BENEFITS AND COSTS OF SUPPORTED EMPLOYMENT: AN ANALYSIS OF THE ILLINOIS SUPPORTED EMPLOYMENT PROJECT

This investigation presents a cost-benefit analysis completed for one of 27 states implementing supported employment as a result of federal funding. Based upon the benefits and costs detailed, society realized a $0.75 return for every $1.00 invested in supported employment in Illinois. Supported employees realized a 37% increase in their earnings over a comparable period. The results of this study are discussed and recommendations are made for similar analyses across states.     

AN EVALUATION OF GENTLE TEACHING AND VISUAL SCREENING IN THE REDUCTION OF STEREOTYPY

Gentle teaching and visual screening techniques have been used to control severe behavior problems in persons with mental retardation. An alternating treatments design was used to compare gentle teaching, visual screening, and a task-training condition in the reduction of the high-level stereotypy of 3 persons with mental retardation. Following a baseline phase, a task-training condition using standard behavioral techniques was implemented to establish the effects of training the subjects on the tasks. Results showed a modest decrease in stereotypy. This phase was followed by an alternating treatments phase in which visual screening, gentle teaching, and baseline conditions were compared. Both procedures were superior to the control condition in reducing stereotypic behavior, with visual screening being more effective than gentle teaching. When compared with data from the prior phase, gentle teaching was found to be more effective than task training for 2 subjects but less effective for the 3rd, whose stereotypy increased during gentle teaching. Two succeeding phases in which visual screening was implemented across two and then all three daily conditions reduced stereotypy further to near-zero levels. An additional phase with 1 subject demonstrated that the treatment effects of visual screening were easily replicated across therapists. Mixed and idiosyncratic changes in collateral behaviors occurred. For example, “bonding,” the goal of gentle teaching, occurred at the same low levels under both treatments, contrary to the predictions of gentle teaching's proponents. The results indicate that gentle teaching may not be the universal treatment of choice for stereotypy its proponents suggest, and that it requires further empirical evaluation.     

SELF-RECORDING OF ATTENTION VERSUS PRODUCTIVITY

We investigated the relative effects of self-recording of attentive behavior and self-recording of academic productivity with 5 upper elementary-aged special education students in their special education classroom. Following baseline, both self-recording treatments were introduced according to a multielement design. After the multielement phase, we assessed the pupils' performance under a choice condition, faded the overt aspects of the treatment program according to a withdrawal design, and probed maintenance over 5 weeks. Results revealed that both treatments produced clear improvements in arithmetic productivity and attention to task, neither treatment was clearly and consistently superior to the other, pupils preferred the self-recording of attention treatment, the effects were maintained for all pupils, achievement test scores improved, and pupils generally recorded accurately.     

MULTIPLE TREATMENT INTERFERENCE IN THE ALTERNATING TREATMENTS DESIGN AS A FUNCTION OF THE INTERCOMPONENT INTERVAL LENGTH

In experimental designs requiring the administration of more than one treatment to the same subject(s), the effect of one treatment may be influenced by the effect of another treatment (Campbell & Stanley, 1963), a phenomenon known as multiple treatment interference. We conducted two studies in which multiple treatment interference in an alternating treatments design was shown to be a function of the length of the intercomponent interval (ICI) separating treatment conditions. In the first study, we evaluated the effects of four different treatments on the mouthing of a severely retarded boy. Under a 1-min ICI no consistent differential responding to treatment was obtained. Differential responding emerged when the ICI was increased from 1 min to 120 min, thus suggesting multiple treatment interference in the lack of differential responding under a 1-min changeover interval. Functional control of the nondifferential and differential responding as a function of the ICI length was replicated in a reversal phase. In the second study, we compared two treatment procedures for the disruptive noncompliant behavior of a moderately retarded boy. Multiple treatment interference (i.e., the lack of differential responding) occurred with the 1-min intercomponent interval. An increase to a 120-min ICI again resulted in differential responding. A replication of multiple treatment interference by a reversal to a short interval phase was not achieved in the second subject. Results of this study support much of the basic literature on discrimination and multiple treatment interference. Major findings of this study are twofold: Multiple treatment interference can depend on the length of the changeover interval between treatments and multiple treatment interference can take the form of a lack of differential responding to various treatments. Implications for future research are discussed.     

