We investigated the validity of the Questions About Behavioral Function (QABF), a checklist designed to assess antecedent behavior, using a sample of 398 persons with mental retardation and a targeted maladaptive behavior of self-injurious behavior, aggression, or stereotypies. The QABF was used successfully to derive clear behavioral functions for most individuals (84%) across all three target behaviors. Further, subjects with treatments developed from functional assessment (QABF results) improved significantly when compared to controls receiving standard treatments not based on functional analysis. Implications of the present findings for assessing and treating maladaptive behaviors are discussed.
In this study, we investigated differences in social skills among four groups of individuals with severe and profound learning disabilities. The comparison groups were composed of individuals engaging in self-injurious behavior, aggression, both behaviors, or neither of the behaviors. We measured social skills using the Matson Evaluation of Social Skills for Individuals with Severe Retardation, a standardized assessment of social skills in persons with severe or profound learning disability. The results indicated that individuals displaying maladaptive behaviors exhibited a restricted range of social behaviors compared to controls. Also, group membership based on self-injury and aggression was predicted based on profiles of scores on the Matson Evaluation of Social Skills for Individuals with Severe Retardation. These findings are consistent with reports in other studies that note social skills deficits in aggressive and self-injurious persons with learning disabilities. However, in this case a standardized assessment of these deficits was possible and specific skills problems were identified. Implications of the findings for identification and treatment of self-injury and aggression are discussed. Copyright (C) 1999 Elsevier Science Ltd.
Fifty-seven individuals with severe and profound mental retardation (18 with a DSM-IV diagnosis of depression, 19 with a Diagnostic Statistical Manual, 4th edition diagnosis of autism, and 20 who meet no criteria for an emotional disorder) were studied. The validity of the Diagnostic Assessment for the Severely Handicapped 11 depression subscale was evaluated to determine its value in categorizing individuals in these two groups. Suggestions were made for diagnosing depression in persons with severe and profound mental retardation. In a second study the above individuals were compared on symptomology to assess comorbidity with related symptoms. These 'core,' peripheral, or associated features of depression were identified. Implications of the findings for describing and defining depression in these persons are discussed.
We examined the functions of five severe problem behaviors in a sample of 417 institutionalized persons with mental retardation by using the Questions About Behavior Function Scale. The behaviors we examined included self-injurious behavior, aggression, stereotypies, pica, and rumination. The most common function for all behaviors except aggression was nonsocial. Aggression, however, was maintained by external environmental contingencies. Particular items of the Questions About Behavior Function Scale were identified as more frequently occurring and critical in ascertaining behavioral function. Implications of these results for developing more effective treatment plans are discussed.
In this study, we examined the conditions necessary to construct appropriate sentences in three autistic students using computer-based training and testing procedure. In Experiment 1, when a picture was presented on the computer display as a sample stimulus, the student was required to construct an appropriate sentence with five words. After training with three stimuli, each student could construct the correct sentence for 24 untrained stimuli. Appropriate vocal responses also emerged. In Experiment 2, the appropriate use of particles, which specify the subject and the object, was acquired by particle choice or sentence construction training. The rule was transferred to untrained stimuli and writing response. These results are discussed in terms of applicability of computer-based training for establishing appropriate sequential responding and particle usage in autistic students.
This paper reports on the development, psychometric properties, and validity of a self-report measure designed to assess potential stressors among staff in services for people with intellectual disabilities, the 33- item Staff Stressor Questionnaire (SSQ). A questionnaire including the SSQ and scales measuring staff outcomes was administered to 512 staff across seven services for people with intellectual disabilities. The SSQ was factor analyzed to produce seven subscales reflecting different potential stressors for staff: user challenging behavior; poor user skills; lack of staff support; lack of resources; low-status job; bureaucracy; and work-home conflict. The SSQ subscales showed adequate internal reliability in terms of Cronbach's alpha and mean inter-item correlations. Associations between SSQ subscale scores and different staff groups, and patterns of associations between SSQ subscales and a range of staff outcomes, provided evidence suggestive of the face-, construct-, and criterion-related validity of the questionnaire. The SSQ shows promise as a measure for assessing potential stressors for staff in services for people with intellectual disabilities. Further studies to examine the reliability, validity, and utility of the SSQ are recommended.
Deficits in appropriate play have been widely documented among children with developmental disabilities. However, there has been little research on the development of play or the relation between play and adaptive behavior in such children. The present study involved a longitudinal assessment of play and adaptive behavior among 13 preschool children with developmental disabilities. Children were assessed every 6 months over a 3-year period. Assessments included standardized ratings of adaptive behavior and videotape observations during unstructured free-play times in the preschool classroom. Adaptive behavior increased by almost one standard deviation from the first to the last round of data collection. Appropriate play was observed during approximately 20% of each 30-min observation and showed little overall change over 3 years of study. Observed play was primarily functional (57%) and exploratory (28%) with less constructive (5%) and pretend (10%) play. Adaptive behavior scores were not consistently correlated with the amount or type of play. The results suggest little overall relation between appropriate play and other major domains of adaptive behavior. Implications for play- based assessment and intervention in early childhood special education are discussed.
