Behavioral assessment of methylphenidate in a child with frontal lobe damage

The assessment and management of inattentive, hyperactive, and impulsive behavior in a 6-year-old girl who experienced frontal lobe damage are described. A multimodel approach combining medical, educational, and behavioral techniques to assess hyperactive behavior, optimal medication level, and medication and psychotherapeutic effectiveness is described. The results of the study suggest that in similar cases, children and adolescents manifesting these behaviors should be given a trial of stimulant medication in a controlled environment to assess if such therapy is indicated. Additional support is given for the increasing need for detanté and cooperation with health-care professionals.     

The differential validity of hyperactivity/attention deficits and conduct problems among mentally retarded children

The independence of hyperactivity, attention deficits, and conduct problems among mentally retarded children was addressed using factors of the Conners' Teacher Rating Scale-39 (CTRS-39) and the more recently developed IOWA Conners' inattention/overactivity (IO) and aggression (A) subscales. CTRS-39 ratings were obtained for children of normal intelligence and for mentally retarded children. Differences between the groups were examined as were intercorrelations of the Conners' factors and IOWA subscales. Conduct problems proved to be less strongly associated with hyperactivity and attention deficits among mentally retarded children compared to children of normal intelligence. However, attention problems and conduct problems may be associated with mental retardation in general. Implications of these data and CTRS scoring system recommendations for mentally retarded children are discussed.     

A controlled group study of pedestrian-skill training for the mentally retarded

Pedestrian-skills training procedures were compared using 30 mentally retarded institutionalized adults. Ten subjects were randomly assigned to a no-treatment control group and ten subjects were assigned to each of two modes of pedestrian-skills training. The training methods included a form of individualized classroom training consisting of the practice of correct behavior using movable figures on a scale model of an intersection, vs independence training which emphasized self-evaluation of performance, social reinforcement, sign recognition and the utilization of a mock-up of an intersection on the hospital grounds. Data were taken on sign recognition, verbal and performance based responses to classroom training of pedestrian skills, performance of skills at an intersection on the hospital grounds, and performance of pedestrian skills in the community. Independence training proved to be significantly more effective than no treatment or classroom training. In addition, classroom training proved to be significantly more effective than no treatment at all.     

Social skill performance among normal and psychiatric inpatient children as a function of assessment conditions

The present investigation examined the effects of varying the standard assessment conditions on performance of social skills among normal and psychiatric inpatient children. Sixty children (30 normals, 30 patients), ages 6–12, completed behavioral and self-report measures of social skills on two separate occasions. During the second assessment, half of the children received feedback and incentives for performance; the other half did not. The testing conditions consistently altered social skill performance. Children who received the incentives during assessment showed significantly higher levels of social skills, as reflected in concrete behavior (e.g. eye contact, facial expressions), and molar responses (e.g. giving compliments, responding to provocation). The results suggest that social skills performance varies considerably as a function of the assessment conditions. Training programs should not assume that persons do not have the responses in their repertoires merely because of low pretest performance unless more extensive efforts are made to evoke appropriate responses.     

An account of a time-limited therapeutic group in an NHS setting for women with a history of incest

Group therapy may be a useful treatment modality for women who have been sexually abused as children. The group described here involved patients referred to the British NHS psychiatric service. This closed time-limited group was run by male and female cotherapists. Reasons are advanced for advocating a mixed-sex cotherapy team. The progress of the group is described. Issues of selection, preparatory individual therapy, further individual therapy following the group, and stress on the therapists are discussed. It is suggested that the mode of referral influences the severity of presenting problems and the level of additional support likely to be required by group members. The participants' views concerning the most helpful components of therapy are recorded and self-report measures are considered alongside the assessments of the therapists.     

Effectiveness of hand overcorrection for topographically similar and dissimilar self-stimulatory behavior

Response contingent hand overcorrection was used to reduce the frequency of self-stimulatory behaviors in four retarded adult males. For two of the subjects, the treated behaviors (hand shaking and nose touching) involved hand movements which were topographically similar to the hand overcorrection procedure. For the other two subjects, behaviors topographically dissimilar to the treatment procedure were treated (inappropriate laughing and head weaving). All four behaviors were decreased in frequency during treatment. However, the hand overcorrection procedure was more effective with the topographically similar behaviors.