ON THE RELATION OF MANDS AND THE FUNCTION OF DESTRUCTIVE BEHAVIOR

When standard analogue functional analysis procedures produce inconclusive results in children with conversational speech, the child's mands may help to identify the function of destructive behavior. In the current investigation, functional analyses conducted with 2 children who exhibited self-injury, aggression, and property destruction were undifferentiated across conditions. Based on informal observations and school and parental report, an analysis was conducted using mands to help determine the function of the destructive behavior. Using a multielement design, the therapist's compliance with the child's mands occurred either on a fixed-ratio (FR) 1 schedule or contingent on destructive behavior. Destructive behavior occurred at high and consistent levels when reinforcement of mands was contingent on destructive behavior and at near-zero levels when reinforcement of mands occurred on the FR 1 schedule. Based on these results, a second analysis was conducted in which compliance to mands occurred only when the child appropriately requested it (i.e., functional communication training plus extinction) and, for 1 child, compliance with mands was terminated contingent upon destructive behavior (i.e., functional communication training plus response cost). For both children, the rates of destructive behavior decreased markedly. The results suggest that assessing the child's mands may be useful in decreasing destructive behavior when a functional analysis is inconclusive.     

The evaluation and treatment of aggression maintained by attention and automatic reinforcement.

In the current investigation, we used direct and indirect methods to assess and treat several topographies of aggression that were hypothesized to have separate operant functions in a young boy with severe mental retardation and pervasive developmental disorder. First, a functional analysis of aggression, using the methods described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994), was conducted and produced inconclusive results. Next, indirect methods were used to develop a second functional analysis, which showed that chin grinding (firmly pressing and grinding his chin against the skin and bones of others) persisted independent of social contingencies and that the other topographies of aggression (e.g., hitting, kicking) were maintained by social positive reinforcement (attention). A treatment designed to decrease aggression maintained by attention—functional communication training with extinction—reduced all forms of aggression except chin grinding. This latter topography of aggression, which we hypothesized was maintained by automatic reinforcement, was reduced when the response-reinforcer relation was interrupted through response blocking and the child was provided with an alternative form of chin stimulation.     

REDUCTIONS IN SELF-INJURY PRODUCED BY TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION

Transcutaneous electrical nerve stimulation is used to reduce pain but also may be useful for self-injurious behavior (SIB). In the current investigation, a microcurrent electromedical device, classified as a transcutaneous electrical nerve stimulator (TENS), was applied with a man with Down syndrome who displayed SIB that persisted in the absence of social contingencies. Although clinically significant results were not maintained, a clear difference in the rates of SIB during active and inactive TENS was observed.     

ESTABLISHING DISCRIMINATIVE CONTROL OF RESPONDING USING FUNCTIONAL AND ALTERNATIVE REINFORCERS DURING FUNCTIONAL COMMUNICATION TRAINING

Functional communication training (FCT) is a popular treatment for problem behaviors, but its effectiveness may be compromised when the client emits the target communication response and reinforcement is either delayed or denied. In the current investigation, we trained 2 individuals to emit different communication responses to request (a) the reinforcer for destructive behavior in a given situation (e.g., contingent attention in the attention condition of a functional analysis) and (b) an alternative reinforcer (e.g., toys in the attention condition of a functional analysis). Next, we taught the participants to request each reinforcer in the presence of a different discriminative stimulus (S^D). Then, we evaluated the effects of differential reinforcement of communication (DRC) using the functional and alternative reinforcers and correlated S^Ds, with and without extinction of destructive behavior. During all applications, DRC (in combination with S^Ds that signaled available reinforcers) rapidly reduced destructive behavior to low levels regardless of whether the functional reinforcer or an alternative reinforcer was available or whether reinforcement for destructive behavior was discontinued (i.e., extinction).     

The Role of Relational Aggression in Identifying Aggressive Boys and Girls

Peer perceptions of relational and overt aggression and peer evaluations of social competencies were obtained for 461 boys and 443 girls in second and third grades. In contrast to Crick and Grotpeter (1995), boys obtained higher relational and overt aggression scores than girls, and the relation between both types of aggression and peer evaluations were similar for boys and girls. When controlling for levels of overt aggression, relational aggression made a statistically significant but small contribution to the prediction of both peer-evaluated competencies and teacher ratings of aggression in boys and girls. Analyses treating relational and overt aggression as categorical variables revealed gender differences in the prevalence and corresponding sociometric status of aggressive subtypes. When peer-rated relational aggression status is not considered, 60% of aggressive girls, compared to 7% of aggressive boys, are not identified as aggressive. High levels of overt aggression were more likely to result in peer rejection for girls than for boys. In a subsample of 112 children, peer-rated relational aggression contributed more to the discrimination of teacher-identified aggressive and nonaggressive girls, whereas peer-rated overt aggression contributed more to the discrimination of teacher-identified aggressive and nonaggressive boys.     

Psychosocial Considerations in Sickle Cell Disease (SCD): The Transition from Adolescence to Young Adulthood

Sickle cell disease (SCD) occurs in 1 of every 400 to 500 African American births. Despite its prevalence, there has been a relative dearth of attention paid to SCD in the psychological literature. African American SCD adolescents and young adults, individuals at an already vulnerable developmental stage, are at increased risk for psychological distress and psychosocial impairments (e.g., depression and low self-esteem, poor social and academic/vocational functioning). Such difficulties often result in problematic adherence to medical regimens, and thus represent a potentially serious clinical and public health problem that merits the attention of psychologists working in medical settings. This article (1) reviews the psychosocial needs peculiar to SCD patients transitioning from adolescence to young adulthood; (2) applies a culturally informed stress-coping-adjustment framework to assess and address the psychological status, psychosocial functioning, and disease outcomes of these individuals; and (3) describes a culturally and developmentally sensitive, psychoeducational group intervention.     

Olfaction in Persons with Alzheimer's Disease

The need for low cost, noninvasive procedures for aiding in the diagnosis and understanding of Alzheimer's Disease (AD) has led to theories and procedures examining the role of olfactory disorders because of the finding that the brains of AD patients invariably exhibit neuropathology hi the hippocampus and entorhinal cortex. This loss correlates with the increase in the number of plaques and tangles and with the severity of dementia. Considered together, these findings suggest that brain structures closely related to the olfactory system demonstrate significant histopathology in AD. A comprehensive review of the literature pertaining to olfaction in persons with AD revealed that the olfactory identification ability of patients with memory disorders is impaired relative to controls. Consistency is lacking, however, when olfactory detection thresholds are investigated. Also, there is inconsistency in regards to severity of illness and olfactory function. In addition to differentiating AD patients from normals, the olfactory paradigm has shown some limited usefulness in differentiating AD patients from some other demented patients.     

Psychological adjustment of pediatric lung transplantation candidates and their parents

Investigated psychological functioning of 45 children and adolescents (ages 5 to 17 years) and their parents presenting at a major medical center for evaluation for lung transplantation. Patients completed self-reports, and parents completed measures on their children's behavior problems and emotional distress as well as on their own symptoms of distress. In general, children and their parents reported normal functioning on standard psychological measures. Few children fell in the clinically significant range, whereas 21% of mothers and 14% of fathers reported clinically significant levels of distress. Older children reported lower levels of depressive symptoms than younger children, and patients with cystic fibrosis manifested lower levels of internalizing symptoms than those with other pulmonary diseases. Findings demonstrate the resiliency of children and their parents facing a stressful point in the child's medical status and document the usefulness of psychological screening of patients and parents to identify those in need of clinical intervention.