Reduction of disruptive mealtime behavior by facial screening. A case study of a mentally retarded girl with long-term follow-up

This study examined the effectiveness of facial screening as a treatment to reduce repetitive spoon banging by an 8-year-old, severely mentally retarded girl during meal time. In baseline, each episode of spoon banging was terminated by the behavioral observer saying "no bang" while gently grasping the subject's wrist, and returning her hand to a scoop dish. Treatment consisted of saying "no bang" and pulling a terry-cloth bib over the subject's entire face for 5 seconds. Results of an A-B-A-B design showed high frequencies of spoon banging during nontreatment conditions, which rapidly decelerated when facial screening was in effect. Follow-up data at 6-, 10-, 15-, and 19-month intervals indicated long lasting treatment benefits. Facial screening research was extended to a new experimental setting: a public school classroom.

Suppression of pica by water mist and aromatic ammonia. A comparative analysis

This study compared the effects of water mist and aromatic ammonia for the suppression of pica behavior in a severely retarded, autistic adolescent. The water mist program reduced the target behavior rapidly and effectively, whereas the ammonia program did so only after a strong increase during the first two sessions. No negative collateral effects on other inappropriate behaviors occurred during either one of the two treatments. Water mist maintained almost complete suppression of pica behavior during 3 months of daily follow-up sessions in the subject's natural environment.

Use of a treatment package in the management of a profoundly mentally retarded girl's pica and self-stimulation

A treatment package was employed to manage the pica and self-stimulation of a 4-year-old profoundly mentally retarded girl. Each instance of pica was followed by a verbal reprimand, the removal of the particular objects/fingers from the subject's mouth, and physical restraint. Each instance of self-stimulation was followed by response interruption and positive practice overcorrection. In both cases, praise was contingent upon the absence of target behaviors. A multiple-baseline design across settings was employed. The treatment package resulted in rapid and dramatic decreases in the levels of pica and self-stimulation in each setting. These results significantly contributed to the reduction of the cost of treatment. Results suggest that efficacy and efficiency of treatment interventions should be emphasized when dealing with multiple problems of profoundly retarded children and special emphasis should be placed on the treatment package strategy to enhance the efficiency of a given therapeutic technique.

Suppressive effects of visual and facial screening on self-injurious finger-sucking

Effects of following the self-injurious finger-sucking of two profoundly mentally retarded persons by 5 seconds of either visual or facial screening were compared using an alternating treatments design. The two screening procedures reduced the self-injury more than did a no-treatment control condition. Visual screening was more effective than facial screening with one of the subjects. Subsequently, when the only treatment was visual screening, the contrast in the effect on self-injury between visual screening and no-treatment was further increased. The greatest suppression occurred when visual screening was given in all sessions. Toy play reliably occurred only with appropriate training: The mere provision of toys had no impact on toy play. The effect of toy play on self-injury was equivocal. Possible limitations to the generality of the findings were discussed.

Treating self-injury: water mist spray versus facial screening or forced arm exercise

In three experiments, the effect of water mist spray on self-injurious and collateral behaviors was compared with either facial screening or forced arm exercise. Water mist spray was as effective as facial screening in suppressing face-slapping in Experiment 1. However, it was not as effective as facial screening for self-injurious finger-licking in Experiment 2 or forced arm exercise for excessive ear-rubbing in Experiment 3. These results suggest that while water mist spray is effective, it may be less so than alternative procedures. In Experiments 2 and 3 there was a consistent decrease in the occurrence of untreated maladaptive behaviors. In addition, there was a moderate increase in appropriate social interaction in Experiment 2 and a substantial increase in Experiment 3.

A case of kleptomania treated by covert sensitization

A client with a history of daily compulsive shoplifting of 14 years' duration was treated by covert sensitization. By her preference, the aversive imagery used was that of nausea and vomiting, as described by Cautela (1967), rather than that of being apprehended by the authorities used by later workers. On 19-month follow-up she was free of stealing behaviour apart from a single lapse, and there were corresponding improvements in her self-esteem and socialization.

