Search

This research evaluated parent reports of sleep behaviors of four groups of children: those with Autism or Pervasive Developmental Disorders, those with General Mental Retardation alone, those attending Special Education classes (with no MR diagnosis), and a control group of similar aged children without a developmental diagnosis. Diagnostic classification and demographic information were determined through parent report, report of classroom registration, and the Gilliam Autism Rating Scale (Gilliam, 1995). To evaluate sleeping behavior the study used a 28-item, five-factor scale (Behavioral Evaluation of Disorders of Sleep/BEDS; Schreck, 1997/1998) constructed from the diagnostic criteria for childhood sleep disorders found in the International Classification of Sleep Disorders: Diagnostic and Coding Manual (ICSD, American Sleep Disorders Association, 1990). Findings suggest that reports of parents with children with autistic characteristics exhibit expected quantities of sleep, but parent perception of their sleep difficulties and sleep quality is different for children with autism than for children in all other study groups. [ABSTRACT FROM AUTHOR]

This study provided preliminary validation of the Autism Detection in Early Childhood-Virtual (ADEC-V) for telehealth assessment of possible autism. Participants were 121 children (24.79% female) aged 18-47 months who completed telehealth evaluations at a large pediatric hospital in the Midwestern United States between October 2020 and February 2021. The ADEC-V showed good sensitivity (0.82) and specificity (0.78) and was significantly correlated with other ASD symptom measures (i.e., CARS-2, ADI-R). Internal consistency was acceptable (α = 0.77). These results need replication in a larger and broader sample including more children without ASD. This preliminary validation study identifies the ADEC-V as a promising measure for telehealth ASD assessments in young children., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study investigated language profiles in a community-based sample of 104 children aged 1-3 years who had been diagnosed with autism spectrum disorder using Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnostic criteria. Language was assessed with the Mullen scales, Preschool Language Scale, fifth edition, and Vineland-II parent-report. The study aimed to determine whether the receptive-to-expressive language profile is independent from the assessment instrument used, and whether nonverbal cognition, early communicative behaviors, and autism spectrum disorder symptoms predict language scores. Receptive-to-expressive language profiles differed between assessment instruments and reporters, and Preschool Language Scale, fifth edition profiles were also dependent on developmental level. Nonverbal cognition and joint attention significantly predicted receptive language scores, and nonverbal cognition and frequency of vocalizations predicted expressive language scores. These findings support the administration of multiple direct assessment and parent-report instruments when evaluating language in young children with autism spectrum disorder, for both research and in clinical settings. Results also support that joint attention is a useful intervention target for improving receptive language skills in young children with autism spectrum disorder. Future research comparing language profiles of young children with autism spectrum disorder to children with non-autism spectrum disorder developmental delays and typical development will add to our knowledge of early language development in children with autism spectrum disorder.

The present study examined the link between poor self-regulation (measured by the child behavior checklist dysregulated profile [DP]) and core autism symptoms, as well as with developmental level, in a sample of 107 children with autism spectrum disorder (ASD) aged 19-46 months. We further examined the utility of DP in predicting individual differences in adaptive functioning, relative to the influence of ASD severity, chronological age (CA), and developmental level. Poor self-regulation was unrelated to CA, developmental level, and severity of ADOS-2 restricted and repetitive behaviors, but was associated with lower ADOS-2 social affect severity. Hierarchical regression identified poor self-regulation as a unique independent predictor of adaptive behavior, with more severe dysregulation predicting poorer adaptive functioning. Results highlight the importance of early identification of deficits in self-regulation, and more specifically, of the utility of DP, when designing individually tailored treatments for young children with ASD. Autism Res 2018, 11: 1157-1165. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study explored the relationship between poor self-regulation and age, verbal and non-verbal developmental level, severity of autism symptoms and adaptive functioning in 107 children with autism under 4 years of age. Poor self-regulation was unrelated to age, developmental level, and severity of restricted and repetitive behaviors but was associated with lower social affect severity. Importantly, more severe self-regulation deficits predicted poorer adaptive functioning., (© 2018 International Society for Autism Research, Wiley Periodicals, Inc.)

