Behavior Modification最新文献

The pyramidal training approach is a promising strategy to train behavioral interventionists in applied settings, as it maximizes efficiency of training by allowing for more trainees to learn and implement a diverse range of behavioral strategies in less time. This systematic review synthesized 30 single-case studies that evaluated pyramidal training in training practitioners to implement behavioral interventions. Results support the effectiveness of the pyramidal training model at the case, tier, and study levels across various settings, targeted skills, and participant types, particularly for improving practitioner implementation fidelity. However, strategies for promoting maintenance of trained skills, such as feedback and coaching, have not been routinely incorporated into pyramidal training procedures. Future researchers should evaluate the utility of post-training observations of implementation fidelity to determine the sustainability and most efficacious methods for promoting fidelity of trained behavioral interventions. Ultimately, the pyramidal training approach shows great promise but requires further optimization and empirical scrutiny.

Many people with serious mental illness (SMI) experience cognitive disabilities and poor independent living skills which limit their ability to live independently in the community. This study examined the feasibility and initial effectiveness of integrating a new cognitive remediation program, Thinking Skills for Life (TSL), into independent living skills training programs in four secure residential treatment facilities (SRTFs) to facilitate discharge to more independent living situations. Participants were 30 individuals in the SRTF, of whom 11 were forensically committed to the SRTF. Results showed the intervention was feasible to implement, with 97% of participants exposed to TSL and 67% completing the program. Initial promise of the TSL program at improving independent living was suggested by post cognitive program discharge to less restrictive living situations of 63% of participants not on forensic commitment, and 55% of those on forensic commitment. These promising findings set the stage for more rigorous evaluation of the efficacy of the TSL program.

The identification of behavioral markers that predict the trajectory of behavior could guide the allocation of limited clinical resources to improve efficacy, efficiency, and safety. As a preliminary exploration of this possibility, we conducted a retrospective records review of incident reports for aggression displayed by residents at a secure juvenile detention center. Our purpose was to evaluate latency to first aggression as a candidate behavioral marker for predicting subsequent high-rate aggression. Our results indicate that latency to first aggression may be a high-quality predictor of subsequent high-rate aggression, and we identified specific cutoff scores that added high levels of predictive value. We use these data to demonstrate a process by which clinicians and researchers can identify predictor variables and use them to guide subsequent allocation of clinical resources. Practical, conceptual, and ethical considerations related to applications of this process as well as potential directions for future research in this area are discussed.

This review evaluated single-case experimental design research that examined challenging behavior interventions utilizing punishment elements. Thirty articles published between 2013 and 2022 met study inclusion criteria. Study quality was also assessed. Through multiple levels of analysis (e.g., descriptive statistics, non-parametric statistics), we examined (a) participant and study trends, (b) differential outcomes related to temporal reinforcement approaches (antecedent, consequent, or combined reinforcement) applied alongside punishment element(s), (c) differential outcomes related to the punishment type (negative, positive) applied alongside reinforcement, and (d) effect sizes associated with study rigor across peer-reviewed and gray literature. Our results may tentatively suggest that, for certain situations, concurrently applying punishment with antecedent reinforcement approaches may coincide with significantly larger effect sizes compared to combined temporal reinforcement approaches, while positive punishment applied concurrently with reinforcement may coincide with larger but non-significant intervention effects. Most featured articles met rigor criteria, but larger effects were seen in peer-reviewed literature.

Past research has shown the effectiveness of contingent acoustic feedback (CAF) in various human performance settings, but its impact on staff performance in clinical settings remains unclear. The current study replicated and extended Herron et al. (2018) by using vocal instructions and CAF to teach staff to use behavior-specific praise (BSP) to reinforce designated client behavior in a clinical setting. Results from a multiple-baseline-across-staff design revealed that this intervention increased the rate at which staff used BSP to reinforce designated client behavior. Paired sample t-tests showed a significant increase in the rate of BSP for each participant from baseline to the intervention phase, and participants maintained increased rates of BSP during probes conducted 1 to 3 weeks after the intervention was complete. Additionally, paired sample t-tests showed statistically significant increases in the rates of designated behavior for each client. Participants also rated the instructions and CAF procedure as more worthwhile, helpful, relevant, pleasant, and less disruptive than feedback methods typically used in their agency.

