THE EFFECTS OF FEEDBACK ON BLOOD PRESSURE DISCRIMINATION

Discrimination of blood pressure in the natural environment as a function of feedback was assessed. Seventeen normotensives screened for blood pressure lability were randomly assigned to two groups. These subjects were then asked to estimate their systolic and diastolic blood pressure values two times per day over a 4-week period. Feedback for accuracy of blood pressure discriminations was implemented across the two groups in a multiple baseline fashion, using a feedback withdrawal condition in Group I to assess maintenance effects over time. Results showed improvement in discrimination accuracy for subjects in both groups when feedback was used, and no decrement in performance over a 2-week period after feedback was removed for subjects in Group I. Discrimination of systolic pressures improved at a slightly faster rate than discrimination of diastolic pressures.     

THE GOOD PRODUCTIVITY GAME: INCREASING WORK PERFORMANCE IN A REHABILITATION SETTING1

Simple reinforcement systems have been used to improve performance in a broad range of settings. For example, in classrooms, the “Good Behavior Game” has been shown to be very effective (Barrish, Saunders, and Wolf, Journal of Applied Behavior Analysis, 1969, 2 , 119–124). In industry, small bonuses were used to increase the punctuality of workers (Hermann, deMontes, Dominquez, Montes, and Hopkins, Journal of Applied Behavior Analysis, 1973, 6 , 503–572). In a sheltered workshop setting, Shroeder (Journal of Applied Behavior Analysis, 1972, 5 , 45–52) examined work rates under varying frequencies and amounts of reinforcement and response force. The present study involved the utilization of simple group contingencies to increase productivity in a rehabilitation industry. Four state hospital residents who were trainees at a rehabilitation industry participated in the study which examined the effects of feedback, and feedback plus the “Good Productivity Game” to improve work output. The task, for which the employees were paid a wage, involved sorting boards by size. When the employees were provided with feedback on the number of boards sorted during the observation period, productivity increased slightly over baseline. After a return to baseline, the “Good Productivity Game” was played. For performance, the game afforded the employees pseudo-competition (in that teams were paired against each other, but both teams always “won”) and simple rewards such as candy and early work termination. The game improved performance by 104% over the second baseline and by 64% over the third baseline. Data gathered on rates of on-task behavior by the employees correlate with the productivity rates. Data gathered on rates of staff attention paid to employees show little difference across conditions, thus corroborating the function of the “Good Productivity Game” in increasing work output. Although no formal data were collected, the staff continued to use the game with considerable success after the formal termination of the study. The “Good Productivity Game” appears useful in increasing work output in a rehabilitation setting. Further research should concentrate on the utility of the game throughout longer periods of the workday and over extended periods of time.     

A company-based lottery to reduce the personal driving of employees

A company-based lottery was used to reduce the number of nonessential miles employees drove their personal cars each day and thereby save gasoline. Employees were divided into an experimental and a contrast group. The experimental design involved two conditions: (a) a baseline in which no consequences were attached to driving behavior, and (b) a month-long lottery in which the experimentals were rewarded for decreasing their percentage of average miles driven per day relative to their initial baseline average. The experimentals received an ABA order of conditions while the contrast group remained in baseline. The lottery condition consisted of four weekly lotteries and one grand drawing held at the end of the month. During the lottery condition, the experimentals reduced their average daily mileage by 11.6% relative to their initial baseline (7.85 miles per employee per day) while the contrast employees increased their average mileage by 21.2%. Both groups exceeded their initial baseline averages in the return to baseline. The study was almost cost-effective because the experimentals' gas savings ($75) was within $4 of the cost of motivating them to reduce their mileage ($79).     

Differential effects of fixed- and variable-time feedback on production rates of elementary school children

The performance of 26 third-grade students who worked on individual weekly academic tasks was compared under fixed- and variable-time "home reports". During fixed-time home reports, each student was given a report to take home on Friday that indicated the quantity of work the student had completed that week, contained comments concerning the quality of the work, and had a space for parental remarks and signature. The same report was given during the variable-time reports, except that seven to nine students were randomly selected each day to receive a home report. During variable-time reporting, students completed more assignments and completed assignments on a greater percentage of available workdays than during fixed-time reporting. The teachers' preference for the variable-time reporting was one additional advantage for the variable system.     

