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| #84 Poster Session - CBM |
| Saturday, May 28, 2005 |
| 5:30 PM–7:00 PM |
| Southwest Exhibit Hall (Lower Level) |
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| 34. A Parent Survey of Medication Acceptance Among Children |
| Area: CBM; Domain: Service Delivery |
| JODI A. POLAHA (University of Nebraska Medical Center), Connie Schnoes (University of Nebraska, Lincoln) |
| Abstract: The effectiveness of behavioral protocols for rapidly training children to swallow pills is well-documented. Such training can preempt parent-child conflict and improve adherence to medical regimen, however, these protocols are not used widely. The present study investigates the need for such training by surveying parents about their children’s pill-swallowing and their interest in teaching this skill. Three hundred surveys were collected from parents responding about 702 children total (mean age of eight years). Five percent were described as having a disability and 8% as having a chronic illness. Results showed 40% of parents stated their child has refused to accept liquid medication and 28% stated their child has refused to accept a pill. Young children were estimated to have the most difficulty, but even among children 11 years and older, 27% stated they would have some difficulty with a Tylenol-sized capsule. Parents expressed modest interest in programming to teach this skill. It is noteworthy that 21% of the parents stated that at least one adult in the home had difficulty swallowing pills. These data are the first to offer normative information. Additional data, analyses, and comparisons will be offered. Implications for practice in pediatric and primary care settings will be described. |
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| 35. Parent as Coach: Enhancing Sports Participation and Social Behavior for ADHD-Diagnosed Children |
| Area: CBM; Domain: Service Delivery |
| DAVID REITMAN (Nova Southeastern University), Patrick M. O'Callaghan (University of Nebraska Health Sciences Center), Patrick Mitchell (Argosy University), Kyle W. Boerke (Nova Southeastern University) |
| Abstract: Many children diagnosed with Attention-Deficit/Hyperactivity Disorder experience difficulties in social relations. While psychosocial approaches based on a combination of skills training and contingency management approaches do appear to improve social behavior, evidence that these benefits generalize and persist following training has been limited. We describe a social skills training program designed to help parents promote the display of appropriate social behavior and better athletic performance in sports settings. The program consists of standard psychological assessment, behavioral parent training, functional assessment, parent-mediated social and sports skills coaching, and generalization and maintenance programming. The goals of this intervention are to promote retention of the child in team sports and facilitate friendship acquisition. Training parents to effectively coach their children in sports-related social skills may prove useful in promoting the maintenance and generalization of skills as well as preventing some of the negative effects of social isolation that frequently accompany an ADHD diagnosis. Case study data are used to illustrate the approach. |
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| 36. Correlation Between The Home Situation Questionnaire (HSQ) and Direct Observation of Child Noncompliance |
| Area: CBM; Domain: Service Delivery |
| SUSAN K. PERKINS-PARKS (Kennedy Krieger Institute), Amy L. Palmer (Kennedy Krieger Institute), Tracey Horn (Kennedy Krieger Institute), Kristina Gilbert (Kennedy Krieger Institute), Greg Everett (Kennedy Krieger Institute), Purva Rawal (Kennedy Krieger Institute), Greg Selke (Kennedy Krieger Institute), Katia Jones (Kennedy Krieger Institute) |
| Abstract: The HSQ provides a situational profile helpful in designing contingency management interventions during parent training (Barkley & Edelbrock, 1987). It’s greatest utility has been shown where assessment of oppositional or aggressive behavior is targeted. (Barkley, 1990). Severity ratings of noncompliance measured by the HSQ and direct observation of child noncompliance using functional analysis methodology has not been explored. Results of a preliminary comparison of HSQ and direct observation of child noncompliance for children with externalizing behavior disorders are presented. Subjects were typically developing preschoolers from 4 years through 5 years, 6 months of age referred to a parent training program for assessment and treatment of problem behavior. Data were gathered via a behavioral assessment inclusive of the HSQ and direct observation of parent-child interactions across demand condition, using parents as therapists. A total of two (demand) analog sessions were conducted for each participant, all of which were 5 or 10 minutes in duration. Target behaviors including disruptions and noncompliance were observed through a one-way mirror and data were collected via lap top computers. Interobserver reliability will be calculated for 33% of sessions. Data collection is on-going, but to date shows a strong positive correlation between the HSQ and child noncompliance. |
