Token‐economy‐based contingency management increases daily steps in adults with developmental disabilities

Adults with developmental disabilities are less likely to meet physical activity guidelines than typically developing counterparts. Contingency management (CM) interventions increase physical activity in sedentary adults. The current study systematically replicated previous research among sedentary adults diagnosed with developmental disabilities living in a residential group home, using a token economy in the context of a CM intervention. Using a changing criterion design, participants (N = 4) were given tokens contingent on meeting increasing step goals over 8 weeks, tracked via a Fitbit Flex?. CM increased the number of steps substantially for three of four participants. These findings extend previous research supporting the use of token‐based CM interventions for increasing daily steps among individuals with developmental disabilities. Because the current study was conducted in a residential group home setting, it may offer a long‐term sustainable approach to improving the health of some individuals living with developmental disabilities.     

Transgender and gender non-conforming adult preparedness for aging: Concerns for aging,and familiarity with and engagement in planning behaviors

Abstract

Background: Research on transgender and gender-nonconforming (TGNC) aging is limited. To date, most of the literature about TGNC aging has focused on discrimination (particularly in healthcare), violence and abuse, caregiving and family relations, and religiosity.

Aims: The purposes of this study were to: (a) document concerns about aging among TGNC adults, including concerns that are identity-specific; (b) examine preparation for aging and end of life (i.e., familiarity and planning) among TGNC adults; and (c) examine potential differences in familiarity and planning based on gender identity.

Methods: One hundred fifty-four individuals who currently or have ever identified as TGNC completed a national online survey assessing these constructs.

Results: TGNC individuals reported many concerns about aging, both gender identity-specific and not. The most common aging concern was losing the ability to care for themselves followed by having to go into a nursing home or assisted living facility. The age preparatory behaviors individuals were most commonly aware of included: life insurance, wills, organ donation, regular medical checkups, living wills, durable power of attorney for healthcare, and trusts. Gender-nonconforming individuals had significantly more familiarity with age preparatory behaviors than trans feminine individuals, but had lower levels of planning to engage in age preparatory behaviors than both trans masculine and trans feminine individuals.

Conclusion: The current findings highlight the need for providers to address age preparatory behaviors with TGNC individuals or provide referrals to support individuals in this planning.     

A preliminary analysis of self-control with aversive events: the effects of task magnitude and delay on the choices of children with autism

When faced with a choice between two aversive events, a person exhibits self-control by choosing a smaller, more immediate aversive event over a larger, delayed aversive event. Task demands are often aversive to children with autism and other developmental disabilities. The purpose of this study was to evaluate behavioral sensitivity to differences in the amount and delay of tasks as part of a preliminary study on self-control. Participants were 2 children with autism who engaged in problem behavior maintained by escape. Results indicated a lack of self-control with respect to choosing between two aversive tasks and suggested potential strategies for increasing self-control (i.e., choosing a small immediate task over a large delayed task).     

Establishing and maintaining treatment effects with less intrusive consequences via a pairing procedure

The generality and long-term maintenance of a pairing procedure designed to improve the efficacy of less intrusive procedures were evaluated for the treatment of problem behavior maintained by automatic reinforcement exhibited by 2 individuals with developmental disabilities. Results suggested that a less intrusive procedure could be established as a conditioned punisher by pairing it with an effective punisher contingent on problem behavior. Generalization across multiple therapists was demonstrated for both participants. However, generalization to another setting was not achieved for 1 participant until pairing was conducted in the second setting. Long-term maintenance was observed with 1 participant in the absence of further pairing trials. Maintenance via intermittent pairing trials was successful for the other participant.     

On the status of knowledge for using punishment implications for treating behavior disorders

In this paper, we review basic and applied findings on punishment and discuss the importance of conducting further research in this area. The characteristics of responding during punishment and numerous factors that interact with basic processes are delineated in conjunction with implications for the treatment of behavior disorders in clinical populations. We conclude that further understanding of punishment processes is needed to develop a highly systematic, effective technology of behavior change, including strategies for improving the efficacy of less intrusive procedures and for successfully fading treatment.     

Predictors of Satisfaction with Obstetric Care in High-risk Pregnancy: The Importance of Patient–Provider Relationship

The study set out to examine the predictive effects of patients’ emotional distress and their relationships with their health care providers on satisfaction with obstetric services in high-risk pregnancies. Participants were 104 pregnant women with a history of recurrent losses, fetal demise, previous or current fetal genetic abnormality, advanced maternal age, or obstetric or medical complications of the present pregnancy. Self-report measures of emotional distress and the quality of their relationships with their medical provider were administered. Hierarchical multiple regression analyses were conducted to assess the predictive effect of these variables on satisfaction with services. Provision of information, constructive communication, and good relationships predicted elevated satisfaction with health services. Provision of information also buffered against the adverse effect of emotional distress on satisfaction with health services. These findings elucidate the central role of provider–patient interaction, particularly as it is related to provision of information, in high-risk pregnancy.     

Metabolic mapping of the rat cerebellum during delay and trace eyeblink conditioning

The essential neural circuitry for delay eyeblink conditioning has been largely identified, whereas much of the neural circuitry for trace conditioning has not been identified. The major difference between delay and trace conditioning is a time gap between the presentation of the conditioned stimulus (CS) and the unconditioned stimulus (US) during trace conditioning. It is this time gap or trace interval which accounts for an additional memory component in trace conditioning. Additional neural structures are also necessary for trace conditioning, including hippocampus and prefrontal cortex. This addition of forebrain structures necessary for trace but not delay conditioning suggests other brain areas become involved when a memory gap is added to the conditioning parameters. A metabolic marker of energy use, radioactively labeled glucose analog, was used to compare differences in glucose analog uptake between delay, trace, and unpaired experimental groups in order to identify new areas of involvement within the cerebellum. Known structures such as the interpositus nucleus and lobule HVI showed increased activation for both delay and trace conditioning compared to unpaired conditioning. However, there was a differential amount of activation between anterior and posterior portions of the interpositus nucleus between delay and trace, respectively. Cerebellar cortical areas including lobules IV and V of anterior lobe, Crus I, Crus II, and paramedian lobule also showed increases in activity for delay conditioning but not for trace conditioning. Delay and trace eyeblink conditioning both resulted in increased metabolic activity within the cerebellum but delay conditioning resulted in more widespread cerebellar cortical activation.