Functional analysis procedures have been demonstrated to be effective for identifying the operant mechanisms underlying problem behavior. However, functional analyses sometimes yield results that are undifferentiated (i.e., show similar levels of responding across test conditions). Within-session (i.e., minute-by-minute) analyses of response patterns during undifferentiated functional analyses have proven useful in clarifying behavioral function. This study extends previous research by examining within-session changes in responding associated with variations in relevant establishing operations. Levels of problem behavior during the presentation and removal of reinforcement were compared when responding occurred in test conditions associated with sources of social reinforcement (i.e., access to attention, materials, escape). Results showed that changes in responding associated with changes in relevant establishing operations could be examined to clarify behavioral function.
Naltrexone (NLTX), an opiate receptor antagonist, has been prescribed as a pharmacological intervention for the treatment of self-injurious behavior (SIB). Previous research has investigated NLTX's effects in the absence of information about the role of environmental events related to SIB. This study extended previous analyses by administering NLTX on analog baselines using a double-blind, placebo-controlled reversal design. Pretreatment functional analysis results showed that the SIB of the two participants occurred in more that one assessment condition. For one participant NLTX produced slight reductions in SIB across baseline conditions. The second participant's results showed that NLTX reduced head-slapping occurring during demand sessions, but had no apparent effect on head-banging occurring during alone and demand sessions. These outcomes suggest that NLTX may have function- and/or response-specific treatment effects. The potential utility of this model as a general method for assessing pharmacological interventions, as well as other implications and limitations, are discussed.
Demographic and behavioral correlates of the use of restraint were analyzed in an institutional population of 300 persons with developmental disabilities. Examination of the frequency distributions of restraint frequency and duration indicated that there were 33 consumers who experiences relatively few, short-duration restraint and 11 consumers who had daily restraint for many hours. Separate analyses of these two kinds of restraint were performed. Short-duration restraint was predicted by behavioral variables indicating extra-personal maladaptive behaviors. Demographic variables did not predict short-term restraint. Multiple regression analysis indicated that only independent predictor of short-term restraint was the severity rating of Hurts Others. Similar results were found for predictors of the duration of short-term restraint. The only correlates of long-duration restraint was low weight, Hurts Self, and Withdrawn Behavior. Multiple regression analysis indicated that the only variable that independently predicted long-duration restraint was the severity rating of Hurts Self. The implications of these data for the management of restraint are discussed.
Children and adolescents with developmental disorders exhibit a wide range of self-destructive behaviors. Interestingly, suicidal ideation and gestures have been underreported in this population. This study was designed to examine suicidality in a clinically referred sample. The medical records of all individuals assessed in a specialized program during a 1-year period were reviewed looking at the incidence, the type and the clinical characteristics of any suicidal behavior. Forty-seven patients (20%) experienced either suicidal ideation, threats, or attempts with hanging being the most frequent method considered. Suicidality was more often encountered in individuals diagnosed with oppositional defiant disorder, depressive disorders, and past traumatic stress disorder, and less often in the autistic and the severely/profoundly mentally retarded groups Suicidal behaviors were frequently encountered in children and adolescents with developmental disabilities. Prospective studies should be conducted to examine rigorously the variables associated with suicidality in this population. (C) 1999 Elsevier Science Ltd.
This study reports on the development and assessment of the psychometric properties of three measures to assess sexual knowledge, experience, feelings, and needs. The first was designed to assess the Sexual Knowledge, Experience, Feelings, and Needs of people with mild intellectual disabilities (SexKen-ID). The two parallel measures were designed to assess the same areas of sexuality among people with physical disabilities (SexKen-PD) and among the general population (SexKen-GP). The areas of sexuality included in the scales were Friendship, Dating and Intimacy, Marriage, Body Part Identification, Sex and Sex Education, Menstruation, Sexual Interaction, Contraception, Pregnancy, Abortion and Childbirth. Sexually Transmitted Diseases, Masturbation, and Homosexuality. Generation of the items in these scales is described in Studies 1-3. Study 4 describes the evaluation of the psychometric properties of the scales. Sixty-six people with intellectual disabilities, 54 people with physical disabilities, and 100 people from the general population completed the scales. Test-retest reliabilities were also calculated with 30 people with intellectual disabilities, 30 people with physical disabilities, and 30 people from the general population. These data demonstrate the good psychometric properties of the scales and so their simitability for assessing the sexual knowledge, experience, feelings, and needs of people with disability.
