Locus of control and peer status: a scale for Children's Perceptions of Social Interactions

A total of 985 third through sixth grade children participated in the development of a 48-item Locus of Control Scale for Children's Perceptions of Social Interactions (LOC-CPSI). Scores are based on the number of positive, negative, and total social reinforcers a child attributes to his or her own behavior (internal control). A social desirability subscale is included. Reliability coefficients were comparable to or greater than those of existing locus of control measures. Convergent validity was demonstrated by low, significant correlations with other locus of control measures. Internal scores correlated significantly with sociometric measures of popularity and predicted peer status better than other locus of control measures. Theoretical implications and potential clinical application are discussed.     

Distraction intervention for preschoolers undergoing intramuscular injections and subcutaneous port access.

This study evaluated a distraction intervention designed to reduce the distress of preschool children undergoing repeated chemotherapy injections. Twenty-nine children aged 2-5 years were randomly assigned either to distraction by a developmentally appropriate electronic toy or to a wait-list control. Children who received the distraction intervention demonstrated lower overt behavioral distress and were rated by parents and nurses as less anxious than children in the control condition. The improvements were maintained over the 8-week intervention. The results suggest that a developmentally appropriate, multisensory, variable-distracting activity that requires active cognitive processing and active motor responses may be a viable cost-effective alternative to more time-intensive parent-training programs for preschool-age children.     

USING PARENTS TO MAINTAIN IMPROVED DENTAL FLOSSING SKILLS IN CHILDREN

An experimenter-administered intervention involving prompts, self-monitoring, permanent product collection, rewards for plaque reduction, and corrective feedback was used to improve the flossing skills of four 7- to 11-year-old children. Parents were subsequently trained in the reward and feedback procedures to facilitate maintenance. In a multiple baseline across subjects design, all four subjects snowed improvement in plaque between teeth during experimenter-administered intervention. Three subjects maintained low plaque levels during the 3- to 4-month parent-administered rewards and feedback follow-up condition. Improved plaque levels on nontargeted tooth surfaces also were observed. Pediatric dentistry applications are discussed.     

Virtual-reality distraction and cold-pressor pain tolerance: does avatar point of view matter?

This study tested the effects of distraction using virtual-reality (VR) technology on acute pain tolerance in young adults. Forty-one undergraduate students, aged 18-23 years, used a VR head-mounted display helmet, steering wheel, and foot pedal to play an auto racing video game while undergoing exposure to very cold water (cold pressor set at 1 °C). Two different game views were tested that were hypothesized to affect the degree to which participants felt "present" in the virtual environment: a first-person view, in which the participant saw the virtual environment through the eyes of the game character being manipulated; and a third-person view, in which the participant viewed the game character from a distance. The length of time participants tolerated the cold-water exposure (pain tolerance) under each distraction condition was compared to a baseline (no distraction) trial. Subjects also rated the degree to which they felt "present" in the virtual environment after each distraction trial. Results demonstrated that participants had significantly higher pain tolerance during both VR-distraction conditions relative to baseline (no distraction) trials. Although participants reported a greater sense of presence during the first-person condition than the third-person condition, pain-tolerance scores associated with the two distraction conditions did not differ. The types of VR applications in which presence may be more or less important are discussed.     

Helping Children and Caregivers Cope with Repeated Invasive Procedures: How Are We Doing?

This paper discusses recent developments in the medical and psychological management of child behavioral distress during invasive (i.e., needle stick) procedures for diagnosis and treatment of chronic pediatric disorders. Along with a review of relevant studies from the medical, pediatric psychology and behavior analysis literatures, representative data are presented from recent research on pediatric procedural pain management. The impact of increasing use of implanted subcutaneous intravenous catheters (ports) and decreased reliance on intravenous cannulation is discussed. Similarly, the effects (and limitations) of more frequent use of topical anesthesia to prepare needle sites also are presented. The continuing need for adjunctive, nonpharmacological (i.e., cognitive and behavioral) interventions for procedural pain is emphasized, and recent studies on distraction and counter-conditioning-based treatments are described. Future research is encouraged on (1) behavioral interventions in relation to day-to-day contextual variables that modulate treatment effects and (2) the development of efficient screening measures to identify children and families who are least likely to cope effectively with repeated procedures, allowing them to be given greater priority for allocation of limited resources for psychosocial intervention.     

The influence of preferred coping style and cognitive strategy on laboratory-induced pain.

