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This research was conducted to teach two adults with schizophrenia and mental retardation to respond to recorded audio prompts in order to eliminate the need for instructor assistance in completing routine prevocational tasks. Studying individuals with dual diagnosis is an important step in moving toward success in community living and vocational placement. A multiple probe design across tasks was conducted. Prior to the investigation, both individuals demonstrated low levels of independent task completion. Following the implementation of the audio prompts, both individuals' task completion performances dramatically increased. These findings suggest that audio prompts may serve as an efficient alternative to instructor promoting, which is often required by individuals with dual diagnosis in prevocational job settings.

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A Spanish-speaking mother reported for child abuse of her 6-yr-old son and referred by child protective services received Spanish training protocols in their home provided by Project SafeCare. Treatment consisted of (1) child health care training, (2) planned activities training (PAT), and (3) home safety training. Following training, the mother met criterion in all training components. Although PAT was conducted with the mother and her youngest child only, the mother reported decreases in negative interactions between the oldest (untreated) child and his parents. Follow-up observations indicated that treatment gains were maintained. The mother rated the content and outcome of the training favorably on a social validation questionnaire.

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Planned Activities Training (PAT) teaches mothers to plan and structure activities to prevent challenging child behaviors. PAT was evaluated with four mothers of children with developmental disabilities, including autism, Down Syndrome, and ADHD. PAT was used independent of any other behavior management techniques to examine its impact on mother and child behaviors, which were examined in addition to "fidelity" data on the mothers' implementation of PAT techniques. A multiple probe experimental design across two families with a replication across two more families demonstrated that PAT produced marked improvements in mother and child behavior in three generalization settings. In most cases, mothers' use of PAT procedures more than doubled. Three mothers' appropriate behavior increased from 25% to 40%. Improvements in child behavior ranged from 20% to more than 50%. Intervention gains were maintained at 1, 3, and 6 months. These results suggest that PAT is a useful technique for promoting durable generalization of mother child skills.

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This study examined the extent to which competence in applying behavioral procedures (time-out from positive reinforcement) was sufficient to establish competence in teaching others to apply the same procedures. During baseline, graduate students attempted to instruct parents with a history of child abuse and neglect in the use of time-out. Students were then instructed in the use of time-out until they achieved proficiency in a role-play context. They then reattempted to instruct the parents. Finally, the students were instructed in certain consultation skills (i.e., teaching others to apply behavioral procedures) and again attempted to instruct parents in the application of time-out. Observations of students' consultation skills, parents' proficiency at administering time-out, and children's compliance to parental instructions revealed that explicit training in behavioral consulting skills was necessary to produce improvements in these behaviors. Students proficiency at administering time-out was insufficient to enable them to instruct others in its application. These results were corroborated by surveys of both students and staff. The implications for graduate training and service delivery are discussed.

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The purpose of this research was to determine the relationship between schizophrenic individuals' cognitive functioning and their performance in interpersonal interactions and skills training procedures. Thirty schizophrenic individuals and 15 non-mentally ill individuals were administered two versions of the Continuous Performance Test, the Span of Apprehension Test, the Digit Span Distractibility Test, the Assessment of Interpersonal Problem Solving Skills, and three elemental skills training tasks. Vigilance level as measured by the Continuous Performance Test was substantially correlated with performance in both roleplayed interactions and skills training tasks, while recall memory as measured by the Digit Span Distractibility Test was correlated with performance in the skills training tasks independently of vigilance level. Thus, the results indicated that the cognitive dysfunctions of schizophrenia are associated with poorer social functioning and with reduced performance in the elemental procedures that constitute efforts to improve that functioning.

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A multiple-probe design across three groups of subjects was used to assess adult-child interaction skills by graduate students being trained to work with children. These skills were subjected to content and social validation by experts in childhood education and behavior analysis. Subjects in our research evinced generalization across settings. It is therefore suggested that when teaching behavior management, affective skills should also be included in the curriculum.

