An ESID Case Study at the Federal Level

The D (dissemination) phase of the ESID model has been often overlooked in our efforts to create innovative and widespread social change. The process of replicating successful social innovations is both a prerequisite for dissemination (in order to assess the consistency of effects) and an obvious outcome of a successful dissemination effort. Fidelity, the extent to which a replicated program is implemented in a manner consistent with the original program model, is an important dimension of replication. This study was designed to provide empirical data related to three questions. Can complex social programs be implemented with fidelity? How much fidelity is appropriate or desired? What are the organizational dynamics of adoption with fidelity? Data were collected from grantees of a national replication initiative funded by the Center for Substance Abuse Prevention. Data suggest that high fidelity can be achieved, at least in the context in which programs are mandated to do so as part of the funding agreement and are given technical assistance in achieving fidelity. Secondly, programs perceived high fidelity as having positive effects on the program and its participants, a finding consistent with a limited assessment of the relationship of program outcomes and fidelity. Finally, much was learned about the human and organizational dynamics of replicating with fidelity. Implications for policy and direction regarding replication are discussed.     

A study of repetition in aphasic patients

The ability of the aphasic patient to repeat a message is a capacity of considerable diagnostic value. While it is well known that certain aphasic groups (e.g., transcortical aphasics) repeat better than other groups (e.g., conduction aphasics), possible qualitative differences among the groups have not been subjected to analysis. To secure information on repetition profiles in various aphasic subgroups, a test consisting of 11 types of items, presented under conditions of both immediate and delayed recall, was administered to eight groups of aphasic patients. The results documented a significant difference across aphasic groups, one related to site of lesion but not to severity of comprehension defect. Performance proved to be a joint product of the length and the meaningfulness of the stimulus items. The delayed condition aided Broca's aphasics and impeded anomic aphasics; in addition, nonsense syllables proved to be easier on immediate recall, while meaningful stimuli, particularly those which were number related, were relatively easier on delayed recall. Finally, sound errors were more likely to be made by Broca's and “mixed anterior” aphasics, while meaning errors were particularly prominent among conduction aphasics. These results are discussed in terms of the mechanisms which may mediate repetition in aphasic patients.     

Repetition in the transcortical aphasias

Transcortical aphasic patients were assessed on a repetition task comprised of both well-formed and deviant sentences. The patients faithfully repeated those sentences that were factually incorrect but grammatically well formed, and those sentences that were ungrammatical because of selection restriction violations. In contrast, presented with sentences featuring only minor syntactic violations (e.g., lack of number agreement), the patients spontaneously, and without awareness, resisted exact repetition; moreover, the resultant changes most often served to correct the syntactic deviations. Repetitions of sentences of this latter type also revealed a difference between the patients as a function of level of comprehension. The transcortical motor aphasic patient was influenced by semantic factors in his alterations of the minor syntactic violations, while the transcortical sensory aphasic was not. These findings are discussed in relation to the notion of autonomous syntactic processing. They are taken to suggest that syntactic facts such as number agreement are represented at a level in the processing chain that is distinct from that of semantic representation.     

The appreciation of antonymic contrasts in aphasia

To secure information on the ability of aphasic patients to comprehend antonymic relations, the kinds of confusions typically made, and the extent to which antonymic sensitivity depends upon mode of presentation and task demands, three linguistic and nonlinguistic tests were administered to aphasic patients, right hemisphere-damaged patients, and non-neurological controls. Although difficulty with antonymous relations was found among all the organic patients, the kinds of problems evidenced and the relative profile of difficulties differed across populations. Among the principal findings were the generally preserved sensitivity to antonymy found among anterior (particularly Broca's) aphasics; a surprising insensitivity to antonymy and a preference for synonyms, found among right hemisphere patients, particularly on the nonlinguistic tasks; a relative preservation of sensitivity to antonymy on nonlinguistic tasks, coupled with a loss of such sensitivity on linguistic tasks, found among posterior (particularly Wernicke's) aphasics; a proclivity toward stereotypical correct responses among the organic patients; and an absolutely worse performance by right hemisphere patients on tasks involving antonymic relations in pictures and abstract designs.     

A study of spelling in aphasia

To secure systematic information on spelling abilities following damage to the dominant hemisphere, a test probing performance in three modalities of response was administered to a group of aphasic patients. Except for a predictable deficit among anterior aphasics in oral spelling, anterior and posterior aphasics exhibited comparable performances on the measures of spelling. However, anterior and posterior aphasics differed from one another on the kinds of words they most accurately spelled, the errors they were prone to make, and certain strategies which they characteristically adopted. These results suggest two alternative approaches to spelling: one approach, common in posterior aphasics, entails choosing letter combinations on the basis of their customary sounds; a second approach, common among anterior aphasics, appears to rely on a partially preserved image of the word's appearance.     

