Selective mutism in children: A structural family therapy approach to treatment

When children refuse to speak in some social settings, but can understand and speak in other settings, the diagnosis of selective mutism must be considered. A review of the literature describes the disorder, the various types of mutism, and related family dynamics. A family systems approach to treatment using structural family therapy is suggested. The case history presented illustrates one type of mutism as well as the family rules and hierarchy which appeared to be maintaining it. Structural and strategic family systems theory techniques that were used to move the family toward resolution of this problem are discussed.Diane Wolf Tatem, MA, MS, completed graduate work in marriage and family therapy at New Mexico State University, Las Cruces, NM. She is employed at Life Management Center of El Paso's Child Development Services and also has a private practice in marriage and family therapy in El Paso, Texas. Robert L. DelCampo, PhD is a professor of family science at New Mexico State University and maintains a private practice with Associates for Marriage and Family Therapy in Las Cruces, NM. Please address all correspondence to Dr. DelCampo at Box 3470, New Mexico State University, Las Cruces, NM, 88003-3470.Appreciation is expressed to Dr. Charles Huber, New Mexico State University in Las Cruces, for his insightful critique of the final draft of this paper. This paper was presented at the Texas Association for Marriage and Family Therapy Annual Conference, January 25–29, 1995 in Dallas, TX.     

An extension of the partial credit model with an application to the measurement of change

The partial credit model is considered under the assumption of a certain linear decomposition of the item × category parameters _ih into basic parameters _j. This model is referred to as the linear partial credit model. A conditional maximum likelihood algorithm for estimation of the j is presented, based on (a) recurrences for the combinatorial functions involved, and (b) using a quasi-Newton approach, the so-called Broyden-Fletcher-Goldfarb-Shanno (BFGS) method; (a) guarantees numerically stable results, (b) avoids the direct computation of the Hesse matrix, yet produces a sequence of certain positive definite matricesB _k ,k=1, 2, ..., converging to the asymptotic variance-covariance matrix of the . The practicality of these numerical methods is demonstrated both by means of simulations and of an empirical application to the measurement of treatment effects in patients with psychosomatic disorders.The authors thank one anonymous reviewer for his constructive comments. Moreover, they thankfully acknowledge financial support by the Österreichische Nationalbank (Austrian National Bank) under Grant No. 3720.     

SEQUENTIAL APPLICATION OF MAJOR HABIT-REVERSAL COMPONENTS TO TREAT MOTOR TICS IN CHILDREN

In this study, we sequentially administered up to four components of the habit-reversal treatment to 4 children with motor tics within a multiple baseline design. The habit-reversal components included (a) awareness training; (b) awareness training and self-monitoring; (c) awareness training, self-monitoring, and social support; and (d) awareness training, social support, and the use of a competing response. Results demonstrated that the combined use of awareness training, social support, and competing response training was effective in eliminating motor tics in 2 of 4 children, that awareness training alone was effective for 1 child, and that a combination of awareness training and self-monitoring was effective for the 4th child. The treatment and ensuing improvement were found to be socially valid. We discuss possible explanations for these results and recommend directions for future research.     

Physical characteristics of residential psychiatric and substance abuse programs: Organizational determinants and patient outcomes

Described the Physical and Architectural Characteristics Inventory (PACI), which assesses the physical characteristics of hospital- and community-based psychiatric and substance abuse residential treatment programs for adults. Developed using data from 94 representative programs, the PACI has 7 dimensions that assess community accessibility, physical features that add convenience, aid recreation, and provide support for patients, and space for patient and staff functions. In comparison to community-based programs (n=63), hospital programs (n=31) had more social-recreational and prosthetic aids, safety features, staff facilities, and space. The PACI dimensions were also related to other organizational features, such as facility ownership and program size and staffing level. Programs with more physical amenities had patients who were more involved in self-initiated and community activities and were more likely to successfully complete the program and be discharged to independent living situations and paid jobs. Programs with more social-recreational and prosthetic aids, space, and access to community resources also had better patient outcomes. In addition, PACI dimensions were related to observers' ratings of facility attractiveness. Potential applications of the PACI and the full inventory of which it is a part are discussed.     

TEACHING ELEMENTARY STUDENTS WITH DEVELOPMENTAL DISABILITIES TO RECRUIT TEACHER ATTENTION IN A GENERAL EDUCATION CLASSROOM: EFFECTS ON TEACHER PRAISE AND ACADEMIC PRODUCTIVITY

Four fourth graders with developmental disabilities were trained to recruit teacher attention while they worked on spelling assignments in a general education classroom. The students were taught to show their work to the teacher two to three times per session and to make statements such as, “How am I doing?” or “Look, I'm all finished!” Training was conducted in the special education classroom and consisted of modeling, role playing, error correction, and praise. A multiple baseline across students design showed that recruitment training increased (a) the frequency of students' recruiting, (b) the frequency of teacher praise received by the students, (c) the percentage of worksheet items completed, and (d) the accuracy with which the students completed the spelling assignments.     

