EXPERIMENTAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED SELF-INJURY

A functional analysis of the self-injurious behavior (SIB) of 3 adults with profound developmental disabilities showed that each engaged in SIB in more than one assessment condition. Such outcomes may result from a failure to isolate the variable maintaining SIB, or they may reflect multiple sources of control over SIB. In order to identify more clearly the determinants of SIB, each subject was exposed to a series of treatments appropriate to one or both of the apparent functions of SIB. These treatments, applied sequentially on baselines appropriate to each behavioral function, identified the maintaining variables for SIB through differential outcomes across baselines. Results indicated that the SIB of 2 subjects was multiply controlled, confirming the outcomes of the functional analysis. However, the SIB of the 3rd subject was eliminated using a treatment designed for a single function, suggesting spurious results of the original assessment. Alternative interpretations of undifferentiated assessment data are discussed, as are analysis and treatment issues related to multiply determined behavior disorders.     

FUNCTIONAL COMMUNICATION TRAINING WITH AND WITHOUT EXTINCTION AND PUNISHMENT

Functional communication training has been reported to be a promising treatment for severe behavior problems. In this study, functional communication training alone and combined with extinction and/or punishment was evaluated for 4 clients with severe retardation, behavior problems, and communication deficits. The participants were inpatients on a hospital unit for treatment of severe behavior disorders. They received individualized interventions based on functional assessment that included reinforcement of a communication response with the same function as their destructive behavior. Results showed that for some patients, functional communication training was not sufficient to produce clinically significant reductions in destructive behavior, and the combination of training plus punishment produced the largest and most consistent reductions.     

Internal Objects - A Theoretical Analysis of Jungian and Kleinian Models

In this paper I discuss the ways in which experimental and objective research from cognitive science and developmental psychology can help analysts evaluate the theoretical models of mental objects which we use; I indicate the ways in which such evidence tends to support models of internal objects as mental representations or developmental capacities rather than as wish-fulfilling expressions of instinctual drives. This land of empirical evidence is not just of academic interest but also has direct clinical relevance, particularly with borderline patients; such patients' sense of identity is totally dependent on the analyst's understanding of their internal world and for this to be misunderstood by the analyst can be catastrophic. An accurate theoretical model of mental objects can therefore help analysts to contain their patients more effectively.     

Fictions of the internal object

This paper examines internal objects in their role as theoretical constructs which analysts use to make sense of human experience. Object relations theory is based upon a vision that the personality is divided or split into parts. Clinical experience reveals that such splits are commonly expressed in the language of our analysing. However, a lexical reality is not a thing-in-itself, but a way of organizing and understanding experience. Jung's vision of the dynamics of the split self encompass a unique 'object relations theory' that is both similar and yet quite different from the object relations theories of Klein, Fairbairn, Winnicott and Thomas Ogden A clinical example is used to examine the way in which these different theoretical views explain the same clinical phenomenon. The last section of the paper is devoted to a narrational analysis of the place of internal objects in analytic theory. The split self, dynamic is seen as a narrative device - one that makes sense and provides coherence, but is neither the only view of psychic reality nor necessarily an accurate reflection of the nature of the internal world.     

HYPOTHESIS-BASED INTERVENTIONS FOR TANTRUM BEHAVIORS OF PERSONS WITH DEVELOPMENTAL DISABILITIES IN SCHOOL SETTINGS

We conducted a functional assessment of problem behaviors of 2 students with developmental disabilities in their classroom environments. Results of the assessments showed that although there were more tantrums in demand than in no-demand conditions, the function of the behavior was to gain attention (positive reinforcement) rather than to avoid or escape demands (negative reinforcement); demand conditions apparently served a discriminative function for the availability of attention. Therefore, intervention was based on the positive reinforcement hypothesis, resulting in a substantial reduction of tantrums for both subjects.     

Treatment of escape-maintained aberrant behavior with escape extinction and predictable routines

We evaluated the effects of two daily activity schedules on 2 participants' rates of aberrant behavior and their compliance. Functional analysis identified the operant function of the participants' aberrant behaviors to be escape from tasks. Participants were taught to use stimuli contained in daily schedules, and were tested based on a modified stimulus-equivalence model that consisted of flash cards and activity schedules comprised of words or photographs that corresponded to the participants' daily activities. On pretests, the participants demonstrated simple and conditional discriminations with the photographs but not with the printed stimuli. A time-delay procedure was used to teach the participants to name the flash cards. Following training, the printed activity schedules corresponded to lower rates of problem behavior and higher rates of compliance than the photographic activity schedules. Performance on posttests indicated the establishment of functional classes of stimuli involving the flash cards and activity schedules even though this type of correspondence was not directly trained.     

ANALYSIS OF A HIGH-PROBABILITY INSTRUCTIONAL SEQUENCE AND TIME-OUT IN THE TREATMENT OF CHILD NONCOMPLIANCE

This study evaluated the effectiveness of high-probability requests and time-out as treatments for noncompliance that appeared to be maintained by contingent attention in 2 developmental normal children. The introduction of high-probability requests increased compliance for 1 child but not the other. Time-out was effective with both children, and improvements in compliance were maintained at an 8-week follow-up.     

REDUCING ESCAPE BEHAVIOR AND INCREASING TASK COMPLETION WITH FUNCTIONAL COMMUNICATION TRAINING,EXTINCTION AND RESPONSE CHAINING

The effects of functional communication training, extinction, and response chaining on 3 subjects' escape-maintained aberrant behavior were evaluated using a multielement design. Functional communication training consisted of teaching subjects a verbal response that was functionally equivalent to their aberrant behavior. Subjects initially were allowed to escape from a task contingent on the trained verbal response. In subsequent treatment phases, escape was contingent on the trained verbal response plus the completion of the specified number of steps in the task (response chaining). The number of steps was increased until a subject completed the task to obtain a break. Results showed that the treatment reduced rates of aberrant behavior and that the chaining procedure was effective in decreasing the availability of escape.