A controlled group study of pedestrian-skill training for the mentally retarded

Acquisition and Generalization of Coffee Purchase Skills by Adults with Severe Disabilities

Six adults with severe disabilities were taught to purchase coffee in a community sit-down restaurant. Skills in the community were taught using a 46 step task analysis, a prompt hierarchy of least to greatest prompts, and social reinforcement. Generalization was assessed across two restaurants with similar characteristics and one with dissimilar characteristics (i.e., a fast food restaurant). At the completion of training, the people involved in the study demonstrated competencies equal to non-handicapped customers and they maintained these skills at a two to five month follow-up assessment.

Guidelines for Making Simulation an Effective Adjunct to in Vivo Community Instruction

A recent controversy has arisen over the relative merits of simulated versus in vivo community instruction. The view presented here is that in cases where in vivo instruction alone is unfeasible, practitioners should employ both training formats in a concurrent fashion. Accordingly, five guidelines for making simulated instruction a more effective adjunct to community instruction are presented and discussed. Future research needs in this area also are suggested.

Comparison of Three Strategies for Teaching Generalized Grocery Purchasing to High School Students with Severe Handicaps

Teachers often provide classroom based instruction on the assumption that behaviors learned in the classroom will be performed in natural settings. The present study examines this assumption by comparing the effectiveness of three strategies for purchasing grocery store items with four high school students labeled moderately or severely retarded. Students were trained to negotiate payment to the cashier by (a) role playing in the classroom with flashcards designating the amount of purchase, (b) role playing in the classroom with slides of cash registers at different amounts, or (c) role playing with the slides and in vivo training in one store. A multiple baseline design across subjects indicates afunctional relationship between the combined slide and in vivo strategy and correct performance across a range of nontrained probe stores. Neither role playing strategy alone was successful at teaching a generalized purchasing skill. The data are discussed in terms of research implications for studying generalization and instructional recommendations for teachers.

A Functional Approach to Teaching Generalized Street Crossing

The effects of general case instruction for teaching street crossing to individuals with moderate and severe mental retardation were examined. Three dependent variables were assessed within a multiple baseline probe design across subjects. The first measure was performance across a group of 20 nontrained streets systematically selected to represent the range of street crossing situations encountered in the subjects' home town. The second dependent variable was performance across 20 additional nontrained streets selected individually for each subject by parents or guardians as particularly relevant in the subject's daily life. The third dependent variable was the number of training trials to criterion. Two subjects completed training with the third serving as a no-treatment control. Results support the effectiveness and efficiency of general case instruction for teaching subjects to cross nontrained streets. Implications for further research on generalization and for instructional programming in the community are addressed.

Computer-Assisted versus Teacher-Directed Teaching of Community Living Skills in People with a Mild Learning Disability

An experiment was carried out in which adults with a learning disability of the mild type undertook either computer-assisted or teacher-implemented instruction in community living skills, with a third group acting as a control group. All groups were pre-tested on a standardised psychometric measure of community living skills (the HANC 2 subscale of the Hampshire Assessment for Living with Others test), after which the experimental groups received one half-day per week training in such skills as money handling and budgeting for 3 months, when all groups were reassessed. It was found that both the teacher-led and computer-assisted instruction groups appeared to gain more than the control group, but only the teacher-led group differed significantly from the control group. The computer-assisted group improved in their scores by an intermediate amount, with their gains being non-significantly different from either the control or the teacher-led groups. The strengths and weaknesses of the software used in the study are discussed.

The effects of instructional interventions related to street crossing and individuals with disabilities

Adequate street crossing skills reduce the risk of injury and increase the functional independence of individuals with disabilities. This paper reviews research involving instructional interventions for street crossings with individuals with disabilities. Eight studies were included. There was evidence individuals could be taught street crossings using classroom based interventions, roadside instruction, or virtual reality technology. Classroom based methods were successful when involving strategies which promoted generalization of skills. Task analysis found the steps involved in street crossing included: stopping at the curb, looking left and right, walking quickly, walking within the crosswalk, and continuing to look left and right. A variety of instructional strategies were used, but the small body of literature did not allow clear identification of superior strategies.

Safety education of pedestrians for injury prevention: a systematic review of randomised controlled trials

OBJECTIVES

To quantify the effectiveness of safety education of pedestrians.

DESIGN

Systematic review of randomised controlled trials of safety education programmes for pedestrians of all ages.