Behavioral therapies for substance abuse

The authors review more than two decades of research in the use of behavioral interventions for the treatment of drug and alcohol abuse. This survey covers major areas of research activity, including the use of aversive stimuli (chemical, electrical, and covert), skills training, contingency management, extinction/desensitization, and combined behavioral treatments. The reviewers conclude that while many of these treatment interventions hold promise, few have been fully explored with the use of properly controlled group studies. Suggestions are offered which may facilitate research and aid in the evaluation of behavioral interventions for substance abuse.

Behavioral treatment of trichotillomania

The frequency of a 29-yr.-old woman's chronic hair pulling was reduced by training in awareness of the habit and the application of a mildly aversive stimulus. This report presents a review of the relevant literature on behavior therapy, a description of assessment and treatment procedures, data supporting the elimination of hair pulling, and a discussion of factors which might have influenced behavioral change.

The effects of contingent water mist on the stereotypic responding of a severely handicapped adolescent

The reductive effects of the water misting procedure on the stereotypic responding of a severely handicapped adolescent were investigated by using a variation of the multiple baseline design across settings, with sequential interventions across settings and simultaneous interventions across teachers. The results indicated that the intervention was related to reduced rates of stereotypic responding in each setting. The effects of the intervention were also maintained across multiple administrators of the procedure and during follow-up. Instructional implications are discussed. Further research is suggested.

Stereotypic responding: a review of intervention research

More than 60 studies using behavioral strategies to suppress stereotypic responding in handicapped individuals were reviewed in order to identify the populations studied, the behavior observed, the interventions employed, and the relative effectiveness of these interventions when used alone or in combinations. The target populations were distributed across nine categories, three of which (severely mentally retarded, profoundly mentally retarded, and severely emotionally disturbed) constituted approximately three-quarters of all subjects studied. Fifty types of target behavior were identified; body rocking was the target in approximately two-thirds of all studies, and mouthing and complex finger and hand movements were the targets in at least one-third. Ten interventions (seven aversive, three positive) were identified. The aversive interventions were used in approximately three-quarters of the studies whereas positive procedures were used in approximately one-third. One aversive procedure (overcorrection) was used in more than one-third of the studies, whereas another, shock, was the most effective. The other six aversive procedures, however, and three positive procedures were relatively equal in effectiveness. Discussion centered on the relative effectiveness of the interventions and their relationship to the concept of least restrictive alternatives.

A comparison of cessation strategies for the outpatient alcoholic

The present study compared the relative effectiveness of group-administered covert sensitization, supportive group therapy, and a non-specific control in disrupting the drinking response of 28 outpatient alcoholics. Multiple measures of treatment outcome were examined to insure a more comprehensive assessment of treatment effects. These included (a) randomly sampled blood/alcohol levels, (b) reported mean daily drinking frequencies and (c) reported urges to drink. Results indicated that supportive group therapy was significantly more effective than the other two treatments in reducing subjects' reported daily drinking. No significant differences were found on measures of blood/alcohol concentration or subjects' ratings of frequency of urges to drink. All three groups reported significant improvement over time on urge ratings. Results seriously question the efficacy of covert sensitization in helping outpatient alcoholics reduce their intake of alcohol.

Response prevention in the treatment of cigarette smoking

The present study developed and tested a response prevention treatment for cigarette smoking. Response prevention is based on the conditioning theory of addictions. Thirty-nine smokers were divided into two groups, one receiving response prevention and the other a rapid smoking comparison treatment. No significant differences were found between the two treatments in terms of their effectiveness in achieving abstinence or smoking reduction. The abstinence rate at the 6-month follow-up for response prevention was 7% and for rapid smoking was 23%.

Mediating factors in the modification of smoking behavior

This study was designed to investigate two personality variables that may influence the effectiveness of covert sensitization in reducing smoking behavior. These are GSR reactivity to stressors and GSR adaptation to repeated stressors. It was predicted that both high reactivity and nonadaptivity to stressors would facilitate covert sensitization therapy. Fifty-nine subjects underwent treatment and were followed up at 3, 6 and 12 week intervals. Subjects were distributed among four groups: A. High reactors, nonadaptive (15); B. High reactors, adaptive (14); C. Low reactors, nonadaptive (9); D. Low reactors, adaptive (21). The results demonstrate that the measure of reactivity to stressors is significantly related to the success of the treatment, but the relevance of the measure of adaptivity factor was not demonstrated.