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Treatment for Eye Rubbing and Avoidance of Medical Treatments |
Thursday, November 29, 2001 |
4:00 PM–4:50 PM |
Council Hall |
Area: DDA |
Chair: Anthony DeCasper (University of North Carolina) |
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Escape-Motivated Problem Behavior in the Medical and Dental Setting: A Multicomponent Intervention |
Domain: Applied Behavior Analysis |
JANE I. CARLSON (Virginia Commonwealth University), Edward Carr (SUNY at Stony Brook) |
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Abstract: Behavioral difficulties during medical/dental examinations are a significant barrier to the provision of adequate healthcare services to people with developmental disabilities. Two-process theory and the role of personal control in the development of fear offer logical theoretical bases for the development and maintenance of problem behavior in the medical/dental setting. The present study evaluated a multicomponent intervention for escape-motivated problem behavior during general medical and dental examinations. The first phase of the study involved the use of direct observation and interview with relevant staff to validate that escape was the motivating factor in the maintenance of problem behavior during medical/dental examinations. The second and third phases involved two multiple baseline studies, each across three participants. The second phase was conducted in a general medical examination setting and the third, in a dental setting. The purpose of these phases was to evaluate a multicomponent intervention protocol designed to ameliorate the conditioned negative responses (problem behavior) that participants displayed when presented with specific aversive stimuli in medical/dental settings. Results showed that the multicomponent intervention was effective in increasing both the latency to problem behavior and the number of examination steps completed without problem behavior during both medical and dental examinations. Issues pertaining to respondent processes, cost effectiveness, and medical risk reduction are discussed. |
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Treatment of Chronic Eye-Rubbing Using Behavioral Contracting |
Domain: Applied Behavior Analysis |
SCOTT S. HALL (University of Birmingham, England), Sunny Kalsy (University of Birmingham, England) |
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Abstract: In addition to contingency management procedures, verbal stimuli can also be used to directly alter the probability of problem behaviors. In this single case study, the treatment of chronic eye-rubbing shown by a verbal autistic man was investigated using behavioral contracting. The man was observed in his classroom at college with all behaviors being recorded onto a palm-top computer. (Inter-observer reliability was good). In brief analogue conditions, eye rubbing occurred at persistently high levels during close social interaction conditions and occurred at low levels during alone conditions. Weekly contracts were devised in which the client agreed to spend longer periods of time without eye-rubbing in exchange for periods working alone. Contracting produced significant reductions in eye rubbing without producing a significant increase in self-restraint behaviors (i.e., clasping of the hands). The results are discussed in terms of the influence of rules, instructions and self-control versus contingency management procedures on problem behaviors. |
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