MAIN OUTCOME MEASURES

Effect of safety education on pedestrians' injuries, behaviour, attitude, and knowledge and on pedestrian-motor vehicle collisions. Quality of trials: methods of randomisation; and numbers lost to follow up.

RESULTS

We identified 15 randomised controlled trials of safety education programmes for pedestrians. Fourteen trials targeted children, and one targeted institutionalised adults. None assessed the effect of safety education on the occurrence of pedestrian injury, but six trials assessed its effect on behaviour. The effect of pedestrian education on behaviour varied considerably across studies and outcomes.

CONCLUSIONS

Pedestrian safety education can change observed road crossing behaviour, but whether this reduces the risk of pedestrian injury in road traffic crashes is unknown. There is a lack of good evidence of effectiveness of safety education for adult pedestrians, specially elderly people. None of the trials was conducted in low or middle income countries.

Safety education of pedestrians for injury prevention

BACKGROUND

Each year about one million people die and about 10 million are seriously injured on the world's roads. Educational measures to teach pedestrians how to cope with the traffic environment are considered to be an essential component of any prevention strategy, and pedestrian education has been recommended in many countries. However, as resources available for road safety are limited, a key question concerns the relative effectiveness of different prevention strategies.

OBJECTIVES

To quantify the effectiveness of pedestrian safety education programmes in preventing pedestrian-motor vehicle collisions.

SEARCH STRATEGY

We searched the Injuries Group specialised register, Cochrane Controlled Trials Register, TRANSPORT, MEDLINE, EMBASE, ERIC, PSYCHLIT, SPECTR, and the WHO database on the Internet. We checked reference lists of relevant reviews and papers and contacted experts in the field. Most database searching was conducted in 1999.

SELECTION CRITERIA

Randomised controlled trials of safety education programmes for pedestrians of all ages.

DATA COLLECTION AND ANALYSIS

One reviewer screened records. Two reviewers independently extracted data and assessed methodological quality of trials. Because of differences in the types of interventions and outcome measures used in the trials, meta-analyses were not carried out.

MAIN RESULTS

We found 15 randomised-controlled trials of pedestrian safety education programmes, conducted between 1976 and 1997. Methodological quality of the included trials was generally poor. Allocation concealment was adequate in three trials, outcome assessment was blinded in eight, and in most of the studies large numbers of participants were lost to follow-up. Study participants were children in 14 studies and institutionalised adults in one. Eight studies involved the direct education of participants, seven used parents as educators. No trials were conducted in a developing country and there were none of pedestrian safety training in the elderly. None of the included trials assessed the effect of pedestrian safety education on the occurrence of pedestrian injury but six trials assessed the effect on observed behaviour. Some of these trials showed evidence of behavioural change following pedestrian safety education but it is difficult to predict what effect this might have on pedestrian injury risk.

REVIEWER'S CONCLUSIONS

Pedestrian safety education can result in improvement in children's knowledge and can change observed road crossing behaviour but whether this reduces the risk of pedestrian motor vehicle collision and injury occurrence is unknown. There is evidence that changes in safety knowledge and observed behaviour decline with time suggesting that safety education must be repeated at regular intervals.

A comparison of behavioral techniques to teach functional independent-living skills to individuals with severe and profound mental retardation

The efficacy of two treatment approaches was compared for functional skill acquisition in individuals with severe and profound mental retardation. Participants included 22 residents from a large developmental center (Pinecrest) in central Louisiana. Treatment including staff training, feedback, and edible reinforcement in addition to prompting, modeling, and physical guidance was more effective than prompting, modeling, and physical guidance alone. Additionally, daily documentation of teaching did not enhance treatment effectiveness. Implications of the findings are discussed.

Using independence training to teach independent living skills to children and young men with visual impairments

Two groups of students with visual impairments were taught various independent living skills. Of the 7 students, 5 also had a diagnosis of mental retardation. One group (3 first graders) was taught the tasks of folding a shirt, making an emergency telephone call, and spreading soft foods with a knife. The other group (4 young men) was taught to increase leisure skills through three different leather-work tasks. Independence training was conducted in a group format and included social learning components (e.g., self-evaluation, peer evaluation and reinforcement) in addition to traditional operant procedures (e.g., modeling, prompting). However, because of the presence of visual impairments, a physical and verbal modification of modeling was used, whereby the subject was physically guided through the steps and simultaneously provided with a narration of the steps. A multiple baseline design across behaviors demonstrated the efficacy of the comprehensive training package in training various independent living skills to the two groups of visually impaired and mentally retarded students. Social validity measures demonstrated the clinical significance of the subsequent changes in behavioral skills. Follow-up data collected 10 months after the completion of training indicated a good degree of maintenance. The current positive results show that training procedures used exclusively with persons with mental retardation can be modified and be effective with a different and younger population, while targeting different independent living skills.