A durable recording and feedback system

A durable low-cost data-recording and feedback system is described. Data transcribed with a special pen onto a plastic sheet can be removed only with two solvents. These data can be displayed for feedback purposes without fear of destruction.     

BEHAVIOR ANALYSIS OF MOTION CONTROL FOR PEDIATRIC NEUROIMAGING

Magnetic resonance imaging is a promising technological advance used for research and diagnosis of disease. The procedure has no risks, except when uncooperative patients require sedation. Four normal children participated in simulated scans to study the effects of (a) antecedent changes in the imaging environment and (b) operant conditioning of movement inhibition. Changing the environment can decrease movement, but operant contingencies were necessary to decrease movement to a level that, in most cases, would allow the procedure to occur without sedation.     

Instructive feedback: A comparison of simultaneous and alternating presentation of non-target stimuli

Instructive feedback involves presenting extra, non-target stimuli in the consequent events for children's responses. Two methods of presenting instructive feedback during direct instruction were compared. These methods involved presenting two extra stimuli on all trials, and presenting the two extra stimuli separately on alternating trials. Preschool students were taught coin combinations using a constant time delay procedure with instructive feedback stimuli added to both praise and correction statements. An adapted alternating treatments design was used to evaluate the two methods of presenting instructive feedback. The students were assessed to determine the extent to which instructive feedback stimuli were learned. The results indicate that students learned some of the instructive feedback stimuli and no consistent differences in the effectiveness of the two presentation methods were noted. Further, relationships between the two instructive feedback stimuli appeared to be established. Implications for instruction and future research are discussed.     

AIDS PREVENTION: IMPROVING NURSES' COMPLIANCE WITH GLOVE WEARING THROUGH PERFORMANCE FEEDBACK

A performance feedback procedure was used to increase glove wearing by nurses in a hospital emergency room in situations in which contact with body fluids was highly likely. Infection-control nurses provided biweekly performance feedback to staff nurses on an individual private basis to inform them of the percentage of contact opportunities in which they wore gloves. Observations made prior to (baseline) and during feedback in a multiple baseline design across 4 subjects indicated that substantial increases in glove wearing in target situations occurred after implementation of the feedback program and that increases occurred across most of the specific situations in which glove wearing was advised. Percentage increases in glove wearing ranged from 22% to 49% across subjects. The results are discussed in terms of prevention of acquired immune deficiency syndrome (AIDS) by use of universal precautions.     

Use of didactic training and feedback to improve quality and acceptability of progress notes written by direct-care staff on a psychiatric inpatient unit

Writing progress notes represent a critical activity of practicing clinicians in a variety of settings. They provide a way for medical practitioners, insurance companies, and others to communicate in a timely fashion regarding ongoing clinical care. Previous research showed that intervention components like didactic training, using note templates, and feedback improved the quality of progress notes. At least two questions remain despite several studies already addressing progress note writing. First, previous research most often used multiple intervention components to improve progress notes. Thus, the relative impact of two common components of interventions, such as didactic training and feedback, is unclear. Second, previous research has not evaluated the acceptability of improved progress notes for the practitioners that actually utilize them. Thus, the purpose of the current study evaluated the components of didactic training and feedback on improved progress note writing for four direct staff employed by a psychiatric inpatient unit. A second purpose of this study was to evaluate the acceptability of the training procedures by both (a) the direct-care staff participating in this study and (b) four members of the psychiatric treatment team that used direct-care staff progress notes to inform their clinical care. Results showed that feedback was necessary to improve the accuracy of progress notes for three of four participants. The direct-care staff reported the training procedures as acceptable and the treatment team noted improvements in the quality of the progress notes after intervention. These data will be discussed in terms of ways to arrange effective training programs to improve direct-care staff's progress notes.     

Emergent control for play responses following instructive feedback for children with autism spectrum disorder

Play provides children learning opportunities in the natural environment to acquire communication skills. While working to establish skills that may lead to additional leisure and social opportunities of children with autism spectrum disorder (ASD), procedures need to be both effective and efficient. One way to increase efficiency of teaching is through the use of instructive feedback (IF). Therefore, the purpose of the current study is to systematically replicate and extend previous research by examining if play behaviors emerge when using IF to teach conceptually related primary (i.e., tacts) and secondary targets (i.e., play skills). The results of the present study extend previous research by demonstrating the effectiveness of teaching tacts to individuals with ASD, and that using IF during tact training can help promote the acquisition of play skills.