Three intensive community-based programs for children and youth with serious emotional disturbance and their families

Systems of care for children with serious emotional disturbance and their families have generally lacked intensive community-based programs. We describe three types of newly established community-based programs in New York State and present a general evaluation plan for determining which programs work for various children and their families. The three community-based programs are Intensive Case Management, Family-Based Treatment, and Family-Centered Intensive Case Management. Process and outcome evaluations are being conducted for each of these programs. These evaluations make use of common intake and termination instruments, based on a minimum data set, standardized assessment instruments, and a common logic model, thus facilitating the comparison of findings across evaluations.     

Sex stereotypes in Norway revisited: 1977–87

In 1977 sex-trait stereotypes in Norway were measured at the young adult level and at the level of five-year-olds. At the young adult level the Adjective Check List was used, and the results were analysed according to an affective meaning scoring system, and a scoring system based on Transactional Analysis. The instrument used for children was a picture-story technique (Sex Stereotype Measure II). Persistence and change in sex-trait stereotypes were examined by replicating the study in 1987. Quantitatively, young adults' sex-trait stereotypes seemed to have changed little during the last decade, but qualitative analyses indicated that stereotypes have changed in the direction of greater favourability, activity and strength towards women and in the reverse direction towards men. The children in the 1987 sample expressed less stereotype knowledge than children in the 1977 sample concerning traits which traditionally have been ascribed to men.     

ACQUISITION,GENERALIZATION, AND MAINTENANCE OF QUESTION-ANSWERING SKILLS IN AUTISTIC CHILDREN

We conducted an investigation to evaluate the effects of a training strategy for teaching autistic students generalized responses to three forms of wh— questions (what, how, and why). Students were taught, using modeling and reinforcement procedures, to answer questions with magazine pictures as the referents. Each question form was divided into two or more subcomponents reflective of common social usage and was taught within the context of a modified multiple probe design across subcomponents. Following acquisition of each subcomponent, generalization to natural context and storybook questions was assessed; additional probes were conducted to assess responding over time and whether acquisition of responses to questions promoted question-asking skills. Results showed that the picture training procedure was effective in teaching a generalized response to questions for which the relevant cue was visible, whereas specific generalization programming was required for situations in which the relevant cue was not visible. All acquired responses were durable over time.     

Children's choice: Sensitivity to changes in reinforcer density

Two experiments were carried out in which children's sensitivity to changes in reinforcer density (number of reinforcers per session) was measured in a choice paradigm. In Experiment 1, 24 girls (ages 6, 9, and 12 years) performed on concurrent-chain schedules of reinforcement. The initial links were variable-interval 10-s schedules. One terminal link always gave three tokens after 30 s, but the parameters associated with the other were varied. Independent manipulations of reinforcer size (two tokens or four tokens) and prereinforcement delay (25 s or 65 s) led to equal changes in the relative density of tokens that could be earned on the schedules. Subjects at all ages were sensitive to changes in reinforcer density brought about by changes in reinforcer size, whereas only 3 12-year-olds showed sensitivity to the changes brought about by manipulation of prereinforcer delay. In Experiment 2, titration procedures were used to test the extent of this insensitivity to delay in 32 6- and 12-year-old children. In these procedures, a repeated choice of the large reinforcer increased the delay to its delivery, and a repeated choice of the small reinforcer reduced the delay to the delivery of the large reinforcer. Whereas 6-year-old boys and girls tended to maintain a strong preference for the large reinforcer, so increasing the delay to its delivery, 12-year-olds tended to distribute their responses to both alternatives, thus producing a stable level of delay to the large reinforcer. The results from the two experiments support the idea of two stages in the development of adaptive intertemporal choice.     

THE USE OF BEHAVIORAL ASSESSMENT TO PRESCRIBE AND EVALUATE TREATMENTS FOR SEVERELY HANDICAPPED CHILDREN

Behavioral assessment procedures were used to prescribe and evaluate treatments of maladaptive behavior for 2 children with severe multiple handicaps. In Experiment 1, the results of an assessment of reinforcer preference were used in conjunction with a functional analysis of the conditions maintaining self-injurious behavior to prescribe a treatment for a child with severe disabilities. The treatment procedure involved the use of a pressure-sensitive microswitch to activate reinforcing stimuli during two solitary conditions, during which self-injurious behavior had occurred at high rates. The results were evaluated with a multiple baseline across settings design and indicated that self-injury decreased with concomitant increases in microswitch activation. Results were maintained at 6 weeks, 8 weeks, and 6 months. In Experiment 2, the results of behavioral assessments of reinforcer preference and self-injurious behavior were combined to develop a treatment for a second severely handicapped child, who exhibited high rates of self-injury in demand situations. This treatment was evaluated with a multiple baseline across tasks design and resulted in the elimination of self-injury for up to 15 months.     

