Who uses community mental health centres? A study of one health district

A caseload analysis was undertaken to investigate those clients seen by five community mental health centre teams within one healthcare district. The 985 clients are described in terms of demographic and clinical features and questions relating to service provision are discussed.     

PROMPTING ONE LOW-FAT,HIGH-FIBER SELECTION IN A FAST-FOOD RESTAURANT

Evidence increasingly links a high-fat, low-fiber diet to coronary heart disease and certain site cancers, indicating a need for large-scale dietary change. Studies showing the effectiveness of particular procedures in specific settings are important at this point. The present study, using an A-B-A-B design and sales data from computerized cash registers, replicated and extended previous work by showing that inexpensive prompts (i.e., signs and fliers) in a national fast-food restaurant could increase the sales of salads, a low-fat, high-fiber menu selection. Suggestions also are made pertinent to more widespread use of the procedures.     

ACQUISITION AND FUNCTIONAL ANALYSIS OF MANDING WITH AUTISTIC STUDENTS

Three autistic students were trained to request a specific object from an adult “supplier” with the sentence, “Give me —” and to deliver that object to another adult, the “director.” Subsequently, the degree to which the object offered by the supplier controlled the “Give me —” verbal response was assessed by delivering to the student an object other than the one requested. Despite knowing the names of all objects used in the experiment, students accepted and delivered to the director any object offered by the supplier regardless of its match with the requested object. After training to say “That's not it. Give me —” when nonrequested objects were offered, students responded differentially to requested and nonrequested objects, suggesting control of the “Give me —” response by the requested object, a characteristic of a mand. These results generalized across settings and objects. Results are discussed in terms of the training technique to establish manding and the functional analysis of the resulting verbal behavior.     

COVARIATION WITHIN FUNCTIONAL RESPONSE CLASSES: IMPLICATIONS FOR TREATMENT OF SEVERE PROBLEM BEHAVIOR

Two studies examined the effects of a reductive treatment versus instruction-based treatments on the generalized reduction of problem behaviors. Each study involved a detailed analysis of multiple problem behaviors performed by school-aged youth with severe intellectual disabilities. The analysis examined the contrasting effects of one of two different positive intervention procedures (teaching a positive alternative behavior or providing additional teacher assistance during instruction) versus blocking and/or verbally reprimanding a problem behavior. The focus of each analysis was on the covariation of multiple problem behaviors within functional response classes. Results of the investigation indicated that when only one member of the response class was blocked, a collateral increase was observed in one or more different problem behaviors from the same response class. Alternatively, when 1 participant was taught a functionally equivalent mand response, all problem behaviors in the response class were reduced. Problem behaviors also were reduced for the remaining participant by presenting antecedent teacher assistance. Implications of the research extend to analysis of covariation within response classes and to procedures that result in generalized reduction of problem behaviors within a response class.     

AN ANALYSIS OF MAINTENANCE FOLLOWING FUNCTIONAL COMMUNICATION TRAINING

The multiple and long-term effects of functional communication training relative to a common reductive procedure (time-out from positive reinforcement) were evaluated. Twelve children participated in a functional analysis of their challenging behaviors (Study 1), which implicated adult attention as a maintaining variable. The children were then matched for chronological age, mental age, and language age and assigned to two groups. One group received functional communication training as an intervention for their challenging behavior, and the second group received time-out as a contrast. Both interventions were initially successful (Study 2), but durable results were achieved only with the group that received functional communication training across different stimulus conditions (Study 3). Students whose challenging behaviors were previously reduced with time-out resumed these behaviors in the presence of naive teachers unaware of the children's intervention history. The value of teaching communicative responses to promote maintenance is discussed as it relates to the concept of functional equivalence.     

Genetics and adoption: Forming a partnership

Genetic issues are demanding more attention in the area of public health. Adoption agencies and policymakers are beginning to address these issues where they relate to the adoption process and to the many families involved in adoption in this country. Genetic counselors need to play an active role as both educators of and consultants for adoption professionals and the families with whom they work. To facilitate a partnership between genetics and adoption we have developed a workshop intended to educate adoption professionals about the lifelong implications of genetic conditions on the adoption triad.     

TOWARD A NEW RELATION BETWEEN HUMANITY AND NATURE: RECONSTRUCTING T'IEN-JEN-HO-I

Abstract. The traditional Chinese idea of t'ien-jen-ho-i (Heaven and humanity in union) implies that humanity has to live in harmony with nature. As science and technology progress, however, the idea appears increasingly outmoded, and it becomes fashionable to talk about overcoming nature. Ironically, though, the further science reaches the more clearly are its limitations exposed. The exploitation of nature not only endangers many life forms on earth but threatens the very existence of the human species. I propose that a reconstruction of the traditional Chinese idea of T'ien-jen-ho-i will help us envisage a new and salutary relation between humanity and nature.