Three intensive community-based programs for children and youth with serious emotional disturbance and their families

Systems of care for children with serious emotional disturbance and their families have generally lacked intensive community-based programs. We describe three types of newly established community-based programs in New York State and present a general evaluation plan for determining which programs work for various children and their families. The three community-based programs are Intensive Case Management, Family-Based Treatment, and Family-Centered Intensive Case Management. Process and outcome evaluations are being conducted for each of these programs. These evaluations make use of common intake and termination instruments, based on a minimum data set, standardized assessment instruments, and a common logic model, thus facilitating the comparison of findings across evaluations.     

Assessing the relationship of Type A beliefs to cardiovascular disease risk and psychosocial distress

Investigators have begun to take a multimodal approach to the assessment and treatment of psychosocial risk factors for cardiovascular disease (CVD). For instance, cognitive responses have become the focus of contemporary research along with continued examination of overt Type A behaviors. Price (1982) has outlined a set of beliefs purportedly associated with Type A behavior and subsequent CVD risk. The current study examines the validity of this belief set as represented by a newly developed measure, the Type A Cognitive Questionnaire (TACQ). Subjects were 221 employed adults participating in a worksite CVD risk reduction program. They completed the TACQ as part of a pretreatment CVD risk screening protocol. As hypothesized, TACQ scores were significantly associated with Type A behavior, hostility, physiological mediators of CVD, and psychosocial distress. Discussion addresses continued refinement of the Type A belief construct.     

On the limits of the matching concept in monkeys (Cebus apella).

Two cebus monkeys, with many years of experience matching a variety of static visual stimuli (forms and colors) within a standard matching-to-sample paradigm, were trained to press a left lever when a pair of displayed static stimuli were the same and to press a right lever when they were different. After learning the same/different task, the monkeys were tested for transfer to dynamic visual stimuli (flashing versus steady green disks), with which they had no previous experience. Both failed to transfer to the dynamic stimuli. A third monkey, also with massive past experience matching static visual stimuli, was tested for transfer to the dynamic stimuli within our standard matching paradigm, and it, too, failed. All 3 subjects were unable to reach a moderate acquisition criterion despite as many as 52 sessions of training with the dynamic stimuli. These results provide further evidence that, in monkeys, the matching (or identity) concept has a very limited reach; they consequently do not support the view held by some theorists that an abstract matching concept based on physical similarity is a general endowment of animals.     

Visually guided catching and tracking skills in pigeons: A preliminary analysis

Research on reaching, tracking, and catching in the pigeon has been hampered by limitations of technology. A new system was developed in which the target was a small rectangle presented on a video display terminal and the pecking response was detected with touch technology. The target moved up and down vertically with sinusoidal velocity. A coincidence between the location of the pigeon's beak and the cursor produced reinforcement. The pigeon pecked ahead and behind the target, but most pecks occurred behind the target so the dominant tracking strategy was lagging. The pigeon was adept at “catching” the target at many locations throughout the trajectory. Transfer of motor learning was tested on probe trials during which the trajectory changed from vertical to horizontal. On transfer trials the pigeons' dominant pattern of pecking immediately shifted from vertical to horizontal. The motor skill displayed by the pigeons was flexible and adaptive, suggesting that the pigeons had learned to track the cursor.     

THE USE OF BEHAVIORAL ASSESSMENT TO PRESCRIBE AND EVALUATE TREATMENTS FOR SEVERELY HANDICAPPED CHILDREN

Behavioral assessment procedures were used to prescribe and evaluate treatments of maladaptive behavior for 2 children with severe multiple handicaps. In Experiment 1, the results of an assessment of reinforcer preference were used in conjunction with a functional analysis of the conditions maintaining self-injurious behavior to prescribe a treatment for a child with severe disabilities. The treatment procedure involved the use of a pressure-sensitive microswitch to activate reinforcing stimuli during two solitary conditions, during which self-injurious behavior had occurred at high rates. The results were evaluated with a multiple baseline across settings design and indicated that self-injury decreased with concomitant increases in microswitch activation. Results were maintained at 6 weeks, 8 weeks, and 6 months. In Experiment 2, the results of behavioral assessments of reinforcer preference and self-injurious behavior were combined to develop a treatment for a second severely handicapped child, who exhibited high rates of self-injury in demand situations. This treatment was evaluated with a multiple baseline across tasks design and resulted in the elimination of self-injury for up to 15 months.     