The study examined the confidence accuracy relationship, and the influence of child characteristics on clinician confidence, when predicting a diagnosis of Autism Spectrum Disorder during screening of 125 referred children aged under 3.5 years. The diagnostic process included observation, interview, language and developmental testing. Clinical judgement accuracy was compared against final diagnosis for high and low confidence levels (with confidence assessed on a 0-100 % scale). We identified a significant CA relationship with predictive accuracy highest at confidence levels of 90-100 %. Parent report of unusual behaviors was the only significant independent predictor of confidence. Clinicians' confidence may be important when evaluating decisions to refer, or not to refer, children for further diagnostic assessment.

The Autism Detection in Early Childhood (ADEC) is a brief, play-based screening tool for the assessment of autism spectrum disorder (ASD) in children aged 12-36 months. We examined the psychometric properties of the ADEC in a clinical sample of toddlers (n = 114) referred to a US pediatric hospital for assessment due to concerns of developmental delay or ASD. The ADEC (cutoff = 11) returned good sensitivity (.93-.94) but poorer specificity (.62-.64) for best estimate clinical diagnosis of ASD, and compared favorably with the ADOS-2. Internal consistency was acceptable, α = .80, and inter-rater reliability was high, ICC = .95. Results support the use of the ADEC as a clinical screen for ASD.

Importance: Disruptive behavior is common in children with autism spectrum disorder. Behavioral interventions are used to treat disruptive behavior but have not been evaluated in large-scale randomized trials., Objective: To evaluate the efficacy of parent training for children with autism spectrum disorder and disruptive behavior., Design, Setting, and Participants: This 24-week randomized trial compared parent training (n = 89) to parent education (n = 91) at 6 centers (Emory University, Indiana University, Ohio State University, University of Pittsburgh, University of Rochester, Yale University). We screened 267 children; 180 children (aged 3-7 years) with autism spectrum disorder and disruptive behaviors were randomly assigned (86% white, 88% male) between September 2010 and February 2014., Interventions: Parent training (11 core, 2 optional sessions; 2 telephone boosters; 2 home visits) provided specific strategies to manage disruptive behavior. Parent education (12 core sessions, 1 home visit) provided information about autism but no behavior management strategies., Main Outcomes and Measures: Parents rated disruptive behavior and noncompliance on co-primary outcomes: the Aberrant Behavior Checklist-Irritability subscale (range, 0-45) and the Home Situations Questionnaire-Autism Spectrum Disorder (range, 0-9). On both measures, higher scores indicate greater severity and a 25% reduction indicates clinical improvement. A clinician blind to treatment assignment rated the Improvement scale of the Clinical Global Impression (range, 1-7), a secondary outcome, with a positive response less than 3., Results: At week 24, the Aberrant Behavior Checklist-Irritability subscale declined 47.7% in parent training (from 23.7 to 12.4) compared with 31.8% for parent education (23.9 to 16.3) (treatment effect, -3.9; 95% CI, -6.2 to -1.7; P < .001, standardized effect size = 0.62). The Home Situations Questionnaire-Autism Spectrum Disorder declined 55% (from 4.0 to 1.8) compared with 34.2% in parent education (3.8 to 2.5) (treatment effect, -0.7; 95% CI, -1.1 to -0.3; P < .001, standardized effect size = 0.45). Neither measure met the prespecified minimal clinically important difference. The proportions with a positive response on the Clinical Global Impression-Improvement scale were 68.5% for parent training vs 39.6% for parent education (P < .001)., Conclusions and Relevance: For children with autism spectrum disorder, a 24-week parent training program was superior to parent education for reducing disruptive behavior on parent-reported outcomes, although the clinical significance of the improvement is unclear. The rate of positive response judged by a blinded clinician was greater for parent training vs parent education., Trial Registration: clinicaltrials.gov Identifier: NCT01233414.

