Promoting widespread, durable service quality via interlocking contingencies.

Technologies for promoting quality of organizational services to the developmentally disabled have been evolving over the past several decades. Feedback reinforcement and, often, goal-setting, powerful change tools, generally are incorporated within behavioral interventions. Despite their promise, wide-scale application of these strategies often is impeded by natural and informal organizational contingencies. In an attempt to combat such impediments, a structure of interlocking contingencies was designed to train and support managers' provision of effective feedback to their subordinates, peers, and superiors. The system included formal scheduling of feedback, reinforcement and goal setting in a way that attempted to (a) minimize financial costs, time and effort; (b) empower participants by involving them in designing the specifics of the system; and (c) promote momentum by encouraging dense schedules of feedback. Within a period of less than 6 months, supervisors, managers, and professional specialists conducted brief audits and delivered nearly 9,000 written feedback reports to workers serving 129 clients, with the result that staff-client interactions and client engagement levels increased substantially. Future research should replicate these methods under more rigorous experimental conditions and formally assess some of the system's spillover into realms such as gains in clients' skill levels, and staff and public acceptance.

Self-control in boys with attention deficit hyperactivity disorder: effects of added stimulation and time.

Preference for larger-delayed versus more immediate-smaller rewards was studied in 5- and 6-year-old typical boys with Attention Deficit Hyperactivity Disorder (ADHD) in a repeated measure design. The effect of adding stimulation on preference also was studied. Boys with ADHD chose delayed-larger rewards significantly less than did typical boys. Adding stimulation reduced motoric behavior, but did not affect choice. As rates of motoric activity increased in boys with ADHD, their preference for delayed, larger rewards decreased over time. These findings argue for the external validity of choice tasks in the study of ADHD.

Beyond training: organizational performance management techniques.

Performance management is a branch of behavioral science that, in part, addresses the reasons workers return to bad or dangerous work habits despite training to the contrary. This chapter details the use of performance management techniques in health and safety training programs. An extensive table describes 44 studies that have incorporated performance management safety interventions.

Increasing nurses' use of feedback to promote infection-control practices in a head-injury treatment center.

This study established regular implementation of a simple feedback procedure by supervisory nurses with their assistants at a head-injury treatment center. Five nurses were trained to distribute brief written comments to their assistants about infection-control practices, including using gloves to avoid contact with body fluids. Following low rates of written feedback, nurses met with the trainer weekly to set goals for using the system, to review feedback rates, and to examine contingent letters of appreciation. Written feedback increased from 0.09 to 0.58 per day. When outcome data on glove use were subsequently added to the feedback provided to nurses, nurses' feedback on glove use increased and overall glove use by assistants increased by 36.7% for 66.7% of assistants who responded to feedback. Assistants rated feedback as highly accurate and indicated some interest in receiving future feedback. However, nurses and assistants expressed a preference for oral over written feedback.

Promoting reciprocal interactions via peer incidental teaching.

This study evaluated peer incidental teaching as a strategy for increasing reciprocal peer interactions by children with autism. Three typical preschoolers were trained as peer tutors for 3 young children with autism. During a classroom free-play session, peer tutors used incidental teaching to obtain verbal labels of preferred toys by children with autism. A multiple baseline across the 3 target children showed replicated positive effects of the intervention. Adult supervision and assistance were then faded systematically, with resulting maintenance of increased reciprocal interactions. Multiple measures of the extent and limits of generalization suggested that 1 child increased interactions in free-play periods throughout the day, but none of the children showed increases at lunch. Teacher and peer ratings supported the social validity of positive findings.

Acquisition and maintenance of health-care routines as a function of feedback density.

Two schedules of feedback were examined to determine their relative effects on the acquisition and maintenance of three health-care routines: feeding, positioning, and transferring physically disabled patients. Four direct service providers' performances in the natural environment were measured weekly. Concurrent schedules and multiple baselines across subjects and response classes were used to evaluate the effects of written instructions combined with either continuous, intermittent, or nofeedback schedules. Results showed that instructions alone led to slight and usually brief changes. Marked improvements were noted after feedback was introduced, with the continuous schedule producing more rapid acquisition. Follow-up measures indicated performance maintenance for both schedules. Subjects rated the feedback programs favorably and recommended provision of this service to co-workers. Cost estimates indicated that, although considerable time was spent developing the observational system, the feedback procedure was relatively inexpensive, easy to use, and did not interfere with patient care.

Trends in behavior analysis in education.

The preparation of the Journal of Applied Behavior Analysis Reprint Series: Behavior Analysis in Education (1988) provided an opportunity to survey and analyze trends in the field, as reflected by publications in the journal. Apparently, the large volume of behavior-analytic papers on educational topics has been declining and its contents undergoing some interesting but not uniformly welcome shifts. Although the intense concern with classroom conduct has diminished somewhat, that topic continues to be heavily emphasized. Simultaneously, reports of social skills and language studies have accelerated, but analyses of academic performance have progressively declined. Explanations for the findings remain speculative, but behavior analysts are encouraged to address these areas of essential social need.