GENERALIZED LANGUAGE LEARNING BY CHILDREN WITH SEVERE MENTAL RETARDATION: EFFECTS OF PEERS' EXPRESSIVE MODELING

In this study, we investigated the conditions that contribute to observational learning of generalized language in children with severe mental retardation. Matrix-training strategies were used to teach 6 children with mental retardation to combine known words into two- or three-word utterances consistent with syntactic rules. Subsequently, the children learned two or more unknown words concurrently, inducing word-referent relations consistent with these word order rules. Generalized learning of responses not taught directly was shown to be under experimental control using a multiple baseline design across submatrices. Expressive modeling of only four or five responses was sufficient to promote recombinative generalization in the expressive and receptive modalities. Thus, 95% to 98% of subjects' learning was attributed to generalization processes. This study demonstrates how the efficiency of language training with children with mental retardation might be enhanced by coupling observational learning and matrix-training strategies.     

DISTRACTION: ITS UTILIZATION AND EFFICACY WITH CHILDREN UNDERGOING DENTAL TREATMENT

We investigated the utilization and efficacy of distraction in reducing the anxious and disruptive behavior of 4 children undergoing dental treatment. During the distraction procedure, the children were shown a poster and told a story about it during dental treatment. They earned a prize if they attended to the poster and story and could correctly answer questions about them following each intervention visit. The children's disruptive behavior was assessed via direct observation, and results were analyzed within a multiple baseline design. The children exhibited high levels of anxious and disruptive behavior across baseline visits, regardless of the length of time in treatment or number of visits. Anxious and disruptive behavior decreased upon introduction of the intervention for all children. This was accompanied by the children meeting the criterion for correct answers on the distraction quiz. However, 2 of the children demonstrated an increase in their anxious and disruptive behavior across intervention visits. Results are discussed in terms of the need to evaluate treatment strategies that promote maintenance as well as initial changes.     

EFFECTS OF WAIT-TIME AND INTERTRIAL INTERVAL DURATIONS ON LEARNING BY CHILDREN WITH MULTIPLE HANDICAPS

We investigated the influence of teacher wait-time and intertrial interval durations on the performance of 4 multiply handicapped students during instruction in 10 skills. Four experimental conditions were evaluated: long wait-time and long intertrial interval, long wait-time and short intertrial interval, short wait-time and long intertrial interval, and short wait-time and short intertrial interval. Instructors attempted to keep short intervals as close as possible to 1 s and long intervals as close as possible to 10 s for both variables. Results showed that student performance was superior under the long wait-time conditions irrespective of the length of the intertrial interval.     

CLINICAL BEHAVIORAL PHARMACOLOGY: METHODS FOR EVALUATING MEDICATIONS AND CONTINGENCY MANAGEMENT

We evaluated methods for comparing the effects of dextroamphetamine (Dexedrine), thioridazine (Mellaril), and contingency management in the control of severe behavior problems. A reversal design was used in which medications were systematically titrated and assessed in unstructured as well as structured settings with three clients. Subsequently, behavioral procedures including timeout, differential reinforcement of other behavior, and visual screening, were used in a multiple-baseline design across settings. The assessment and design methods were useful in comparing the interventions. Dextroamphetamine decreased inappropriate behaviors and improved academic behaviors in one client, but no reliable effects were observed in the other two clients. Thioridazine was variable across clients, settings, behaviors, and dosages. Contingency management produced consistent decreases in inappropriate behaviors and small improvements in academic performance.     

Discriminated interresponse times: role of autoshaped responses.

When discriminated interresponse-time (IRT) procedures have been used to assess preference relations among temporally extended operants, deviations from matching have been obtained. Using a yoked-control procedure, the present study found that key pecking in a discriminated IRT procedure has two sources of strength--that arising from the response-reinforcer contingency that is explicitly arranged, and that arising from a stimulus-reinforcer contingency that is a by-product of the explicitly arranged contingency. The key pecking of all lead birds, and that of 3 of the 4 birds exposed to a yoked autoshaping procedure, was controlled by the keylight that signaled the lead birds' criterion IRTs. Because stimulus control of key pecking by the keylight, whether autoshaped or discriminative, fosters deviations from matching, the discriminated IRT procedure does not provide an appropriate basis for conclusions about preference relations among IRTs.