1992. Mean levels of self-citation for JABA and for JEAB were 22.6% and 36.1%, respectively. Overall, 2.4% of JABA citations were JEAB articles, and 0.6% of JEAB citations were JABA articles, which suggests limited integration of basic and applied research.     

The Effects of a Self-sacrificing Minority on Pro-environmental Norms and Behavior: An Investigation Using a Sea Pollution Game

This research investigated how a minority member sacrificing his/her personal benefits to protect the environment might influence the attitudes and behavior of others. The experiment, using a sea pollution game, employed a 2(minority factor)×2(cost factor) factorial design. Under the high-cost condition, in which an ecological minority bears the substantial cost it was hypothesized that the rate of subjects' pro-environmental behavior would be higher in the one-minority case than in the no-minority case. In contrast, under the low-cost condition, the differences between these two cases would decrease. The results supported this assumption. In prompting pro-environmental behavior, a self-sacrification minority member is more influential than one whose behavior is not self-sacrificing. Moreover, under the one-minority condition, path analyses indicated that the subjects' cost evaluation did not affect their behavior. It was concluded that when the subjects saw an ecological minority, the inhibiting effects of cost on their pro-environmental behavior would decrease.     

Improving the Social-Behavioral Adjustment of Adolescents: The Effectiveness of a Social Skills Group Intervention

We evaluated the efficacy of a social skills training intervention designed to improve adolescents’ social, emotional and behavioral adjustment, Social Skills Group Intervention-Adolescent (S.S.GRIN-A). Seventy-four adolescents (ages 13–16 years) and their parents were randomly assigned to either the treatment group (N = 40) or a wait-list control group (N = 34). Adolescents in the treatment and control groups were compared on global self-concept, social self-efficacy, internalizing problems, and externalizing problems pre- and post-intervention. Youth in the treatment group demonstrated enhanced global self-concept, increased social self-efficacy, and decreased internalizing problems as compared to youth in the control group. No differences in externalizing behavior were found. We discuss the effectiveness of S.S.GRIN-A as a general program designed for addressing a range of adjustment issues and social skill deficits in adolescents.     

Brief Experimental Analysis of Spanish Reading Fluency: An Exploratory Evaluation

Brief experimental analyses of reading fluency are useful for identifying effective interventions for improving reading fluency. The current study extends previous research by conducting an exploratory evaluation of brief experimental analyses of reading fluency for Spanish reading. A 10-year old Hispanic male presented with reading fluency deficits for English and Spanish reading. Brief experimental analyses of English and Spanish reading identified distinct interventions for each which increased oral reading fluency. Intervention procedures evaluated during brief experimental analyses included listening passage preview, repeated readings, and reward. Replication of analyses was conducted to examine changes in instructional need over time. For English reading, the intervention identified during the initial analysis (i.e., listening passage preview with repeated readings) was identified as the most effective when the analysis was replicated. For Spanish reading, listening passage preview was identified as the most effective intervention during the initial analysis, while repeated readings was identified as most effective when the analysis was replicated. Results are discussed in terms of future research given the exploratory nature of the current study.     

An Experimental Analysis of Mathematics Instructional Components: Examining the Effects of Student-Selected Versus Empirically-Selected Interventions

Within the context of an experimental analysis, the current study examined the effects of student- and empirically-selected interventions on the mathematics computational fluency of three elementary-aged students. For all of the participants, the empirically-selected intervention resulted in higher levels of computational fluency then the student-selected intervention. These results suggest that empirically-selected interventions may enhance the mathematics computational fluency of students experiencing mathematics problems. However, individual responsiveness to empirically-selected interventions suggests the importance of conducting brief experimental analyses to determine the most efficacious intervention. The implication of these results for intervention selection and incorporating choice-making opportunities into academic interventions are discussed.     

Predictors of Adherence to a Brief Behavioral Insomnia Intervention: Daily Process Analysis

Behavioral interventions for insomnia are effective in improving sleep, yet adherence is variable, and predictors of adherence have not been consistently replicated. The relationships between daily variations in state factors at the initiation of treatment and adherence have not been investigated. Using 2-week, self-report online logs, this study determined, among 53 college students with probable insomnia, the associations of pretreatment factors and daily factors during treatment on daily variations in adherence to one session of behavioral treatments for insomnia. These treatments included stimulus control therapy (SCT), sleep restriction therapy (SRT), and sleep hygiene (SH). Low self-efficacy was associated with poorer SCT and SH adherence. Participants with a “bed partner or pet” at least some of the time had better SCT adherence. Greater total sleep time and poorer sleep quality were associated with poor SCT and SRT adherence the following night. Greater sleep efficiency was related to greater next night SCT and SRT adherence. Alcohol consumption was related to poorer SRT and SH adherence the following night. Future studies should test the replicability of these findings. Adherence trials may want to test whether discouraging alcohol intake, enhancing treatment-related self-efficacy, and monitoring and providing feedback on sleep, early in treatment, affects adherence.     

An Open Trial Investigation of a Transdiagnostic Group Treatment for Children With Anxiety and Depressive Symptoms

The current study investigates the feasibility and preliminary outcomes associated with a transdiagnostic emotion-focused group protocol for the treatment of anxiety disorders and depressive symptoms in youth. Twenty-two children (ages 7 to 12; M = 9.79) with a principal anxiety disorder and varying levels of comorbid depressive symptoms were enrolled in an open trial of the Emotion Detectives Treatment Protocol (EDTP; Ehrenreich-May & Bilek, 2009), an intervention adapted from existent unified protocols for the treatment of emotional disorders among adults and adolescents. Results indicate that participants experienced significant improvements in clinician-rated severity of principal anxiety disorder diagnoses (d = 1.38), the sum of all anxiety and depressive disorder severity ratings (d = 1.07), and child-reported anxiety (d = 0.47) and parent-reported depressive symptoms (d = 0.54) at the posttreatment assessment. EDTP had good retention rates and reports of high satisfaction. Thus, preliminary evidence suggests that EDTP is a feasible and potentially efficacious treatment of youth anxiety disorders and co-occurring depressive symptoms. Children experiencing a range of internalizing symptoms may benefit from this more generalized, emotion-focused treatment modality, as it offers flexibility to families and the mental health clinician, while maintaining a concurrent focus on the provision of cognitive-behavioral treatment skills vital to the amelioration of anxiety and depressive disorder symptoms in youth.