Lynn G. Bowman

Facilitating tolerance of delayed reinforcement during functional communication training.

Fewclinical investigations have addressed the problem of delayed reinforcement. In this investigation, three individuals whose destructive behavior was maintained by positive reinforcement were treated using functional communication training (FCT) with extinction (EXT). Next, procedures used in the basic literature on delayed reinforcement and self-control (reinforcer delay fading, punishment of impulsive responding, and provision of an alternative activity during reinforcer delay) were used to teach participants to tolerate delayed reinforcement. With the first case, reinforcer delay fading alonewas effective at maintaining lowrates of destructive behavior while introducing delayed reinforcement. In the second case, the addition of a punishment component reduced destructive behavior to near-zero levels and facilitated reinforcer delay fading. With the third case, reinforcer delay fading was associated with increases in masturbation and head rolling, but prompting and praising the individual for completing work during the delay interval reduced all problem behaviors and facilitated reinforcer delay fading.

Assessing Psychopathology in Individuals with Developmental Disabilities

Individuals with developmental disabilities are at high risk for developing mental health problems. The prevalence of psychopathology is approximately 4 times higher than that found in the general population. Yet there is a tendency to underdiagnose psychiatric disorders in the developmentally delayed population because of diagnostic overshadowing, the lack of appropriate diagnostic criteria, and the paucity of appropriate assessment measures. Over the past decade, there has been an emergence of scales developed specifically to screen for psychopathology in individuals with developmental disabilities. In addition, advancements have been made in observation techniques, thus facilitating the ability to objectively observe behaviors often described as internal events. Adescription of a multimethod approach to assessing psychopathology in individuals with developmental disabilities is provided incorporating the recent advancements in the field, as well as suggestions for future research.

Aberrant sleep patterns in children with the rett syndrome

Previous studies on the characteristics of disturbed sleep/wake patterns in children with the Rett syndrome have yielded inconsistent findings. In the current study, momentary time sampling procedures were used to measure the sleep/wake patterns of 20 girls with classical Rett syndrome. These patients had significantly more total sleep than age peers (M = 110.1; Zm = 2.58; p = .01), significantly less nighttime sleep (M = 80.8; Zm = -7.53; p less than .0001), and significantly more daytime sleep (M = 24.5; Zm = 8.71; p less than .0001). Night sleep was negatively correlated with age (r = -.59; p less than .01); day sleep was positively correlated with age (r = .54; p = .01). These girls also displayed night wakings on 20.9% of nights, delayed sleep onset on 67.8% of nights and early wakings on 24.5% of nights. These data clearly demonstrate that children with the Rett syndrome have markedly impaired sleep/wake patterns and suggests that the sleep dysfunction may worsen over time.

Empirically derived consequences: A data-based method for prescribing treatments for destructive behavior

Behavioral treatments are often prescribed on the basis of a functional assessment. However, in a significant number of cases, functional assessment results are equivocal or suggest that internal stimuli are maintaining the behavior. In this investigation, we evaluated an alternative data-based assessment that may be useful in such cases. This assessment was used to identify reinforcers and punishers based on the reinforcement assessment procedure described by Pace, Ivancic, Edwards, Iwata, and Page (1985). We then assessed whether empirically derived reinforcers and punishers could be combined to treat the destructive behaviors of two clients. For both clients, the rates of destructive behavior decreased markedly. The results suggest that empirically derived consequences may be useful in decreasing destructive behavior when a functional assessment is inconclusive or is consistent with the hypothesis that the behavior is stereo-typic and maintained by internal stimuli.

Reinforcement of Incontinent Stools in the Treatment of Encopresis

In this paper, fecal incontinence and constipation were treated in two mentally retarded individuals using a novel intervention wherein incontinent stools were first rewarded in order to increase the frequency of bowel movements. This intervention was implemented only after more traditional pediatric and behavioral treatments were unsuccessful. The reinforcement of incontinent stools procedure resulted in an increase in both the frequency and the number of continent stools for both individuals. Hypotheses regarding the failure of previous treatments and the success of the current treatment are discussed as well as directions for future research.

A FUNCTIONAL ANALYSIS OF CRYING

Crying has yet to be examined systematically in isolation from other problem behavior, such as aggression or tantrums, during functional analyses (Hanley, Iwata, & McCord, 2003). Identification of variables that may maintain crying is especially important for populations who are susceptible to psychiatric interventions (e.g., individuals who have intellectual disabilities and communication deficits). The current study extended functional analysis methodology to crying with an adolescent boy who had been diagnosed with intellectual disabilities. Results suggested that crying was maintained by caregiver attention delivered in a sympathetic manner.

Effects of Specified Performance Criterion and Performance Feedback on Staff Behavior A Component Analysis

The present study isolated the effects of frequently used staff training intervention components to increase communication between direct care staff and clinicians working on an inpatient behavioral unit. Written “protocol review” quizzes developed by clinicians were designed to assess knowledge about a patient’s behavioral protocols. Direct care staff completed these at the beginning of each day and evening shift. Clinicians were required to score and discuss these protocol reviews with direct care staff for at least 75% of shifts over a 2-week period. During baseline, only 21% of clinicians met this requirement. Completing and scoring of protocol reviews did not improve following additional in-service training (M = 15%) or following an intervention aimed at decreasing response effort combined with prompting (M = 28%). After implementing an intervention involving specified performance criterion and performance feedback, 86% of clinicians reached the established goal. Results of a component analysis suggested that the presentation of both the specified performance criterion and supporting contingencies was necessary to maintain acceptable levels of performance.

Alterations to functional analysis methodology to clarify the functions of low rate, high intensity problem behavior.

Current research provides few suggestions for modifications to functional analysis procedures to accommodate low rate, high intensity problem behavior. This study examined the results of the extended duration functional analysis procedures of Kahng, Abt, and Schonbachler (2001) with six children admitted to an inpatient hospital for the treatment of severe problem behavior. Results of initial functional analyses (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) were inconclusive for all children because of low levels of responding. The altered functional analyses, which changed multiple variables including the duration of the functional analysis (i.e., 6 or 7 hrs), yielded clear behavioral functions for all six participants. These results add additional support for the utility of an altered analysis of low rate, high intensity problem behavior when standard functional analyses do not yield differentiated results.

An Evaluation of Staff Preference for Graphic Characteristics

ABSTRACT The purpose of the current study was to assess staff preference for how data were displayed on graphs. Specifically, preference for line versus bar graphs was assessed, as well as preference for data displayed as one date in time versus multiple dates showing performance trends. A secondary purpose of the study was to assess staff comprehension of the data presented across different graphic displays. Participants included 60 entry-level direct care staff and 25 seasoned therapists. Therapists had more advanced training in applied behavior analysis than the direct care staff. The vast majority of direct care staff preferred data depicted as a bar graph versus data depicted as a line graph, even preferring a single bar graph over a time-series line graph. The therapists preferred time-series line graphs to bar graphs. Most staff demonstrated understanding of the data, regardless of how it was depicted.