Child abuse and neglect by parents with disabilities: A tale of two families.

Two families, in which the children had been placed in foster care due to abuse and neglect by parents who had disabilities, were studied. In the first case, the mother was instructed in skills that our assessment suggested were important for her child's survival. The mother readily acquired and applied these skills, a fact reflected both in changes in her behavior and in changes in the child's well-being. In the second case, the parent's incremental resumption of child custody was made contingent upon completion of relevant parenting tasks. Initially, improvements in the completion of such tasks were evident, but over time and with the onset of militating factors, no further progress was made and all parental rights were terminated. The implications of these cases for behavior analysis and the effort to reunite and preserve families are discussed.

Competence in aspects of behavioral treatment and consultation: implications for service delivery and graduate training.

This study examined the extent to which competence in applying behavioral procedures (time-out from positive reinforcement) was sufficient to establish competence in teaching others to apply the same procedures. During baseline, graduate students attempted to instruct parents with a history of child abuse and neglect in the use of time-out. Students were then instructed in the use of time-out until they achieved proficiency in a role-play context. They then reattempted to instruct the parents. Finally, the students were instructed in certain consultation skills (i.e., teaching others to apply behavioral procedures) and again attempted to instruct parents in the application of time-out. Observations of students' consultation skills, parents' proficiency at administering time-out, and children's compliance to parental instructions revealed that explicit training in behavioral consulting skills was necessary to produce improvements in these behaviors. Students proficiency at administering time-out was insufficient to enable them to instruct others in its application. These results were corroborated by surveys of both students and staff. The implications for graduate training and service delivery are discussed.

Validating and teaching affective adult-child interaction skills.

A multiple-probe design across three groups of subjects was used to assess adult-child interaction skills by graduate students being trained to work with children. These skills were subjected to content and social validation by experts in childhood education and behavior analysis. Subjects in our research evinced generalization across settings. It is therefore suggested that when teaching behavior management, affective skills should also be included in the curriculum.

An analysis of and intervention in the sexual transmission of disease.

Sexually transmitted diseases are a serious threat to the public health. Indeed, when an individual seeks medical treatment for a sexually transmitted disease, health authorities frequently attempt to identify, procure, and treat that individual's sexual contact(s). We conducted a comparative analysis of three alternative approaches to tracing the sexual partners of individuals diagnosed as having a sexually transmitted disease. The first approach involved counseling individuals (n = 27) infected with either gonorrhea or nongonococcal urethritis and exhorting them to procure their sexual partners for treatment. In addition to counseling, the second and third approaches involved distributing "occasion cards" for patients to use when informing sexual contacts of the need for treatment. Moreover, in the second approach, the counselor (a nurse or physician) informed infected patients (n = 19) that they and their partners could waive the $3 clinic fee contingent upon the partners seeking treatment within 1 week. In the third approach, the counselor asked infected persons (n = 19) to accept a follow-up telephone contact if their sexual partners failed to seek treatment within 1 week. The third approach was most effective. Ninety percent of the partners identified through this approach sought treatment, versus only about 60% of the partners in the other two conditions. The third approach was also the least expensive, costing about $2.95 to procure each partner for treatment.

Nongonococcal urethritis incidence has fallen at one university health service: are "safer sex" messages being heard?

The authors determined the incidence of nongonococcal urethritis (NGU) longitudinally in patients attending a university health service between August 1986, and May 1988. During this period, the authors observed a statistically significant fall in NGU incidence. This fall coincided with awareness of AIDS risks due to national and local media encouragement of condom use and avoidance of anonymous or promiscuous contacts. Although the authors have no evidence that these educational efforts resulted in the observed fall in NGU incidence, other examined, potentially intervening variables can not completely explain the observed changes. A fall in NGU incidence may be a marker for a more generally decreased risk of sexually transmitted diseases (STDs) in at least some men.

Behavior analysis and public policy.

The Task Force on Public Policy was created to examine ways for behavior analysts to be more functional citizen scientists in the policymaking arena. This report informs readers about the contexts and processes of policymaking; and it outlines issues regarding the roles of behavior analysts in crating policy-relevant conceptual analyses, generating research data, and communicating policy-relevant information. We also discuss a possible role for the professional association in enhancing analysis, research, and advocacy on policies relevant to the public interest.

A behavioral system for assessing and training cardiopulmonary resuscitation skills among emergency medical technicians.

Many deaths from cardiopulmonary arrest can be prevented by the prompt and effective administration of cardiopulmonary resuscitation (CPR). In this study, we examined the standard training program for teaching CPR to emergency medical technicians (EMTs). We developed an alternative experimental program whereby the behaviors involved in CPR were assessed easily and in greater detail. This assessment provided the basis for a system in which effective CPR skills were reinforced and problems were corrected. Subjects who were trained in CPR according to this experimental program performed more effectively than subjects in the standard program. In addition, retention (maintenance) measures indicated that experimental subjects continued to perform well, often more effectively than professionally employed EMTs.

A self-instructional manual for installing low-cost/no-cost weatherization materials: Experimental validation with scouts.

In this study, we describe the development and evaluation of a self-instructional program for installing 10 low-cost/no-cost weatherization materials (e.g., weatherstripping, caulking). This program was a weatherization and retrofit manual (WARM) providing step-by-step instructions and illustrations. Boy and Girl Scouts participated and used either the WARM or existing product instructions (EPI) to apply the materials. Scouts installed the materials properly only when they used the WARM.

Behavior analysis in consumer affairs: Retail and consumer response to publicizing food price information.

