Management of a hyperactive-conduct disordered child through correspondence training: a preliminary study

This study examined the clinical effects of correspondence training procedures in the management of a hyperactive-conduct disordered boy. During the reinforcement of promise-do correspondence procedure, a toy (reinforcer) was given contingent upon the presence of a promise to inhibit target behaviors (e.g., inattention, overactivity, aggression) and the actual inhibition of such behaviors. This intervention was programmed in a multiple baseline design across settings. Consistently lower levels of hyperactivity and conduct disorders were noted during treatment, relative to baseline. A demonstration of the indirect effects of the procedures upon the child's academic performance was also seen.     

Say-do-report training to change chronic behaviors in mentally retarded subjects

Two mentally retarded subjects with language deficits participated. A say-do-report correspondence training was implemented to break the functions of present conditions given by a long history of contingencies maintaining chronic inadequate patterns of behavior. The say-do-report procedure was implemented following a multiple baseline design across two behaviors in one subject and in an AB design for the other. During baseline, all possible social contingencies maintaining the inadequate behaviors were eliminated. Promising or saying what a subject would do was then implemented and followed by the differential reinforcement of say-do correspondence reports. All behaviors changed and were maintained at an appropriate level, even after eliminating the components involved in the say-do-report procedure, that is, the reports, the extra consequences, and even the promise. Results are discussed in the context of verbal behavior altering the function of present conditions in subjects with limited verbal repertory, as well as in the context of new applications to make a difference in chronic behaviors.     

Teaching refusal skills to sexually active adolescents

Refusal skills training was extended to sexually active handicapped female adolescents who lacked an effective refusal strategy. Role-plays for assessment and training were developed using the who, what, when and where of situations which resulted in unwanted intercourse. Refusal skills were trained following the format of rationale, modeling, rehearsal, feedback, and reinforcement. Baseline rates of most target behaviors were quite low. High frequencies of target behaviors were observed as each behavior became the focus of training. Generalization across staff and time was also observed. The skillfulness and effectiveness of the subjects' refusal skills were judged to be improved as a function of training. One-year follow-up showed decreased sexual activity for each girl.     

Social skills training to teach prosocial behaviors in an organically impaired and retarded patient

A social skills training program consisting of behavior rehearsal, modeling, instruction, feedback, and reinforcement was used to teach prosocial behaviors (e.g. number of words spoken, eye contact, smiles) in an organically impaired and intellectually deficient young adult. Six months following initial treatment, booster sessions were used to bolster the effects of initial training. All behaviors improved initially; decrements in skill performance seen over the six months of no treatment were reinstituted in booster sessions. The effects of treatment were evaluated in a multiple baseline design across behaviors.     

Increasing play and decreasing the challenging behavior of children with autism during recess with activity schedules and task correspondence training

We examined the effects of a teacher implemented playground intervention consisting of activity schedules and task correspondence training on the challenging behaviors and play of three school age children with moderate to severe autism. A multiple baseline design across participants was used to evaluate the intervention effects. Results indicated that each of the participants learned to use an activity schedule to follow a schedule of play activities and demonstrated improved play. Moreover, challenging behavior decreased for two participants during the intervention and remained at low levels for the third participant. The findings from this study provide support for the use of activity schedules and task correspondence training to reinforce appropriate play and decrease challenging behaviors during recess.     

Teaching students to self-regulate their behavior: the differential effects of student-vs. teacher-delivered reinforcement

The effects of selected student-directed learning strategies on the classroom behavior of six students with varying disabilities in general education were examined using a multiple baseline design across groups. Target behaviors included academic, study, and social skills. Results indicated increases in student target performance for all participants, however, differential effects were observed across groups and reinforcement conditions (student-vs. teacher-delivered). Additionally, anecdotal reports obtained from the cooperating teacher and students supported the study's findings. The implications of these findings are discussed.     

