Psychiatric Hospitalization and School and Community Adjustment of Children and Adolescents with Acquired Brain Injury

There is a high prevalence of psychiatric disorders in children and adolescents who have acquired brain injury (ABI). We examined the records of 82 students with ABI who were admitted to a community-based school for education and neurorehabilitation over a three-year period to determine how many experienced one or more psychiatric hospitalizations before admission, and whether hospitalization status was related to positive school and community adjustment. Results were that 30.4% of the students had a documented history of one or more psychiatric hospitalizations. Of this group, 60.0% were able to be maintained in the community-based school program and 40.0% were discharged to other settings. When discharged, 70.0% of students entered more restrictive treatment programs (e.g., psychiatric hospital, secure residential facility, residential school). The number of psychiatric hospitalizations did not predict discharge from the community-based school and was unrelated to the type of discharge setting. Clinical and research issues concerning psychiatric disorders in children and adolescents with ABI in relation to post-acute adjustment are discussed.     

Behavioral intervention to reduce physical restraint of adolescents with developmental disabilities

Physical restraint procedures sometimes are approved for implementation in human service settings for children and adults who have developmental disabilities and seriously challenging behaviors. Although use of restraint may be clinically justified to manage behavior disorders and prevent injury to self and others, procedures should be evaluated to decrease, and possibly eliminate, such methods. This study addressed the effects of restraint‐reduction procedures with two adolescents who had developmental disabilities and displayed severe aggression. Clinically significant reductions in the frequency of physical restraint were achieved through a treatment package that included the behavior‐specific criterion for the application of restraint and antecedent control approaches. The implementation of strategic interventions to decrease physical restraint utilization is discussed. Copyright © 2000 John Wiley & Sons, Ltd.     

Evaluation of a participatory,competency‐based model of staff training in a community habilitative setting

This study evaluated a participatory model of staff training within a community habilitative setting for adults with developmental disabilities. The objectives were to formulate an approach to training that was not time intensive, included multiple instructional methods, and incorporated all levels of staff involvement. Senior administrative, middle‐level supervisory, and direct‐care personnel comprised a committee that designed and implemented a training program that targeted performance and verbal report competencies required by ‘on‐line’ staff. Training consisted of corrective feedback, modeling, rehearsal, and practice procedures that were carried out with three individuals in a multiple baseline design across sets of target competencies. The training program was effective in establishing staff competencies although individual learning effects were revealed. The implications of these findings for the design of staff training programs within human service agencies are discussed. Copyright © 2001 John Wiley & Sons, Ltd.     

The impact of violations on uncertainty and the consequences for attractiveness

This investigation aimed at extending past research on expectation violations by arguing that violations vary both in valance and in their influence on uncertainty and that the combination of valence and uncertainty states conjointly influences judgments of a violator's social attractiveness. In explaining the predicted variance in uncertainty following violations, a distinction is proposed between congruent violations (i.e., behaviors that are more intense instantiations of a previously displayed message) and incongruent violations (i.e., behaviors that are opposite in meaning from previously displayed messages). Five models for explaining violation effects are contrasted. Results (a) confirm that violations differ in their impact on uncertainty, (b) generally support the validity of the proposed distinction between congruent and incongruent violations, and show that the inclusion of uncertainty and valence in models of violation outcomes accounts for greater variance in social attraction than either one separately.     

IMPROVING INTERVENTION INTEGRITY OF DIRECT‐SERVICE PRACTITIONERS THROUGH PERFORMANCE FEEDBACK AND PROBLEM SOLVING CONSULTATION

The purpose of this study was to improve intervention integrity of behavior support plan implementation by teachers at a specialized school. During the first phase of a multiple baseline design, performance feedback was given to the teachers during (correction) and immediately following (praise) classroom observations. In a second phase, the teachers received problem solving consultation that addressed behavior support plan misapplication and respective procedural modifications. Only one of the three teachers demonstrated improved intervention integrity with performance feedback, whereas problem solving consultation produced uniform improvement. We discuss these findings and implications for intervention integrity assessment and research. Copyright © 2014 John Wiley & Sons, Ltd.     

Comparative Effects and Social Validation of Support Strategies to Promote Mindfulness Practices Among High School Students

Abstract

We compared the effects of support strategies for promoting formal mindfulness practices of 9th grade high school students who participated in a 10-week school-based mindfulness education program. The students also completed social validity ratings of the support strategies they selected and the formal mindfulness practices they learned. All of the support strategies were associated with increased average minutes of formal mindfulness practices. Students who did not select an extra support strategy also had increased minutes of formal mindfulness practices but of less magnitude in contrast to the two most effective strategies. The social validity ratings of the support strategies ranged from equivocal to good approval, and the students gave positive ratings to the majority of formal mindfulness practices. We discuss the implications of these findings for designing mindfulness education programs, implementing practice-promoting support strategies, and conducting mindfulness research with school children and youth.     

Shaping approach responses as intervention for specific phobia in a child with autism

We evaluated contact desensitization (reinforcing approach responses) as intervention for specific phobia with a child diagnosed with autism. During hospital-based intervention, the boy was able to encounter previously avoided stimuli. Parental report suggested that results were maintained postdischarge.     

Assessing pharmacological and contingency management interventions with mentally retarded adolescents in a residential treatment program

Two studies were performed using applied behavior analytic methodology to evaluate pharmacological and contingency management interventions with mentally retarded adolescents in a residential treatment facility. In the first study, stimulant (methylphenidate) and beta-blocking (propranolol) medications were compared with an overcorrection procedure to manage the disruptive vocalizing of a 14-year-old female. In the second study. the effects of thioridazine and a reinforcement-response interruption program on stereotypic body-rocking of an 18-year-old male were assessed. Both studies failed to demonstrate a positive response from any of the prescribed medications. Substantial reductions in behavior did occur with application of the contingency management programs. The programs were equally effective whether utilized alone or in combination with medication. Assessment and programmatic issues in the area of clinical behavioral pharmacology are discussed.     

Intervention,stimulus control,and generalization effects of response interruption and redirection on motor stereotypy

This study evaluated the effects of response interruption and redirection (RIRD) on motor stereotypy (hand and body movements) in a child with neurodevelopmental disorders. We also assessed whether a stimulus paired with RIRD could acquire inhibitory control when tested during nonintervention conditions. Compared with baseline phases in a reversal design, RIRD decreased both hand and motor stereotypies, and there was evidence of stimulus control. Extending RIRD to a second setting was also effective. The care providers responsible for intervention implemented RIRD with fidelity, and they rated the procedure positively. Clinical and research implications from these findings are discussed.     

Brief Report: Assessment of Training and Supervision Needs Among Registered Behavior Technicians

We assessed the self-perceived training needs of Registered Behavior Technicians (RBTs) to inform the content and direction of supervision provided by Board Certified Behavior Analysts (BCaBAs). The RBTs identified several training priorities that would improve their delivery of applied behavior analysis (ABA) services. Self-assessment by RBTs combined with direct observation allows supervisors to develop individualized training plans with these paraprofessional providers.