Self-control: teaching tolerance for delay in impulsive children.

We investigated a procedure to increase the selection of larger, more delayed reinforcers (i.e., more advantageous in the long run) over smaller immediate reinforcers, in an effort to increase a key aspect of self-control in children. Six preschoolers, including one comparison subject, identified by their teachers as impulsive, were preassessed and found consistently to select smaller immediate reinforcers over larger, more delayed ones. The teaching procedure consisted of gradually increasing the durations of the delay interval over many sessions. The follow-up assessments showed that 5 of these children increased the proportion of their choices of the delayed reinforcers. Before training, indifference points ranged from 1.7 to 51.7 s; following treatment, points rose to a range of 37.5 to at least 90 s, with 3 children preferring the larger reinforcer at all delay intervals tested. The results demonstrated the feasibility of teaching young children to make choices more advantageous to them in the long run.

The effects of performance feedback on the safety of client lifting and transfer.

Individual written and verbal performance feedback was examined to determine its influence on the safety with which physically disabled clients were transferred. Two client-transfer techniques were task analyzed and six direct service providers' on-the-job performance was measured weekly. A multiple baseline across settings and subjects was used to evaluate effects of the feedback. Consumer satisfaction and the costs of the procedures were also assessed. Results showed that feedback was consistently followed by improvements in safe performance. These improvements tended to maintain as feedback was faded. Participants favorably rated the feedback procedure and consistently recommended its use with other staff.

An on-the-job method to evaluate patient lifting technique.

Two frequently used patient transfer techniques were task analysed. An observational system, incorporating these analyses, was developed to evaluate systematically the safety with which nurses, aides and attendants lifted and transferred physically handicapped patients. The reliability, cost effectiveness and practical application of this procedure are discussed.

Verbal relations within instruction: Are there subclasses of the intraverbal?

Six college undergraduates received programmed concept training on three kinds of intraverbal relations. These relations involved definition, exemplification, and example identification questions. The experimenter presented the questions, the subject answered them in writing, and the experimenter provided specific corrective consequences. After completing the training on a concept, the subject immediately received a test on the concept. The test included novel questions similar to the kind used in training (extension tasks) and question types that were not used in training but which were also considered intraverbal relations (transfer tasks). Training results indicated rapid, errorful responding on example identification tasks and slow, accurate responding on exemplification and definition tasks. Test results indicated rapid, errorful responding on example identification extension tasks; slow, accurate responding on exemplification extension tasks; and slow, errorful responding on definition extension tasks. In testing, differential responding occurred on transfer tasks as a function of the kind of intraverbal training received, and substantially lower levels of performance were obtained on transfer tasks than on extension tasks. It appears that the intraverbal can be subdivided into more specific categories of operants.

A behaviorist's response to the report of the national commission on excellence in education.

The National Commission on Excellence in Education was charged with the responsibility for examining the quality of education in America. Its report, "A Nation at Risk" (1983), contained a set of alarming facts about the status of American education. These were followed by a set of five major recommendations for improving the situation. They related to (1) content, (2) standards and expectations, (3) time, (4) teaching, and (5) leadership and support. The present paper examines each of the set of recommendations from a behavior analytic perspective. It notes what the field of behavior analysis can say on the subject now; what it potentially might address and remediate at this time; what it might explore and predict; and in general what it can do to make a difference. Behavior analysis has made many important discoveries that should be communicated to educators and the public, and it has tools and concepts for further contributing toward the improvement of education.

The effects of adding interruption to differential reinforcement on targeted and novel self-stimulatory behaviors.

This study compared differential reinforcement of other (DRO) and incompatible (DRI) behaviors to these same two procedures combined with a mild interruption procedure on a 6-year-old developmentally disabled girl's self-stimulatory behaviors. The results showed that the combination was more effective for reducing all of the targeted behaviors. These low rates were maintained at a 4-month follow-up. In addition, several new forms of stereotypy that appeared as the targeted behaviors diminished decreased rapidly when interruption was applied to them. Finally, independent toy play increased as a by-product of the treatment.

Preventing school vandalism and improving discipline: a three-year study.

