CHOICE-MAKING TREATMENT OF YOUNG CHILDREN'S SEVERE BEHAVIOR PROBLEMS

The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an alternative neutral response) to obtain different durations and qualities of reinforcement, was conducted. Finally, treatment packages involving choice making via manding were implemented to decrease inappropriate behavior and to increase mands. The results extended previous applications of choice making to severe behavior disorders and across behaviors maintained by positive and negative reinforcement.     

Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.     

An Ecological Approach to Enhancing Parenting Skills in Family Therapy

To increase the effectiveness of parent education interventions, family therapists can address those factors that shape the way in which parents interact with their children. This article presents ecological theory as a framework that can help clinicians expand the range of their parent training efforts. In order to assess the utility of ecological theory for clinical practice, the present study empirically explored the ways in which selected characteristics of parents, children, and the family context related to mothers' parenting behavior. Specific recommendations for family therapists who employ parent training techniques are offered.     

AUGMENTING SIMPLIFIED HABIT REVERSAL WITH AN AWARENESS ENHANCEMENT DEVICE: PRELIMINARY FINDINGS

The chronic hair pulling of a 36-year-old woman with moderate mental retardation was initially treated with a simplified habit-reversal (SHR) procedure that consisted of awareness training, competing response training, and social support. When SHR did not produce large and sustained reductions in hair pulling, an awareness enhancement device was added, and it reduced hair pulling to near-zero levels in two settings. The results are discussed, and directions for future research with this device are provided.     

Competing interests: The need to control conflict of interests in biomedical research

Individual and institutional conflict of interests in biomedical research have becomes matters of increasing concern in recent years. In the United States, the growth in relationships — sponsored research agreements, consultancies, memberships on boards, licensing agreements, and equity ownership — between for-profit corporations and research universities and their scientists has made the problem of conflicts, particularly financial conflicts, more acute. Conflicts can interfere with or compromise important principles and obligations of researchers and their institutions, e.g., adherence to accepted research norms, duty of care to patients, and open exchange of information. Disclosure is a key component of a successful conflict policy. Commitments which conflict with a faculty member's primary obligations to teaching, research, administrative responsibilities, or patient care also need attention. Institutional conflict of interests present different problems, some of which are discussed in an analysis of an actual problem posed by two proposed clinical trials. This paper is adapted from a lecture presented to a Symposium on Scientific Integrity, Warsaw, Poland, 23 November 1995. Daniel Steiner was Vice-President and General Counsel of Harvard University (1972–92) and in that capacity became familiar with conflict of interest issues. He is currently Counsel to the Boston law firm. Ropes and Gray, and is Adjunct Lecturer in Public Policy at the John F. Kennedy School of Government. Harvard University.     

TEACHING FOSTER GRANDPARENTS TO TRAIN SEVERELY HANDICAPPED PERSONS

Five foster grandparents were taught training skills for use in their daily interactions with severely handicapped persons in an institution. Following baseline, specific teaching procedures consisting of teacher instructions, prompts, modelling, and praise were implemented. The grandparents' frequency of training three skill areas increased as the specific teaching was implemented in multiple-baseline format. The total amount of training continued as teacher instructions, prompts, and modelling were terminated and praise continued, although the grandparents spent their training time emphasizing only two of the three skill areas. Teacher presence was gradually reduced over an 11-week period, with no decrease in grandparents' frequency of training. Four of the foster grandchildren, all profoundly retarded and multiply handicapped, demonstrated progress throughout the study. Results were discussed in light of the available contributions of foster grandparents in institutional settings and maintenance of staff training.     

SEVERE CLASSROOM BEHAVIOR PROBLEMS: TEACHERS OR COUNSELLORS

This experiment was designed to determine the relative effectiveness of teacher and counselling approaches in the reduction of disruptive or inappropriate classroom behavior. Inappropriate classroom behavior frequencies of 12 academically low achieving, seventh-grade, black male students, with a reported high rate of inappropriate classroom behavior, were recorded. Three groups, with nearly equal mean inappropriate behaviors, were randomly assigned to one of three treatment conditions: behavioral counselling, client-centered counselling, or no counselling. Each counselling group received fifteen 30-minute counselling sessions, at a rate of two to three times a week. In addition to counselling, all students subsequently received teacher approval within the classroom. Results indicated that the teacher was able to reduce inappropriate behavior more than any counselling group. There were also indications that behavioral counselling, but not client-centered counselling, was moderately helpful in reducing inappropriate classroom behavior.     

THE EFFECTIVENESS OF INTERPERSONAL SKILLS TRAINING ON THE SOCIAL SKILL ACQUISITION OF MODERATELY AND MILDLY RETARDED ADULTS

Sixteen moderately and mildly retarded adults were selected from a group residential facility and randomly assigned to experimental and control groups. The experimental group received a 12-session interpersonal skills training program consisting of instruction in the following areas: (1) Introductions and Small Talk, (2) Asking for Help, (3) Differing with Others, and (4) Handling Criticism. The social skills instructional package included verbal instruction, modeling, role playing, feedback, contingent incentives, and homework. As a result of this training program, moderately and mildly retarded adults acquired new social skills as evidenced by performance on a situation role play assessment. These gains generalized to untrained role play situations but did not result in significant group differences when assessed in a more natural setting (i.e., local grocery store).     

A new measure for determining children's subjective organization of speech

A new technique for determining children's subjective organization of speech is described. The technique consists of teaching a child a sentence and then repeatedly (1) reading the sentence up to a selected point, (2) sounding a tone, and (3) having the child supply the next word. The time from the tone to the onset of the child's voice is the dependent variable. In the first study 6- and 8-year-old children memorized the following sentence: “John likes to feed the little puppies in the barn.” Their response times suggested that the dominant segmentation pattern consisted of four phrases: a subject phrase, a verb phrase, an object phrase and a modifier phrase. Within each phrase differences between reaction times were on the order of 30 msec. Across phrases they were on the order of 120 msec. The same trend emerged for subsamples of the children with various short-term memory sizes, and for adults. It also appeared for subsamples of the total scores (e.g., first six trials and last six trials). In order to provide further evidence of the technique's validity, different sentences of the same general type were presented to children with short-term memory spans of either 3, 4, or 5. As predicted, it was found that when children's spans corresponded to the number of hypothesized chunks (i.e., 4), they could repeat the sentences verbatim on the first exposure. They could not do so, however, when their spans were lower than that value or when the number of phrases was increased. It was concluded that the new technique is a promising one for assessing young children's patterns of speech segmentation.     

Effects of neutral and positive stimuli on stuttering: “Calling attention to stuttering” revisited

This study investigated the effects of presumably positive and neutral response-contingent stimuli on the occurence of stuttering. Eight adult stutterers spoke spontaneously during a 60-min experimental session, which was divided into three 20-min periods. During Condition I no stimuli were delivered. During Condition II a digital counter and a pair of yellow lights were activated each time the subject stuttered. During Condition III these same response-contingent stimuli were delivered, but with the additional factor that the subject would earn 5¢ each time the counter moved forward and the lights were illuminated. Conditions II and III were counterbalanced across subjects. The experimenter was unaware of which of the two contingencies were operative during Conditions II and III. Results showed no significant changes in occurence of stuttering due to either response-contingent stimulus. A discussion of theoretical and experimental implications is given.