DISTRACTION: ITS UTILIZATION AND EFFICACY WITH CHILDREN UNDERGOING DENTAL TREATMENT

We investigated the utilization and efficacy of distraction in reducing the anxious and disruptive behavior of 4 children undergoing dental treatment. During the distraction procedure, the children were shown a poster and told a story about it during dental treatment. They earned a prize if they attended to the poster and story and could correctly answer questions about them following each intervention visit. The children's disruptive behavior was assessed via direct observation, and results were analyzed within a multiple baseline design. The children exhibited high levels of anxious and disruptive behavior across baseline visits, regardless of the length of time in treatment or number of visits. Anxious and disruptive behavior decreased upon introduction of the intervention for all children. This was accompanied by the children meeting the criterion for correct answers on the distraction quiz. However, 2 of the children demonstrated an increase in their anxious and disruptive behavior across intervention visits. Results are discussed in terms of the need to evaluate treatment strategies that promote maintenance as well as initial changes.     

CO-WORKER IMPLEMENTED JOB TRAINING: THE USE OF COINCIDENTAL TRAINING AND QUALITY-CONTROL CHECKING ON THE FOOD PREPARATION SKILLS OF TRAINEES WITH MENTAL RETARDATION

In two studies, co-workers of persons with disabilities were taught to use coincidental training procedures while completing their own jobs. In Study 1, the effects of coincidental training on the salad-making skills of 3 trainees with mild and moderate mental retardation were evaluated. Coincidental training by co-workers resulted in improved accuracy of the salad-making skills of the trainees. In Study 2, trainees were also coincidentally taught to make quality-control checks of their salads. An alternating treatments and multiple baseline design indicated that the trainees more readily acquired the skills when taught to check the correctness of their work.     

EFFECTS OF WAIT-TIME AND INTERTRIAL INTERVAL DURATIONS ON LEARNING BY CHILDREN WITH MULTIPLE HANDICAPS

We investigated the influence of teacher wait-time and intertrial interval durations on the performance of 4 multiply handicapped students during instruction in 10 skills. Four experimental conditions were evaluated: long wait-time and long intertrial interval, long wait-time and short intertrial interval, short wait-time and long intertrial interval, and short wait-time and short intertrial interval. Instructors attempted to keep short intervals as close as possible to 1 s and long intervals as close as possible to 10 s for both variables. Results showed that student performance was superior under the long wait-time conditions irrespective of the length of the intertrial interval.     

EVALUATION OF TACTILE PROMPTS WITH A STUDENT WHO IS DEAF,BLIND, AND MENTALLY RETARDED

We provided tactile cues to a student who was deaf, blind, and mentally retarded to guide her performance on a variety of packaging tasks. The student had previously received extensive training on multiple packaging and sequencing tasks through her vocational education program. Although she was able to complete these tasks, each change in materials necessitated that similar levels of retraining be conducted in order for her to perform revised tasks. Tactile cues were introduced and evaluated through a multiple baseline with sequential withdrawal design for two envelope-stuffing tasks and one bagging task. Results indicated that the tactile prompts were effective in guiding her performance on the training task and in promoting generalization to novel tasks and cues. Continued use of the cues was necessary to maintain the student's performance. Our findings suggest that tactile prompts function similarly to picture prompts and may be an effective alternative external prompting system for persons for whom picture prompts would not be appropriate.     

THE RELATIVE MOTIVATIONAL PROPERTIES OF SENSORY AND EDIBLE REINFORCERS IN TEACHING AUTISTIC CHILDREN

We compared the effects of sensory and edible reinforcers on resistance to satiation in three autistic children while learning visual discrimination tasks. Within-subject designs were used to compare a single sensory reinforcer with a single edible reinforcer and to compare multiple sensory reinforcers with multiple edibles. Results indicated that multiple sensory reinforcers maintained responding over more trials than did multiple edible reinforcers; however, the use of single sensory reinforcers and single edibles resulted in about equal numbers of trials to satiation. Both multiple and single sensory reinforcers produced higher percentages of correct responses than edible reinforcers. The findings are discussed in terms of the advantages of sensory reinforcers in teaching autistic children.