The effects of self-management in general education classrooms on the organizational skills of adolescents with ADHD

Self-management procedures have been used in school settings to successfully reduce problem behaviors, as well as to reinforce appropriate behavior. A multiple-baseline across participants design was applied in this study to evaluate the effects of using a self-management procedure to enhance the classroom preparation skills of secondary school students with attention-deficit/ hyperactivity disorder (ADHD). Three male students enrolled in a public secondary school were selected for this study because teacher reports suggested that these students were insufficiently prepared for class and inconsistently completed assignments. The intervention involved training in self-management procedures focusing on the improvement of classroom preparation skills. Following the intervention, the training process was systematically faded. Results were consistent across the 3 participants in enhancing classroom preparation behaviors. Implications for practice and future research are discussed.     

Training novice psychotherapists: Helping skills and beyond

We provide a rationale for doing helping skills training with novice psychotherapists, present a basic framework for our ideas, outline the major components of training, and then talk about what comes after helping skills training. We provide hypotheses that can be tested to determine the effectiveness of helping skills training for novice psychotherapists and encourage researchers to do more research in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved).     

A review of research on procedures for teaching safety skills to persons with developmental disabilities

Safety skills are an important but often neglected area of training for persons with developmental disabilities (DD). The present study reviewed the literature on teaching safety skills to persons with DD. Safety skills involve a variety of behaviors such as knowing how to cross the street or what to do in case of a house fire. A number of studies have been conducted on teaching these skills to individuals with DD. The studies reviewed have varying degrees of success and demonstrate varying degrees of generalization, but the general finding has been that prompting, reinforcement, and role-playing are effective teaching procedures across a variety of participants, skills, and settings.     

Reduction of multiple aberrant behaviors and concurrent development of self-care skills with differential reinforcement.

A modified functional analysis was used to assess the behavioral function of a profoundly retarded man's self-injurious behavior (SIB). Results of that analysis showed that the behavior was most likely to occur in a demand context (self-care instructions) but was maintained by positive reinforcement in the form of attention and physical contact. The results of the functional analysis also prescribed a treatment involving differential reinforcement of alternative behavior (DRA). Further investigation showed that other aberrant behaviors, such as aggression and disruption, were members of the same functional response class as SIB. The differential reinforcement of alternative behavior (DRA) procedure effectively reduced those behaviors while compliance to a self-care acquisition task increased markedly. The results are discussed in terms of the importance of determining behavioral function prior to treatment.     

Parent reported treatment priorities for children with autism spectrum disorders

We designed an Internet survey to identify the educational priorities that parents have for their children with autism spectrum disorders and to examine the relation between these priorities and the children's level of adaptive behavior functioning. The survey listed 54 skills/behaviors (e.g., toileting, expressing wants and needs, and tantrums) representing 10 adaptive behavior domains (e.g., self-care, communication, and problem behavior). Parents rated their child's current level of ability/performance with respect to each skill/behavior and indicated the extent to which training/treatment was a priority. Ninety surveys were completed during the 8-month data collection period. The top 10 treatment priorities represented skills/behaviors from six different domains. Results supported the view that parent priorities tended to be higher in areas where children have the greatest deficits or show emerging skills. The results suggest there may be value in targeting the assessment of children's deficits and emergent skills for treatment planning.     

Enhancing appropriate and variable responding in young children with autism spectrum disorder

Objective: The present study utilized lag schedules of reinforcement, in conjunction with training multiple exemplars and provision of prompts, to promote appropriate variability of social skills. Methods: Participants included in three children between the ages of 5 and 7 with ASD. Participants attended a social skills training program twice per week for eight weeks. A multiple probe design across target social skills was used to assess the effects of intervention. Results: Findings indicate that training multiple exemplars alone did not appreciably increase appropriate and variable responding, whereas the addition of lag schedules of reinforcement and prompting to training multiple exemplars resulted in appropriate and variable responding that exceeded baseline levels. Conclusion: Use of lag schedule of reinforcement in conjunction with prompts was more effective than multiple exemplar training in isolation for increasing appropriate variability of social skills.     

