Durability, negative impact, and neuropsychological predictors of tic suppression in children with chronic tic disorder.

Chronic tic disorders are characterized by involuntary motor and vocal tics, which are influenced by contextual factors. Recent research has shown that (a) children can suppress tics for brief periods of time, (b) suppression is enhanced when programmed reinforcement is provided for tic-free intervals, and (c) short periods of suppression do not result in a paradoxical "rebound" in tic frequency when active suppression has ceased. The current study extended existing research in three important ways. First, we examined whether tic suppression ability decreased as suppression duration increased from 5 to 25 to 40 min. Second, we examined post-suppression tic frequency to test whether longer periods of suppression were more likely to be associated with a rebound effect. Finally, we explored neuropsychological predictors of tic suppression. Thirteen children with Tourette syndrome or a chronic tic disorder completed the study. Results showed that (a) tic suppression was sustained for all of the suppression durations, (b) rebound effects were not observed following any of the suppression durations, and (c) ability to suppress was correlated with omission, but not commission errors on a continuous performance task. Implications of these findings are discussed.

Preliminary evaluation of a parent training program to prevent gun play.

Recent research has shown that behavioral skills training with in situ training is an effective strategy to teach children the safety skills needed if they ever encounter an unattended firearm. The current study evaluated the use of parents as trainers to increase the efficiency of training. The success of parent training on their children's safety skills was evaluated in a multiple baseline across participants design. The results showed that the training was effective for 3 of the 4 children.

Meta-analysis of noncontingent reinforcement effects on problem behavior.

A meta-analysis of noncontingent reinforcement (NCR) outcomes was conducted using hierarchical linear modeling (a) to document the effect size for decreasing problem behavior, (b) to compare effect sizes for NCR using functional reinforcers and nonfunctional reinforcers, and (c) to document the influence of schedule thinning on effect size. Analyses were conducted with data from 55 studies and 91 participants. Results indicate that NCR was associated with a very strong effect size (d =-1.58) for reduction of problem behavior, functional reinforcers were slightly more effective than nonfunctional reinforcers, and schedule thinning resulted in minor degradation of effect size. Meta-analysis of single-case design data provides a method to quantitatively estimate effect sizes of interventions across participants. Therefore, it allows one to identify important variables that are not otherwise evident in single-case data, helps to disseminate findings to the broader scientific community, and contributes to the documentation of empirically supported interventions.

Evaluating the Effects of Matched and Unmatched Stimuli on Nail Biting in Typically Developing Children.

We evaluated the effects of matched and unmatched stimuli on nail biting for three typically developing children and adolescents. Antecedent-based assessments identified conditions when subjects were most likely to engage in nail biting. Treatment included the noncontingent delivery of four types of highly preferred stimuli: items hypothesized to match the oral, the tactile, or both the oral and tactile stimulation inherent to nail biting, as well as items that did not involve oral or tactile stimulation. Results suggested that all forms of alternative stimulation decreased nail biting.

Evaluation of extinction as a functional treatment for binge eating.

Binge eating is a serious behavior problem exhibited by individuals diagnosed with binge eating disorder and bulimia nervosa. Binge eating is thought to be maintained by automatic negative reinforcement in the form of relief from negative emotional responding. Current treatments produce only moderate abstinence, perhaps because they do not attempt to alter the functional consequences of the behavior. Although extinction has been thought impossible with behaviors maintained by automatic negative reinforcement, this study evaluated the application of extinction with binge eating. Four women who reported engaging in binge eating at least twice per week participated. Participants listened to an audio tape recording of the covert verbal behavior associated with their negative emotional responding during the binge to prevent alleviation of the negative emotional responding, thus eliminating the reinforcer in an attempt to reduce the behavior. The procedure effectively reduced frequency of the binges when correctly implemented. Implications and suggestions for future research are discussed.