Applied research in mental retardation最新文献

Satiation procedures involving increased food intake recently have been used to reduce rates of ruminative vomiting in mentally retarded children. Use of these nonaversive intervention procedures has been limited almost exclusively to clients who are seriously underweight since excessive weight gain is a common side effect. The purpose of the present study was to determine whether modified satiation, provided by unlimited quantities of low calorie foods, could decelerate ruminative vomiting to clinically acceptable rates without producing undesirable weight gain. The two subjects were a severely mentally retarded man and a profoundly mentally retarded woman whose histories of ruminative vomiting were extensive but whose body weights were within their ideal ranges. A multiple-baseline-across-subjects combined with a withdrawal design demonstrated significant reductions in both subjects' rates of ruminative vomiting while their body weights remained within the middle of their ideal weight ranges. The results are discussed in terms of their clinical utility and the need for future analyses of the critical components of food satiation techniques.

Four mentally retarded adolescent females participated in a program for assessment and training of independent menstrual care skills. Three task analyses served as the basis for instruction: (a) menstrual stain on underwear, (b) menstrual stain on a sanitary pad, and (c) menstrual stain on both sanitary pad and underwear. During individual training sessions, subjects were taught to perform correct sequences via simulation training with a small doll, in which a trainer utilized instructions, praise, modeling, and corrective feedback. Three types of assessment probes were conducted prior to training, upon completion of specified mastery criteria, and during post-training follow-up sessions. Doll probes assessed performance with the toy doll, self-probes assessed naturalistic performance but under conditions of stimulated menstruation, and in vivo probes assessed performance during actual menstruation. Results of a multiple baseline analysis indicated that subjects emitted few correct responses during baseline probes, but showed consistent improvements that corresponded to the introduction of training. Generalization to untrained skills was noted with all subjects. Follow-up assessments indicated maintenance of skills for periods up to 30 weeks following termination of training.

Seven community-dwelling, mildly and moderately mentally retarded adults participated in a group social skills training program designed to improve conversational skills. A group multiple-baseline design was used. Conversational components trained were asking questions about the conversational partner, giving compliments, and appropriately disclosing information about oneself. Training sessions consisted of instructions, modeling, and behavioral rehearsal. Assessment during baseline and treatment consisted of recording conversations between subject dyads after each session. Generalization of training was assessed during baseline and treatment and at 1-month, 3-month, and 6-month follow-ups by recording conversations between subjects and novel, nonretarded persons. Behavioral ratings of the tapes indicated substantial improvements in the targeted behaviors as a function of training. Subjective social validity ratings of pretraining and posttraining generalization tapes by community volunteers reflected improvements in their social perceptions of subjects as a function of training. The results suggest that community-dwelling, mentally retarded adults can be taught to make changes in their conversational behavior that are viewed positively by others living in their comunities.

Recent research suggests that the effects of social skills training programmes are often not evident outside the training setting. Correspondence training has been advocated as a means of overcoming this problem, although few studies have demonstrated its effectiveness. Three intellectually handicapped adults were given social skills training. At other times, generalisation was tested during conversations with staff. Subsequent to mastery in the social skills training setting, behaviours that did not occur at criterion in the generalisation setting were selected for correspondence training. After correspondence training was introduced, targetted behaviours increased in frequency in the generalisation setting. These increases were maintained during follow-up sessions, which took place 1 month after the training programme ceased. The effects of correspondence training are examined in the context of previous reinforcement history, accuracy of reporting, and verification of performance in unobserved settings.

Disabled people often do not use leisure time productively. Past research has focused on teaching specific recreational activities isolated from related skills that would provide subjects a functional independent living repertoire. In the present study disabled subjects were taught the art of macrame. Additionally, they role-played related shopping skills such as buying materials, engaging in appropriate social-interpersonal skills, making monetary transactions, and securing their own transportation to and from the store. Subjects were taught six basic macrame knots using an instructional manual, series of error-correction procedures, and social reinforcement. After mastering those basic knots they independently used the instructional materials to make three complete macrame projects without direct instruction on the projects themselves. Subjects also demonstrated skill maintenance and generalization by making a novel project after independently engaging in all relevant shopping behavior. Two varieties of the multiple baseline design were employed. The importance of teaching a leisure skill cluster and adapting instructional materials were emphasized.

This study evaluated methods for empirically identifying environmental determinants of aggressive and disruptive behavior in three developmentally delayed children. A variety of sessions conducted on an inpatient treatment unit were designed to simulate contingencies maintaining aggression and disruption in the subjects' natural environments. The basic analog conditions included: 1) instructional demands, 2) contingent social disapproval, and 3) structured play. In addition, variations of the three basic conditions were developed based on informal observation and parental reports of naturally occurring contingencies. Results showed considerable variability both between and within subjects. However, for each subject a specific analog condition was shown to produce relatively higher rates of aberrant behavior. Subsequently, behavioral treatments based on assessment results were successfully implemented with two of the subjects. Results are discussed in terms of the importance and practical limitations of conducting systematic assessment of aberrant repertoires in developmentally delayed clients.

It is argued that self-injury should be conceptualized within accepted diagnostic schemes prevalent in the United States and abroad. This approach is viewed as having several benefits including better and more clearly emphasizing to practitioners the nature of the problem by inclusion in DSM III and related diagnostic systems that are readily available in applied settings. It is believed that encorporating self-injury more clearly as a diagnostic entity would also have the result of further legitimizing it for reimbursement by third party payers who routinely use DSM III categories. Additional issues pertaining to the relationship of self-injury to diagnosis a are discussed.

One-hundred and twenty-four mentally retarded persons with behaviors suggestive of epilepsy were monitored with an 8-channel radiotelemetered electroencephalograph-video recording system (TEEG-VR). Target behaviors were identified by the clinical description of the primary care providers before the TEEG-VR sessions. Whenever possible, the known antecedents of those behaviors were replicated. The target behaviors were considered epileptic when they were observed simultaneously with epileptiform EEG patterns, and pseudoepileptic when nonepileptiform patterns were observed. Twenty persons were classified as epileptic, 50 as pseudoepileptic, 11 as both epileptic and pseudoepileptic, and 43 as inconclusive. Among the pseudoepileptics there were 15 with abnormal EEGs and 4 with epileptiform EEGs. The most frequent topographies of behavior were not significantly related to diagnosis. These included myoclonus, eye blink, head drop, cessation of ongoing activity, and hand and arm automatisms. The diagnosis of epilepsy in mentally retarded persons, on the basis of clinical description, interictal EEG, and medical history, may be inaccurate. TEEG-VR is extremely useful for obtaining a definitive diagnosis of each target behavior.

The Neonatal Network, a model program for interagency service coordination for primarily indigent, minority very-low-birth-weight infants and their families is described. The Neonatal Network has been an effective service delivery coordination system and training mechanism that should be applicable and easily replicable in other communities with the same or different target populations.