ABSTRACT
The long-term effectiveness of the response restriction method for establishing diurnal bladder control was assessed with 48 participants with intellectual disabilities. Intervals of assessment ranged from 28 to 66 months across the individuals following initial baseline. Difference scores in terms of the mean number of toileting accidents per hour were related to participants' stereotypic behaviour and their housing conditions, as these were hypothesized to differentially influence the maintenance of diurnal bladder control. It was found that (a) across all participants there was a statistically significant decrease of the mean number of toileting accidents during follow-up as compared to initial baseline (b) stereotypic behaviour failed to be related to maintenance of bladder control, and (c) housing condition was significantly related to the above dependent variable, in that those living in a residential facility were more likely to wear a diaper again as compared to those living with their family. Implications for the clinical practice are discussed.
Subject(s)
Circadian Rhythm/physiology , Urinary Incontinence/therapy , Adolescent , Adult , Behavior Therapy , Child , Female , Humans , Intellectual Disability/complications , Male , Middle Aged , Time Factors , Toilet Training , Treatment Outcome , Urinary Incontinence/etiologyABSTRACT
In this study, the side effects of contingent shock (CS) treatment were addressed with a group of nine individuals, who showed severe forms of self-injurious behavior (SIB) and aggressive behavior. Side effects were assigned to one of the following four behavior categories; (a) positive verbal and nonverbal utterances, (b) negative verbal and nonverbal utterances, (c) socially appropriate behaviors, and (d) time off work. When treatment was compared to baseline measures, results showed that with all behavior categories, individuals either significantly improved, or did not show any change. Negative side effects failed to be found in this study.
Subject(s)
Electroconvulsive Therapy , Self-Injurious Behavior/therapy , Adolescent , Adult , Aggression/psychology , Child , Electroconvulsive Therapy/adverse effects , Electroconvulsive Therapy/psychology , Electroshock , Female , Humans , Male , Psychology , Treatment Outcome , Young AdultABSTRACT
PURPOSE: To assess expressive communication in individuals with Angelman syndrome. METHOD: Communicative functioning of individuals with Angelman syndrome (AS) (n = 109) was compared with individuals with mixed etiologies (n = 117) using the Verbal Behaviour Assessment Scale (VerBAS). RESULTS: Within-group analyses of those with AS revealed that the communicative function of manding was significantly more developed than tacting and echoing, and that tacting was significantly more developed than echoing. Low mean total VerBAS-scores were found with individuals who had epilepsy and used anticonvulsant medication, and with those who had profound developmental disabilities. In the comparison group, the function of manding was significantly more developed than both tacting and echoing, while tacting did not differ from echoing. Between-groups analyses revealed that individuals with AS had significantly lower scores on tacting and echoing, but not on manding. CONCLUSION: The overall pattern of VerBAS scores for individuals with AS suggests a possible communicative phenotype.
Subject(s)
Angelman Syndrome/complications , Angelman Syndrome/diagnosis , Communication Disorders/rehabilitation , Verbal Behavior , Adolescent , Adult , Case-Control Studies , Child , Child, Preschool , Communication Disorders/etiology , Female , Follow-Up Studies , Humans , Male , Neuropsychological Tests , Risk Assessment , Severity of Illness Index , Stanford-Binet Test , Surveys and Questionnaires , Treatment OutcomeABSTRACT
The communication profiles of individuals with Down's syndrome (DS), Angelman syndrome (AS) and pervasive developmental disorder (PDD) were investigated and contrasted. Seventy-seven individuals participated in the study. A within-group analysis revealed that those with DS performed better on tacting or labelling and echoing than on manding or requesting. No other effects were found, apart from an absence of echoing in those with AS, a result that is hardly surprising. A between-groups analysis revealed no differences between the aetiological groups in terms of their use of mands or requests and tacts. Individuals with DS and PDD did not differ in their scores on echoic functioning. The implications of these findings for the study of behavioural phenotypes and for communication intervention are discussed.
Subject(s)
Angelman Syndrome/psychology , Child Development Disorders, Pervasive/psychology , Communication , Down Syndrome/psychology , Adolescent , Adult , Analysis of Variance , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Phenotype , Surveys and QuestionnairesABSTRACT
In this study, a new procedure to establish diurnal bladder control was evaluated. Eight children with severe and moderate levels of mental retardation participated. The procedure was based on the behavior theoretical concept of response restriction. Data were collected within a nonconcurrent multiple baseline design. Seven participants attained a level of bladder control in that they remained without urinary accidents between regular toileting times. Follow-up measures revealed maintenance of these results. The results are discussed in terms of the advantages of this procedure as compared with existing procedures in this area, especially with respect to the omission of the restitutional overcorrection procedure.
