Caregiving for children through conflict and displacement: a pilot study testing the feasibility of delivering and evaluating a light touch parenting intervention for caregivers in the West Bank

A child's adjustment to wartime stress is reliant not only on individual responses and qualities, but very significantly on the availability of support that they may receive from their parent or caregivers and quality of relationships. Strengthening parental support has the potential to be valuable. A pilot two-arm randomised controlled trial investigated the feasibility of delivering and evaluating the “Caring for Children Through Conflict and Displacement” intervention with caregivers in the West Bank. Feasibility to recruit and train non-specialist staff on-the-ground to screen families for eligibility, collect outcome data, deliver the intervention and to recruit and retain families in the study were examined. Research staff and intervention facilitators were successfully appointed in the field, screened participants and delivered the intervention to 120 caregivers, collecting outcome measures pre-and post-delivery. All families completed the outcome measures, with very little missing data. This indicated that the intervention can be delivered feasibly and evaluated with families in this humanitarian context. Preliminary outcome data showed promise that the intervention may have the potential to both improve family functioning and reduce children's problem behaviour. Implications of family-focused initiatives, particularly within a conflict/post-conflict context for the prevention of several negative health and social outcomes directions, are discussed.     

The role of vital exhaustion in predicting the recurrence of vascular events: A longitudinal study

Background/objective

The aim of this study was to examine the role of vital exhaustion in predicting the recurrence of vascular events.

THE EFFECTIVENESS OF A CONSTANT TIME-DELAY PROCEDURE TO TEACH CHAINED RESPONSES TO ADOLESCENTS WITH MENTAL RETARDATION

The effectiveness of a 5-s constant time-delay procedure to teach three chained food preparation behaviors to four moderately retarded adolescent students was evaluated within a multiple probe design across behaviors. Results indicate that the procedure was effective in teaching all four students to make a sandwich, boil a boil-in-bag item, and bake canned biscuits. The skills maintained with at least 85% accuracy over a 3-month period. Training generalized from the school to the home setting for the 2 subjects that completed generalization probe sessions. The percentage of errors across all skills and students was less than 9%.     

A COMPARISON OF PEER-DIRECTED AND TEACHER-DIRECTED EMPLOYMENT INTERVIEW TRAINING FOR MENTALLY RETARDED ADULTS

Interview skills deficits may limit employment prospects of mentally retarded adults. Although numerous papers highlight the importance of interview skills, few have validated effective strategies for use with mentally retarded persons. Further, there has been a lack of research contrasting rival interview skills training strategies. The present study was conducted with two mentally retarded young adults. It contrasted peer-directed instruction, in which both participants were equally deficient in the target skills, with teacher-directed instruction. Results of the investigation indicated that instruction, rehearsal, and feedback may be effective strategies regardless of who provides instruction. Comparisons of teacher-directed and peer-directed instruction indicated little or no difference in the effectiveness of the two procedures. However, the peer-directed procedure involved considerably less staff time than did the teacher-directed procedure.     

Effectiveness of the GOFER course in decision making for high school students

The paper describes and evaluates the GOFER course in decision making for high school students (Mann, Harmoni and Power, 1988). The course was based on principles from the conflict theory of decision making (Janis and Mann, 1977) and was designed to provide adolescents with an understanding of factors that produce good and poor decision making as well as knowledge and practice of sound decision skills. Two evaluation studies were conducted to examine effectiveness of the course. Study 1 was conducted with young adolescents (12 year olds). It found a significant difference between students trained in the course and a control group on measures of self-esteem as a decision maker, self reported decision habits and knowledge of decision strategy. Study 2 was conducted with mid-adolescents (15 year olds). It, too, found a significant difference between students who took the course and a control group on measures of self esteem as a decision maker and self-reported decision habits. It is concluded that while the evaluation study fell short of an ideal test, the GOFER course met the criteria of improving student knowledge, raising confidence in decision making and changing self reported decision habits.     

A content analysis of the conversational behavior of accepted and rejected children

The present study was designed to assess whether the conversational behavior of children separated into accepted, rejected, and mixed-status dyads differed along the dimensions of listening to, paying attention to, and indicating interest in their dyadic partner. Conversations of 40 third-grade dyads were analyzed as they occurred in a 2- min waiting period and a 4- min conversation period. Seventeen categories of verbal behaviors that indexed these dimensions were used as content codes. Multivariate analyses of variance performed on the observational data yielded significant main effects for status, sex, and experimental condition. Results are interpreted in terms of previous social skills research, and suggestions for future research are offered.     