A Structured Observational Analog Procedure (SOAP), an analogue measure of parent-child interactions, was used to assess treatment outcome in children with Autism Spectrum Disorder and serious behavior problems. It served as a secondary outcome measure in a 24-week, randomized trial of risperidone (MED; N =49) versus risperidone plus parent training (COMB; n =75) (ages 4-13 years). At 24-weeks, there was 28 % reduction in child inappropriate behavior during a Demand Condition ( p =.0002) and 12 % increase in compliance to parental requests ( p =.004) for the two treatment conditions combined. Parents displayed 64 % greater use of positive reinforcement ( p =.001) and fewer repeated requests for compliance ( p <.0001). In the analysis of covariance (ANCOVA), COMB parents used significantly more positive reinforcement ( p =.01) and fewer restrictive statements ( p <.05) than MED parents. The SOAP is sensitive to change in child and parent behavior as a function of risperidone alone and in combination with PMT and can serve as a valuable complement to parent and clinician-based measures.

Sleep problems associated with autism spectrum disorders (ASD) have been well documented, but less is known about the effects of sleep problems on day-time cognitive and adaptive performance in this population. Children diagnosed with autism or pervasive developmental disorder-not otherwise specified (PDD-NOS) (N = 335) from 1 to 10 years of age (M = 5.5 years) were evaluated for the relationships of Behavioral Evaluation of Disorders of Sleep (BEDS; Schreck, 1998) scores to measures of intelligence and adaptive behavior. Results suggested that children who slept fewer hours per night had lower overall intelligence, verbal skills, overall adaptive functioning, daily living skills, socialization skills, and motor development. Children who slept fewer hours at night with waking during the night had more communication problems. Breathing related sleep problems and fewer hours of sleep related most often to problems with perceptual tasks. The results indicate that quality of sleep--especially sleep duration--may be related to problems with day-time cognitive and adaptive functioning in children with autism and PDD-NOS. However, future research must be conducted to further understand these relationships., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: Children with Pervasive Developmental Disorders (PDDs) have social interaction deficits, delayed communication, and repetitive behaviors as well as impairments in adaptive functioning. Many children actually show a decline in adaptive skills compared with age mates over time., Method: This 24-week, three-site, controlled clinical trial randomized 124 children (4 through 13 years of age) with PDDs and serious behavioral problems to medication alone (MED; n = 49; risperidone 0.5 to 3.5 mg/day; if ineffective, switch to aripiprazole was permitted) or a combination of medication plus parent training (PT) (COMB; n = 75). Parents of children in COMB received an average of 11.4 PT sessions. Standard scores and Age-Equivalent scores on Vineland Adaptive Behavior Scales were the outcome measures of primary interest., Results: Seventeen subjects did not have a post-randomization Vineland assessment. Thus, we used a mixed model with outcome conditioned on the baseline Vineland scores. Both groups showed improvement over the 24-week trial on all Vineland domains. Compared with MED, Vineland Socialization and Adaptive Composite Standard scores showed greater improvement in the COMB group (p = .01 and .05, and effect sizes = 0.35 and 0.22, respectively). On Age Equivalent scores, Socialization and Communication domains showed greater improvement in COMB versus MED (p = .03 and 0.05, and effect sizes = 0.33 and 0.14, respectively). Using logistic regression, children in the COMB group were twice as likely to make at least 6 months' gain (equal to the passage of time) in the Vineland Communication Age Equivalent score compared with MED (p = .02). After controlling for IQ, this difference was no longer significant., Conclusion: Reduction of serious maladaptive behavior promotes improvement in adaptive behavior. Medication plus PT shows modest additional benefit over medication alone. Clinical trial registration information-RUPP PI PDD: Drug and Behavioral Therapy for Children With Pervasive Developmental Disorders; http://www.clinicaltrials.gov; NCT00080145.

