Training behavioral technicians to implement naturalistic behavioral interventions using behavioral skills training

Training behavioral technicians mainly focuses on teaching accurate implementation of structured behavioral intervention programs. Often behavioral technicians are unable to adequately promote their clients' learning in less structured environments, which can limit opportunities for generalization of the clients' skills to the natural environment. The aim of the present study was to evaluate the effectiveness of using behavioral skills training to coach behavioral technicians on the implementation of naturalistic behavioral interventions. Naturalistic behavioral interventions take advantage of naturally occurring situations to teach new skills and practice mastered skills in natural settings, thus promoting generalization across environments and in the presence of natural contingencies. Five behavioral technicians were trained to implement a novel protocol based on play therapy. Specifically, they were coached to engage in well‐defined positive behaviors during their interactions with clients (e.g., labeled praise). All participants reached mastery criteria, maintained skills at follow‐up, and demonstrated generalization of skills with novel clients.     

The Association Between Delirium and Cognitive Decline: A Review of the Empirical Literature

Delirium is a common neurobehavioral syndrome that occurs across health care settings which is associated with adverse outcomes, including death. There are limited data on long-term cognitive outcomes following delirium. This report reviews the literature regarding relationships between delirium and cognitive impairment. Psych Info and Medline searches and investigation of secondary references for all English language articles on delirium and subsequent cognitive impairment were carried out. Nine papers met inclusion criteria and documented cognitive impairment in patients following delirium. Four papers reported greater cognitive impairment among patients with delirium than matched controls. Four papers reported higher incidence of dementia in patients with a history of delirium. One study found 1 of 3 survivors of critical illness with delirium developed cognitive impairment. The evidence suggests a relationship between delirium and cognitive impairment, although significant questions remain regarding the nature of this association. Additional research on delirium-related effects on long-term cognitive outcome is needed.     

Training staff to conduct a paired-stimulus preference assessment

Three staff members were trained to conduct stimulus preference assessments using a paired-stimulus format with 8 children with autism. Staff were trained to mastery level using brief instruction, a video model, and rehearsal with verbal feedback. Training took about 80 min per staff member. Results demonstrated that staff rapidly learned to correctly perform paired-stimulus preference assessments with children.     

Maintaining proficient supervisor performance with direct support personnel: an analysis of two management approaches

A traditional management approach using indirect feedback was compared to an approach involving direct feedback for maintaining supervisory proficiency in observing and providing feedback to staff. Three supervisors participated in each condition. The first 3 supervisors then received direct feedback. Direct feedback was accompanied by high levels of performance relative to the indirect feedback protocol. The need for maintenance procedures with supervisors is discussed.     

THE EFFECTS OF SELF-MONITORING AND SUPERVISOR FEEDBACK ON STAFF PERFORMANCE IN A RESIDENTIAL SETTING

We evaluated the effects of a self-monitoring procedure to increase staff on-task behavior and adherence to scheduled activities. Self-monitoring involved the use of activity cards that staff members completed and carried with them to assist in determining the activities for which they were responsible at any given time. Increases in both on-schedule and on-task behavior resulted. Supervisor feedback was subsequently added because some staff members did not maintain consistently high levels of performance. Generalization data indicated that staff members implemented the procedure during evening hours without specific programming. The advantages and limitations of using a self-monitoring procedure for improving performance of staff members in residential settings are discussed.     

INCREASING IMPLEMENTATION OF SPECIAL EDUCATION INSTRUCTION IN MAINSTREAM PRESCHOOLS: DIRECT AND GENERALIZED EFFECTS OF NONDIRECTIVE CONSULTATION

Two studies evaluated a consultation strategy for increasing teachers' implementation of instruction related to specific Individualized Education Plan objectives for handicapped children mainstreamed into regular preschool programs. In the first study, teachers viewed videotaped sequences of regular classroom routines and were asked to generate ideas for embedding IEP-related instruction into those routines. All teachers demonstrated increases in instructional behaviors in targeted routines, and 2 of the 3 teachers increased instruction in additional settings that had not been the focus of the consultation. Children demonstrated concomitant increases in IEP-targeted behaviors. In follow-up questionnaires and interviews, teachers reported increased confidence in their ability to implement specialized instruction. These findings were replicated in a second study in which the videotaping was replaced by teacher interview, and in which the consultation was carried out by a previously untrained special education teacher.     

Perspective role-taking in young children

Children between the ages of 4 and 7 years were asked to select a photograph depicting the visual perspective of a puppet which was placed at various locations around a dollhouse in a modified version of Piaget and Inhelder's three-mountain task. A shielded condition was used for half of the children. Three types of errors were examined in relation to the shield condition, age, and type of vantage point (views from the corners and from the sides). Shielding of the stimulus array reduced egocentric errors among 4-year-olds, producing a pattern of responses more typical of that observed among older children. Increasing specificity in perspective role-taking with age was indicated by changes in error patterns. Finally, the task was more difficult on trials with corner views, particularly when the child's own view included some of the cues present in the puppet's perspective.     

A PERFORMANCE-BASED LOTTERY TO IMPROVE RESIDENTIAL CARE AND TRAINING BY INSTITUTIONAL STAFF

Two experiments were conducted on four units of a residential facility for the multiply-handicapped retarded in an attempt to improve daily care and training services. Experiment I compared the effects of two procedures in maintaining the work performance of attendants, using an A-B design on two units. One procedure consisted of implementing specific staff-resident assignments, the other consisted of allowing attendants who had met performance criteria to be eligible for a weekly lottery in which they could win the opportunity to rearrange their days off for the following week. Results showed that the lottery was a more effective procedure as measured by the per cent of time attendants engaged in predefined target behaviors, and by their frequency of task completion in several areas of resident care. Experiment II replicated and extended these results to the area of work quality on two additional units, using a multiple-baseline design. The performance lottery was found to be an effective economical procedure that could be implemented by supervisory staff on a large scale.     

Locus of control,perceived responsibility for prior fate,and helping behavior

One-hundred-and-sixty adolescents participated in two studies designed to investigate the relationship between $\text{I}\text{E}$ and helping behavior as mediated by the perceived cause of another's need. In the first study, Ss were given the opportunity to help, either “indirectly” or “directly,” a supervisor who had been over- or underpaid in a prior similar task. Internals helped more in the “direct” help than the “indirect” help conditions but their helping behavior and their perceptions of their supervisors were not consistent. The perceptions of the externals were relatively consistent with their greater help of the “overpaid” supervisor. In study 2, the Ss were given additional information to increase the possibility of their making causal attributions as a function of the supervisor's prior fate. Once again, the external subjects' helping behavior reflected their perception of their supervisor's merit. The internal subjects exhibited relatively little helping behavior regardless of their supervisors' prior fate or perceived competence.