CHOICE-MAKING TREATMENT OF YOUNG CHILDREN'S SEVERE BEHAVIOR PROBLEMS

The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an alternative neutral response) to obtain different durations and qualities of reinforcement, was conducted. Finally, treatment packages involving choice making via manding were implemented to decrease inappropriate behavior and to increase mands. The results extended previous applications of choice making to severe behavior disorders and across behaviors maintained by positive and negative reinforcement.     

An emperor without clothes: The Church's views about treatment of domestic violence

Once upon a time there was an emperor who was very vain about his elegant clothing. Two swindlers convinced him that they could make him the finest clothes he ever had, and set to work on an empty loom. Rumors of their fame began to spread, and even the emperor's high officials were convinced that the invisible garments were the finest they had ever seen. One minister even decided, “I know I'm not stupid, so it must be my fine position I'm not fit for. Some people might think that rather funny, but I must take good care they don't get to hear of it.” And then he praised the material which he couldn't see and assured them of his delight in its charming shades and its beautiful design. The emperor finally went on parade with his new garments. Crowds gathered, and they all said how magnificently clad he was. No one dared admit they couldn't see the clothes, and many concluded there was simply something wrong with them that he appeared naked. Finally a little child said, “But he hasn't got anything on!” “Goodness gracious, do you hear what the little innocent says?” one whispered to another, until finally everyone shouted at last, “He hasn't got anything on!” The emperor was embarrassed, but he drew himself up and went on with the procession still more proudly, while his chamberlains walked after him carrying the train that wasn't there.     

Predictors of Developmental Task Attainment for Young Adults from Divorced Families

To determine which variables impact developmental task attainment for young adults from divorced families, respondents completed demographic questions, the young adult version of the Personal Authority in the Family System Questionnaire, and the three family relationship subscales of the Family Environment Scale. Of the factors assessed, results suggest that the quality of post-divorce family functioning is the most salient predictor of development for young adults from divorced families. Additionally, although conflict and cohesion have unique effects on task attainment for young adults, expressiveness appears to be the dimension of post divorce family functioning most related to young adult development.     

Empirically defined symptom scales using the DISC 2.3

Empirically defined scales of depressive, attention deficit hyperactivity disorder, oppositional-defiant disorder, and conduct symptoms from the lay-administered National Institute of Mental Health (NIMH) Diagnostic Interview Schedule for Children (DISC), version 2.3, and evidence of their reliability and validity, are presented. The scales were developed using factor analyses of data obtained from an epidemiologic survey of over 1,200 children drawn from four sites across the U.S. and Puerto Rico (the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders, or MECA Study). Their psychometric properties were tested in a subsample of children reinterviewed by clinicians. The findings support the use of these continuous measures. The scales are strongly related to the diagnostic categories and show good test-retest reliability. The scales can be used to characterize severity in children with diagnoses and to describe problems and symptoms in children without diagnoses. Because these scales can measure gradations in symptomatology, they may be more useful than categorical measures. Like categorical measures, the scales based on the DISC are greatly influenced by the informant, whether child or parent.This research was supported by grant MH-46732 from the National Institute of Mental Health, Bethesda, Maryland.The MECA Program is an epidemiologic methodology study performed by four independent research teams in collaboration with staff of the Division of Clinical Research, which was reorganized in 1992 with components now in the Division of Epidemiology and Services Research and the Division of Clinical and Treatment Research, of the NIMH, Rockville, Maryland. The NIMH Principal Collaborators are Darrel A. Regier, MD, MPH, Ben Z. Locke, MSPH, Peter S. Jensen, MD, William E. Narrow, MD, MPH, and Donald S. Rae, MA; the NIMH Project Officer was William J. Huber. The Principal Investigators and Coinvestigators from the four sites are as follows: Emory University, Atlanta, Georgia, UO1 MH46725: Mina K. Dulcan, MD, Benjamin B. Lahey, PhD, Donna J. Brogan, PhD, Sherryl Goodman, PhD, and Elaine Flagg, PhD; Research Foundation for Mental Hygiene at New York State Psychiatric Institute (Columbia University), New York, New York, UO1 MH46718: Hector R. Bird, MD, David Shaffer, MD, Myrna Weissman, PhD, Patricia Cohen, PhD, Denise Kandel, PhD, Christina Hoven, PhD, Mark Davies, MPH, Madelyn S. Gould, PhD, and Agnes Whitaker, MD; Yale University, New Haven, Connecticut, UO1MH46717: Mary Schwab-Stone, MD, Philip J. Leaf, PhD, Sarah Horwitz, PhD, and Judith H. Lichtman, MPH; University of Puerto Rico, San Juan, Puerto Rico, UO1 MH46732: Glorisa Canino, PhD, Maritza Rubio-Stipec, MA, Milagros Bravo, PhD, Margarita Alegría, PhD, Julio Ribera, PhD, Sarah Huertas, MD, and Michael Woodbury, MD.The authors gratefully acknowledge Zenaida González and José Martínez who performed the data nalayses, as well as Elizabeth Pastrana, and Felícita Laboy, secretaries, for their valuable contributions to this work.     