Utilization of general case programming for teaching health education behaviors to students with severe handicaps

Students with severe handicaps are acquiring safety behaviors through the implementation of systematic instruction. Absent from this instruction is the inclusion of generalization strategies. Included in this article is a procedure for selecting representative teaching examples to promote optimal generalization. This procedure is referred to as general case programming. The steps of this strategy are delineated using an example of applying an adhesive bandage to a cut.

Acquisition, generalization and maintenance of grocery shopping skills by severely mentally retarded adolescents

A program designed to teach severely mentally retarded adolescents grocery shopping skills was evaluated. A multiple-probe design was used to assess the training program which was systematically introduced across four participants. To determine the minimally sufficient conditions for generating shopping skills, store probes were interpolated between successive presentations of three more involved shopping skill training procedures (verbal instruction, role play, and in vivo.). A mnemonic training procedure and a simplified monetary transaction component were employed to obviate the participants' deficient reading and math skills. The results indicated that all participants acquired grocery shopping skills, that the acquired skills were maintained for at least five months, and that only a modest decrement in performance was obtained on generalization probes in two novel grocery stores. Additionally, the results suggested that role play training contributed most significantly to the acquisition of shopping skills and that in vivo training was not required to teach this community living skill.

Teaching developmentally disabled persons how to react to fires

Four elements of fire reaction are delineated: investigating, reporting, suppressing, and evacuating areas in which fires are present. Important issues in the acquisition, maintenance, and generalization of fire reaction skills for developmentally disabled persons are identified and reviewed. Learning-based treatment strategies and fire safety literature relevant to the authors' concerns are reviewed. The authors suggest that behavioral research on training should be congruent with fire safety experts' recommendations on fire reaction skills.

Stacking the deck: teaching social skills to retarded adults with a modified table game

This study developed and evaluated a social skills training program for institutionalized mildly or moderately retarded and dually diagnosed individuals. Social skills were conceptualized as requiring an action or reaction within six skill areas: compliments, social interactions, politeness, criticism, social confrontation, and questions/answers. The program taught social skills using a commercially available table game, Sorry, and a specially designed card deck. Each card represented one of the skill areas and was designed to train either an actor or reactor response. The program featured response specific feedback, self-monitoring, individualized reinforcers, and individualized performance criterion levels. A multiple baseline across two groups (N = 3 per group) revealed that the game contingencies increased social skills in all targeted areas. After training, the subjects displayed their newly learned skills at or above their trained levels in two different settings with novel persons present. Although untargeted, the complexity of the subjects' responses increased across conditions, since there was a steady increase in the number of words they used per response. The program appears to be a viable means of training social skills since it uses standardized training procedures, requires only one facilitator, and is in itself a social situation that may encourage interactions with peers, cooperation, competition, and politeness.

The effect of communicative demands on request-making in the moderately and severely mentally retarded

Two experiments were reported investigating the conditions that elicit request-making in the moderately and the severely mentally retarded. In both experiments single-subject designs were used with a store game task designed to closely approximate a naturalistic communication situation. In the first experiment moderately retarded adults were able to consistently communicate which of two objects they wished to obtain from a store counter. In the second, severely retarded adolescents initially made some errors but communicated effectively on 100% of the trials by the end of the experiment. These results contrast markedly with the results from the less naturalistic task used previously. In both experiments the amount of verbalization was greater when the task was arranged to create a demand for communication. Applications of these findings to everyday communicative situations involving the mentally retarded are discussed.

Teaching an autistic child pedestrian skills

An autistic child was taught pedestrian skills in a classroom by use of a model of the streets and the intersection she most often frequented. She manipulated a doll and verbalized what the doll was doing to get to the designated location. After mastering the pedestrian skills on the model, video recordings familiarized her with traffic at local intersections. She successfully generalized the pedestrian skills to the natural environment.