Evaluating pediatric psychology consultation services in a medical setting: An example

We examined the nature of referrals to a health center-based pediatric psychology service from 1990 to 1993 and assessed the satisfaction of health professionals with these services. Archival evaluation of 1467 records showed that over half of the consultation requests came from general pediatrics, pediatric neurology, and surgical services and that 70% of the psychological services were delivered on an outpatient basis. The most frequent referrals were for cognitive/neuropsychological evaluation and externalizing behavior problems. Pediatric psychology trainees were involved in 94% of the consultations. Survey of health professionals (n = 143) indicated very high overall satisfaction with the quality of services delivered. Presenting problems yielding the greatest likelihood for future consultation requests were behavior problems, child abuse, coping with illness, and depression/suicide. Results are discussed in the context of previous evaluations of pediatric psychology services and recommendations for future evaluation research.     

Driving assessment with computer-video scenarios: More is sometimes better

Several factors are critical in designing effective simulator systems for driving research and driver assessment. First, there is cost, in terms of which, less is better. Costly systems are sometimes fine for specific research purposes, but they are impractical for most other purposes. Second, there is realism; in this case, more may be better, but we don’t know how much realism is really necessary for good prediction of actual driving behaviors. Recent evidence suggests that real-world clutter may enhance prediction, but it also makes interpreting research more difficult. More realism may increase cost, but this is not necessarily the case. Third, there is user-friendliness, in terms of which, again, more is better. Systems that are easier to operate require less-highly trained personnel; hence, increasing user-friendliness also decreases cost, especially for assessment. We demonstrated a highly user-friendly, low-cost, moderately realistic, and partly interactive computer-video driving research and assessment system. In recent research, we obtained multipleR values ofA7 for older drivers with only three to four scenarios predicting a real-world crash index.     

The Influence of Outcome Expectancy and Self-Efficacy on the Behavioral Intentions of Novice Exercisers

The present study was based upon self-efficacy (SE) theory (Bandura, 1986). Its purpose was to examine whether incentives, defined as the product of outcome expectancy and outcome value, would help to predict the behavioral intentions of novice exercisers when coupled with SE expectations for a specific form of exercise. Fifty- three volunteers who were novices at weight training for exercise, participated in a 2-day learn-to-weight-train clinic offered at a university. They completed pre- and postclinic measures of SE for weight training, expectancy-value ratings of outcomes primary and secondary to 1 month's weight-training participation, and a strength- of-intention measure of multiple actions consequent to clinic participation. Results indicated that primary physical health outcomes expected of postclinic participation independently predicted the variability in pre- and postclinic future intentions beyond the variance predicted by SE. Further, incentives and SE clearly discriminated between individuals extreme in the strength of their intentions at pre- and postclinic. Discussion concerns the inclusion of measures of incentive in studies using self-efficacy theory in order to examine individuals who begin exercise and then move through various decision stages about exercise adoption and maintenance. Rather than merely assuming the influence of incentives necessary and sufficient to encourage a cognitive or behavioral impact of efficacy, arguments are made for actively examining incentive as manifested through outcome expectations.     

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.     

TEACHING MULTIPLICATION FACTS TO STUDENTS WITH LEARNING DISABILITIES

Multiple baseline designs were used to examine the effects of an instructional package on accuracy of performance in solving multiplication facts by 3 students with learning disabilities. The instructional package included the following components: (a) a modified instructional sequence in which multiplication facts were grouped into the zeros, ones, doubles, fives, and nines categories, and those remaining; (b) identification of the category in which each fact belonged; (c) mnemonic strategies associated with solving facts in each category; and (d) steps to be completed for solving facts in each category. Results indicated that the instructional package produced substantial and immediate effects. After receiving instruction, a participant's accuracy was often 100%, and this was maintained throughout the evaluation even as other strategies were introduced. Comparable results occurred across students, demonstrating replication of the effects of the instructional package.