Many individuals with intellectual and developmental disabilities (DD) encounter difficulties in performing daily living skills, which limits their self-sufficiency and autonomy. Caregivers, such as parents, are often the individuals who interact with individuals with DD the most during daily living skills routines. Therefore, it is critical to teach caregivers to implement daily living skills interventions with their children. A systematic review of the literature related to caregiver-implemented daily living skills interventions yielded 38 articles. Of those, 20 articles, with 21 experiments, were rated as high quality based on What Works Clearinghouse design standards. Behavior skill training was the most common strategy used to teach caregivers to implement interventions. Common daily living skills interventions included prompting, reinforcement, and task analysis. The most common form of prompting was verbal prompting, and the most common schedule of reinforcement was a continuous schedule of reinforcement. Of the 21 high-quality experiments, 86% demonstrated caregiver-implemented interventions yielded improvements in daily living skills. Several studies demonstrated generalization and maintenance of daily living skills. Implications for research and practice are discussed.

The purpose of this study was to evaluate a progressive functional analysis (FA) model and function-based intervention delivered by caregivers with coaching via telehealth. Children diagnosed with autism and at least one caregiver (e.g., parent) participated in the study. We conducted three assessments prior to and following intervention: a researcher-developed 10-min observation, the Parental Stress Index, and the externalizing section of the Vineland Adaptive Behavior Rating Scales, Third Edition (VABS-3). We included 47 participants in the present evaluation of the progressive FA model. We identified the function of challenging behavior for 36 participants. A function was not identified for nine participants who exhibited low or no challenging behavior during the assessment; the results were inconclusive for two participants. For the 17 participants who participated in the intervention evaluation phase, each of the participants achieved the mastery criterion, which was an 80% reduction in challenging behavior for most participants. Additionally, there was a statistically significant decrease in the VABS-3 externalizing behavior measure from pre- to post-assessment, although neither of the other pre-post measures resulted in statistically significant changes. This study replicates and extends previous research, supporting the use of progressive FA model and function-based interventions to improve challenging behavior.

Complex motor stereotypies are rhythmic, repetitive, fixed, and non-goal directed movements (e.g., bilateral flapping/waving movements of the hands/arms). Movements typically begin in early childhood and can occur in otherwise normally developing ("primary") or autistic ("secondary") children. Stereotypies persist, occur multiple times a day, have prolonged durations, can be socially stigmatizing, and may lead to bullying and isolation. Prior behavioral treatment studies have focused on older children (ages 6-12) and report modest reductions in stereotypy (i.e., between 14% and 33%). The current study involves the functional assessment and treatment of five children with Primary Complex Motor Stereotypy using a modified awareness training procedure, differential reinforcement of other behavior, and schedule thinning in a nonconcurrent multiple baseline design. Results suggest a 99% reduction of motor stereotypy from baseline across all participants.

Deficits in positive emotion regulation skills may be an important factor in the development and maintenance of anxiety and mood disorders. A treatment, which includes strategies to build and strengthen positive emotion regulation skills has been provided to patients primarily diagnosed with an anxiety and or mood disorder in an adult mental health outpatient service setting. To study the effects on positive and negative emotion, emotion regulation skills, emotional disorder symptoms, quality of life, and wellbeing during a new developed treatment. An exploratory clinical trial was used to conduct a preliminary assessment of a novel intervention. The intervention was provided in a group format over a 6-week period and independent practice over an 8-week period. Outcome variables were assessed pre- and post-treatment and at a 2-month follow up. Life quality, subjective wellbeing ratings, depressive and anxiety symptoms improved at follow up. The data suggests that the intervention may have the potential to produce desired change in positive emotion regulation. Preliminary findings suggest the intervention can have beneficial effects. These findings are promising and support the possibility that disturbances in positive emotion regulation may be a generative target for treatment research.

School refusal behaviors in adolescents have deleterious immediate and long-term consequences and are associated with mental ill-health such as anxiety and depression. Understanding factors that place youth at higher risk of school refusal behavior may assist in developing effective management approaches. We investigated parental and adolescent factors that may be associated with school refusal behaviors by specifically focusing on the role of parental and adolescent emotion dysregulation, their anxiety and depression, and parental rearing style. First, we hypothesized that adolescents with school refusal behaviors, as well as their parents, will report higher levels of emotion dysregulation, anxiety, and depression compared to their counterparts without school refusal behaviors. Furthermore, we hypothesized that multivariate models testing the role of parental and child factors concurrently will show that parental (emotion dysregulation, anxiety and depression, and rearing styles) and adolescent (emotion dysregulation, anxiety, and depression) factors are associated with school refusal behaviors. One hundred and six adolescents aged 12 to 18 years and their parents completed an online questionnaire measuring both parental and adolescent emotion dysregulation, anxiety, depression, parental rearing styles, and adolescents' school refusal behaviors. Adolescents with school refusal behaviors reported greater anxiety and depression, with their parents showing greater emotion dysregulation. Multivariate analyses showed that parental emotion dysregulation and adolescent age were associated with school refusal behaviors independently. Future management for school refusal behaviors should consider age-tailored approaches by incorporating training for parental emotion regulation skills.