Objective: Many children with pervasive developmental disorders (PDDs) have serious, functionally impairing behavioral problems. We tested whether combined treatment (COMB) with risperidone and parent training (PT) in behavior management is superior to medication alone (MED) in improving severe behavioral problems in children with PDDs., Method: This 24-week, three-site, randomized, parallel-groups clinical trial enrolled 124 children, aged 4 through 13 years, with PDDs, accompanied by frequent tantrums, self-injury, and aggression. The children were randomized 3:2 to COMB (n = 75) or MED (n = 49). The participants received risperidone monotherapy from 0.5 to 3.5 mg/day (with switch to aripiprazole if risperidone was ineffective). Parents in the COMB group (n = 75; 60.5%) received a mean of 10.9 PT sessions. The primary measure of compliance was the Home Situations Questionnaire (HSQ) score., Results: Primary: intent-to-treat random effects regression showed that COMB was superior to MED on HSQ (p = .006) [effect size at week 24 (d) = 0.34]. The HSQ score declined from 4.31 (± 1.67) to 1.23 (± 1.36) for COMB compared with 4.16 (± 1.47) to 1.68 (± 1.36) for MED. Secondary: groups did not differ on Clinical Global Impressions-Improvement scores at endpoint; compared with MED, COMB showed significant reductions on Aberrant Behavior Checklist Irritability (d = 0.48; p = .01), Stereotypic Behavior (d = 0.23; p = .04), and Hyperactivity/Noncompliance subscales (d = 0.55; p = .04). Final risperidone mean dose for MED was 2.26 mg/day (0.071 mg/kg), compared with 1.98 mg/day for COMB (0.066 mg/kg) (p = .04)., Conclusions: Medication plus PT resulted in greater reduction of serious maladaptive behavior than MED in children with PDDs, with a lower risperidone dose.

This article reviews the origins and characteristics of the positive behavior support (PBS) movement and examines those features in the context of the field of applied behavior analysis (ABA). We raise a number of concerns about PBS as an approach to delivery of behavioral services and its impact on how ABA is viewed by those in human services. We also consider the features of PBS that have facilitated its broad dissemination and how ABA might benefit from emulating certain practices of the PBS movement.

Researchers have been placing an increased importance on discovering what variables contribute to better prognosis during behavioral interventions for children with autism. This article preliminarily identifies sleep problems that may exacerbate symptoms of autism; thus, possibly influencing effectiveness of daytime interventions. A data-base of parent report of sleep problems of children with autism (N=55), ranging from 5 to 12 years of age (M=8.2 years) was evaluated. Results suggested that fewer hours of sleep per night predicted overall autism scores and social skills deficits. Similarly, stereotypic behavior was predicted by fewer hours of sleep per night and screaming during the night. Increased sensitivity to environmental stimuli in the bedroom and screaming at night predicted communication problems. Finally, sensitivity to environmental stimuli in the bedroom also predicted fewer developmental sequence disturbances. The results indicate that sleep problems and the diagnostic characteristics of autism may be related. However, future research must be completed to determine the specific relationship.

It is still not universally accepted within the scientific community that the habilitation of autistic children is possible, or that their ability to function without supports in regular education by third, fourth, or fifth grade happens as a direct result of EIBI. However, using the outcome studies that have been reported, the rate of children reaching a best-outcome status appears to be between about 10% and 47%. There is a more global way to look at the effects of EIBI or behavioral intervention. Even if the child retains many characteristics of autism, the usual outcome of treatment is that the child learns useful skills. Behavioral intervention results in effective and efficient learning, which is precisely what it aims to accomplish and what behavioral techniques have been developed to do. Children and families have been able to achieve much more than many would ever have believed before EIBI became a realistic possibility.

Parents of children with autism and pervasive developmental disorder and educational and clinical practitioners providing services to them regularly confront a wide range of service selection and financial decisions that are not as yet effectively addressed by applied research. Relevant systems issues span a very broad range of concerns: (a) systems delivery models and issues (e.g., costs of services, implementation of intensive intervention, and teacher or therapist training); (b) how best to integrate treatments; (c) providing treatment to those with limited monetary resources; (d) cost and cost/benefit analyses; (e) how to educate adult psychiatrists (as well as other practitioners and personnel) regarding autism; and (f) gaps between research and practice.