EFFECTS OF SELF-EVALUATION ON PRESCHOOL CHILDREN'S USE OF SOCIAL INTERACTION STRATEGIES WITH THEIR CLASSMATES WITH AUTISM

This study investigated effects of a self-evaluation procedure on preschool children's use of social interaction strategies among their classmates with autism. Three triads of children (comprised of 1 trained normally developing peer, 1 untrained peer, and 1 child with autism) participated. A multiple baseline design across subjects was used to demonstrate that peers who were taught facilitative strategies increased their use of strategies only after the self-evaluation intervention was introduced. Improvements in social behavior of children with autism was associated with peers' increased strategy use. Untrained peers demonstrated little change in their social behavior. Treatment effects were replicated when trained peers were asked to use self-evaluation with other children with autism during other play times. Self-evaluation procedures enhanced the use of social interaction strategies on the part of normally developing peers during social skills interventions.     

COMPARISON OF STAFF TRAINING STRATEGIES TO PROMOTE GENERALIZED TEACHING SKILLS

Two studies compared the effectiveness of different strategies for promoting generalization of staff skills in teaching self-care routines to clients with developmental disabilities. In Study 1, 9 direct-care staff members of group homes were trained sequentially through four conditions: (a) the provision of written instructions, (b) performance-based training using a single client program exemplar and simulated clients (single case training), (c) performance-based training using actual developmentally delayed clients as trainees (common stimuli training), and (d) performance-based training using multiple client program exemplars with simulated clients (general case training). The results indicated that staff members did not reach all generalization criteria until general case training was provided. Because staff members had been trained sequentially through several conditions in Study 1, a second study controlled for potential sequence effects. In Study 2, 7 staff members were trained using only the general case strategy after baseline. All staff members reached generalization criteria with only general case training, replicating the findings of Study 1. Together, the two studies demonstrated that the general case training strategy was more effective at promoting generalized training effects across clients, settings, and client programs than other commonly used staff training approaches.     

TEACHING CHILD-CARE SKILLS TO MOTHERS WITH DEVELOPMENTAL DISABILITIES

The present study identified and remediated child-care skill deficits in parents with developmental disabilities to reduce their risk of child neglect. Eleven mothers with developmental disabilities who were considered by social service and child welfare agencies to be providing neglectful child care were found in baseline to have several important child-care skill deficits (e.g., bathing, diaper rash treatment, cleaning baby bottles) compared to nonhandicapped mothers. Parent training (consisting of verbal instructions, pictorial manuals, modeling, feedback, and reinforcement) resulted in rapid acquisition and maintenance of child-care skills in all mothers. Mean percentage correct scores increased from 58% in baseline to 90% in training and 91% in follow-up (M = 31 weeks). The latter two scores compare favorably to the mean score (87%) of 20 nonhandicapped mothers on the same skills. Where observable, parent training was associated with corresponding benefits to the children (e.g., elimination of diaper rash and cradle cap, increased weight gain, successful toilet training). These results indicate that parent training may be a viable option to the removal of the child from the home when parenting skill deficits place the child's well-being in jeopardy.     

TEACHING SAFETY SKILLS TO HIGH SCHOOL STUDENTS WITH MODERATE DISABILITIES

Teaching students with disabilities to respond appropriately to potentially dangerous situations is a useful skill that has received little research attention. This investigation taught 3 students with moderate mental retardation to remove and discard broken materials (plates, glasses) safely from (a) a sink containing dishwater, (b) a countertop, and (c) a floor. A 4th student was instructed on the sink task only. A multicomponent treatment package was used to teach the skills. Simulated materials were used initially and were replaced with broken plates and glasses. A multiple probe design was used to evaluate the effectiveness of the treatment package. The results indicated that the treatment package was effective in teaching the skills. Data were collected 1 week and 1 month following the completion of training, and indicated mixed results. No student was injured during any phase of training. Issues pertinent to teaching safety skills to students with moderate disabilities are discussed.