Functional assessment, curricular revision, and severe behavior problems

An adolescent female with multiple handicaps and a long history of severely disruptive behavior participated in a functional assessment linked directly to specific revisions in her school curriculum. During Phase 1, reversal designs were used to test hypotheses pertaining to antecedent and curricular influences on problem behavior. During Phase 2, a multiple baseline across afternoon and morning time periods demonstrated that the curricular revisions were effective in eliminating severely disruptive behavior and increasing on-task responding. Data also showed that inappropriate "psychotic" speech was reduced and appropriate social interactions were increased. Follow-up results showed that the changes were maintained throughout the school year. Questionnaire data provided social validation of the procedures and outcomes. The findings are discussed in relation to their implications for functional assessment, individualized curricula, and positive programming for students with disabilities and serious behavior problems.

Characteristics of children and adolescents in a psychiatric hospital and a corrections facility

Popular opinion holds that youngsters in corrections programs are delinquents in need of reform, whereas youngsters in psychiatric settings have mental health problems and need therapy. Yet some literature suggests that youth in the two settings may not differ greatly in their mental health status. The authors compared demographic, emotional, and behavioral characteristics of youngsters placed in public psychiatric hospital and corrections settings, and they found few differences. Child Behavior Checklist scores for social competence and total problems were high and quite similar for youngsters in the two settings. White children scored significantly worse than black children on Child Behavior Checklist Internalizing, Externalizing, and total problems in corrections settings but not in the psychiatric hospital. Moreover, race was the only variable that predicted the site in which youth were placed. The findings suggest a need to study (1) the mental health needs of youngsters in nonmental health settings and (2) the procedures by which youth are assigned to service settings.

Arrests among emotionally disturbed violent and assaultive individuals following minimal versus lengthy intervention through North Carolina's Willie M Program

Time to first arrest after termination of Willie M Program services was compared in 2 groups of former clients. All Ss had met program criteria and "aged out" after their 18th birthday, but the two groups differed in duration and extent of intervention received: (a) A short-certification group (n = 21), because they turned 18 near the 1981 program start date, had received Willie M services for a mean of only 26 days (all cases less than 3 months); (b) a long-certification group (n = 147) averaged 896 days in the program (all cases greater than 1 year). The groups did not differ significantly in gender or race; geographic region; IQ; diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III, American Psychiatric Association, 1980); or age at earliest antisocial acts. A survival analysis compared the short and long groups on proportion avoiding arrest as a function of time since aging out. The long group showed slightly better arrest survival, but survival curves for the 2 groups did not differ reliably. Thus the program was not found to significantly reduce the risk of young adult arrests.

Anger control training for adolescents in residential treatment

A group of twelve adolescents exhibiting aggressive behavior in a residential treatment center received six weeks of anger control training consisting of thought stopping, relaxation training, and rehearsal of problem-solving, self-talk patterns. The subjects were divided into two groups, and a multiple baseline design was employed. Houseparents kept daily observational records of subjects' verbal and physical aggression. Both observational data and teacher ratings indicated that nine of the subjects reduced their rates of aggression. Two did not behave aggressively during the study period. One briefly deteriorated following a major disappointment, after which his aggression rate also declined.

Psychiatric morbidity in clients of social workers: social outcome

141 clients referred to social service department local social work teams (area workers) and general practice attachments were interviewed to assess their levels of psychiatric morbidity. 101 cases received clinical and social reassessment at twelve months. A substantial proportion (63%) had a positive social outcome according to the client and social worker, a finding confirmed by an independent social assessment. Family break up, more common in the area setting, was associated with a better clinical outcome. Attachment clients had significantly higher levels of psychiatric morbidity, and in clinical terms improved more frequently than area cases, but not significantly so. Clinically improved cases had a higher number of GP-social worker contacts. Both social and clinical variables contributed to the prediction of clinical outcome. By reducing the availability of attached workers, social services departments are removing a valuable source of help for people with psychiatric disorders.

Protection and advocacy for the mentally ill: new hope for emotionally disturbed children?

A study was conducted to ascertain the potential effect of recent federal protection and advocacy legislation (Public Law 99-319) on the lives of mentally ill children. Findings indicate a strong potential, especially regarding efforts to improve community based services. Implications for mental health professionals and CMHCs are examined.