影响学习迁移的几个因素的实验研究

针对前人较多地从学习材料本身的特点或学习者的心理特点出发去孤立地考察对学习迁移的影响这一现象 ,本研究试采用代数运算材料 ,系统地探讨了学习材料的相同要素和学习者概括化认知过程两者之间的内在关系 ,并将相同要素进一步区分为表述形式相似和内在原理相似。旨在对较为复杂的认知学习中迁移的影响因素做更深入的考察。结果表明 :①概括化和相同要素对学习迁移的影响依然存在 ,但需作具体分析。其中 ,前者应成为影响学习迁移的更重要因素。②在学习材料的相同要素中 ,实质上对迁移起作用的是内在原理相似性 ;而表述形式相似性不起主要作用。③概括化因素和内在原理相似性因素之间的交互作用对学习迁移影响极大。     

A comparison of multiple versus single examples of the correct stimulus on task acquisition and generalization by persons with developmental disabilities

In teaching discriminations to persons with retardation, we often presume we will improve acquisition and generalization if we use multiple examples of boththe correct and incorrect stimuli. Two experiments were conducted to test this hypothesis. In the first experiment, 7 persons with moderate retardation learned to discriminate between functional words under two conditions. In one condition, Multiple Example of S- Only,1 example of the correct stimulus (S+) and 10 examples of the incorrect stimulus (S-) were used during acquisition. In the other condition, Multiple Examples of S+ and S-,10 examples of the S+ and 10 examples of the S- were used. Results showed that the condition which presented only a single example of S+ was superior 16 times and inferior 4 times during acquisition, generalization, and maintenance. A second experiment was conducted to (a) replicate the methodology and procedures in Experiment 1 with different participants, (b) determine whether the results were replicable, and (c) obtain efficiency data. Results replicated the findings of the first experiment. The condition which presented only a single example of S+ was superior on measures of (a) trials to criterion, (b) percent correct during acquisition, and (c) minutes to criterion. On measures of generalization, the two conditions were relatively equal. Thus, the condition which presented only a single example of the correct stimulus was more efficient and was just as effective in generalization as the condition which presented multiple examples of both the S+ and S-. These surprising results were discussed in terms of stimulus control, why students performed just as well during generalization when only one example of the S+ was used, why acquisition was also poorer for this condition, and how future studies might address these points.     

THE BEHAVIOR OBSERVATION INSTRUMENT: A METHOD OF DIRECT OBSERVATION FOR PROGRAM EVALUATION1

The background and development of a multicategory direct observation system, the Behavior Observation Instrument (BOI), is described. This time-sampling procedure for recording the behavior of persons is demonstrated in several treatment settings and the results applied to issues of program evaluation. Elements that have prevented direct observation from being widely adopted, such as costs, manpower, and training requirements, are systematically analyzed. A basic psychometric analysis of the instrument is used to determine optimum frequency and duration of observation intervals as well as observer agreement. The results imply that direct observation methods, once assumed by some to belong to the special province of the single-subject design, can be used to assess the effects of programs on groups of psychiatric clients in an efficient and economic manner.     

TRAINING PRESCHOOL CHILDREN TO RECRUIT NATURAL COMMUNITIES OF REINFORCEMENT1

Four normal and four deviant children aged four-to-six years were taught to judge the quality of their academic work in a preschool classroom, and to prompt or cue their teachers to comment about the quality of that work. When these skills did not generalize spontaneously to other teachers in concurrent natural situations, generalized responding was taught by the experimenter, in multiple-baseline design across subjects. This generalization programming enabled the children to contact a sometimes dormant, but readily available natural community of teacher praise and reinforcement, i.e., to recruit an increase in cued praise and schedules of praise for their good work. These behaviors may be important to young children who find themselves bereft of attention in classrooms.     

ACCEPTABILITY OF ALTERNATIVE TREATMENTS FOR DEVIANT CHILD BEHAVIOR

The acceptability of alternative treatments for deviant child behavior was evaluated in two experiments. In each experiment, clinical cases were described to undergraduate students along with four different treatments in a Replicated Latin Square Design. The treatments included reinforcement of incompatible behavior, time out from reinforcement, drug therapy, and electric shock and the treatments were described as they were applied to children with problem behaviors. Experiment 1 developed an assessment device to evaluate treatment acceptability and examined whether treatments were rated as differentially acceptable. Experiment 2 replicated the first experiment and examined whether the severity of the presenting clinical problem influenced ratings of acceptability. The results indicated that treatments were sharply distinguished in overall acceptability. Reinforcement of incompatible behavior was more acceptable than other treatments which followed, in order, time out from reinforcement, drug therapy, and electric shock. Case severity influenced acceptability of alternative treatments with all treatments being rated as more acceptable with more severe cases. However, the strength of case severity was relatively small in relation to the different treatment conditions themselves which accounted for large portions of variance.