R. S. Drabman, K. J. Tarnowski, and P. A. Kelly (1987) and K. J. Tarnowski, D. F. Anderson, R. S. Drabman, and P. A. Kelly (1990) examined children's month of birth in relation to referral for psychological services and found that younger children in the classroom were disproportionately referred for services. No differences were found between younger and older students on standardized measures of intelligence or academic achievement. Results of a replication and extension of these studies indicated (a) that younger children in the classroom were referred at a disproportionately higher rate, (b) that the referral pattern could not be explained by differences in children's competencies, (c) that Caucasian students were referred at disproportinately higher rates than minority students, and (d) a trend in which the proportionate referral rate of students as height or weight increased. Results are discussed within the context of teacher expectancies.

Eugenics refers to the investigation of means of social control to improve the mental or physical qualities of future generations. The present study investigated whether the self-reported attitudes toward mental retardation and eugenics of a sample of 572 respondents would vary as a function of (I) severity of the mental retardation attitude referent; and (2) respondent sociodemographic characteristics. Among the respondents, 380 were health and human service providers (66% upper division undergraduate students and 34% graduate level professionals) and 192 were upper division undergraduate students majoring in fields other than health and human services. The results supported these conclusions: (1) psychometric characteristics of the scales used to measure attitudes were adequate; (2) increasing mental retardation severity was related to increasing endorsement of eugenic principles, independent of global attitudes toward people with mental retardation; and (3) respondent education was related to the expression of eugenic attitudes toward mild mental retardation, while familiarity with people with mental retardation was related to the expression of eugenic attitudes toward moderate and profound mental retardation.

Although profound mental retardation is generally associated with various organic etiologies that result in substantial cognitive and behavioral deficits, little is known about specific subgroups of persons with profound mental retardation. This study presents data on the physical, developmental, and behavioral characteristics of a group of 203 nonambulatory persons with profound mental retardation residing within a specialized service setting. The results indicate that nonambulatory persons with profound mental retardation have a high prevalence of physical and medical problems along with high rates of self-injurious, stereotypic, and aggressive behavior. Assessment results from the Stanford-Binet (L-M), Bayley Scales of Infant Development-Mental Scale, and Vineland Adaptive Behavior Scale reveal a high degree of variability in cognitive and adaptive functioning. However, developmental age-equivalent scores of cognitive ability, communication, daily living, socialization, and motor skills for the group fell below the 1-year level. The data illustrate the complexity of needs in providing habilitative services to nonambulatory persons with profound mental retardation.

The relation of staff knowledge of behavioral principles to ratings of treatment acceptability for interventions used in the management of self-injurious behavior (SIB) was examined with 57 direct-care staff members from an ICF/MR. Case descriptions of an adult with severe mental retardation who exhibited SIB were presented, followed by descriptions of six behavioral interventions rated on acceptability. Subjects also completed a 25-item measure of general knowledge of behavioral principles. Results indicated that staff age and educational attainment but not treatment acceptability ratings were significantly related to knowledge scores. Implications of the findings were discussed.

As part of a larger study of the attitudes of diverse samples towards the application of eugenics to the treatment of people with mental retardation, a 32-item summated rating scale was developed as a contemporary, brief, easy to administer and score, and psychometrically sound instrument. Data were collected and analysed that indicated satisfactory item characteristics and reliability, and initial support for the content and construct validities of the scale. Analyses of social desirability data revealed that scale scores were not influenced by the subjects' desire to adhere to socially desirable expectations. The scale should be useful for the investigation of questions concerning the formation, structure and correlates of attitudes toward the application of eugenics to the treatment of people with mental retardation, and the relationship of these attitudes to contemporary mental retardation policies and practices.