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The purpose of this research was to conduct a consumer evaluation of Project Ecosystems, an in-home ecobehavioral program serving families with children with developmental disabilities. A consumer satisfaction questionnaire was designed and validated to examine process, programmatic outcome, and to assess perception of staff performance across consumer groups. The questionnaires were distributed to parents, careproviders, Regional Center workers who provided the referrals to Project Ecosystems, and other professionals who worked with Project Ecosystems' staff. The questions were divided into process, outcome, and staff performance so each element could be separated in the analysis. The data suggest considerable satisfaction from the consumers of Project Ecosystems' services.

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Child Management Training (CMT) involves compliance training with a focus on consistent use of antecedents and consequences. Planned Activities Training (PAT) focuses on teaching parents to plan for and engage in activities with their children. A multiple probe design counterbalancing PAT and CMT showed that PAT and CMT were about equally effective in improving mother-child interactions in four families with children with developmental disabilities. Responses to a social validation questionnaire indicated that parents were satisfied with the services received, and that PAT was the slightly preferred treatment. Prior research demonstrated that PAT enhanced the results of CMT. The practical advantages of PAT over CMT are discussed.

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Child neglect is a serious and prevalent problem. It is often chronic, and parents accused of child neglect may refuse treatment or may fail to cooperate fully. Described here are some examples of empirically evaluated treatments for child neglect dealing with hygiene, nutrition, home safety, and cleanliness, affective skills training, infant stimulation, and teaching health-related skills. Also discussed is a concern for a need for primary prevention programs.

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We developed a comprehensive training program to teach young parents what symptoms to look for to judge the severity of their children's illnesses, what to do at home to comfort their children, and when to consult their children's physician or take them for emergency treatment. Three pairs of subjects received training that included written handouts, verbal instructions, modeling, positive practice, and verbal reinforcement. Skill acquisition was assessed by a behavioral test in which parents assessed, treated, or reported a simulated illness in a child. Written materials when used alone did not improve the parent's ability to identify and report children's illnesses. Modeling and role-playing followed by positive practice were successful in teaching these parents skills that were maintained for 3 months without additional training or instruction.

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This paper addresses an evaluation of an administrative decision to change the manner in which services were paid for at a Student Health Center (SHC). The impact of the change in payment was observed through monitoring the number of scheduled appointments at the SHC which the patient failed to attend, reschedule, or cancel. The impact was assessed through a comparison of the weekly no-show rates from the year prior to the change in payment practices through the year following the change. A time-series statistical package was used to analyze the no-show data. Collateral measures on the number of students attending the university, staff opinions, and usage of the SHC by different student groups were collected. Evaluations of the impact of administrative decisions on health related behavior were discussed, in addition to a discussion of the usefulness of time-series models for this type of evaluation.

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Behavior change professionals have developed treatment programs for a wide variety of health care problems affecting adolescents. Although a substantial data base of experimentally tested techniques exists for obesity, smoking prevention, and dysmenorrhea, much work remains in other areas. For example, the case studies reported on neurodermatitis and the survey work in teenage alcohol abuse must give way to systematic interventions employing group experimental designs. In addition, behavioral procedures should be compared to other treatments. Also, component analysis should be performed when multiple treatment strategies are used. Finally, strategies aimed at increasing the generalization of treatment, such as from classrooms to different community settings in substance abuse prevention programs and maintenance of treatment effects over long follow-up periods, are necessary. Only in this way will the efficacy of behavioral interventions for specific health problems be established. The leading causes of mortality among adolescents are due to accidents. Of the total number of deaths due to accidents, approximately 50% are attributed to motor vehicle accidents (National Safety Council, 1977). Many of these accidents are due to negligence, substance abuse, and, in general, immature behavior (Bakwin & Bakwin, 1972). In spite of a slow but consistent trend toward lower accidental deaths over time (National Safety Council, 1977), there still is a need for interventions designed to decrease risk-taking behavior, substance abuse, and carelessness in adolescents. Again, behavior change professionals might follow the example set by researchers who have begun to develop successful strategies for decreasing onset of cigarette smoking. These interventions and research methods, designed for use in schools, may provide a promising approach for addressing other kinds of prevention problems. It also seems appropriate to categorize cigarette smoking not only as a risk factor in the development of cardiovascular disease (Kuller, 1976), but also as a member of the risk-taking behaviors. Thus, procedures used to prevent cigarette smoking might also be adapted to prevent other kinds of risk-taking behaviors among adolescents. The work of McAlister et al. (1980), in preventing alcohol abuse as well as cigarette smoking by use of the same or similar procedures, is a case in point. Use of a procedure designed to train competency in refusing peer pressure has clear implications for reducing other risk-taking behaviors, such as reckless driving, drug abuse, and swimming and boating accidents.(ABSTRACT TRUNCATED AT 400 WORDS)