A popular program among consumer action groups involves publicizing comparative food price information (CFPI) gathered from retail stores. Its significance is based on the assumption that publishing CFPI maximizes retail competition (i.e., moderates price levels or price increases) and occasions more frugal store selections among consumers. We tested these assumptions during a 2-year analysis. Specifically, we monitored the prices of two distinct market baskets in the supermarkets of two midwestern cities (target and contrast cities). Following a lengthy baseline, we published the prices of only one of the market baskets at stores in the target city in the local newspaper on five different occasions. The results suggested that reductions in price inflation occurred for both market baskets at the independently operated target stores. The corporate chain stores were not similarly affected. In addition, surveys indicated that many consumers used the CFPI as a basis for store selection. Finally, the analysis included a discussion of the politics, economics, and future of CFPI programs.

Turning the table on advice programs for parents: Using placemats to enhance family interaction at restaurants.

There are many opportunities in a family's daily routine to enrich the interactions among its members. One such opportunity arises at family restaurants. Surveys of restaurant personnel and customers suggested the possibility of enriching family interactions by redesigning indigenous materials such as table placemats. Accordingly, we developed Table-Talk placemats that provided conversational topics and illustrated games in which the entire family could participate. After some testing of these placemats in a preschool, a field experiment was conducted with families dining in restaurants. Table-Talk placements occasioned more social and educational dialogue among family members than either traditional-placemat or no-material conditions. Social validation ratings provided by mental health counselors and the parents suggested that Table-Talk placemats occasioned healthy and enjoyable interactions among family members.

Home safety: development and validation of one component of an ecobehavioral treatment program for abused and neglected children.

Parents may be charged with child abuse or neglect or both on the basis of a variety of circumstances. Child neglect, for example, is often documented when caseworkers observe that the family's home itself is so poorly kept that it presents an environment in which young children have ready access to lethal hazards such as poisons, uncovered wall outlets, and firearms. In this study, we describe the development of a Home Accident Prevention Inventory (HAPI) which was validated and used to assess hazards in the homes of several families under state protective service for child abuse and neglect. The HAPI included five categories of hazards: fire and electrical, mechanical-suffocation, ingested object suffocation, firearms, and solid/liquid poisons. Following the collection of baseline data, parents were presented with a treatment package that included instructions and demonstrations on making hazards inaccessible to children, plus feedback regarding the number and location of hazards in the home. The multiple-baseline design across hazardous categories in each family's home showed that the package resulted in decreases in the number of these accessible hazards. These improvements were maintained over an extended period of unannounced follow-up checks. This research provides a model for the development and assessment of an area previously unexamined in the child abuse and neglect literature.

Behavior analysis in consumer affairs: encouraging dental professionals to provide consumers with shielding from unnecessary X-ray exposure.

An unobtrusive observation system was developed to determine the extent to which dental professionals in two communities provided lead shielding to patients during X-ray exams. A lengthy baseline revealed low and irregular provision of shielding among half of these professionals. Subsequently, a program was undertaken by a consumer's group in which these professionals were requested to provide shielding and were given confidential feedback regarding its use during the baseline period. The provision of shielding dramatically increased at all offices and was maintained throughout a follow-up period extending to more than 9 months after the program's implementation. Little or no generalized effect was observed in the occurrence of three collateral behaviors that were also assessed throughout the study.

An analysis and reduction of disruptive behavior on school buses.

Thousands of children are injured or killed each year in school bus accidents. A significant number of these tragic incidents is precipitated by disruptive child behavior that distracts the drivers from their difficult task. Two experiments were conducted which addressed this problem. For both experiments an automated sound recording device (referred to as a Noise Guard) selectively responsive to frequencies above 500 Hz (i.e., unresponsive to bus drone) recorded both the duration and frequency of noise outbursts above a tolerable threshold. Additionally, an observer made in situ measurements of other disruptions including roughhousing and getting-out-of-seat. In the first experiment, following baseline measurements of these behaviors, middle-school students received feedback for noise outbursts. That is, when "Noise Guard" was activated, it in turn operated one of several lights on a panel visible to all passengers. Each day students were allowed to listen to high-appeal taped music while riding the bus and to participate in a raffle for prizes, provided the number of outbursts on the preceding day remained below a specified criterion indicated on the light panel. This intervention resulted in drastic reductions of noise outbursts with a concomitant reduction in other disruptive behaviors. Comparable results were obtained in the second experiment which eliminated the raffle from the intervention.

Measuring client gains from staff-implemented programs.

Confidence in the adequacy with which staff implement training programs requires an analysis of the impact on the client. In two experiments, measures, were devised to reflect this impact. In the first, a measure of the consistency with which clients participated in a toilet-training program revealed their participation to be erratic. Consistent participation occurred after a public display of the consistency of participation was introduced. In Experiment II, detailed measures were devised to reflect the client's performance during the implementation of two physical-therapy programs: range-of-motion and ambulation. Additionally, standardized measures of the benefits that accrued from their participation in these programs were devised. Improvements in both measures were slight and unstable during a condition of immediate feedback (supervisor praise) to staff but substantial improvements were obtained with the addition of a public display of the client's performance.

A parent advice package for family shopping trips: development and evaluation.

THIS ARTICLE REPORTS ON THE PRIMARY STEPS IN THE DEVELOPMENT OF PARENT ADVICE FOR POPULAR DISSEMINATION: (a) developing advice for one specific problem situation, family shopping trips; (b) testing the advice program for benefit to children and convenience to adults; and (c) packaging the advice so it can be used successfully by interested parents. Systematic observation of 12 families using the written advice package on shopping trips revealed its effectiveness in reducing child disruptions and increasing positive interactions between parents and children. These findings, along with interview information from families, showed that the package is usable, effective, and popular with both parents and children, and thus is ready for dissemination to a wide audience of parents-a step that in itself should involve research and evaluation.