Viewed from a behavior analytic perspective as a form of verbal behavior, regulatory rules affect the behavior of service providers in residential programs directly and indirectly; they can facilitate habilitative services or exert a powerful counter-habilitative influence. Because regulations are written to apply to the general case, regulatory rules tend to become decontextualized, often failing to address (a) the needs of individuals and (b) specific environmental circumstances. Ecobehavioral analysis of rule-governed behavior in residential settings can provide a means of understanding and measuring the effects of regulatory rules. Feedback from field settings about the effects of regulatory rules on the behavior of people who live and work in residential settings would help to recontextualize the rule-making process and promote better correspondence between the intended effects of regulations and their actual effects.

The programs on BOAD represent a set of useful simulations and demonstrations of learning phenomena that successfully convey important practical and theoretical information to students. The most successful modules deal with shaping and the selective effect of positive reinforcement on behavior. The range of examples is sufficiently broad to convey the generality of these learning phenomena, but the graphics and particular examples are better suited to the college classroom (for which they were developed and in which they have received extensive field testing) than to the general public, where some users might be distracted by working with simulated animal "subjects" or bored by the simple graphics. There is a separate application on the disk that drills students on behavioral vocabulary, a useful resource for helping to assure that behavioral issues are discussed using consistent terminology. Although a single disk is initialized for a single user so that individual progress can be tracked accurately in printed reports, the cost of a disk is so low that no student who needs to learn about teaching would be discouraged from purchasing it. In truth, this is the best deal in instructional software I have seen yet.

The conflict between those who view aversive therapeutic interventions from an ideological perspective and those who view them from a scientific perspective was examined. Special attention was devoted to the most detailed review of punishment procedures in mental retardation that has been written from an ideological perspective, a monograph published by The Association for Persons With Severe Handicaps (Guess, Helmstetter, Turnbull, & Knowlton, 1986). The monograph was found to suffer from a number of serious conceptual and methodological flaws that militate against accepting its conclusions as bases for research and social policy in mental retardation. The conclusion was drawn that some of those who reject aversive therapeutic interventions do so out of a poor understanding of behavioral science and a primarily ideological frame of reference.

Using a case description methodology, Tarnowski, Rasnake, Mulick, and Kelly (1989) examined the effects of behavior problem severity and intervention type on staff ratings of six behavioral interventions used to treat self-injurious behavior (SIB). Results indicated that accelerative interventions were judged more acceptable than reductive treatments, and acceptability of treatments varied as a function of SIB severity. We hypothesized that judgments of treatment acceptability might vary as a function of specific institutional characteristics and conducted a replication of the previous study in a setting where the institutional treatment philosophy was explicitly behavioral. Results indicated that (a) accelerative interventions were preferred to reductive treatments, (b) acceptability ratings were not significantly influenced by SIB severity, and (c) interventions were generally found to be more acceptable by staff working in a behavioral treatment milieu.

Different levels of influence result in contingencies of reinforcement that can affect the behavior of staff members and residents in facilities for people with mental retardation. Although the intent of any residential facility is surely habilitation, some types of influence result in contingencies of reinforcement that do not promote adaptive behavior by residents, that is, are counter-habilitative. Some of the conceptual issues involved in understanding the operation of these contingencies in complex caregiving environments were discussed. Preliminary data gathered from one highly specialized residential facility were used to illustrate the influence of social, ecological, and regulatory contingencies that could have a counter-habilitative impact on residents. We concluded that a close examination of all levels of influence affecting institutions, their staff, and residents will be necessary if better progress is to be made towards adequately serving the needs of people who live in institutional settings.

The present study combined a multiple category observational data system with a correlational analysis in order to test the value of such a combination as an ecobehavioral assessment instrument and determine whether this package would reveal relationships both between and within the behavioral repetoires of several children. Four severely and profoundly mentally retarded children between the ages of 9 and 12 years were observed in their self-contained special education classroom, and the teacher collected the data over a 20-day period using an interval recording system. Bivariate correlational analysis of the 38 observed categories with the school-day as the unit of analysis revealed significant relationships both between and within children. Two children showed a pattern of relationships in which social interaction in either child was associated with maladaptive behavior in the other, and another child's destructive and self-injurious behaviors were positively associated with his noncompliance. Patterns of related child behaviors suggested ways in which they may have been affected by the behavior of adults in the classroom. The value of such an instrument for ecological assessment is discussed.