Subject(s)
Circadian Rhythm/physiology , Toilet Training , Urinary Bladder/physiopathology , Urinary Incontinence/prevention & control , Urinary Incontinence/physiopathology , Child , Female , Follow-Up Studies , Humans , Institutionalization , Intellectual Disability/psychology , MaleABSTRACT
Eight individuals with mental retardation and imposed mechanical restraints due to severe, life-threatening self-injurious behavior received electrical aversive treatment. Eight other individuals, who had been matched with the treatment group in terms of the degree of imposed mechanical restraint due to the above problem behavior, had not received electrical aversion treatment. A comparison of imposed mechanical restraint scores, as a measure of severity of self-injurious behavior, between both groups over a period of three years, revealed that electrical aversion treatment significantly reduces the degree of imposed mechanical restraint.
Subject(s)
Avoidance Learning , Electric Stimulation Therapy , Self-Injurious Behavior/therapy , Adolescent , Adult , Female , Humans , Intellectual Disability/complications , Male , Middle Aged , Restraint, Physical , Severity of Illness Index , Treatment OutcomeABSTRACT
A questionnaire, the Verbal Behavior Assessment Scale, was developed to assess the communicative functions of individuals with developmental disabilities and severe mental handicap. To assess its psychometric characteristics, the questionnaire, comprising 15 items, was administered to pairs of caregivers of 115 participants. Exploratory factor analysis, involving 11 more participants, revealed satisfactory evidence concerning the distinction of three different communicative functions with the present sample. The questionnaire had good levels of interrater reliability and internal consistency.
Subject(s)
Surveys and Questionnaires , Verbal Behavior , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Intellectual Disability/rehabilitation , Male , Reproducibility of Results , Residential TreatmentABSTRACT
This study pertains to assessing the effects of electric shocks that are used in the treatment of severe self-injurious behavior. With pain sensation and startle response as the dependent variables and focusing versus distraction of recipient's attention to the electric shocks as the independent variable, these stimuli were administered to 60 paid volunteers. Using ANOVA, no significant effect of the independent variable was found on either measure. However, repeated administration of the electric shock produced a significant increment of pain sensation, with a concomitant significant decrease of magnitude of the startle response. No interaction effect was found.
Subject(s)
Attention , Aversive Therapy , Electroshock/psychology , Pain Threshold , Adolescent , Adult , Female , Humans , Male , Reflex, Startle , Self-Injurious Behavior/prevention & control , Self-Injurious Behavior/psychologyABSTRACT
The effects of resident behaviors and resident characteristics on the quantity and quality of care they receive from direct-care staff was examined. Four hundred and fifty-two residents with severe and profound mental retardation and 416 direct care staff members were involved. Naturalistic observations were conducted on direct-care staff behavior, that is, staff-resident initiatives, staff affection, staff communicative behavior, on resident behaviors (i.e., maladaptive, stereotypic, and adaptive behavior, position, attending, and communicative behavior), and on resident characteristics (i.e., gender, age, ambulancy, sensory handicaps, and seizure disorder). By importance, residents' ambulancy/motoric skills, their communicative behavior, and attending behavior accounted for the greatest differences in the quality and quantity of the care they receive from direct-care staff. Given that certain resident characteristics can be ameliorated through training, residents themselves may control, to a certain extent, the care they receive from direct-care staff in residential facilities.
Subject(s)
Caregivers/psychology , Intellectual Disability/rehabilitation , Quality Assurance, Health Care/standards , Quality Indicators, Health Care/statistics & numerical data , Residential Facilities/standards , Residential Treatment/standards , Adult , Analysis of Variance , Attention , Attitude of Health Personnel , Communication , Custodial Care/psychology , Data Collection/methods , Female , Humans , Male , Middle Aged , Motor Skills , Netherlands , Observer Variation , Regression Analysis , Sampling Studies , Stereotyped BehaviorABSTRACT
The psychometric properties of the Motivation Assessment Scale (MAS) were examined. Specifically, reliability, internal consistency, and construct validity were estimated using 90 ratings of different problem behaviors among 86 individuals with mental retardation. Data were analyzed under conditions of (a) three topographies of problem behavior and (b) two methods of calculation. Although reliability and internal consistency were generally poor, the results depended upon the above conditions. Factor analysis revealed that the four factors of the MAS differed from the subscale structure obtained in this study, proposed by the authors of the MAS. Thus, the construct validity of this scale was ambiguous. It is concluded that the MAS should be employed in conjunction with other instruments to assess the functional characteristics of problem behavior with individuals who have mental retardation.