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Described here is Project 12-Ways, a large service project employing an ecobehavioral approach to the treatment and prevention of child abuse and neglect. By ecobehavioral it is meant that multifaceted in-home services are provided to clients, and that in-home data are collected on as many variables related to these services as possible. Four levels of research, data collection, and assessment are used to evaluate these services: Included here is a discussion of these levels of assessment. They are: data collected for clinical purposes; data from single-case experiments; research through the use of single-subject design logic applied to several subjects or groups of subjects, or by group statistical research designs; and program evaluation. The particular focus here is the program evaluation data which compare incidents of abuse and neglect during and after treatment between 50 families served by Project 12-Ways and 47 comparison protective service families. The data showed significantly fewer combined abuse and neglect incidents among the families served by Project 12-Ways. Suggestions for additional program evaluation data are provided along with a discussion of the limitations of the current analysis.

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In this study, we evaluated follow-up appointment keeping at a family practice center. To determine if noncompliance could be reduced, four treatments were implemented: no-treatment control, modified appointment card, free follow-up, and a reduced rate follow-up. Thereafter, the reduced rate follow-up was implemented again to determine the extent noncompliance could be reduced for all eligible patients. Incentives significantly increased follow-up appointment keeping, whereas the modified appointment card was ineffective. A cost analysis suggested that the no-treatment control and modified appointment card conditions were the least expensive, but also the least effective. The incentive conditions were more expensive, but the reduced rate condition generated the most net revenue. Questionnaire data suggested that the incentive conditions had an effect on noncompliance and may be considered for use in other medical settings.

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Parents may be charged with child abuse or neglect or both on the basis of a variety of circumstances. Child neglect, for example, is often documented when caseworkers observe that the family's home itself is so poorly kept that it presents an environment in which young children have ready access to lethal hazards such as poisons, uncovered wall outlets, and firearms. In this study, we describe the development of a Home Accident Prevention Inventory (HAPI) which was validated and used to assess hazards in the homes of several families under state protective service for child abuse and neglect. The HAPI included five categories of hazards: fire and electrical, mechanical-suffocation, ingested object suffocation, firearms, and solid/liquid poisons. Following the collection of baseline data, parents were presented with a treatment package that included instructions and demonstrations on making hazards inaccessible to children, plus feedback regarding the number and location of hazards in the home. The multiple-baseline design across hazardous categories in each family's home showed that the package resulted in decreases in the number of these accessible hazards. These improvements were maintained over an extended period of unannounced follow-up checks. This research provides a model for the development and assessment of an area previously unexamined in the child abuse and neglect literature.

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A low-income family received in-home treatment after the mother expressed a desire to kill her daughter. The ecobehavioral approach focused on stress reduction of the frequency and duration of the mother's migraine headaches, on parent-child training, and on behavioral marital counselling. Follow-up data 1 yr after the beginning of services indicated maintenance of improvements in all areas. This was sufficient to terminate services. Also, the mother reported that she no longer had any negative feelings about her child, and the home environment lacked the stressors originally seen when the counselors began treatment. Finally, a consumer satisfaction questionnaire indicated a high level of satisfaction by the couple about the services offered by Project 12-Ways, an ecobehavioral approach to the treatment and prevention of child abuse and neglect.

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