INCREASING GENERALIZED SOCIAL INTERACTIONS IN PSYCHOTIC AND MENTALLY RETARDED RESIDENTS THROUGH PEER-MEDIATED THERAPY

This study investigated whether withdrawn adults living in a residential center for psychotic and mentally handicapped persons could serve as peer therapists to increase the social interaction of other withdrawn residents. Two pairs of residents served as participants. Treatments were introduced and evaluated within a multiple baseline with reversal design. After baseline, the peer therapist was instructed to increase the social interactions of a target peer through engagement in social interactions. The results demonstrated that the peer therapist increased the social interactions of target peers. However, these increases did not generalize to other residents until the introduction of a multiple peer therapist condition. The percentage of time the peer therapists interacted with other nontarget residents also increased throughout the study. These results were maintained during a 4-month follow-up condition.     

GENERALIZED EFFECTS OF A PEER-DELIVERED FIRST AID PROGRAM FOR STUDENTS WITH MODERATE INTELLECTUAL DISABILITIES

Peers with mild intellectual disabilities taught first aid skills to 4 students with moderate intellectual disabilities. A multiple probe design across participants was used to examine the effects of the peer teaching program during an acquisition and a partial sequential withdrawal phase. Generalization assessments were conducted in the participants' homes using novel, randomized simulated injuries. Results suggested that the peer teaching program resulted in acquisition of first aid skills, and the participants' skills generalized to the home, to novel simulated-injury locations, and to new trainers. Additionally, a more detailed analysis of the generalized responding suggested that when given a choice among first aid materials, participants treated burns using large adhesive bandages rather than the materials used in training. Participants also successfully treated injuries when novel instructional cues were used. The findings are discussed with respect to training issues, generalization and maintenance of the acquired skills, and the use of peer tutors with disabilities.     

Acquisition and generalization of manual signs by hearing-impaired adults with mental retardation

Behavioral procedures have been used to teach manual communication skills to individuals with mental retardation, although few studies have examined the assessment of generalization of such skills beyond the teaching environment. In this study, we investigated the effectiveness of directed rehearsal for teaching and facilitating the generalization of manual signs by six hearing-impaired adults with mental retardation. The effects of directed rehearsal, alone and combined with positive reinforcement for correct responses, were compared to a no-training control condition in an alternating treatments design. Although directed rehearsal was superior to the no-training control condition in teaching manual signs, the procedure was more effective when combined with positive reinforcement. The combined procedure was used to facilitate the generalization of learned signs across a number of variables. The results showed that there were high levels of generalization by all participants across novel phrases, settings, and trainers but variable levels of generalization to another response mode by some subjects. Further, increased levels in overall vocal communication were found for most participants.     

Assisted death and martyrdom.

Against the backdrop of ancient, mediaeval and modern Catholic teaching prohibiting killing (the rule against killing), the question of assisted suicide and euthanasia is examined. In the past the Church has modified its initial repugnance for killing by developing specific guidelines for permitting killing under strict conditions. This took place with respect to capital punishment and a just war, for example. One wonders why in the least objectionable instance, when a person is already dying, suffering, and repeatedly requesting assistance in dying, there is still such widespread condemnation of assisted suicide and euthanasia. In a Gedankexperiment, I suggest that certain stories of martyrdom in the history of the Christian Church shed some light on the role of taking one's life, or putting one's life in danger out of love. I further suggest that requesting assisted suicide and/or euthanasia from the motive of love of one's family or care givers might possibly qualify as one instance of justifiable euthanasia, although I acknowledge that the Church will not be making changes in its stance any time soon.     

Classwide Peer Tutoring: Effects on the Spelling Performance and Social Interactions of Students with Mild Disabilities and Their Typical Peers in an Integrated Instructional Setting

The effectiveness of Classwide Peer Tutoring (CWPT) to enhance the spelling performance and social interactions of three typical students and three students with mild disabilities was investigated. The classroom ecology was measured using the New Code for Instructional Structure and Student Academic Response (NCISSAR). Social interactions were assessed using the Multiple Option Observation System for Experimental Studies (M.O.O.S.E.S.). Spelling performance was measured by weekly pre-posttests. Using an ABAB single-subject design, results indicated that CWPT resulted in: (a) gains in the spelling accuracy of all students (up to 49%), (b) increases of students' duration of positive social interactions (up to 86%), and (c) high satisfaction ratings for both the students and the teacher. Comparisons between typical students and students with mild disabilities during CWPT suggested no differences in their duration of social interactions. Furthermore, the mean spelling accuracy of the students with mild disabilities was comparable to the spelling accuracy of the typical students (91% vs. 96%, respectively). Implications of the findings for the inclusion of students with mild disabilities in general education settings are discussed.     