Using helping skills with Korean clients: The perspectives of Korean counselors

Objective: The purpose of this study was to investigate how Korean counselors modify the helping skills they learned during training in their work with Korean clients. Method: Thirteen practicing Korean therapists who had taken two master’s level courses in the Hill helping skills model were interviewed about their experiences in applying the model in their work with clients. Data were analyzed using consensual qualitative research (CQR). Results: Several characteristics were noted of Korean clients that might influence the appropriateness of the helping skills model (e.g., clients regard counseling as authorities and wise experts). Participants had a number of reactions to the overall helping skills model (e.g., noting that Korean counselors deliver empathy and genuineness more through non-verbal rather than verbal channels). Participants also noted needed modifications to specific stages or skills in the model (e.g., using the insight stage less than the exploration stage). Discussion: Based on these findings, six guidelines are offered for modifying the Hill helping skills approach to fit the needs of Korean clients: Provide a pre-exploration stage to educate clients about approach, utilize indirect and non-verbal communication more than verbal communication, validate client’s experiences, work cautiously with emotions, be cautious about using insight skills, and respond to clients’ implicit communication when they ask for action.     

Effects of training and feedback on Discrete Trial Teaching skills and student performance

This study examined the effects of training and feedback on instructor performance of Discrete Trial Teaching (DTT) and support skills. This included an examination of the generalization and maintenance of instructor skills, and the impact of instructor skills on student performance. Six undergraduate research assistants received an 8-h training in DTT and taught a variety of skills and behaviors to four preschool students who had developmental disabilities. A multiple-baseline design was used to assess instructor performance following training alone, during implementation of oral and written performance feedback, and at 2, 4, 6, and 10 weeks follow-up. Instructors demonstrated correct use of DTT and related skills at a rate of 63-80% following training. When performance feedback was provided, all instructors attained proficiency ratings of 90% by the second session and 97-100% by the fourth session. High levels of instructor proficiency were maintained at follow-up and generalized across students and learning tasks. Student learning and instructional efficiency were superior in the feedback and follow-up conditions compared to baseline. The results highlight the need for training programs that allow school personnel to correctly use DTT to effectively facilitate learning and development in students who have developmental disabilities.     

Changes in internal states across the binge-vomit cycle in bulimia nervosa

While there is considerable evidence that bulimic behaviors serve the function of modifying internal states (e.g., satiety, mood), there is less clarity over the roles of the different behaviors across the binge-purge cycle. The present study examines the impact of bingeing and vomiting upon these internal states at different time points, and evaluates the potential reinforcement of those behaviors by the changes in internal states. Twenty-three women with diagnoses of bulimia nervosa completed a diary of all binge-vomit episodes over the course of 7 days, rating their internal states (satiety, negative mood, positive mood) at four time points during each episode. There were substantial changes across the cycle in levels of hunger, fullness, guilt/shame, anxiety/worry, and happiness/relief, but not in other states. The changes indicate that the binge-vomit cycle is maintained by the effects of both behaviors, but that the vomiting behavior evokes the strongest pattern of reinforcement. Further research is needed to determine the levels of internal states during the binge itself.     

Peer-mediated discrete trial training within a school setting

The present study evaluated the feasibility and effects of a peer-mediated, school-based, discrete trial training (DTT) protocol for students with autism spectrum disorder (ASD). Six typically developing elementary-age peers were trained to implement a basic DTT protocol. A multiple baseline across student interventionists design was utilized to evaluate the integrity with which trained peers implemented the DTT protocol and the efficacy of the student interventionists in training target academic behaviors. Results indicate that student interventionists acquired skills to implement the DTT protocol with high levels of integrity. Additionally, it was observed that participation in peer-mediated DTT resulted in mastery of target academic skills by participants with ASD. Measures of acceptability indicated high levels of student interventionist satisfaction with intervention procedures.     