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| 37. You Want Me to What? Role-Play or Modeling for Parent Training |
| Area: CBM; Domain: Applied Research |
| JAMES H. BOSCOE (Kennedy Krieger Institute), Tina Sidener (Kennedy Krieger Institute), Charles S. Gulotta (Kennedy Krieger Institute), Peter Girolami (Kennedy Krieger Institute) |
| Abstract: Consistent implementation of a behavioral protocol is critical to the success of a behavioral intervention (Allen & Warzak, 2000). Component analysis of parent training procedures has shown that minimal interventions can result in high treatment integrity (Mueller et al., 2003). This study compared two parent-training procedures used in the Kennedy Krieger Pediatric Feeding Disorders program; role-play outside of treatment and an alternating feeder design in treatment sessions with the identified patient. All caregivers were provided written and verbal instruction regarding treatment implementation and were allowed to feed three treatment sessions. If the caregiver did not reach 80% integrity by the third session an additional intervention was implemented for training purposes: condition one; role-play between sessions condition two; an alternating feeder design. Data were collected on the parent's implementation and the child’s behavior to compare differences in the training procedures. Initial results suggest little difference in the efficacy between the two procedures. Implications for training caregivers in behavioral techniques will be discussed. |
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| 38. Errorless Compliance Training: Assessing Generalization During Implementation |
| Area: CBM; Domain: Service Delivery |
| REBECCA K. ARVANS-FEENEY (Western Michigan University), Scott T. Gaynor (Western Michigan University) |
| Abstract: Child noncompliance is the most commonly presented complaint at child treatment clinics. Ducharme and colleagues developed errorless compliance training, a parent training technique based on stimulus fading technology that does not incorporate disciplinary procedures. The available data suggest errorless compliance training is a promising approach. The current study offers the possibility of an independent replication of error compliance training procedures. In addition, the current study addresses whether, while training at the lower levels of compliance, the overall level of compliance at higher levels increases without direct training, information which could be used to implement errorless compliance training in a more streamlined and efficient manner. Mothers and/or fathers with children 3 to 10 years of age reporting child noncompliance will be recruited for participation and offered errorless compliance training. The poster will provide a detailed description of the study rationale along with preliminary data. |
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| 39. Generalizing Treatment from Therapists to Parents: A Case Study of a 3-year-old Girl with G-tube Dependence |
| Area: CBM; Domain: Applied Research |
| ALYSIA PALMISCIANO (Kennedy Krieger Institute), Charles S. Gulotta (Kennedy Krieger Institute), Kelli Wheeler (Kennedy Krieger Institute) |
| Abstract: This case study examined the difficulty of generalizing a successful treatment package for a 3-year-old girl with G-tube dependence to the child’s mother. Upon admission, the child was receiving 100% of her caloric needs via G-tube feedings. With therapists feeding, treatment consisting of escape extinction (non-removal of the spoon) and a DRA for swallowing, her acceptance and swallowing increased to over 80% while her food refusal behaviors decreased to near zero levels. The mother was trained to implement the protocol and faded into the meals. Subsequent to the mother’s implementation of the behavior protocol, acceptance decreased and food refusal behaviors increased. After multiple treatment modifications (e.g., reinforcement, punishment, and response effort), the child never achieved a stable pattern of responding that she previously demonstrated when therapists fed. Variables impacting the transition from therapist to parent will be discussed. Follow-up information regarding mealtime behavior after discharge will also be presented. Interobserver reliability was collected for approximately 35% of the sessions and agreement was greater than 80% across all phases. |
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| 40. Parent Acceptability of Various Treatments Used in the Treatment of Pediatric Feeding Disorders |
| Area: CBM; Domain: Service Delivery |
| ANNMARIE MARANDO (St. Joseph's Children's Hospital), Merrill J. Berkowitz (St. Joseph's Children's Hospital), Paula Tokar (St. Joseph's Children's Hospital), Jaymie Mooers (St. Joseph's Children's Hospital), Veronica Armellino (St. Joseph's Children's Hospital) |
| Abstract: The etiology of pediatric feeding disorders is often the result of poor gastrointestinal physiology, deficits in oral-motor skills and a lack of exposure to a variety of foods and textures. The treatment of children exhibiting feeding difficulties is typically provided via multidisciplinary teams. The field of behavioral psychology has provided a variety of interventions that have been shown to be effective in increasing the exposure and consumption of a variety of foods and textures to children with feeding difficulties (e.g., Babbitt, Hoch, and Coe, 1994). Treatment acceptability may be a factor in predicting caregiver integrity. (Sterling-Turner & Watson, 2002). The current study examines parents’ ratings of acceptability toward a variety of treatment procedures related to pediatric feeding disorders across three disciplines (medical, speech pathology, and behavior psychology). Parents of children who participated in an intensive day treatment program for the assessment and treatment of pediatric feeding disorders participated in the study. The parents were asked to rate each of the interventions implemented during their child’s admission using a questionnaire similar to the Intervention Rating Profile (Witt & Martens, 1983). The results and their implications will be discussed. Directions for future research will also be provided. |
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| 41. A Component Analysis of Nondirective Play Therapy |
| Area: CBM; Domain: Applied Research |
| KEITH M. WILSON (Eastern Illinois University), Jessica Beckett (Eastern Illinois University), Kevin M. Jones (Miami University of Ohio), Heather Sawyer (Eastern Illinois University), Jane E. Wilson (Sexual Assault Counseling and Information Service) |
| Abstract: A component analysis of therapist attention was conducted in the context of nondirective play therapy. The participant was a developmentally normal 7 year old female with a history of physical and sexual abuse. Assessment utilized a multi-element design that isolated noncontingent therapist attention as an effective component of nondirective play therapy. Implications for further analysis of nondirective play therapy are discussed. |
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| 42. Antecedent Influences on Adolescent Compliance in a Residential Treatment Setting |
| Area: CBM; Domain: Applied Research |
| SEAN T. SMITHAM (Girls and Boys Town), Michael I. Axelrod (Girls and Boys Town) |
| Abstract: In the last decade, there has been increasing focus on the influence of antecedent events on problematic behavior. Much of this research has been limited to specific populations such as individuals with autism, individuals with pervasive developmental disorders, and individuals identified as developmentally delayed. To date, little applied research has examined the influence of antecedent events on typically developing populations. The current study utilized a single-case, multiple baseline across settings design. Antecedent events were manipulated across settings as a clinical intervention for typically developing adolescents residing in a residential treatment program. Results are discussed in the context of utilizing conceptual analysis of antecedent events to inform clinical decisions and expand the range of possible interventions for typically developing children and adolescents displaying disruptive or non-compliant behaviors. |
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| 43. Medication Compliance of Adults with a Mental Illness |
| Area: CBM; Domain: Applied Research |
| LINDSY J. BEDNAR (St. Cloud State University) |
| Abstract: Medication compliance is important for everyone who is prescribed medications; especially for those diagnosed with a mental illness. This study focused on three adults diagnosed with a mental illness, living together in a group home. Medication compliance was defined as the participant requesting their medications within ten minutes of the prescribed times. A wristwatch equipped with an alarm was used as a simple auditory prompt. When the alarm sounded this was a prompt to the participants to request their prescribed medications from a staff member. Participants were able to request their medications ten minutes before or after the alarm sounded. Staff members then observed the time that the medication was requested and recorded a "+" or "-" to signify if the participant was within the allotted time or not. The results for all three participants showed improvement in medication compliance. |
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| 44. School Based Behavioral Health Teams Treating Children with Emotional And Behavioral Disorders: Replication, Extentsion and Comparision of the First and Second Year |
| Area: CBM; Domain: Applied Research |
| ILEANA HELWIG (Children Crisis Treatment Center), Nadine Harrington (Children Crisis Treatment Center), Joseph D. Cautilli (Children Crisis Treatment Center), Lamar Murray (Children Crisis Treatment Center) |
| Abstract: School based behavioral health program attempts to keep children in the least restrictive environment by providing services through a behavioral health team. The team consists of 7 bachelor level and three master level person. Each team provides behavioral support to 22 children. The staff conducts functional behavioral assessment, consults to teachers, write behavioral intervention plans, and provides direct support and de-escalation as needed. In the first year of the program, we found that 71% of the children made clinically significant reliable change in the first six months of the program. This paper reviews the second year data and contrasts it with the first year data. |
