Alan M. Gross

Children with diabetes. Social skills training and hemoglobin A1c levels.

In a multiple baseline design across behaviors with a control group component, insulin-dependent diabetic children were administered social skills training. Additionally, a metabolic measure of diabetic control was administered at baseline and follow-up assessments. When compared with control subjects, youngsters who received social skills training exhibited large improvements on a role-play test in their abilities to cope with stressful disease-related social situations. No changes were observed, however, on the metabolic measure of diabetic control. The implications of these findings are discussed.

A Review of Methods and Instruments for Assessing Externalizing Disorders: Theoretical and Practical Considerations in Rendering a Diagnosis.

This review addresses the most current and widely used methods of assessing childhood and adolescent externalizing disorders. Interviews, rating scales, and self-report instruments are described, and their strengths and weaknesses are discussed. Direct observational techniques in naturalistic and analogue settings are also reviewed. Throughout the article, commentary is offered regarding the psychometric adequacy and clinical validity of these instruments. It is suggested that, although the instruments presently used to assist in diagnosing externalizing disorders generally possess adequate reliability and representational validity, evidence of elaborative validity is lacking. Clinicians and researchers are encouraged to adopt a broader conceptualization of the diagnostic process, to question existing standards for establishing validity, and to consider alternative means of demonstrating diagnostic utility.

Handbook of Clinical Behavioral Pediatrics

I Basic Principles.- 1 Clinical Behavioral Pediatrics: An Introduction.- 2 The Psychologist as a Pediatric Consultant: Inpatient and Outpatient.- 3 Developmental Issues in Behavioral Pediatrics.- 4 Assessment Strategies in Clinical Behavioral Pediatrics.- II Clinical Disorders.- 5 Cognitive-Biobehavioral Assessment and Treatment of Pediatric Pain.- 6 Headache.- 7 Eating Disorders: Food Refusal and Failure to Thrive.- 8 Cancer in Children and Adolescents.- 9 Behavioral Management of the Child with Diabetes.- 10 Bladder-Control Problems and Self-Catheterization.- 11 Asthma.- 12 Childhood Sleep Disorders.- III Newer Areas of Clinical Intervention in Behavioral Pediatrics.- 13 Pediatric Burns.- 14 Tics and Tourette Syndrome.- 15 The Role of Behavior Therapy in Cystic Fibrosis.- 16 Allergies: Behavioral Effects and Treatment Implications.- 17 Therapeutic Consultation in Pediatric Dentistry.- 18 Recurrent Abdominal Pain in Children: Assessment and Treatment.- 19 Elevated Blood Pressure.- 20 Prematurity and Low Birthweight: Clinical Behavioral Intervention.- 21 Short Stature: The Special Case of Growth Hormone Deficiency.- IV General Issues.- 22 Preparing Children for Hospitalization and Threatening Medical Procedures.- 23 Patient Compliance: Pediatric and Adolescent Populations.- 24 Accident Prevention: Overview and Reconceptualization.- 25 Psychology and Pediatrics: The Future of the Relationship.

Patient cooperation in treatment with removable appliances: A model of patient noncompliance with treatment implications

The uncooperative or noncompliant patient presents a substantial problem during treatment with removable orthopedic/orthodontic appliances. Frequently, the uncooperative patient is labeled as having a poor or defiant attitude toward orthodontic treatment. In contrast to this attitude model of patient noncompliance, this article presents an analysis of uncooperative behavior in terms of behavior-environment relationships. The authors bring together backgrounds of expertise in both clinical psychology and orthodontics. The behavioral model presented is applied to clinical orthodontic patients undergoing treatment with removable functional appliances. Preliminary research findings suggest that the behavioral model described is a successful system for the introduction of a removable device to be worn by the patient. The techniques described also are useful for the previously uncooperative patient undergoing remedial treatment. Another major benefit of using this strategy is found in the response of the childrens parents. The approach reduces the potential for and frequency of parent-child conflicts over dental health. Currently, a small sample of children are being treated by the behavioral method. Both parents and patients are involved. A specific schedule for wearing of a removable appliance is identified, along with parental observations and rewards based on patient compliance. Once the youngster is regularly meeting criteria, the program is altered to increase the desired response of appliance wear. The behavioral model has implications for various aspects of orthodontic care, including the use of such appliances as the Fränkel, Bionator, headgear, intraoral elastics, and proper lip posture. On the basis of this functional analysis of behavior, implications for treatment and prevention of noncompliance in orthodontic patients are discussed.

A longitudinal evaluation of open mouth posture and maxillary arch width in children

Open mouth posture and maxillary arch width were assessed annually for 4 years in a group of children. While younger children exhibited high levels of open mouth posture, this behavior decreased significantly over time. Racial and sex differences, as well as a race-by-time interaction were also evident. The children displayed a significant increase in maxillary arch width across time with sex and racial differences in this growth pattern. Subjects were classified as exhibiting primarily open mouth or closed mouth posture. Although both groups showed increased maxillary arch widths over time, the closed mouth subjects showed significantly greater maxillary arch growth.

Behavioral contrast and behavior therapy

A selective review of behavioral contrast with animals and humans is presented to illustrate the potential implications of contrast for behavior therapy. Examples of behavior modification procedures applied according to a contrast paradigm where generalization, contrast, and no contrast effects were observed are discussed. Possible explanations of the inconsistency of occurrence of the phenomenon are suggested. Additionally a number of ethical considerations resulting from the occurrence of contrast effects are discussed.

Myofunctional and dentofacial relationships in second grade children.

One hundred and thirty-three second graders in rural public school were assessed on a number of dental, skeletal, and oral muscle function measures. Correlational analyses were conducted in order to determine whether specific myofunctional variables were associated with dentofacial development. Significant relationships were observed between open mouth posture and a narrow maxillary arch and long facial height. Labial and lingual rest and swallow patterns were also related to poor coordination of lip and tongue movements.

Increasing and Maintaining Rates of Teacher Praise A Study Using Public Posting and Feedback Fading

This study investigated the effects of public posting of feedback on the praising behavior of teachers in a classroom for handicapped children. In an ABABCA design, following baseline, the daily rate of teacher praise was posted on a graph in the classroom. To reduce the reactive effects of monitoring, observations of teacher behavior were made using random audio tape recordings. Additionally, public posting feedback was gradually faded in an attempt to facilitate maintenance. The procedure resulted in an increase in teacher praise to a rate nearly twice what was observed during baseline. This behavior change was maintained after the withdrawal of the treatment procedures. The implications of this method are discussed.

Self-directed behavior change in children: Is it self-directed?

The present paper examines whether children can learn to effectively manage their own behavior. Focusing on self-reinforcement strategies, studies in which children were reported to be successful and unsuccessful in their attempts to alter their own responding are examined. Special attention is given to the role played by external treatment, mediator-imposed contingencies on the effectiveness of self-management programs. Conclusions regarding the necessary conditions for successful self-control in children are presented.

The role of relaxation in systematic desensitization

Abstract Systematic desensitization has long been recognized as an effective technique for the treatment of a wide variety of phobias. However, there has been no consensus regarding the role of relaxation in this procedure. Research addressing this issue was reviewed and various theoretical explanations were examined in light of this research. The theoretical and practical implications of these findings are considered.