Improving social functioning in schizophrenia by playing the train game

Social impairments have long been recognized as a core feature of schizophrenia. Poor social, self-care, and vocational functioning are criteria for a diagnosis of schizophrenia in most diagnostic systems. Consequently, improving the social behaviors of persons with schizophrenia has been a key target of psychiatric rehabilitation techniques.One such technique, social skills training, has demonstrated effectiveness in yielding skill acquisition, durability, and generalization (1) and has been recognized as a psychosocial treatment of choice for schizophrenia (2). Nevertheless, a number of limitations to the benefits that may be achieved through skills training have been described. For example, the cognitive impairments of persons with schizophrenia, such as poor sustained attention and verbal memory deficits, have been shown to limit the acquisition of social skills (3). Moreover, one study showed that patients with negative symptoms, such as apathy, anhedonia, and amotivation, have an impaired capacity to benefit from social skills training (4). However, the results of a more recent study suggest that only persons with primary, deficit-type negative symptoms-not those with negative symptoms secondary to positive psychotic symptoms, depression, or extrapyramidal side effects-are unable to benefit from conventional social skills training (5).Recognizing these obstacles to implementing a social skills training program for persons with schizophrenia, Torres and his colleagues have created a board game called El Tren (The Train). Several characteristics of El Tren make it ideal for use with this population. First, the game is behaviorally oriented and has an emphasis on positive reinforcement and shaping. Second, it is sensitive to the cognitive limitations of the participants, emphasizing repetition and procedural learning. Third, it is designed to overcome participants' negative symptoms by being entertaining and fun. In this month's column, these authors describe El Tren and present the results of a randomized controlled study of its efficacy.     

Teaching social/sexual skills to mentally retarded adults

A social/sexual skills training program for institutionalized mentally retarded adults was evaluated. The target behaviors involved a verbal action or reaction within six skill areas and were taught using a commercially available table game, Sorry, and a specially designed card deck. The program featured response-specific feedback, self-monitoring, individualized reinforcers, and individualized performance criterion levels. A multiple baseline across two groups (N = 3 per group) revealed that there were increases in all skill areas. Generalization occurred in individual and group tests conducted by a retarded peer. The program appears to be an effective method of training social/sexual skills because it produces effects that generalize.     

Teaching advance movement exploration skills in water to children with autism spectrum disorders

This study evaluated the effectiveness of the ‘most to least’ prompting (MLP) procedure on the teaching of advance movement exploration skills in water to children with autism spectrum disorders (ASD). Three 6-year old children with ASD, participated in the study and were taught 3 different aquatic skills, essential for movement exploration in water and swimming, in a one-to-one training format at three sessions per week. A multiple probe design across behaviors was used and was replicated across subjects to analyze the effects of MLP. The results of the study showed that MLP was effective in teaching advance movement exploration skills in water to children with ASD. Performing the exploration skills in water was continued after the training process during maintenance and generalization probe sessions. In addition, social validity results reflected that parents’ opinions were positive on the learning skills in terms of functionality, beginning swimming and participation in other aquatic settings for their children. The enjoyable intervention and appealing setting are recommended to increase the repertoire of leisure skills and level of physical activity for children with ASD.     

Becoming psychotherapists: Experiences of novice trainees in a beginning graduate class

The authors investigated the experiences related to becoming psychotherapists for 5 counseling psychology doctoral trainees in their first prepracticum course. Qualitative analyses of weekly journals indicated that trainees discussed challenges related to becoming psychotherapists (e.g., being self-critical, having troubling reactions to clients, learning to use helping skills), gains made during the semester related to becoming psychotherapists (e.g., using helping skills more effectively, becoming less self-critical, being able to connect with clients), as well as experiences in supervision and activities that helped them cope with their anxieties. Results are discussed in 5 broad areas: feelings about self in role of psychotherapist, awareness of reactions to clients, learning and using helping skills, reactions to supervision, and experiences that fostered growth. Implications for training and research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved).