Individuals with intellectual disability (ID) often experience barriers accessing appropriate and effective healthcare. Our specialty program was established to provide interdisciplinary services ...across the continuum of care to patients with ID, co-morbid mental illness, and challenging behaviors by identifying the etiology of challenging behaviors and creating a comprehensive plan for treatment. We describe the structure of our inpatient specialty unit and a retrospective chart review completed to evaluate the combined impact on the prevalence of challenging behaviors as measured by the Aberrant Behaviors Checklist (ABC) and polypharmacy. Fifty-five patients were evaluated before and one month following 72 corresponding hospitalizations. Mean ABC scores improved from 69.5 to 54.7 (p=.02) with decreases in subscales for irritability, lethargy, hyperactivity, and inappropriate speech but not stereotypy. Total psychotropic medication use was reduced from a mean of 4.9 to 3.8 medications (p<.001). Our specialized interdisciplinary treatment approach appears to benefit many patients with complex needs.
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CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Research has shown that differential reinforcement of alternative behavior (DRA) can be an effective intervention to address problem behavior maintained by negative reinforcement emitted by young ...children. However, few studies have evaluated the variables that are related to long‐term maintenance (i.e., persistence) of treatment effects. Research on behavioral persistence predicts that the rate of reinforcement provided for a target behavior is correlated with its persistence when challenged. There were 2 purposes of the current investigation. First, we evaluated the effects of the rate of negative reinforcement on the persistence of task completion. Second, we applied the findings regarding rate of reinforcement to a treatment context for 3 participants who engaged in destructive behavior that was reinforced by escape from demands. Results were evaluated within a multielement design and indicated that the rate of negative reinforcement had a moderate influence on the persistence of task completion. These results contribute to the existing literature by extending analyses of persistence to treatment contexts.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Previous research has documented the effects of prompting mands at a relatively high rate (i.e., rich schedule) or low rate (i.e., lean schedule). These previous studies have not addressed the ...possibility of prompt dependency as an explanation for these results. Furthermore, the implications of a collateral effect of prompt density, increased response-reinforcer pairings, have not been investigated. The current studies sought to address these two questions. During Experiment 1, the effect of prompt density (i.e., high and low prompt rate) on manding was evaluated. The inclusion of a control condition (i.e., prompts in the absence of the relevant establishing operation and reinforcement) isolated the effect of prompts on manding. During Experiment 2, a collateral effect of relatively high prompt density, increased reinforcer rate, on response persistence was evaluated. Results showed that manding rates varied with prompt rate and did not appear to be prompt dependent. Finally, mands persisted longer following a relatively rich prompt schedule than a relatively lean prompt schedule.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Some researchers have reported difficulties in identifying preferred items for individuals with severe intellectual and physical disabilities (SIPD), in part because these individuals often do not ...possess the motor skills needed to select and manipulate the items included within the assessments. The purpose of the current study was to address three research questions: a). Would differences in preference patterns occur between assessments that required an individual with SIPD to perform a motor response that was difficult for them to emit versus assessments that used an augmentative device (i.e., press a large microswitch) to activate the toy? b). Would teaching the specific skills needed to activate a toy result in an increase in toy engagement during preference assessment probes? and c) Would teaching the participant a motor response to directly activate the toy result in a shift in preference? Data were collected within a multielement (across conditions) design. The results of this study showed that (a) differences in preference patterns were observed when different motor responses were required to show preference between items, (b) acquisition of specific motor skills to activate a toy resulted in an increase in toy engagement during preference assessment probes that required direct toy manipulation, and (c) acquisition of motor skills also resulted in a shift in preference towards directly manipulating items versus activating items via microswitches.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
This bridge study evaluated the effects of contingency‐specifying instructions (CSIs) and incomplete instructions (IIs) in terms of establishing instructional control of appropriate behavior. Results ...suggested that instructional control and maintenance were achieved with CSIs but not with IIs. Results are discussed in terms of the potential use of instructional control in the maintenance of appropriate behavior for children with attention deficit hyperactivity disorder.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
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