Responding under sequence schedules of electric shock presentation

Lever pressing by squirrel monkeys was examined under second-order schedules of electric shock presentation in which different discriminative stimuli were associated with consecutive components (sequence schedules). Components were always two-minute fixed-interval schedules, and three different overall schedules were studied. Under an overall eight-minute fixed-interval schedule, the first component completion after at least eight minutes had elapsed produced electric shock. The number of components actually completed ranged from one to four; thus, different discriminative stimuli were occasionally associated with electric shock presentation. Under an overall “yoked” variable-ratio schedule, electric shock was presented after completion of a variable number of components; the required number and the distribution of components were matched to those obtained under the overall eight-minute fixed-interval schedule. Under an overall fixed-ratio schedule, electric shock was presented after completion of four components (chained schedule). Under all three sequence schedules, responding in early components was characterized by a pause followed by a single response after the end of the two-minute interval; responding in later components was characterized by a shorter pause followed by positively accelerated responding. Manipulation of overall schedules of shock presentation in these complex behavioral situations produced changes in responding comparable to those ordinarily obtained after similar manipulation of dependencies under both single and second-order schedules of food presentation. These experiments extend the range of conditions and levels of complexity under which responding can be maintained by presentation of electric shock.     

RESPONDING MAINTAINED UNDER INTERMITTENT SCHEDULES OF ELECTRIC-SHOCK PRESENTATION: “SAFETY” OR SCHEDULE EFFCTS?

Four experiments were conducted in which lever pressing by squirrel monkeys was maintained under multiple, mixed, or chained schedules of electric-shock presentation. In the first two experiments, a multiple schedule was employed in which a fixed-interval schedule of shock presentation alternated with a signaled two-minute component. Initially, no events were scheduled during the two-minute component (a safety period). In the first experiment, the safety period was “degraded” by introducing and systematically increasing the frequency of periodic shocks presented during that component. In the second experiment, the proportion of overall safe time to unsafe time was decreased by decreasing the value of the fixed-interval schedule while holding constant shock frequency during the two-minute component. In the third experiment, the overall arrangement was changed from a multiple to a mixed schedule in an attempt to determine whether fixed-interval responding would be maintained when a single exteroceptive stimulus was associated with both components. In the fourth experiment, the overall arrangement was changed from a multiple to a chained schedule in an effort to determine whether fixed-interval responding would be maintained when its consequence was presentation of a signaled “unsafe” period. Fixed-interval responding was well maintained under all experimental conditions; the varied relationships obtained lend more support to conceptualizations of shock-maintained behavior as exemplifying schedule-controlled behavior than to suggestions that such behavior may be readily accounted for by “safety theory.”     

Parameters affecting the maintenance of negatively reinforced key pecking

Three negative reinforcement experiments employing a key-peck response are described. In Experiment I, pigeons shocked on the average of twice per minute (imposed condition) could produce, by pecking a key, an alternate condition with correlated stimuli. Delayed shocks were added, across sessions, to the alternate condition until pecking stopped. Two of three pigeons continued to peck despite a 100% increase in shock frequency. In Experiment II, pigeons were shocked in the imposed condition four times per minute. The postresponse delay to shock was held constant by delivering, in the alternate condition, the next shock, or the next two, three, or four shocks from the imposed-condition shock schedule. All three subjects continued to peck with no change in delay to the first two postresponse shocks but with a 75% reduction in shock frequency. In Experiment III, a response produced an immediate shock followed by a shock-free period. Three of four subjects continued to respond despite reduced delay to shock. Delay-to-shock or shock-frequency reduction was sufficient to maintain key pecking, but neither was necessary. The conditions that negatively reinforce the pigeon's key peck were similar to conditions that negatively reinforce the rat's bar press.     

A multimodal behavior analytic model for evaluating the effects of medical problems on nonspecific behavioral symptoms in persons with developmental disabilities

A relationship between various medical illnesses and the frequency and severity of nonspecific behavioral symptoms such as aggression and self-injury has been described by a number of writers. None, however, provides a clinical case formulation model that articulates the specific nature of this relationship or the manner in which potential biomedical influences interact with psychological and socioenvironmental ones to determine the occurrence and strength of behavioral symptoms. A model is described in this paper that suggests possible contributions of medical illnesses or conditions to occurrence of nonspecific behavioral symptoms and provides a diagnostic basis for selecting and evaluation related interventions. © 1997 John Wiley & Sons, Ltd.