Test-retest reliabilities of the Revised Children's Manifest Anxiety Scale over 1- and 5-wk. intervals were examined for two samples of students, 73 boys and 88 girls in regular sixth, seventh and eighth grade classrooms (11 yr. to 14 yr.). For raw scores the test-retest Pearson r was .88 (1-wk.) and .77 (5-wk.), indicating good reliability. For both samples there was a small difference between test (12.2 for 1-wk. sample; 11.4 for 5-wk. sample) and retest (11.2 for 1-wk. sample; 9.8 for 5-wk. sample) mean raw scores. Implications for test use are discussed.

An experimental analysis of a case of chronic ruminative vomiting in a 15-year-old, profoundly retarded, Down's syndrome boy addressed the consequences of vomiting in the postmealtime environment. The experiment compared four treatments in each hour-long session using a multiple reinforcement schedule with order of the following procedures counterbalanced over days in a Latin square design: differential reinforcement of any behaviors other than vomiting (DRO) in which periods of no vomiting were followed by reinforcement and vomiting postponed reinforcement; differential reinforcement of specific behaviors alternative to vomiting (DRI) in which conjoint periods of no vomiting and sustained toy play were followed by reinforcement and the lack of either postponed reinforcement; extinction plus reinforcement of alternative behavior in which vomiting was ignored but toy play was reinforced; extinction in which vomiting was ignored. Data revealed an orderly dual cyclical pattern of vomiting throughout the day, with increased vomiting in the morning and immediately following food ingestion. Postluncheon treatments emphasizing reinforcement of alternative behavior were more successful in decreasing vomiting than DRO or extinction alone.

Three profoundly retarded adults were observed in an experimental daycare program when they were not wearing self-protective restraints and when they were wearing them to prevent pica and rectal digging. The noncontingently applied devices did eliminate the target behaviors, but they also decreased social interactions between the subjects and their caretakers. A camisole was found to be even more restrictive than a fencing mask.

The prevalence of multiple classes of stereotypic behavior was assessed in a large sample of nonambulatory profoundly mentally retarded people. Implications for programming efforts were discussed.

This paper reports the effects of several environmental variables on the management and maintenance of a treatment program for self-injurious behavior (SIB) in residents in a state facility for retarded persons. Fifteen of the clients who participated in a developmental day-care program were compared across the final four months of the program and then at follow-up two years later. Twelve additional clients who were treated in the overall SIB program did not receive the day-care component, but were included in the follow-up study. Regarding program management, the effects of time, staff-initiated interactions, the presence of a newcomer or disruptive client, and medication changes on the behaviors of the 15 clients in the day-care program were assessed from an ecobehavioral approach. Participants in the follow-up study were compared with respect to the type of SIB program they received, the staff-patient ratio in their program, their visual impairment, use of self-protective devices, presence of stimulating material, and time-of-day observed. These issues are discussed in relation to program maintenance.

Behavioral observations were conducted on 40 children admitted consecutively to an inpatient pediatric burn care unit (PBCU) over a 6-month period. Children's responses to the PBCU environment as well as adult responses to patients were assessed. Data indicated that children most frequently (a) were oriented and alert, (b) emitted vocalizations or verbalizations, (c) were environmentally engaged, (d) and demonstrated positive or neutral affective responding. Adult-child interactions occurred during the majority of observations. Age was found to be significantly related to the type of distress response exhibited. Positive responses indicative of patient well-being were found to be associated with environmental engagement and the presence of other patients. In general, little evidence emerged to support the notion of a PBCU response pattern which resembles that observed in pediatric intensive care units (i.e., ICU syndrome). The use of observational methods for studying the behavioral adaptation of children in medical settings and the implications of the data for the design of interventions on PBCUs are discussed.

