Paul W. Clement

Differential Effects of Methylphenidate and Self-Reinforcement on Attention-Deficit Hyperactivity Disorder

Six boys aged 9 to 12 years attended a tutoring class focusing on reading for 30 minutes each morning. The investigators employed a modified Latin-square design in which each child began with a 5-day baseline phase followed by six 10-day treatment phases that used drug placebo, noncontingent reinforcers, 0.3 mg/kg methylphenidate, 0.7 mg/kg methylphenidate, and self-re-inforcement in various combinations. Amount of academic performance was the major measure of outcome and the target behavior of self-reinforcement. Drug placebo and noncontingent reinforcers had no systematic impact. Methylphenidate had differential effects across the recorded behaviors. Self-reinforcement improved the target behavior; the mean effect size for self-reinforcement was 2.66. The combined effects of methylphenidate and self-reinforcement on academic performance were greater than either of the treatments given alone (mean effect size = 2.89).

Effects of teacher-administered and self-administered reinforcers on learning disabled children *

The subjects were six 8- to 11-year-old boys with attention deficits enrolled in their schools resource specialist program for learning disabled children. The effects of baseline conditions, teacher-administered reinforcers, and self-administered reinforcers were evaluated through six counterbalanced, crossover, intensive studies in which sustained attention was the target behavior. The teacher averaged 96% accuracy in administering reinforcers, and the six subjects averaged 93% accuracy in self-administering reinforcers. Five of six children reliably improved during teacher-administered reinforcers, and the mean effect size across all subjects was 0.79. All subjects reliably improved during self-administered reinforcers, and the mean effect size across all subjects was 1.87. In all of the direct comparisons of the effectiveness of teacher- and self-administered reinforcers, the self-administered condition was more effective.

Quantitative evaluation of 26 years of private practice

Of 683 cases seen by a clinical psychologists, 67 came for assessment only, 132 dropped out during intake, and 40 were sy=till in treatmenbt at the time of data analysis. The subjects fell into 86 DSM-III-R diagnostic categories and ranged in age from 6 months to 79 years at intake. Of the 444 treated clients, 75% were improved at termination.

Teacher-Controlled and Self-Controlled Reinforcement with Underachieving Black Children

Four black, male fourth-graders served in a set of single-subject, intensive studies on the comparative effects of teacher-controlled (TCR) and self-controlled reinforcement (SCR). They attended a one-hour tutoring class three days a week for 14 weeks. Four academic behaviors and four indices of academic achievement constituted the measures of outcome. Each child participated in at least two baseline phases, two TCR phases, and two SCR phases, each lasting two weeks. The order of presenting the active treatment conditions was counterbalanced across subjects. Within- and across-subject analyses were made. Both types of analysis showed SCR to be more effective than TCR in increasing academic behaviors. This difference in effectiveness did not appear consistently on the nontreated academic behaviors, but the achievement data did demonstrate generalized differential effects favoring SCR.

Methylphenidate compared with behavioral self-control in attention deficit disorder: preliminary report.

The effects of methylphenidate and behavioral self-control training on sustained attention were compared in 12 boys aged 6–9 years. Subjects were of low-average intelligence and had academic and behavioral problems including distractibility, short attention span, and impulsiveness. Treatment conditions (baseline, placebo, methylphenidate, and behavioral self-control training) were assigned according to a single-subject randomized block design. Attention was measured by the Childrens Checking Test (CCT). Methylphenidate improved performance on the CCT and was superior to the other treatment conditions. Several children benefited from behavioral training, but statistical analysis of this change was nonsignificant. These results are consistent with and extend those of previous studies.

Self-observation and self-reinforcement as sources of self-control in children

Eight fifth- and sixth-grade black males engaged in a set of single-subject, multiple-baseline studies to determine the relative effects of self-observation and self-reinforcement. A black male college student employed the children as research assistants who would study their own behavior. The employer negotiated a series of individualized contracts with each boy. The contracts specified what self-regulation procedures the subject would perform. Overall, the children were more consistent in carrying out their contracts when they were on self-reinforcement than when they were on self-observation. Second, the children were more effective in increasing behavioral deficits than they were in decreasing excesses. Third, self-reinforcement was clearly a superior means of improving their own behavior than was self-observation.

Setting Generalization during Self-Reinforcement with Educationally Handicapped Children

Eight educationally handicapped boys ranging in age form 10 to 11 years old and described as the worst behavior problems in their class participated in a series of single-subject studies carried out in their self-contained classrooms. Three served as target subjects, using self-reinforcement procedures to increase their sustained on-task behavior in a treatment setting; five served as generalization subjects. Data were collected in three settings within the self-contained classroom; an early morning treatment setting, a late morning generalization setting, and an afternoon generalization setting. The three target subjects averaged a 51% increase over their baseline median levels of sustained on-task behavior in the treatment setting. They averaged 84% and 96% generalization to the late morning and afternoon generalization settings, respectively. These results demonstrate that self-reinforcement can produce setting generalization of treatment effects in the absence of prior externally determined reinforcem...

Temporal Generalization of Self-Regulation Effects in Under-Controlled Children

Four sixth-grade boys described as disruptive and undercontrolled by their teachers and ranging from 11 to 12 years old served in a set of four intensive studies. The basic design of each study was A-B-A-B-A-C-A-C-A where A = Baseline, B = Contrived Self-reinforcement, and C = Natural Self-reinforcement. The first Baseline phase ran 10 days. The final Baseline phase ran 40 days, and all other phases were 5 days in length. Contrived Self-reinforcement included an auditory cue for self-observation, self-recording, self-instructions, and self-administration of pennies and verbal reinforcement. Natural Self-reinforcement included a simplified system of self-recording, self-instructions, and self-administration of verbal reinforcers. Each subject demonstrated clear treatment effects. Summarizing across all four, the median improvement during Contrived Self-reinforcement was 184% for On-task (the target behavior) and 100% for Worksheets Completed (the generalization behavior). During Natural Self-reinforcement ...