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| 45. Follow-Up Study of Former Students of the Judge Rotenberg Center |
| Area: CBM; Domain: Applied Research |
| STEPHEN A. WONG (Judge Rotenberg Educational Center), Andre Vlok (Judge Rotenberg Educational Center), Robert Von Heyn (Judge Rotenberg Educational Center), Matthew L. Israel (Judge Rotenberg Educational Center), Joseph Assalone (Judge Rotenberg Educational Center), Rosemary Silva (Judge Rotenberg Educational Center) |
| Abstract: Examining post-treatment outcomes of residential care clients remains an important aspect in assessing the long-term durability of treatment that clients receive while in the care of a facility and the generalizability of treatment effects to natural environments. This study represents the third year of an ongoing investigation of the post-treatment outcomes of former students of the Judge Rotenberg Center (JRC), a residential care facility that employs a highly consistent application of behavioral treatment and educational programming for children and adults with severe behavior problems, including conduct disorders, emotional problems, brain injury or psychosis, autism and developmental disabilities. The period of time during which the students in this study had been out of the JRC environment ranged from several months to several years. The measures employed included both objective measures of quality of life and subjective measures of life adjustment. Additionally, the post-treatment outcomes of students that received different treatments (either “positive-only behavioral programming” or “positive-only with supplementary contingent skin shock”) will be compared. It is anticipated that data for approximately 50 former students will be included in this study. |
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| 46. A Brief Behavioral Assessment for Children with ADHD: Assessment of Delay, Recruitment and Correspondence |
| Area: CBM; Domain: Service Delivery |
| BRENDA J. ENGEBRETSON (University of Iowa), John A. Northup (University of Iowa), Jason M. Stricker (University of Iowa), Terry S. Falcomata (University of Iowa), Kelly M. Vinquist (University of Iowa), Amanda J. Hornaday (University of Iowa), Brigitte M. Johnson (University of Iowa) |
| Abstract: Treatments to teach children to delay (wait), to recruit naturally available reinforcement, and to correspond (say-do) have demonstrated promise for reducing problem behaviors associated with ADHD. We developed a brief assessment to simultaneously evaluate each of these critical classroom skills.Children were seated with an academic worksheet and told “I need you sit in your seat and work quietly. Raise your hand and wait if you need anything." The child was also asked "tell me how many problems you are going to do while waiting." A session ended when the child got out of their seat or vocalized (or at 5-min). Measures were a) seconds until the child vocalized or got out of their seat, b) number of times they raised their hand and latency to vocalizing and c) correspondence for number of problems completed. Assessment showed that two participants were unable to delay or recruit but both demonstrated frequent correspondence. One participant showed ability to delay and correspond, but he did not recruit. A final participant demonstrated an ability to delay, but did not recruit or demonstrate correspondence. Results indicated that the assessment was efficient and useful for the development of subsequent individualized interventions. |
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| 47. It's All Fun and Games Until Someone Gets Hurt: An Evaluation of a Treatment Package to Promote Safe Play on School Playground Equipment |
| Area: CBM; Domain: Applied Research |
| KIMBERLY SECKINGER (Western Michigan University), R. Wayne Fuqua (Western Michigan University), Nancy J. Lindahl (Kalamazoo Advantage Academy), Michael A. Vreeland (Kalamazoo Advantage Academy), Geoffrey D. DeBery (Western Michigan University) |
| Abstract: Childhood unintentional injuries (“accidents”) constitute one of the most pervasive health threats to children. Each year, over 200,000 people receive emergency room care for injuries sustained on recreational equipment. The vast majority of these injuries involve children under the age of 15 who have been hurt on school playground equipment. Many person- and environment-oriented prevention programs have been employed to reduce the occurrence of playground related injuries. To date, only a single empirical study has been conducted applying behavioral technology to decrease children’s risky behaviors on playground equipment (Heck, Collins, & Peterson, 2001). The purpose of this study was to replicate and extend the previous research on playground safety. We tested the effectiveness of an injury prevention package, consisting of education, peer feedback, and group contingencies, on children’s risk-taking behaviors on school playground equipment. |
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