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.     

Reciprocal peer management: Improving staff instruction in a vocational training program

To test the feasibility and utility of involving peers as sources of feedback, 6 subjects, instructors in a vocational program for adults with mental retardation, participated in a staff training and management program. Subjects' teaching interactions were assessed during baseline, in-service training (on effective teaching), return-to-baseline, peer management, and follow-up phases. Peer management was introduced in multiple baseline fashion across pairs of subjects. Members of each pair were trained to monitor peer teaching, to record and graph data, to provide feedback, and to set goals with the peer. Each pair then performed these procedures on the job for several weeks, during which time 4 of the 6 subjects increased their use of effective teaching methods (over baseline). However, inconsistencies in the magnitude and durability of these increases require that the study be viewed as inconclusive, although it has heuristic value as a promising model for involving co-workers in staff management programs.     

PROMOTING STIMULUS CONTROL WITH TEXTUAL PROMPTS AND PERFORMANCE FEEDBACK FOR PERSONS WITH MILD DISABILITIES

We assessed whether written task analyses would serve as textual prompts for performing functional tasks by persons with mild disabilities. Several variables that could influence the effectiveness of textual prompts to promote stimulus control were examined across four groups. A consistent finding was that written specific task analyses combined with end-of-trial performance feedback were effective for promoting the acquisition and generalization of several tasks. Performance transferred immediately to natural discriminative stimuli when the written task analyses and feedback were withdrawn for most tasks and participants. For 2 participants, transfer of stimulus control was accomplished by prompt fading, using individualized written task analyses either with or without performance feedback (Group 1). When feedback was not provided, the effectiveness of written specific task analyses was inconsistent across groups. In contrast to the controlling effects of written specific task analyses, written generic task analyses, which specified only major task outcomes, when combined with performance feedback (Group 1) did not control responding. Overall, this research demonstrated the effectiveness of written specific task analyses and performance feedback to promote stimulus control for persons with mild disabilities.     

谈谈个人对智力落后儿童早期干预的看法

本文作者根据从事智力落后儿童的早期干预教学研究的实践经验对当今在我国开展早期干预的必要性以及早期干预的目的、设置的理由、内容、方式、对象、教师的条件、效果的评价以及开展的步骤等9个问题,提出了自己的看法。     

Comparison of simultaneous prompting and constant time delay procedures in teaching sight words to elementary students with moderate mental retardation

Simultaneous prompting (a type of antecedent prompt and test procedure) and constant time delay were compared with four students with moderate mental retardation learning expressive sight words. A parallel treatments design across word sets and replicated across students was used. For acquisition, the simultaneous prompting procedures required fewer trials, sessions, and training time to criterion and resulted in fewer student errors during daily probe and training sessions. However, maintenance data indicated mixed results across the two procedures. Reliability data (both dependent and independent variables) revealed no differences between the two procedures in terms of the teacher's accuracy in recording student responses and implementing each procedure. Future research issues are discussed.     

Delayed constructed-response identity matching improves the spelling performance of students with mental retardation

We assessed the effects of a computerized matching-to-sample procedure on the spelling performances of three students with mental retardation. Initially, the students could 1) match pictures and printed words to one another, and 2) match pictures and printed words to spoken words. However, they could not construct words to either pictures or spoken words (e.g., touch, in order, the letters s->h->o->e given the spoken-word sample Shoe). Word constructions then improved markedly after exposure to delayed constructed-response identity matching (e.g., touch the letters s->h->o->e given the printed-word sample shoe). One subject's oral and written spelling also improved. The results extend previous research by showing multiple positive effects of a computerized spelling intervention. These effects may have occurred in part because of the formation of stimulus classes among pictures, printed words, and spoken words.     

GENERALIZED LANGUAGE LEARNING BY CHILDREN WITH SEVERE MENTAL RETARDATION: EFFECTS OF PEERS' EXPRESSIVE MODELING

In this study, we investigated the conditions that contribute to observational learning of generalized language in children with severe mental retardation. Matrix-training strategies were used to teach 6 children with mental retardation to combine known words into two- or three-word utterances consistent with syntactic rules. Subsequently, the children learned two or more unknown words concurrently, inducing word-referent relations consistent with these word order rules. Generalized learning of responses not taught directly was shown to be under experimental control using a multiple baseline design across submatrices. Expressive modeling of only four or five responses was sufficient to promote recombinative generalization in the expressive and receptive modalities. Thus, 95% to 98% of subjects' learning was attributed to generalization processes. This study demonstrates how the efficiency of language training with children with mental retardation might be enhanced by coupling observational learning and matrix-training strategies.     

TEACHING SUPPORTED EMPLOYEES WITH SEVERE MENTAL RETARDATION TO SOLVE PROBLEMS

Two individuals with severe mental retardation, employed by a janitorial supply company, were taught to use self-instruction in combination with multiple exemplar training to solve work-related problems. Use of the combined strategy resulted in generalization of the effects of independent variables, as well as generalization to nontrained problems. Use of the strategy is discussed in terms of promoting independent performance among supported employees.     

CLINICAL BEHAVIORAL PHARMACOLOGY: METHODS FOR EVALUATING MEDICATIONS AND CONTINGENCY MANAGEMENT

We evaluated methods for comparing the effects of dextroamphetamine (Dexedrine), thioridazine (Mellaril), and contingency management in the control of severe behavior problems. A reversal design was used in which medications were systematically titrated and assessed in unstructured as well as structured settings with three clients. Subsequently, behavioral procedures including timeout, differential reinforcement of other behavior, and visual screening, were used in a multiple-baseline design across settings. The assessment and design methods were useful in comparing the interventions. Dextroamphetamine decreased inappropriate behaviors and improved academic behaviors in one client, but no reliable effects were observed in the other two clients. Thioridazine was variable across clients, settings, behaviors, and dosages. Contingency management produced consistent decreases in inappropriate behaviors and small improvements in academic performance.