Dry-bed training: rapid elimination of childhood enuresis

Enuresis has been treated with moderate effectiveness by the urine-alarm method which requires many weeks of training. The present procedure used a urine-alarm apparatus but added such features as training in inhibiting urination, positive reinforcement for correct urinations, training in rapid awakening, increased fluid intake, increased social motivation to be nonenuretic, self-correction of accidents, and practice in toileting. After one all-night training session, the 24 enuretic children averaged only two bedwettings before achieving fourteen consecutive dry nights and had no major relapses. Little or no reduction in bedwetting occurred within the first two weeks for matched-control enuretics who were given the standard urine-alarm training. The results of a control-procedure showed that the new procedure did not involve Pavlovian conditioning. The new method appears to be a more rapid, effective and different type of treatment for enuresis.     

A rapid method of eliminating stuttering by a regulated breathing approach

The Habit Reversal Procedure for eliminating nervous habits was applied to the problem of stuttering. In the new procedure the speaker interrupted his speech at moments of actual or anticipated stuttering and at natural pause points, and resumed speaking immediately after breathing deeply during the pause. In addition to this regularized pausing and breathing, the program included other factors such as formulation of one's thoughts prior to speaking, identification of stutter-prone situations, identification of mannerisms associated with stuttering, speaking for short durations when tense or nervous, daily breathing exercises, relaxation procedures for anxiety, immediate display of improved speaking, and enlisting family support for progress. Fourteen stutterers were given training in the program during a single counseling session of about two hours duration. The next day, the average number of stuttering episodes decreased by 94 per cent, by 97 per cent at the end of one month, and by 99 per cent during the extended follow-up. Each of the clients was improved by at least 93 per cent. The new procedure appears to be more rapid and effective than alternative procedures.     

Heart rate conditioning in the newborn infant

In an attempt to condition heart rate in newborns, 21 infants were assigned to Conditioning, Random Control, and Backward Conditioning Groups. During training trials, the Conditioning Group received an eight-second tone (CS), a six-second ISI, and a ten-second presentation of glucose via nipple (UCS) that overlapped the last two seconds of tone. The Random Control Group received tones at the same intertrial intervals as the Conditioning Group, but glucose varied randomly. The Backward Conditioning Group received glucose during the ten seconds immediately preceding tone onset. The response to both CS and UCS during base trials was HR acceleration. The response to tone habituated in all groups, but the acceleration to glucose was maintained throughout conditioning. Although no conditioned response to the tone developed over trials, a large HR deceleration appeared during extinction to the absence of the UCS in the Conditioning Group only. This deceleration was interpreted as an orienting response to the absence of an expected event.     

A clinical trial of continuous, intermittent and overlearning ‘bell and pad’ treatments for nocturnal enuresis

Sixty-one enuretic children were allocated sequentially to ‘standard’, ‘intermittent’ or ‘overlearning’ bell and pad treatment. The results suggest that the ‘overlearning’ modification of standard treatment was successful in bringing about a reduction in the relapse rate. The present status and implications of research into nocturnal enuresis were discussed in the light of the results of the investigation.     

Oral overcorrection: side effects and extended applications.

Experiment 1: In a specialized daycare program the use of oral overcorrection (contingent toothbrushing with an oral antiseptic) to suppress one child's thumbsucking at Language Time was found to suppress the behavior of another child who was not treated but who witnessed the target child's treatment. Experiment 2: The main effects of oral overcorrection were replicated. Contingent overcorrection threats (warnings), used independently, were then shown to suppress thumbsucking behavior that had returned to its baseline level. These effects were maintained one month after the threats were discontinued, but they did not generalize to other activity periods, particularly Nap Time. Experiment 3: Contingent threats were found to suppress the persistent nap-time thumbsucking of the child from Expt 2. Increments in certain other (nonoral) inappropriate behaviors were correlated with the suppression of thumbsucking. Threats to use oral overcorrection contingent upon nonoral misbehaviors at Nap Time were not effective. However, the actual use of oral overcorrection for these categories of nonoral misbehavior served to suppress these behaviors. Experimental controls combined treatment reversal and multiple baseline single-subject designs.