Vandalism is a major problem facing educators and taxpayers alike. The present investigation analyzed how vandalism costs and student disruption were related to the implementation of a training and consultation package designed to increase the reinforcing ambience of the school. A positive environment, it was posited, would displace previous events that may have set the occasion for vandalism, with cues to promote productive school performance. Eighteen elementary and junior high schools were involved over a 3-year period. Using a delayed treatment control design, treatment was delivered following either 4 or 13 months of baseline. During treatment, teams of school personnel attended training workshops in behavioral strategies for reducing vandalism and disruption by students in school. Each team also met regularly on its campus to plan and implement programs on a schoolwide basis. To demonstrate that reinforcing procedures were actually implemented and accompanied by change in student performance, these variables were periodically probed throughout the study. Project staff also provided consultation. Vandalism costs decreased significantly (p less than .05) more in treatment than control schools, with an average reduction of 78.5% for all project schools. Rates of praise delivered by project teachers and other randomly selected teachers in the school increased significantly (p less than .05), and rates of off-task behavior by students decreased significantly (p less than .05) following treatment. The staff development model used in this study appeared to be both feasible and economical.

An alternating treatment comparison of oral and total communications training programs with echolalic autistic children.

An alternating treatment comparison was conducted of the relative effectiveness of oral and total communication training models for teaching expressive labeling skills to three echolalic autistic children. The results of this comparison demonstrated that total communication proved to be the most successful approach with each of the subjects. In addition, the replication of these findings both within and across subjects suggest that total communication may be, in general, the most effective of these two training models for teaching basic vocal language skills to echolalic children. A number of hypotheses are presented that may provide a basis for the demonstrated effect.

An abbreviated overcorrection program to reduce self-stimulatory behaviors.

An economical, abbreviated overcorrection procedure was implemented to reduce several self stimulatory and self abusive behaviors of a severely retarded child. These were monitored, along with a non-targeted behavior, tantrum screams, during treatment sessions, and during non-treatment sessions with the experimenter present or absent. A withdrawal design demonstrated that substantial reductions in essentially all the behaviors were achieved during treatment sessions, with visible though less dramatic reductions occurring at other times. Although long-term follow-up observations showed a recovery of baseline performance, the behaviors again were rapidly brought under control when a modified form of the procedure was re-instituted.

Behavior modification and human rights: A legacy of Edward Stanton Sulzer, 1930-1970.

Edward Stanton Sulzer was born in New York City on June 4, 1930. He attended school in Laureltown, N.Y., until the age of 15, when, after two years of high school, he was admitted into the University of Chicago. Leaving prematurely due to his mother's death, he returned to New York to work in film production. Sulzer completed his undergraduate work at the City College of New York, studying film production and psychology. In 1953 he entered the doctoral program in clinical psychology at Teachers College, Columbia. Spending two years in the Army during his graduate training, his work was completed in 1958. He then joined the faculty of the Upstate Medical School of the State University of New York, Department of Psychiatry, moving on two years later to the Psychiatry Department at the University of Minnesota. In 1965 Sulzer moved to assume the directorship of the Behavior Modification Program, in the Rehabilitation Institute at Southern Illinois University, where he remained until his death on February 28, 1970.In observance of the 10th anniversary of the death of Edward Stanton Sulzer, these reminiscences are presented. They describe how an individual psychologist could affect the professional and personal lives of many. Edward Sulzer is described in terms of the environment that shaped his values, how they affected the actions of his students and clients, and how they are reflected in current social policy. The account leads to a conclusion that the actions of single individuals may influence the course of human events.

A simultaneous treatment comparison of three expressive language training programs with a mute autistic child.

A study was conducted in order to simultaneously compare the relative effectiveness of three different language training models (total communication sign training, nonverbal "sign-alone" training, and oral [vocal] training) for teaching expressive language skills to a 4 1/2-year-old mute autistic child. A single-subject, alternating-treatment (multielement) design with replication within subject was used to compare the rate of expressive word acquisition across training models. Results show the total communication model to be substantially superior to both oral and sign-alone training models, and place in question the theory of an intersensory integration disability to explain the success of sign language. Alternatively, the data suggest that the use of physical prompts combined with multisensory inputs provide a basis for the demonstrated success.

Industrial safety hazard reduction through performance feedback.

A "feedback package" system, designed to prevent occupational accidents and to fit directly into the normal operations of an industrial organization, was analyzed. Eighteen hazardous conditions in six production departments were assessed during seven observation sessions over a 12-week period, plus four follow-up observations over 4 months. The "feedback package" was presented in multiple baseline fashion, across subjects (department supervisors). It consisted of presenting the supervisor with copies of observational data, accompanied by a note which congratulated good practices and suggested ways for improving safety conditions, along with occasional comments from a senior executive. The results indicated that during the feedback phase, hazard rates were lower and less variable than during the baseline phase. Baseline data were highly variable with peaks ranging from 20 to 55 hazards per department. Following intervention, hazard frequencies dropped by 60%, averaged across departments, with decreases ranging from 29% to 88%. During treatment, data stabilized, with the highest frequency reaching 33. A modified feedback system was implemented by the organization following termination of the study, validating the assumption that such a system would tend to maintain.