Alarm Signals and Prompts to Eliminate Large Urinary Accidents in a Woman with Multiple Disabilities

Urine-triggered alarm signals and prompts were used to help a woman with multiple disabilities halt wetting episodes and walk to the toilet (thus avoiding large urinary accidents). Data indicated that the woman had a mean frequency of 1 large accident nearly every 2 days during the baseline phases and every 20 days during the intervention phases. During the latter phases, large accidents were replaced by small accidents (i.e. only a disposable tissue inside the underwear was wet), which did not cause environmental disruptions and did not require changes of clothes. Implications of the findings are discussed.     

A Preliminary Investigation of the Assessment and Treatment of Tantrums With Two Post-Institutionalized Romanian Adoptees

A functional analysis of tantrums was carried out with 2 children who were adopted from state-run Romanian orphanages. Tantrums included such behaviours as screaming, property destruction, self-injury and aggression. The functional analysis was conducted in an outpatient treatment unit and consisted of exposing the child and mother to a number of specific social contexts that were designed to identify social consequences maintaining tantrums. These social contexts were alternated rapidly in a multi-element design fashion during the outpatient assessment to demonstrate experimental control. Results indicated that tantrums were maintained by attention from the mother when the mother's attention was diverted away from the child (i.e. when the mother was interacting with another person). A treatment plan, which consisted of the mother delivering frequent but brief attention statements to the child during diverted attention contexts eliminated tantrums during the assessment. Follow-up evaluations for up to 6 months indicated that parents used the treatment plan and that tantrums were no longer a difficulty with these children.     

Vibratory Versus Auditory Feedback for Reducing Excessive Vocal Loudness: A Case Study

This study compared vibratory and auditory feedback for reducing excessive vocal loudness in a woman with moderate intellectual disability. The 2 forms of feedback were delivered through small portable devices equipped with a vibratory box at the woman's wrist and an earpiece, respectively. The use of feedback was combined with reinforcement. Data showed that both forms of feedback (plus reinforcement) were successful. Yet, auditory feedback appeared somewhat more effective. The differences in effectiveness are discussed in relation to differences in practicality.     

Promoting Mild Physical Exercise in a Person with Profound Multiple Disabilities

Prompt/orientation cues delivered through an automatic system were combined with one or two reinforcement events in order to promote mild physical exercise independent of staff in a man with profound multiple disabilities. The exercise sessions were gradually extended to 60 minutes. Data indicated that the man achieved high levels of exercise engagement. There were minimal differences in terms of engagement between sessions with one reinforcement event and those with two reinforcement events. Yet, in the latter sessions, the man had higher levels of positive mood. Implications of the findings are discussed.     

Is amenorrhea a clinically useful criterion for the diagnosis of anorexia nervosa?

Aim of the study was to evaluate the clinical characteristics and the treatment outcome of underweight patients with eating disorder (ED) not otherwise specified without amenorrhea (EDNOS-WA), compared with classical anorexia nervosa (AN) cases. Seventy-three consecutive female patients (57 AN, and 16 EDNOS-WA) were evaluated before and after a 20-week cognitive behaviour inpatient treatment (CBT-I). Assessment included anthropometry, the Eating Disorder Examination (EDE), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and the Temperament and Character Inventory (TCI). At logistic regression analysis, amenorrhea was only predicted by baseline BMI and intense exercise, not by psychopathological variables. Response to CBT-I was good and similar between groups, without differences in the dropout rate or time-to-dropout. Our data lend support to the hypothesis that the criterion “amenorrhea” is of no clinical utility in the diagnosis and treatment of AN and could be removed in the forthcoming DSM-V proposal.     

Helping a child with multiple disabilities endure a demanding physical posture through self-managed access to preferred stimuli

This study assessed whether a child with multiple disabilities would endure a difficult (standing) position more easily if allowed to access preferred stimuli while in that position. The study included an ABAB sequence with 2- and 3-mo. postintervention checks. Data showed that self-managed access to preferred stimuli during the B phases of the study and the postintervention checks reduced the child's indices of unhappiness, frowning and crying, while increasing his object contact and smiles as indices of happiness.     

A further comparison of external control and problem‐solving interventions to teach social skills to adults with intellectual disabilities

We compared the effectiveness of a problem‐solving and an external control intervention to teach social skills to two adults with mild intellectual disabilities. Each participant received the problem‐solving intervention with one social skill and the external control intervention with another social skill. The comparative effectiveness of the social skill training protocols was evaluated using individual participant alternating treatment designs. Overall, there seemed to be little difference between the interventions in terms of acquisition, generalization, or maintenance of social skills with either participant. Limitations of the current study and issues for future research are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

A new microswitch to enable a boy with minimal motor behavior to control environmental stimulation with eye blinks

This study assessed whether a boy with profound multiple disabilities and minimal motor behavior would be able to control environmental stimulation using repeated eye blinks with a newly developed microswitch (i.e. an electronically regulated optic sensor mounted on an eyeglasses frame). The study was carried out according to an ABAB design and included a 3 month post‐intervention check. Data showed that the boy had a large increase in the target response (repeated eye blinks) to activate the microswitch and produce environmental stimulation during the B (intervention) phases. This performance was maintained at the post‐intervention check. Practical and developmental implications of the findings were discussed. Copyright © 2005 John Wiley & Sons, Ltd.     

Philosophy and Science Dialogue: Consciousness

This is a dialogue between a philosopher and a scientist about the scientific explanation of consciousness. What is consciousness? Does it admit of scientific explanation? If so, what must a scientific theory of consciousness be like in order to provide us with a satisfying explanation of its explanandum? And what types of entities might such a theory acknowledge as being conscious? Philosopher Owen Flanagan and scientist Giulio Tononi weigh in on these issues during an exchange about the nature and scientific explanation of consciousness.