Analysis and Intervention in Developmental Disabilities最新文献

Three adolescents functioning within the moderate to severe range of mental retardation were taught to use picture prompts to guide their performance on two vocational sequencing tasks. Evaluation of the effects of picture prompts was conducted within a multiple baseline (across subjects and tasks) with reversal design. Baseline was conducted on two tasks, valve assembly with 18 parts, and packaging with 20 parts. During baseline, students were to sequence a specified number of each part across three work stations. Following baseline, students were taught to use picture prompts to guide their performance on one of the tasks. All students completed the training task with at least 96% accuracy with the picture prompts, and generalized their performance with equal accuracy to the untrained task. When picture prompts were removed (reversal to baseline), the performance of all students decreased substantially, indicating that the pictures were controlling their performance. When the pictures were again available to guide behavior, the performance of all three adolescents returned to posttraining levels of accuracy.

In the movie “Harry” (Research Press, 1980), Richard Foxx demonstrated the highly successful treatment of a young man's severe self-injury. This movie has had a dramatic and important impact on professional and lay audiences alike. Dr. Foxx was invited by AIDD's editorial board to present the data from Harry's initial treatment and, most importantly, a four year follow up on Harry's. progress. His article follows.

Harry, a self-injurious man who found restraint reinforcing was treated by a two-phase program. Phase I consisted of reinforcement with restraint for increasinglu longer periods of noninjury and timeout from restraint for self-injurious behavior (SIB). An ABAB reversal design was used to demonstrate the rapid reduction of SIB in Phase I. At the end of Phase I, Harry was displaying low levels of SIB, i.e., less than one episode per day, but had begun self-restraining by holding objects in his hands. Self-restraint was treated in Phase II by fading the size of the held objects to a point where he ceased holding them, An appropriate form of restraint, wearing eyeglasses, was substituted and Harry continues to wear them after four and a half years. A maintenance program was instituted following Phase II that consisted of token reinforcement for adaptive behavior, parent training, and an enriched program day that included vocational training and one-to-one interactions with a unit staff member. The four year follow-up results revealed that Harry's SIB is virtually non-existent and consists of symbolic taps to the nose or very light arm bites. The present study and work of others suggests that the therapeutic use of the reinforcing properties of restraint to treat self-injurious individuals appears to be an extremely effective way of; a) treating SIB, b) overcoming the iatrogenic effects of chronic restraint usage, and c) treating self-restrainers by substituting appropriate forms of restraint.

This study evaluated a community program to teach three formerly institutionalized adult males, ages 51 to 60, to eat well-balanced diets. A well-balanced diet was defined as consisting of two servings each from the meat and milk food groups and four servings each from the fruits and vegetables and breads and cereals food groups, or a total of 12 food servings each day. During baseline observations, the men averaged only 6.7 appropriate food servings per day. Instructions and self-monitoring and praise had little or no effect on the men's diets. When cash reinforcement was made contingent on the men's meeting specified daily criteria, the number of appropriate food servings eaten increased to an average of 10.5 appropriate food servings per day, an increase of 57% over baseline levels. A return to baseline conditions and follow-up observations showed continued maintenance of nearly all the treatment gains.