Subject(s)
Intellectual Disability/psychology , Motivation , Personality Assessment/statistics & numerical data , Social Behavior Disorders/psychology , Group Homes , Humans , Intellectual Disability/diagnosis , Internal-External Control , Observer Variation , Psychometrics , Reproducibility of Results , Social Behavior Disorders/diagnosisABSTRACT
An inventory for assessing the degree of mechanical restraint imposed by others to prevent individuals from inflicting physical injuries to themselves or to others, the Imposed Mechanical Restraint Inventory (IMRI), was developed. The inventory was administered to pairs of residential direct-care staff members to assess 113 individuals with mental retardation who showed self-injurious behavior while various sorts of mechanical restraint were imposed on them. The results indicate that the inventory showed acceptable levels of interobserver reliability, intraobserver reliability, and accuracy.
Subject(s)
Intellectual Disability/complications , Process Assessment, Health Care/standards , Restraint, Physical , Self-Injurious Behavior/prevention & control , Adolescent , Adult , Aged , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Observer Variation , Process Assessment, Health Care/statistics & numerical data , Reproducibility of Results , Restraint, Physical/instrumentation , Restraint, Physical/methodsABSTRACT
Meta-analysis of 482 empirical studies on treatment of problem behaviors of individuals with mental retardation was conducted. A metric of treatment effectiveness was computed for 1,451 comparisons between baselines and treatments, 34 topographies of problem behavior, and 64 treatment procedures. Analysis of variance with percentage of nonoverlapping data as the dependent variable and comparison as the basic unit of analysis revealed that treatment of externally destructive behaviors had significantly lower mean percentage of nonoverlapping data scores than did treatment of socially disruptive and internally maladaptive behaviors. Response contingent procedures were significantly more effective than were other procedures. No significant interactions were found. Results of a stepwise regression showed that only performing a functional analysis made a significant contribution. These results may lead to more objective assignment of treatment procedures to problem behaviors.
Subject(s)
Behavior Therapy/methods , Intellectual Disability/therapy , Social Behavior Disorders/therapy , Adolescent , Adult , Aged , Aggression/psychology , Child , Child, Preschool , Female , Humans , Infant , Intellectual Disability/psychology , Male , Middle Aged , Regression Analysis , Self Mutilation/prevention & control , Self Mutilation/psychology , Social Behavior Disorders/psychology , Stereotyped Behavior , Treatment OutcomeABSTRACT
This study was designed to assess the effects of response-contingent interruption-prompting of stereotypic behaviour on on-task behaviour, inactivity and inappropriate behaviour. Also, the relationship between these behaviours was investigated. Five individuals with severe intellectual disability and autism participated. Data were collected within a reversal design. The results showed a statistically significant increase of on-task behaviour when interruption-prompting of stereotypic behaviour was in effect. Inactivity was statistically related to inappropriate behaviour. In terms of the continuous effort to identify procedures that are least intrusive for the client to attain behaviour improvement, it is suggested that interruption-prompting of stereotypic behaviour may be a reasonable choice for practicians.
Subject(s)
Attention , Autistic Disorder/therapy , Behavior Therapy/methods , Education of Intellectually Disabled , Intellectual Disability/therapy , Stereotyped Behavior , Adolescent , Adult , Autistic Disorder/psychology , Child , Female , Humans , Intellectual Disability/psychology , Male , Reinforcement, Psychology , Social Environment , Treatment OutcomeABSTRACT
Twelve severely and profoundly mentally retarded individuals with life-threatening self-injurious behaviors were exposed to electrical aversion treatment using a remotely controlled device. Long-term effectiveness was assessed for periods ranging from 2 to 47 months for the 12 individuals, respectively. The degree of imposed physical restraint was used as the major dependent variable. With two individuals, the treatment failed to suppress self-injurious behavior. With seven individuals, however, suppression was nearly complete in that physical restraints were no longer necessary. With three individuals moderate effects were obtained, in that, although a substantial decrease of imposed physical restraint had been achieved, they still needed daily administrations of electrical aversive stimuli. The results are discussed in terms of the practical application of this procedure.
Subject(s)
Aversive Therapy/methods , Intellectual Disability/therapy , Self-Injurious Behavior/prevention & control , Adolescent , Adult , Child , Child, Preschool , Combined Modality Therapy , Electroshock , Female , Humans , Intellectual Disability/psychology , Long-Term Care , Male , Psychotropic Drugs/therapeutic use , Restraint, Physical , Self-Injurious Behavior/psychology , Treatment OutcomeABSTRACT
Trainer behavior has been neglected as an area of applied research. Feedback has been demonstrated as potentially effective to increase the accuracy of behavior of teachers, parents, ward-staff members, and other service providers in the area of mental retardation. In this study, we assessed the effect of delayed feedback on the accuracy of training given by four trainers during one-to-one sessions. Trainees were four individuals with severe mental retardation, who were taught communicative gestures. The results, gathered within a multiple baseline design across dyads of trainers and trainees, showed that delayed feedback resulted in an increased accuracy of training.