Folic acid and the prevention of neural tube defects: A position paper of the national society of genetic counselors

Considerable scientific evidence demonstrates the reduction in risk for neural tube defects (NTDs) associated with maternal preconceptional folic acid supplementation. The National Society of Genetic Counselors (NSGC) endorses the U.S. Public Health Service recommendations for folic acid supplementation at the 0.4 mg level for women in the general population and at the 4.0 mg level for women at high or increased risk for NTD pregnancies for at least 4 weeks prior to active pursuit of conception. We encourage targeted educational efforts and surveillance to assess results of this dietary supplementation. The NSGC further urges the Food and Drug Administration to fortify staple foodstuffs with folic acid for a population-based approach to minimize the number of NTD births.     

A critical review of theS/L reliability index

The meaning and properties of a commonly used index of reliability, S/L,were examined critically. It was found that the index does not reflect any conventional concept of reliability. When used for an identical behavioral observation session, it is not statistically correlated with other reliability indices. Within an observation session, the standardizing measure of Lis beyond the control of the investigator. Furthermore, the reason for the choice of Las the standard is unclear. The role of chance agreement in S/Lis not known. The exact interpretation of the index depends on which observer reports L.Overall the conceptual and mathematical meaning of S/Lis dubious. It is suggested that the S/Lindex should not be used until its nature is shown to be a measure of reliability. Other approaches such as the intraclass correlations and generalizability coefficients should be used instead.The authors are indebted to Johnny Matson for his critique of an earlier version of this paper.     

The effects of effort toward comprehension on recall

Four experiments examined free recall of generally incomprehensible sentences with appropriate cues that made the sentences comprehensible. A distinction is made between processes involved in an effort toward comprehension and elaboration processes that occur following comprehension. It was found that providing additional time for effort toward comprehension enhanced recall, while providing additional time for elaboration following comprehension did not enhance recall. It was also shown that the effects of effort toward comprehension were contingent upon eventual understanding of the sentence.     

TEACHING FOSTER GRANDPARENTS TO TRAIN SEVERELY HANDICAPPED PERSONS

Five foster grandparents were taught training skills for use in their daily interactions with severely handicapped persons in an institution. Following baseline, specific teaching procedures consisting of teacher instructions, prompts, modelling, and praise were implemented. The grandparents' frequency of training three skill areas increased as the specific teaching was implemented in multiple-baseline format. The total amount of training continued as teacher instructions, prompts, and modelling were terminated and praise continued, although the grandparents spent their training time emphasizing only two of the three skill areas. Teacher presence was gradually reduced over an 11-week period, with no decrease in grandparents' frequency of training. Four of the foster grandchildren, all profoundly retarded and multiply handicapped, demonstrated progress throughout the study. Results were discussed in light of the available contributions of foster grandparents in institutional settings and maintenance of staff training.