Psychological differences between toilet trained and non-toilet trained 4-year-old children.

OBJECTIVE: Late to complete toilet training has been associated with many psychological factors including behavior and mood problems. Unfortunately, the majority of the research is specific to children with elimination disorders or children identified as incontinent after the age of 7 years. The current study addressed gaps in the literature by comparing the psychological functioning of children not toilet trained by their 4-year-old well child care visit with their toilet trained peers. DESIGN AND METHODS: Parent reports of internalizing and externalizing behavior using the Child Behavior Checklist (CBCL) were compared across groups, non-toilet trained and toilet trained, for 150 children recruited during their 4-year-old well child health care visit. Independent samples t tests of group means and χ2 analyses were performed on all CBCL scales. RESULTS: Results found no clinically or statistically significant differences between groups on parents' reports of internalizing and externalizing behavior. The current study provides no evidence that delays in successfully completing toilet training by 4 years of age were related to psychological problems for this sample of children. PRACTICE IMPLICATIONS: Nursing professionals in primary care settings are positioned to provide anticipatory guidance to parents of children not yet toilet trained. Findings from the current study offer evidence that delays in toilet training might not be related to psychopathology, and these children are not likely to require intervention outside the pediatric setting and could be effectively managed by primary care health providers employing evidence-based toilet training protocols.

Enhanced response using a multicomponent urine alarm treatment for nocturnal enuresis.

PURPOSE: The current study investigated the effects of using the combination of a urine alarm and simple reward system to treat nocturnal enuresis (NE) for three children who failed to fully respond to the urine alarm alone. DESIGN AND METHODS: A withdrawal design (i.e., ABACA) embedded within a delayed multiple baseline design across participants was used to evaluate the effects of the urine alarm alone and in combination with a reward system on participants' frequency of wet nights per week. Results were analyzed through visual and descriptive methods. RESULTS: The urine alarm in combination with a reward system resulted in improvements in all three participants' NE. These results are contrasted with the urine alarm alone, which produced less frequent dry nights. PRACTICE IMPLICATIONS: Nursing professionals in primary care settings are positioned to provide evidence-based treatment recommendations to families with children with NE. Findings from the current study provide a promising approach to the treatment of NE for those children who fail to respond fully to the urine alarm.

Video Self-Modeling: A Promising Strategy for Noncompliant Children.

The current study investigated the effects of a Video Self-Modeling (VSM) intervention on the compliance and aggressive behavior of three children placed in a psychiatric hospital. Each participant viewed brief video clips of himself following simple adult instructions just prior to the school's morning session and the unit's afternoon free period. A multiple baseline design across settings was used to evaluate the effects of the VSM intervention on compliance with staff instructions and aggressive behavior on the hospital unit and in the hospital-based classroom. All three participants exhibited higher levels of compliance and fewer aggressive episodes during the intervention condition, and the effects were generally maintained when the intervention was withdrawn. Hospital staff reported at the conclusion of the study that the VSM intervention was easy to implement and beneficial for all participants. Taken altogether, the results suggest VSM is a promising, socially acceptable, and proactive intervention approach for improving the behavior of noncompliant children.

Increasing the on-task homework behavior of youth with behavior disorders using functional behavioral assessment.

Research has shown a positive correlation between time spent on homework and learning. However, students often engage in off-task behaviors to escape the demands of homework. Youth with emotional or behavioral disorders (EBD) are especially likely to engage in off-task behaviors. Effective interventions to increase on-task behavior during homework are needed to increase students' academic success. Functional behavioral assessment (FBA) procedures may be helpful for intervention planning; however, there has been limited research on use of FBA with youth with EBD experiencing poor academic performance or task completion problems. In the current study, FBA methods were used to identify the contingencies maintaining the off-task behavior of four youth with behavior problems. Effects of interventions based on functional hypotheses were compared to the effects of interventions not linked to such hypotheses. Discussion focuses on utility of FBA procedures for developing and implementing effective interventions for youth with EBD.