Family-centered intensive case management: A step toward understanding individualized care

New York State's initial attempt at individualizing services occurred within the context of an experiment. We randomly assigned children 5–12 years old who were referred for out-of-home placement in treatment foster care to either treatment foster care, Family-Based Treatment (n=15), or to Family-Centered Intensive Case Management (FCICM) (n=27). FCICM used teams of case managers and parent advocates to provide in-home services. Flexible service dollars, respite care, and behavior management skills training were available to assist teams in individualizing care. Preliminary outcomes indicate that children in FCICM are doing as well or better than children assigned to FBT in their functioning and symptom reduction. Parents of children in FCICM have made gains, although not at a statistically significant level, in behavior management skills and family strengths that allow them to provide care for their children at home.     

Infant search tasks reveal early concepts of containment and canonical usage of objects

It is difficult to gain unambiguous evidence on the use of concepts by infants. Many results can be accounted for in terms of action-based strategies. The evidence reported here fulfils the minimal criteria for the operation of working concepts in infants. Search tasks are used with a filled interval which forces memory-search, and the object is hidden in containers which fulfil their customary job or violate it. Infants treat an upright cup as a more reliable location marker than an inverted one. A series of experiments probes the phenomenon. The results indicate that the infants have a working concept of containment which can be triggered by the provision of containers in their canonical orientation. Even “object permanence tasks” lead infants to access their knowledge of the relationships into which things typically enter in the world outside the laboratory.     

TRAINING PARENTS IN BEHAVIORAL SELF-MANAGEMENT: AN ANALYSIS OF GENERALIZATION AND MAINTENANCE

This study examined the generalization and maintenance effects of three phases of parent training (Instructions plus Feedback and two Self-management Training phases) on levels of disruptive child behavior and the accuracy with which parents implemented programs. Data were collected from five families in three main settings: the initial training setting (the home), a variety of generalization settings in the community, and the family breakfast. A multiple baseline across subjects design was used. Instructions plus Feedback comprised instructing parents to use a range of behavior management procedures and provided home-based differential feedback concerning accuracy of program implementation. Self-management Training phases involved training parents in goal setting, self-monitoring, and planning skills, specific to their performance of appropriate parenting skills in generalization settings. Results indicated that the Instructions plus Feedback phase was sufficient to produce reduced levels of problem behavior at home and high levels of accurate implementation, but generalization effects out of home were equivocal. Self-management maintained reduced levels of problem behavior at home but, in addition, resulted in generalization effects in community settings for both children and parents. Maintenance probes 3 months following the program revealed the effects had been maintained.     

DINING OUT WITH CHILDREN: EFFECTIVENESS OF A PARENT ADVICE PACKAGE ON PRE-MEAL INAPPROPRIATE BEHAVIOR

The effectiveness of an advice package designed to restructure the restaurant environment and encourage parent praise was examined. Experiment 1 assessed the usefulness of the package when used with experimenter assistance. Videotapes were used to record the target child's behavior. Pre-meal inappropriate behavior decreased an average of 51% across target children. Mealtime inappropriate behavior and parent praise and disapproval were also measured. Experiment 2 was designed to determine whether families could implement the package without experimenter assistance and whether effects obtained would generalize to a different restaurant. Data were taken in vivo. Nine families were randomly assigned to one of three groups. Group assignment determined the order in which families went to two restaurants, the number of dinners each family participated in, and the point at which parents received the advice package. The order in which the families went to the two restaurants as well as the number of baseline meals was counterbalanced. Results of Experiment 2 showed that, when using the advice package, parents in all sequences were able to decrease pre-meal inappropriate behavior of their children, and that these effects generalized to a second restaurant.     

PARENT REINFORCEMENT FOR CHILD ACHIEVEMENT: THE USE OF A LOTTERY TO MAXIMIZE PARENT TRAINING EFFECTS

This study describes and evaluates a reinforcement program in which parents earned lottery tickets and won prizes for the progress made by their handicapped children during home-based intervention. An ABAB reversal design replicated across three families was used to assess the effects of the lottery on the children's mastery of language skills. Results showed that the reinforcement of the parents for training accomplishments, as indexed by their children's achievements, produced clinically significant increases in the children's progress when compared with the children's progress under the routine supportive practices of the baseline condition. The implications of the findings for parent training programs in general are discussed.     

TRAINING FAMILY THERAPISTS: AN EXPERIMENTAL ANALYSIS

This study implemented and evaluated a training program (a written manual, videotaped models, rehearsal, role plays, and performance feedback) designed to teach five subjects the skills to become effective family therapists. The study examined the therapists' use of three target behaviors: instructing, informing, and praising. The therapists, each paired with a parent and a preschool-aged child (2 1/2–4 1/2 yr old), were trained in the clinic to use, and to teach to the parents, several behavioral skills (e.g., praising, planned ignoring, and time-out) relevant to teaching children compliance to parental instructions. A multiple-baseline design across triads (therapist/parent/child) demonstrated that after the training program was instituted, the therapists increased their rates of instructing, praising, and informing the parents; all parents increased attention to compliance, decreased attention to noncompliance, and increased rates of praise to their children; and all children increased their compliance and decreased their noncompliance.     

Children's strategies in producing three-dimensional relationships on a two-dimensional surface

It is a common task to give children a picture containing implicit depth cues and to require them to extract depth information from it. The cues are always selected from the adult repertoire; little is known about children's production of their own cues. In this experiment, 5- to 10-year-old children were required to draw one object behind another in a situation in which adults invariably produce the further object partially occluded by the nearer. The results were an age-related decline in the tendency to segregate the objects and an increase in the tendency to group the objects using partial occlusion, with a cross-over at 8 years. At all ages some children drew one object inside the boundary of the other. It is argued that the results are composed of two tendencies, a gradual mastery of discrete scaling phenomena (e.g., “up” on the page means “further”) within a given style, and a set of decisions to be made between incompatible styles.     

The processing of fundamental frequency in a dichotic matching task

The temporal characteristics of auditory memory were investigated using a reaction time paradigm. The study attempted to determine whether or not there are functionally distinct left and right hemisphere components of auditory memory with different capacities for the retention of nonlinguistic information, such as fundamental frequency, over the course of several seconds. The results indicated that fundamental frequency information in auditory memory remains substantially unchanged over the course of 2 sec. No evidence was found for the existence of separate left and right hemisphere components of auditory memory with different temporal characteristics. The implications of this finding for the organization of auditory memory in the brain are discussed.