A Broader Perspective: Counseling Psychology’s Emphasis on Evidence

The process of identifying empirically supported treatments developed by the Division 12 of the American Psychological Association has been criticized from various perspectives. However, there are a number of alternative evidence-based models for using research findings to increase the efficacy of mental health services. In this article, the principles of empirically supported interventions developed and adopted by Division 17 (Society of Counseling Psychology) are presented. These principles (a) utilize a broad perspective of evidence, (b) consider a range of psychological interventions, (c) emphasize the quantitative aggregate of research evidence, (d) consider various levels of specificity, and (e) recognize philosophy of science issues that impinge on the types of conclusions that can be made.     

Evaluation of two methods of prompting drivers to use specific exits on conflicts between vehicles at the critical exit

The Florida Department of Transportation used a series of changeable-message signs that functioned as freeway guide signs to divert traffic to Universal Theme Park via one of two eastbound exits based on traffic congestion at the first of the two exits. An examination of crashes along the entire route indicated a statistically significant increase in crashes at the first eastbound exit following the actuation of the system. Furthermore, all of the crashes occurred in close proximity to the exit gore (the crosshatched area at exits that drivers are not supposed to enter or traverse) at the first exit. In Experiment 1, behavioral data were collected using an alternating treatments design. These data revealed that reassigning the exit signs was effective in producing a change in the percentage of drivers using each of the two exits. These data also showed that the reassignment of the theme park exit was associated with an increase in the percentage of motor vehicle conflicts that consisted of vehicles cutting across the exit gore. An analysis revealed that the method used for switching the designated or active theme park exit on the series of changeable-message signs led to the presentation of conflicting messages to some motorists, thus resulting in erratic driving behavior (cutting across the exit gore). In Experiment 2, the treatment evaluated the use of a phased method of switching the designated theme park exit to eliminate the delivery of conflicting messages. The new method for switching the designated theme park exit was not associated with an increase in motorists cutting across the exit gore.     

THEORETICAL,PRACTICAL, AND SOCIAL ISSUES IN BEHAVIORAL TREATMENTS OF OBESITY

Although showing superior maintenance, behavioral treatments of obesity typically produce small weight losses at a decelerating rate. Rather than reflecting poor compliance with treatment, these findings are consistent with known compensatory metabolic changes that operate to slow weight loss and promote regain. Other problems associated with dieting include failure of caloric regulation, hyper-responsivity to food palatability, and hunger, which is greatest under conditions of moderate restriction and unpredictability of access to food. The inevitability of treatment failure in many instances must be faced and efforts made to prevent further worsening of the obese patient's self-esteem. Prognosis and treatment planning may be aided by consideration of the historical difficulties of weight loss, the degree of hunger experienced on diets, which may reflect important physiological differences among individuals, and the use of food to optimize arousal level. Full involvement of the patient in setting goals and planning treatment is recommended.     

Oral behavioral patterns in facial pain, headache and non-headache populations

Patterns of oral behavior have been suggested as factors leading to head and facial pain. The present study evaluated the frequency with which certain oral habits were self-reported by five groups of Ss: Facial Pain. Tension Headache, Migraine Headache, Combined Migraine and Tension Headache and No Pain. Four oral behavior patterns were found to be significantly different among groups. These were diurnal bruxism. thrusting the jaw forward, cupping the chin in the hand and resting the hand on the side of the face. When Ss were reclassified into those reporting no facial pain, temporomandibular joint (TMJ) pain, or a combination of TMJ and jaw muscle pain, the variables of diurnal bruxism and resting the hand on the side of the face were found to predict significantly both pain groups. However, the resting the hand factor was negatively weighted for the TMJ Pain group only. One other factor, nocturnal bruxism. was found to be self-reported at a significantly higher frequency in the Combined Facial Pain group compared to the No Facial Pain and TMJ Pain groups. Discussion focuses on the implications of the present findings on research in the facial pain and headache areas.