INCREASING CALORIE CONSUMPTION IN CHILDREN WITH CYSTIC FIBROSIS: REPLICATION WITH 2-YEAR FOLLOW-UP

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.     

EXTENDED REDUCTIONS IN STEREOTYPIC BEHAVIOR OF STUDENTS WITH AUTISM THROUGH A SELF-MANAGEMENT TREATMENT PACKAGE

The literature suggests that self-management treatment packages have two potential strengths for the reduction or elimination of stereotypic behavior: (a) Self-management may be used for extended periods of time in the absence of a treatment provider, and (b) self-management techniques are easily adapated and used in a wide variety of natural settings. We assessed whether students with severe autistic disabilities could learn to use a self-management treatment package to reduce their stereotypic behavior within a multiple baseline across subjects design with withdrawals. The results showed that all of the students learned to use self-management procedures to reduce greatly levels of stereotypic behavior (typically to zero), and improvement occurred for extended periods of time in new settings without the presence of a treatment provider. The results are discussed in terms of the practical value of the treatment package and in terms of the implications for understanding autism.     

I'll Start My Diet Tomorrow: A Solution-Focused Approach to Weight Loss

This article illustrates through a personal case example how Solution-Focused Brief Therapy concepts can help people lose weight and keep it off.     

Feedback interventions and driving speed: A parametric and comparative analysis

Five experiments were conducted to assess the effects of several variables on the efficacy of feedback in reducing driving speed. Experiment 1 systematically varied the criterion used to define speeding, and results showed that the use of a lenient criterion (20 km/hr over the speed limit), which allowed for the posting of high percentages of drivers not speeding, was more effective in reducing speeding than the use of a stringent criterion (10 km/hr over the speed limit). In Experiment 2 an analysis revealed that posting feedback reduced speeding on a limited access highway and the effects persisted to some degree up to 6 km. Experiments 3 and 4 compared the effectiveness of an unmanned parked police vehicle (Experiment 3) and a police air patrol speeding program (Experiment 4) with the feedback sign and determined whether the presence of either of these enforcement variables could potentiate the efficacy of the sign. The results of both experiments demonstrated that although the two enforcement programs initially produced larger effects than the feedback sign, the magnitude of their effect attenuated over time. Experiment 5 compared the effectiveness of a traditional enforcement program with a warning program which included handing out a flier providing feedback on the number and types of accidents occuring on the road during the past year. This experiment demonstrated that the warning program produced a marked reduction in speeding and the traditional enforcement program did not. Furthermore, the warning program and a feedback sign together produced an even greater reduction in speeding than either alone.     

A PARTICIPATIVE MANAGEMENT APPROACH FOR IMPROVING DIRECT-CARE STAFF PERFORMANCE IN AN INSTITUTIONAL SETTING

The present study evaluated a participative management approach for increasing the frequency of interactions between institutional staff and severely/profoundly retarded residents. The participative management approach involved teaching staff how to use self-monitoring, standard setting, self-evaluation, and self-reinforcement procedures. These procedures were then used by staff with minimal involvement of supervisory personnel. Although supervisors provided feedback and praise to staff for using these self-management behaviors, feedback and praise were never dispensed contingent on staff interactions with residents. Results indicated that during the participative management program there was an increase in staff interactions that were contingent on appropriate resident behavior. The increase in this type of staff interaction was accompanied by an increase in appropriate resident behavior. Follow-up data on both staff and resident behaviors, although showing moderating trends, suggested generally good maintenance of the initial behavior changes. Acceptability data suggested that staff were quite receptive to the program. The advantages of participative management procedures for improving staff performance in residential settings are discussed.     