Subject(s)
Education of Intellectually Disabled , Gestures , Intellectual Disability/rehabilitation , Language Development Disorders/rehabilitation , Nonverbal Communication , Adolescent , Adult , Behavior Therapy , Child , Feedback , Female , Humans , Intellectual Disability/psychology , Language Development Disorders/psychology , Male , Mental Recall , MotivationABSTRACT
In the present study, two experiments were conducted in which the effectiveness of a training package was assessed on the acquisition and generalization of five social behaviors with language-disabled and severe language-disabled deaf adolescents. The training package encompassed modeling, self-monitoring, self-reinforcement, and mediator-directed supervision and feedback. Procedures to promote generality of effects and social validity of the procedures were used as well. Target behaviors were Initiating Interaction, Turn Waiting, Keeping to the Subject, Communicating Orally, and Using Correct Sentences. Data were collected within a multiple baseline design across behaviors. Results indicated that the training package was effective in improving the performance of all participants. However, increases in percentage of appropriate target behaviors were more substantial for the language-disabled deaf adolescents than for the severely language-disabled deaf adolescents. Maintenance of effects was demonstrated as well.
Subject(s)
Behavior Therapy , Deafness/rehabilitation , Language Disorders/rehabilitation , Social Behavior , Adolescent , Adult , Deafness/diagnosis , Deafness/therapy , Female , Follow-Up Studies , Humans , Language Disorders/diagnosis , Language Disorders/therapy , Male , Middle Aged , Residential Facilities , Severity of Illness IndexABSTRACT
Various procedures have been used to establish and increase manual signed and spoken requesting with individuals who are intellectually disabled. A few studies have used the so-called blockable response conditioned establishing operation (BR-CEO) as a stimulus control procedure to increase requesting. A variation on the BR-CEO is the interrupted chain procedure, in which requesting for the activity that had been interrupted is reinforced by continuation of the activity. Rather than interrupting an ongoing activity, six individuals who are severely/profoundly intellectually disabled were studied with respect to the differential effectiveness of presenting them incomplete versus complete referents (i.e. activity and objects) as a consequence of their requesting on their rate of requesting. Data were collected within a reversal design. The results show that five out of six individuals more than doubled their rate of requesting. Incomplete presentation of referents may be a practical procedure to increase requesting.
Subject(s)
Communication , Education of Intellectually Disabled , Intellectual Disability/rehabilitation , Teaching/methods , Adolescent , Adult , Humans , Male , Reinforcement, Psychology , Sign Language , Verbal BehaviorABSTRACT
In the present study, the effectiveness of a multifaceted training package on the acquisition and generalization of three social behaviors--initiating interaction, interacting with others, and turn waiting--was assessed with nine 12- and 13-year-old language-disabled deaf children. The package included (1) child training and (2) supervision, feedback, and goal-setting by teachers and residential staff members. Steps were taken to promote generality of the effects and the social validity of the procedures. Data were collected within a multiple baseline design across behaviors. Visual inspection and statistical analysis showed that instances of appropriate target behaviors increased and were generalized across settings, activities, and subjects during the training procedure and that the effects were maintained following training.
Subject(s)
Deafness/complications , Language Disorders/complications , Learning , Socialization , Adolescent , Child , Female , Humans , MaleABSTRACT
The treatment of a 33-year-old female disabled by mental retardation and Prader-Willi syndrome who exhibited pica is described. Negative practice was administered following each occurrence of the target behavior, that is, biting off and chewing on inedible objects. Data were collected within a reversal design. The results indicated that pica was reduced to a near zero level. Follow-up data collected after 7 months while the procedure was continued revealed a sustained suppression of pica.
Subject(s)
Behavior Therapy/methods , Intellectual Disability/psychology , Pica/therapy , Practice, Psychological , Prader-Willi Syndrome/psychology , Adult , Education of Intellectually Disabled , Female , Humans , Pica/psychology , Reinforcement, PsychologyABSTRACT
Procedures for teaching communicative gestures to individuals with mental retardation are focused mostly on establishing requesting or manding. It is often taken for granted that when a student has been taught to make a request, that he or she is indeed manding. Five students with severe/profound mental retardation accepted referents, regardless of whether the referents matched the gestures they made. Apparently, their responding could not be defined as manding. A correction procedure, including interruption, physical guidance, verbal instruction, and repetition, was then applied and increased the individuals' correct rejecting of unmatching referents. Data were collected within a multiple baseline design across individuals. It is suggested that assessing student's response when the trainer or teacher delivers items that do not match the referent of a prior request is a necessary part of each training program.