OBJECTIVE: To evaluate the effects of matching an individual's coping style (low, mixed, or high monitoring) to an appropriate cognitive strategy (distraction or sensation monitoring) to improve pain management. DESIGN: This study used a split-plot factorial design in a laboratory setting. MAIN OUTCOME MEASURES: Main outcomes were pain threshold, pain tolerance, pain intensity, pain affect, and anxiety. RESULTS: The results of the 2 x 3 x 3 (Experimental Condition x Coping Style x Trial) analysis of variance (ANOVA) interaction were significant for pain threshold scores, F(4, 178) = 2.95, p < .01. Low monitors in the matched distraction trial had higher pain threshold scores than during baseline, t(15) = -2.68, p = .017, and the mismatched sensation monitoring trial, t(15) = 2.80, p = .014. High monitors' pain threshold scores were higher than baseline only during the matched sensation monitoring trial, t(27) = -2.75, p = .010. The results of the 2 x 3 x 3 ANOVA interaction were not significant for pain tolerance scores; however, when the mixed monitors were excluded, the 3-way interaction was significant, F(2, 124) = 3.48, p < .05. The results were nonsignificant for pain intensity, pain affect, and anxiety. CONCLUSION: Results demonstrate that matching coping style to the appropriate cognitive strategy is important for improving pain threshold and pain tolerance; however, matching did not reduce pain intensity, pain affect, or anxiety. Future studies should explore the explanation for differential responses of high and low monitors and should test these hypotheses in a clinical setting.     

In vivo functional assessment and multi-element interventions for problem behaviors of students with disabilities in classroom settings

Persons with developmental disabilities often do not follow instructions or complete tasks in educational settings, thus further disadvantaging themselves as they try to lead more normalized lives. The purpose of this paper was to address the problems of three persons referred for not following instructions and for engaging in associated behavior problems (e.g., crying, hitting, throwing materials) when given instructions. A functional assessment was conducted in the natural school setting without any prescribed conditions as in analogue functional assessments. Results of the assessments showed that problem behaviors for two subjects occurred much more in demand conditions requiring active responses than in demand conditions requiring passive responses. The results for a third subject showed problem behaviors were associated with toileting demands, less so with other demand conditions, but not with conditions in which there were an absence of demands. Individualized multi-element interventions were based on the negative reinforcement hypothesis and were intended to make tasks less aversive and to make instructions easier to understand. Results of the interventions showed increases in task engagement and decreases in problem behaviors during the active tasks and toileting tasks for which interventions were programmed, as well as for the passive tasks and other demand conditions for which no interventions were programmed. Results were discussed in terms of the value of functional assessments in directing therapists to base interventions on hypotheses of the function of the presenting problem.     

Active and passive distraction using a head-mounted display helmet: effects on cold pressor pain in children.

OBJECTIVE: The current study tested the effectiveness of interactive versus passive distraction that was delivered via a virtual reality type head-mounted display helmet for children experiencing cold pressor pain. DESIGN: Forty children, aged 5 to 13 years, underwent 1 or 2 baseline cold pressor trials followed by interactive distraction and passive distraction trials in counterbalanced order. MAIN OUTCOME MEASURES: Pain threshold and pain tolerance. RESULTS: Children who experienced either passive or interactive distraction demonstrated significant improvements in both pain tolerance and pain threshold relative to their baseline scores. In contrast, children who underwent a second cold pressor trial without distraction showed no significant improvements in pain tolerance or threshold. CONCLUSION: Although both distraction conditions were effective, the interactive distraction condition was significantly more effective. Implications for the treatment of children's distress during painful medical procedures are discussed.     

Classroom applications of the disequilibrium model of reinforcement

The present study investigated applications of the disequilibrium model of reinforcement in typical classroom contexts with students perceived by their teachers as being difficult to motivate. The disequilibrium model states that reinforcing effects are produced when access to any response (task) is constrained so that an individual cannot meet an (unconstrained) baseline level for that response (task). The implication of the model is that low‐probability (low‐preference) responses can be constrained and used as reinforcers, a seeming contradiction to the common practice of using a high‐probability response to reinforce increases in a low‐probability response. The present study investigated the effects of disequilibrium schedules of reinforcement with six students with several disabilities in classroom contexts. The specific research questions were (i) whether disequilibrium schedules would produce reinforcing effects if both the instrumental and contingent tasks were of moderate to low preference for the student; (ii) how effects of disequilibrium schedules would compare with those of a teacher‐generated contingency; and (iii) what effects disequilibrium schedules would have with students who engage in non‐task responding during the baseline period. Results suggest that disequilibrium schedules are effective when used with moderate to low‐preference tasks. Results of the comparison with teacher‐generated contingencies were mixed. Results do suggest that the presence of higher levels of non‐task responding during the baseline period may affect subsequent effectiveness of disequilibrium schedules calculated from the baseline. Copyright © 2003 John Wiley & Sons, Ltd.     

Decreasing Child Distress During Needle Sticks and Maintaining Treatment Gains Over Time

This study examined the effectiveness of an intervention for reducing behavioral distress in children during needle sticks. Participants were eight children and their parents. The children received injections or venipunctures for hematological or oncological disease. The distress management intervention included instruction for children to engage in a distraction activity during needle sticks and parent training in coaching their children. The intervention was adapted to clinic and home treatment settings. Results indicated that five children exhibited significantly less distress after treatment when compared with baseline sessions, that treatment gains were maintained at follow-up for three of them, and that child distress was significantly and negatively related to use of the experimental distractor. Implications for clinical practice are discussed.