FUNCTIONAL COMMUNICATION TRAINING TO REDUCE CHALLENGING BEHAVIOR: MAINTENANCE AND APPLICATION IN NEW SETTINGS

We evaluated the initial effectiveness, maintenance, and transferability of the results of functional communication training as an intervention for the challenging behaviors exhibited by 3 students. Assessment indicated that escape from academic demands was involved in the maintenance of the challenging behaviors. Social attention was also implicated as controlling the behavior of 1 student. The intervention involved teaching alternative assistance-seeking and attention-getting phrases to the students in an effort to replace challenging behavior with these verbal equivalents. Multiple baseline data collected across the 3 students indicated that not only did the intervention substantially reduce challenging behavior but also that these results transferred across new tasks, environments, and teachers, and were generally maintained from 18 to 24 months following the introduction of functional communication training. These results are discussed in light of recent efforts to develop effective interventions for severe challenging behavior and to understand the processes underlying transfer and maintenance of intervention effects.     

COLLATERAL GAINS AND SHORT-TERM MAINTENANCE IN READING AND ON-TASK RESPONSES BY INNER-CITY ADOLESCENTS AS A FUNCTION OF THEIR USE OF SOCIAL REINFORCEMENT WHILE TUTORING

Two experiments are reported concerning the effects of the differential use of verbal approval by problematic adolescents serving as tutors in a remedial reading program for an inner-city school. The experiments, each with 3 tutors and 15 tutees, used a combined multiple baseline and ABCBC design. Data showed that tutors' approvals as well as tutors' and tutees' on-task and reading responses were low and stable during baseline. Tutors were trained to use verbal approval for tutees' on-task behavior. Tokens were presented and withdrawn to control the tutors' use of approval. During phases in which tutors' approvals were raised via token dispensation, tutor reading and on-task scores increased in a nonexperimental setting. Tutee reading scores also increased as a function of tutor approvals. The second experiment replicated these findings and, in addition, (a) tested the validity of changes in reading responses via standardized tests, (b) isolated and compared the covariance between variables in all phases, and (c) provided data on tutee attention to tutors as a possible natural reinforcer for the short-term maintenance found in both studies. Data are discussed as evidence that tutors had acquired the ability to recruit reinforcement from the classroom for appropriate behavior.     

NORMAL CHILDREN AS TUTORS TO TEACH SOCIAL RESPONSES TO WITHDRAWN MENTALLY RETARDED SCHOOLMATES: TRAINING,MAINTENANCE, AND GENERALIZATION

The findings of the three experiments reported herein indicate that normal children can successfully teach social responses (i.e., delayed imitation, cooperative play, and verbalization of positive comments) to withdrawn mentally retarded peers. The effects of the intervention generalized across stimulus and response conditions, while the trained and generalized levels of responding were maintained after the end of the intervention. Moreover, the subjects developed social responding within their classrooms and play areas parallel to the intervention and continued to increase such responding after the interruption of the intervention. Direct edible reinforcement appeared to be necessary at least during the initial period of the intervention. Vicarious edible reinforcement seemed useful to prompt the appearance of responding. Vicarious social reinforcement was ineffective at the beginning of the intervention, but apparently acquired prompting power at a later stage of training. Generalization results indicated that the similarity between the response occasions used for training and those used for testing generalization played an important role. Yet, the extensiveness of training and the development of responding within the classrooms and play areas may also have had a relevant effect. The development of social responding within the classrooms and play areas appeared to be mainly the effect of new learning. This was perhaps due to vicarious and direct social reinforcement.     

OVERJUSTIFICATION EFFECTS IN TOKEN ECONOMIES

This study tested the relevance to clinical token economies of the overjustification hypothesis that tangible reward interferes with intrinsic interest in target behaviors and causes such behaviors to be less probable following a period of reinforcement than preceding such a period. The study was carried out in an ongoing token economy for chronic psychiatric patients. Alternated over an 8-week period were weeks of token and no-token reward for one of the program's target behaviors, toothbrushing. Two different amounts of token reward were employed in order to examine whether reward magnitude might influence the presence or extent of overjustification effects. Little evidence was found for the presence of overjustification effects in token economies. However, maintenance of toothbrushing was greater in no-token weeks following weeks of low amounts of token reward than in no-token weeks following weeks of higher amounts of reward. The importance of such complex functional relationships is discussed.