The convergent validity of an experimental (analog) functional analysis was investigated by a comparison of three separate ways of interpreting the data derived from such an assessment: two previously published methods and the criterion Z method derived by the authors. Data from the experimental functional analysis of the challenging behavior(s) of 27 individuals with intellectual disabilities were analyzed to assess agreement between the three forms of interpretation. The test-retest reliability of all three methods over periods of 2 weeks, 1 month, and 3 months was also calculated. The results suggest that the methods of interpreting function from experimental assessments can give different results and that the test-retest reliability of the experimental functional analyses is poor. The implications of these findings are discussed in relation to clinical practice.
Recent research in the area of stimulus-preference assessment has progressively improved the accuracy and efficiency of this technology for predicting reinforcer potency. One way to potentially improve the efficiency of the procedure might be to use pictorial representations of stimuli in the assessment rather than the stimuli themselves. To determine the feasibility of using pictorial stimuli in preference assessments, multiple-stimulus preference assessments were conducted with two adults diagnosed with mental retardation using both tangible stimuli and pictorial cards representing these same stimuli. The tangibles stimulus assessment produced greater variations in selection percentages than the pictorial assessment. Subsequent reinforcer assessments confirmed that stimuli predicted by the tangibles assessment were more potent reinforcers than those predicted by the pictorial assessment. The results are discussed in the context of improving stimulus- preference assessment technology.
Few studies have examined the relationship between communicative and problem behaviors that are already present in a behavioral repertoire. In this study, a detailed microanalysis of the antecedents and consequences of aggressive and communicative behavior of a 7-year-old boy was conducted. By using both descriptive and experimental methodologies, the data suggested that problem and communicative behavior were maintained on thin concurrent schedules of social negative reinforcement. A molar analysis of the descriptive data showed that the relative amount of time allocated to each behavior was a function of the relative amount of reinforcement that each behavior accrued. The implications of these findings are discussed in terms of conducting descriptive analyses and for enhancing the efficacy of interventions for problem behavior.
The effectiveness of a sexual education and health promotion program for 252 women with mental retardation was analyzed using an evaluation model. We used confirmatory factor analysis (LISREL) to explain the pathways of learning and related the number of instructional contacts with the outcomes. Three factors (hygiene, social interaction, and sexual experience) affected sexual knowledge directly. An increase in sexual knowledge was directly associated with a greater number of instructional contacts. The analysis indicates that our program is effective and adds to our understanding of factors contributing to sexual knowledge for adults with mental retardation.
We examined the effectiveness of self-operated auditory prompts when used to decrease the off-task and aberrant behaviors of two students with moderate mental retardation. Its purpose was to determine if self-operated auditory prompts could be effectively used by these individuals to decrease their off-task and aberrant behaviors in work settings and during transitional times between settings. A multiple-probe across settings design with a reversal and replication was used to evaluate the effectiveness of the self-operated auditory prompting system on aberrant student behaviors in school and community settings. Previous findings were replicated in this study that demonstrate that stimulus control can be achieved through the use of self-operated auditory prompts, and demonstrates that these prompts can serve to occasion a decrease in aberrant behaviors when used by individuals with moderate mental retardation in school and community settings. Copyright (C) 1999 Elsevier Science Ltd.
We compared the effectiveness of two extinction interventions, extinction by omission and noncontingent delivery of reinforcement, to treat aggressive behavior with a 10-year-old boy. Before the intervention, a functional analysis revealed that aggression was maintained by positive reinforcement in the form of attention. The extinction by omission intervention consisted of ignoring aggressive behavior. Noncontingent reinforcement involved delivering attention to the boy on a fixed-time schedule. Both treatments were compared using a multielement research design. Noncontingent reinforcement produced a more rapid elimination of aggression. Additionally, the schedule of noncontingent reinforcement was gradually thinned during the intervention. Finally, both parents successfully implemented the noncontingent schedule of reinforcement independently for up to 5 weeks after treatment.
Reinforcement is a cornerstone for treating adaptive skills and eliminating problem behaviors for persons evincing mental retardation. To effectively use reinforcement, professionals must find reinforcers that are most effective for each individual. Establishing reinforcers is particularly important for persons functioning in the severe and profound ranges of mental retardation as reinforcers are often difficult to identify in this population. The current study aimed at developing a reinforcer rating scale that-would have applicability on a broad clinical basis, looking specifically at the psychometric properties of the scale.
Two young children with mental retardation displayed inconclusive patterns of destructive behavior when a functional analysis was conducted using the procedures described by Iwata et al. (1982/1994). A second functional analysis incorporated modifications to the social attention condition that were based on interview data from care providers and descriptive observations. Results of the modified social attention condition indicated that a specific 'quality' of attention was needed to identify the maintaining contingency for destructive behavior within an experimental analysis. Results are discussed in terms of considerations for further assessment when traditional analog functional analysis conditions are ineffective in isolating maintaining contingencies for destructive behavior.