Children's mental health services: a parent perspective

Parents of severely emotionally and behaviorally disturbed children rarely have the opportunity to participate in the policy-making processes that affect their children's welfare. In the present study, a structured parent interview was developed as part of Washington State's Child and Adolescent Services System Program (CASSP). Thirty-five parents of disturbed children provided information about their children's problems and services histories. Respondents identified unmet needs and barriers to timely, effective intervention. The nature and quality of services received were examined in the context of CASSP service standards. The study confirmed that parents of disturbed children can provide information rich in implications for system change.

The prevalence of visual disorders in a school for emotionally disturbed children

Data on the prevalence of visual disorders in special populations as well as in normal populations is sparse. Fifty-five students in a special education school were given a comprehensive screening for pathology, acuity, refractive error, fusion, oculomotor, and perceptual motor skills. This group had a very high prevalence of visual disorders especially perceptual motor, oculomotor and fusion disorders.

Effects of selected activities on affective meaning in psychiatric patients

Occupational therapists have used activity analysis to ensure the therapeutic use of activities. Recently, they have begun to explore the affective components of activities. This study explores the feelings (affective responses) that chronic psychiatric patients have toward selected activities commonly used in occupational therapy. Twenty-two participating chronic psychiatric patients were randomly assigned to one of three different activity groups: cooking, craft, or sensory awareness. Immediately following participation, each subject was asked to rate the activity by using Osgood's semantic differential, which measures the evaluation, power, and action factors of affective meaning. Data analysis revealed significant differences between the cooking activity and the other two activities on the evaluation factor. The fact that the three activities were rated differently is evidence that different activities can elicit different responses in one of the target populations of occupational therapy. The implications of these findings to occupational therapists are discussed and areas of future research are indicated.

Effective special education in regular classes

An educational approach is described that accommodates, in regular classes, a much wider range of individual student differences than usual. Reported results-from a study of program implementation and related outcomes suggest that the program, known as the Adaptive Learning Environments Model (ALEM), can be implemented effectively in a variety of settings and that favorable student outcome measures coincide with high degrees of program implementation.

Learning disabled or emotionally disturbed: does it make any difference? Part II

“Only through abundant faith, considerable wishful thinking, and a ready willingness to leap chasms of ignorance with bold inferences can anyone claim that much is being learned about those ED children and youth for whom, or in the name of whose diagnostic category, thousands of special education programs have been founded.” [Charlie Lakin, 1983.]

Analyses of client variables in a series of psychotherapy sessions with two child clients

Studied the process of child psychotherapy by means of analyses of client verbal behaviors. Audio-video recordings were made of nine intermittent psychotherapy sessions with 2 child clients, aged 8 and 12. A randomized mastertape of 4-minute segments was rated for self-exploration by means of the Carkhuff scale. Transcripts were categorized by means of an extended Snyder system and a preliminary set of grammatical variables. Transcripts then were minutized, and all client variables were intercorrelated and factor-analyzed. According to the research expectations, a high level of interrater reliability for the Carkhuff scale and high levels of interjudge agreement for the extended Snyder system were found. Analyses of the client variables demonstrated the nature of each client's verbal responding as well as their pattern of change across successive therapy sessions. The overall verbal response behavior of each client was summarized best through the factor analyses. Communalities and individual differences between the clients were discussed. Future directions for the study of client variables in child psychotherapy process research were suggested.

Analyses of therapist variables in a series of psychotherapy sessions with two child clients

Studied the process of child psychotherapy by means of an analyses of therapist verbal behaviors. Audio-video recordings were made of nine intermittent psychotherapy sessions with 2 child clients, aged 8 and 12. A randomized mastertape of 4-minute segments was rated for empathic understanding and respect by means of the Carkhuff scales. Transcripts were categorized by means of the Hill Counselor Verbal Response Category System, and a preliminary set of 12 grammatical variables. Transcripts were minutized, and all the therapist variables were intercorrelated and factor-analyzed. According to the research expectations, high levels of interrater reliabilities for the Carkhuff scales and relatively high agreement levels for Hill's system were found. Analyses of the therapist variables demonstrated the nature of the therapeutic interventions as well as the pattern of change across successive psychotherapy sessions. The overall verbal response behavior of each therapist was summarized best through the factor analyses. Communalities and individual differences between the therapists were discussed. Future directions for the study of therapist variables in child psychotherapy process research were indicated.

Academic contracting with emotionally disturbed children

16 underachieving boys contracted for early dismissal from the classroom contingent upon completion of programmed materials. Data support the use of contingency management to increase academic performance. Inappropriate behavior was exhibited less during periods in which academic performance was reinforced.