The effect of dexamethasone phosphate (DEX) administered in rats' drinking water on running activity and open field behavior was investigated. In Experiment 1 males were given DEX continuously from either five days or one day prior to and throughout testing. Only 5 day treatment significantly increased running wheel activity. DEX had no significant effect on males' 4 day open field activity, but significantly reduced open field and home cage defecation. In Experiment 2 females given DEX defecated significantly more in the open field than controls. This effect on females does not appear to be due to a general metabolic change, since DEX females, like males, defecated significantly less than controls in the home cage. Females' open field activity was not significantly affected. Weight loss and plasma corticosterone analysis confirmed the effectiveness of the dosage used. There appears to be a sex difference in the effects of DEX on open field defecation, possibly due to interaction with gonadal hormones.

In Experiment I, (a) extinction, (b) extinction plus reinforcement of a discrete alternative response, and (c) differential reinforcement of other behavior were each correlated with a different stimulus in a three-component multiple schedule. The alternative-response procedure more rapidly and completely suppressed behavior than did differential reinforcement of other behavior. Differential reinforcement of other behavior was slightly more effective than extinction alone. In Experiment II, reinforcement of specific alternative behavior during extinction and differential reinforcement of other behavior were used in two components, while one component continued to provide reinforcement for the original response. Once again, the alternative-response procedure was most effective in reducing responding as long as it remained in effect. However, the responding partially recovered when reinforcement for competing behavior was discontinued. In general, responding was less readily reduced by differential reinforcement of other behavior than by the specific alternative-response procedure.

Using a case description methodology, we examined the effects of behavior problem severity, intervention type (accelerative vs. reductive), client status (child vs. adult), and type of work setting (child vs. adult unit) on staff members' acceptability ratings of six behavioral interventions used to treat self-injurious behavior (SIB). Results indicated that (a) accelerative interventions were rated more acceptable than reductive treatments, (b) acceptability of treatments varied as a function of SIB severity, and (c) client status and type of work setting failed to significantly influence acceptability ratings. Findings were discussed in the context of the current controversy surrounding the use of aversive treatments. The implications of the results for the design of institutionally based behavioral intervention programs were examined.

Starin and Fuqua seriously misread a critical study cited in their recent review in failing to characterize it as an experimental analysis of four treatment procedures, and therefore inappropriately criticized it for several shortcomings. This misreading and a tendency to equate vomiting with and without rumination compromise their conclusions regarding treatment choice. At the present time, the data base favors selection of several aversive procedures and the nonaversive satiation procedure over others, but the number of studies on nonaversive operant treatment procedures remains remarkably limited.

An updated version of a 9-item questionnaire concerning misconceptions about mental retardation originally developed by Winthrop and Taylor (1956) was administered to a total of 558 individuals from heterogenous samples. The relations of the demographic, experimental, and contact characteristics of the respondents in the 1986 sample to their misconceptions score were explored as were differences in the distributions of the percentages of endorsements of the nine misconceptions for the samples in 1956 and 1986.

The paper is a theoretical analysis of the evolution of the concepts related primarily to the definition and to the antecedents of self-injurious behavior (SIB). It was found that the definition of SIB as currently used contains surplus meanings unrelated to its scientific utility. At present, a restricted definition of SIB is not warranted because its basic parameters have not been studied adequately. Analysis of SIB taxonomies suggests two subclasses of SIB: social and nonsocial. Epidemiological studies of SIB suggest chronic and acute subsamples that differ in organicity, chronicity, and length of institutionalization. Ecological analysis suggests that a variety of antecedent conditions affect rates and topographies of SIB, e.g., ambient environmental conditions, background settings, situational demands, self-restraint, and type of daily routine activity. Implications were drawn for the organization of therapeutic environments, the study of covariation among collateral topographies, the dynamics of SIB responding, and sequential dependencies among SIB and related topographies.