Management of hyperactive children through correspondence training procedures: A preliminary study

This study examined the clinical effects of correspondence training procedures in the management of three hyperactive boys between the ages of seven and 10 years. Two subjects were intervened with the “reinforcement of corresponding reports” procedure: reports about the inhibition of hyperactivity (inattention and overactivity) were reinforced only if they corresponded with the actual inhibition of hyperactivity. The “reinforcement set up contingent upon promises” procedure was used with the third subject: the reinforcer was set up (or displayed) contingent on the patient's promises about the inhibition of hyperactivity in the immediate future, and delivered contingent upon fulfillment of the promise (actual inhibition of hyperactivity). These interventions were programmed in a multipie baseline design across two subjects and a multiple baseline design across two behaviors. A changing-criterion design was also used with all subjects: the nonoccurrence of hyperactivity had to be observed across a pre-established criterion level for the actual delivery of the reinforcer. Consistently higher levels of correspondence occurred during treatment, relative to baseline observations. The results also demonstrated the generalization and maintenance of treatment effects. The use of correspondence training as a potential alternative in the development of hyperactive children's self-control is discussed.     

Assumptions of agreement and familiarity on the abbreviated conners teachers rating scale

Implicit in the development and use of the Conners' scales are the assumptions that the raters will agree upon their rating of hyperactivity regardless of a lack of operational defitions of items in such scales, and that the cut-off score (1.5) for ADHD should be higher in cases where the rater has some familiarity with the clinical case. This study describes a method for the evaluation of both assumptions. Seven children were rated by nursing staff and school teachers using the Abbreviated Conners Teachers Rating Scale (ACTRS) daily. Observations were conducted during the 7 a.m.-3 p.m. and 3 p.m.–7 p.m. shifts in order to provide two separate scores across raters. The results supported the assumption of agreement within (for example nurses' ratings during the 7 a.m.–3 p.m. period) and between (i.e. nurses' ratings versus teachers' ratings) settings. The results did not support the assumption of familiarity: scores during early observations were similar to the scores during later observations (when more familiarity with the clinical case is assumed). It was concluded that familiarity with the clinical case does not necessarily lead to higher scores (i.e. a better prediction of hyperactivity as a function of the rater's familiarity with the case) on the ACTRS. Agreements within and between observers could be a function of the raters' agreement in terms of using a specific cut-off point (i.e. 1.5) in their definition of a case as ‘hyperactive’, rather than the raters' agreement on reporting similar scores across observers.