Referees, editors, and publication practices: Improving the reliability and usefulness of the peer review system

The documented low levels of reliability of the peer review process present a serious challenge to editors who must often base their publication decisions on conflicting referee recommendations. The purpose of this article is to discuss this process and examine ways to produce a more reliable and useful peer review system. The author is a Senior Research Scientist & Biostatistician, Child Study Center and Department of Psychiatry in the Yale University School of Medicine. Note: The main points of this report were presented at the Annual Meeting of the American Association for the Advancement of Science (AAAS) in Baltimore, Maryland, on February 9, 1996.     

Emerging quality improvement measures in genetic counseling

The need to establish guidelines for total quality management in genetic counseling is now recognized as new genetic technologies are being introduced into genetics services and primary care. Genetic counselors have an important role in developing methods for assuring quality in the genetic counseling process. Emerging quality improvement measures as well as selected examples from the Quality Assurance Program in the Genetics Services Division at the Foundation for Blood Research are presented as examples of direct genetic counselor involvement. Suggestions for future directions of quality improvement activities for genetic counselors are discussed.     

A behavioral technology for producing concept formation in university students

Three experiments analyzed the effectiveness of a textbook incorporating "concept programming" in producing concept formation in university students. The concept programming portion of each lesson requires students to determine which concept is illustrated by each of 20 short fictional stories about everyday behavioral situations. The stories are selected to illustrate and contrast the concepts of that lesson. Student responses are heavily prompted during the initial stories of each lesson. The first experiment demonstrated that students generalize to entirely novel examples from the examples in the textbook. The second experiment demonstrated that the concept programming portion of the textbook is a critical component in producing generalization. The third experiment demonstrated that the amount of concept formation produced by the concept programmed textbook is greater than that produced by a widely used standard textbook.     

THE EFFECTS OF MODELLING ON THE CONTINGENT PRAISE OF MENTAL RETARDATION COUNSELLORS

A multiple-baseline design was used to evaluate the effects of a simple modelling procedure on the contingent praise of five counsellors while they conducted hygiene-training sessions in toothbrushing and hand-and-face washing with severely retarded children. After varying numbers of baseline sessions, each counsellor watched a model who conducted a series of toothbrushing sessions, in which he conspicuously praised correct toothbrushing responses and approximations to correct responses. No modelling occurred during hand-and-face washing sessions. As a result of several exposures to the model's performance, levels of response-contingent praise provided by four of the five counsellors during toothbrushing sessions increased sharply over baseline. The levels of counsellor praise showed parallel increases during hand-and-face washing sessions. A two-week followup showed that the levels of praise obtained through modelling were maintained in the model's absence.     

ACQUISITION OF SIGN LANGUAGE BY AUTISTIC CHILDREN II: SPONTANEITY AND GENERALIZATION EFFECTS

Autistic children typically do not use their language repertoire in order to communicate. Six autistic children who exhibited poor communication skills were trained to use their sign repertoire to make spontaneous requests of adults. Training consisted of imitative prompting, fading, and differential reinforcement, and included aspects of incidental teaching. The children displayed an increase in the rate and variety of spontaneous sign requests (Experiment 1). Generalization of spontaneity across adults (Experiments 1 and 2) and settings (Experiment 2) was also observed. We suggest that spontaneity may be facilitated when language is brought under the control of broadly defined stimuli such as adult attention rather than narrowly defined stimuli such as the presence of specific objects or verbal prompting in the form of questions. Finally, response generalization was observed as well (Experiment 1). Specifically, as spontaneity increased, self-stimulatory behavior decreased. This result may be accounted for in terms of reinforcer competition, reinforcer consistency, or discriminative stimulus effects.