Ron G. Bittle

The successful treatment of a dually-diagnosed deaf man's aggression with a program that included contingent electric shock

A behavioral program that included contingent electric shock was developed to treat the severely aggressive behaviors of an institutionalized, dually-diagnosed deaf male. All previous interventions including high dosages of psychotropic medications, custodial restraint, seclusion, and various behavioral procedures had been ineffective. The program included: (a) a high density of positive reinforcement for appropriate behavior; (b) a short period of intensive compliance training in a special setting using remote controlled or direct electric shock consequences contingent on aggression or property destruction; and (c) the gradual transfer of programmatic control to supervisory personnel and then direct-care staff with the inclusion of additional procedures (e.g., nonexclusionary time-out) that were intended to help ensure their safety. All forms of aggressive behavior were reduced to zero or near zero levels within one month and these effects have been maintained by direct-care staff for more than a year. The client now works all day at the institutional vocational workshop and has made several home visits without displaying aggression. The ethical, clinical, and practical considerations that arose during the development and implementation of the program are discussed in detail.

Teaching social skills to psychiatric inpatients

Abstract A social skills training program was evaluated with psychiatric inpatients. The targeted social skills required an action or reaction within six component areas including Compliments, Social Interaction, Politeness, Criticism, Social Confrontation and Questions/Answers . The program used a commerciallyavailable social skills training game that features the use of response specific feedback, self-monitoring, individualized reinforcers and individualized performance criteria. A multiple-baseline design across groups demonstrated that the program increased appropriate responding in all skill areas. Two different generalization tests indicated that the S s used their newly-learned skills outside the training setting. The program appears to be applicable to psychiatric inpatients since it targets skills in a variety of areas and employs standardized procedures to enhance replicability.

The reductive effects of reinforcement procedures on the genital stimulation and stereotypy of a mentally retarded adolescent male

This study evaluated the effects of access to opportunities to earn edibles for performing a high probability stereotypic behavior on the public genital stimulation and stereotypy of a severely retarded male in a special education class. The treatment involved the use of a series of increasing DRO lengths in which the absence of genital stimulation was reinforced with edibles and a stereotypic behavior. Later, we attempted to reduce the rate of stereotypy by withdrawing the edibles that had been provided for it during the reinforcement period. The results indicated that (a) genital stimulation was nearly eliminated with the graduated DRO procedure; (b) withholding the edibles had little effect in reducing the stereotypic behavior; and (c) edibles alone were enough to maintain the reductions in genital stimulation. These findings suggest that public genital stimulation is amenable to treatment with a positive treatment procedure, but more research with the reinforcer displacement technique is needed before any firm conclusions can be drawn about its effectiveness in an applied setting.

Replacing a chronic schizophrenic man's delusional speech with stimulus appropriate responses

This study attempted to extend the use of Cues, Pause, Point language training procedures (developed to treat the speech disorders of mentally handicapped persons) to delusional speech. The direct and potential generalized effects of the procedures on the delusional and socially appropriate responding of an institutionalized, chronic schizophrenic man were evaluated in a multiple baseline design across stimulus-response pairs. The procedures encouraged the subject to (a) remain quiet before, during, and after the presentation of verbal stimuli and then (b) respond on the basis of environmental cues (i.e. written word cards) that contained the correct responses. Delusional responding was rapidly replaced by appropriate responding on both sets of the trained stimuli. Across person and setting generalization occurred in assessments conducted immediately following training, and these effects were maintained for 15 months. The results suggest that Cues, Pause, Point procedures may offer some potential for replacing delusional responding with appropriate responding to social stimuli.

Replacing maladaptive speech with verbal labeling responses: A case study promoting generalized responding

We taught a mentally handicapped student to answer five questions with verbal labels and evaluated the generalized effects of this training on his echolalia and correct responding to five untrained questions. The student received cuespause-point training on an initial five question set followed by generalization assessments on a different set in another setting. Generalization to untrained questions did not occur until training was instituted on two exemplars from the untrained set. These results replicate and extend previous research that suggested that cuespause-point procedures may be useful in replacing maladaptive language strategies by teaching students an alternative strategy that involves using their verbal labeling repertoires. They also suggest that training exemplars is a viable means of promoting the generalized use of this strategy.