Factors affecting the reliability of clinical judgments about the function of children's school-refusal behavior.

Conducted two studies to examine the interrater reliability, test-retest stability, and the effect of various clinician variables, such as years of clinical experience, theoretical orientation, and prior experience with children, on clinical judgments about the reinforcement functions of children's school-refusal behavior. Results indicated that the judgments by individual clinicians were of questionable reliability. Judgments aggregated across 3 clinicians yielded acceptable interrater and test-retest reliability in Study 1, but a greater number of clinicians were necessary to achieve acceptable reliability in Study 2. Years of clinical experience and training were the only clinician variables related to the reliability of judgments about reinforcement functions. Several recommendations for the clinical assessment of the function of children's school-refusal behavior are discussed.

Problem social behavior in the workplace: an analysis of social behavior problems in a supported employment setting.

The social skills problems that may influence the work-related success of supported employees has been only infrequently documented in the research literature. Though a multitude of research describes the performance-related challenges faced by supported employees, few papers address the interpersonal difficulties encountered by supported employees in the workplace. The present paper uses job trainer or "coaches" logs and two promising rating scales (the Psychopathology Instrument for Mentally Retarded Adults [PIMRA and PIMRA-S]) to describe the social problems encountered by some supported employees. Job coach's logs indicated that approximately 58% of supported employees had experienced one or more incidents of interpersonal difficulty during their employment tenure and that 40% of the problems experienced by these individuals could be described as sexuality-related. Overall, about 25% of all supported employees had reported incidents of conflict with employees or customers that seemed sexuality-related. In addition, social and developmental factors that might contribute to the interpersonal problems found in the present research are discussed.

The write-say method for improving spelling accuracy in children with learning disabilities.

We evaluated a teaching strategy designed to improve spelling accuracy in children with learning disabilities. The write-say method provides immediate feedback to dual sensory modalities (i.e., visual and auditory) following the administration of a daily spelling test. Four males and three females (mean age = 11.61 years) with learning disabilities were introduced to the write-say procedure within a multiple-baseline design. Compared to control conditions (i.e., studying words on one's own), experimental procedures significantly enhanced subjects' spelling accuracy in a brief period of time. The write-say procedure was also advocated as a cost-effective method of spelling instruction for small classroom settings.

Relationship between peer status and health behaviors.

Over the past decade, univariate studies have identified peer-rated popularity/sociability as a correlate of individual health practices (e.g., alcohol and drug use, exercise habits). Yet, the relationship between multiple health habits and broader social competencies rarely has been systematically examined. Accordingly, using a multivariate approach, the present study investigated the relative influence of background characteristics (i.e., age, gender, race, family type, and socioeconomic status) and peer status on health-related behaviors (i.e., physical activity, eating habits, smoking, alcohol use, and stress-related behaviors) in 589 junior high school students (ages 11-13). In this sample, peer popularity provided no significant increment in the prediction of health habits over and above the effects explained by demographics. These results are consistent with current perspectives on health and interpersonal behaviors, and have important practical implications for the initiation and maintenance of healthful and risky practices in the natural environment.

Risk-taking/gambling-like behavior in preschool children.

The types and characteristics of risk-taking or gambling-like behaviors in children are not well understood. Social learning, as one potential etiological factor of risktaking behavior in preschool children, was empirically examined. Prior to playing a risk-taking game, children in the experimental group were exposed to a peer model who had ostensibly won a large prize, whereas control children were exposed to a peer model who had won nothing. Children in the experimental group initiated more risks to win the large prize in the high-risk situation than children in the control group. The results indicated that modeling can enhance risk-taking/gambling-like behavior in young children. Parallels to compulsive gambling in adults, and recommendations for future research were also discussed.

Exercise as a treatment for hypertension in low-socioeconomic-status black children.

Low-socioeconomic-status (SES) Black children have a higher mean blood pressure than most other groups. The antihypertensive effects of a 12-week aerobic exercise program were examined on 11 low-SES Black children, ages 8-12, who had blood pressure above the 95th percentile. A multiple baseline across three groups of children with baseline and exercise conditions was conducted. After the introduction of the exercise program, there were significant decreases in diastolic and systolic blood pressure. Cardiovascular fitness improved concurrently. The results suggest that vigorous exercise can decrease the blood pressure of low-SES hypertensive Black children.

Disproportionate referrals for child academic/behavior problems: replication and extension.

Drabman, Tarnowski, and Kelly (1987) investigated children's month of birth in relation to mental health referrals and found that the younger children in a class were disproportionately referred for services. We conducted a replication and extension of the Drabman et al. investigation. Data were collected on children's (N = 222) cognitive and academic competencies. Results indicated that (a) younger children in a class were disproportionately referred, (b) the referral pattern remained constant across all grades examined, (c) the referral pattern could not be explained by differences in children's competencies, and (d) although the youngest children in the class were referred most frequently, they had the lowest rate of qualification for special services.

Relationships among children's health-related behaviors: a multivariate, developmental perspective.

Considerable evidence documents the aggregation of cardiovascular risk factors in children; yet, very little is known about the covariation of children's health practices. Accordingly, using a multivariate and developmental perspective, the present research examines the interrelationships among multiple health behaviors (i.e., physical activity, eating habits, smoking, alcohol use, and stress-related behaviors) in 1,092 predominantly low-socioeconomic status, rural schoolchildren (ages 11-18, grades 6-12). Our data provide support for a multidimensional view of children's health habits and suggest that patterns of interrelationships may vary at different developmental levels. Implications of these results are discussed and directions for future research are highlighted.

Videotaped modeling and film distraction for fear reduction in adults undergoing hyperbaric oxygen therapy.

We used a combined videotaped coping model and film distraction technique to reduce the distress of patients undergoing hyperbaric oxygen (HBO) therapy. Five experimental patients ranging in age from 34 to 68 were shown a videotape that depicted a coping model and then viewed a feature film as a distraction during their first exposure to HBO. In comparison with 6 control patients ranging in age from 17 to 53, the experimental patients experienced less arousal and rated themselves as significantly more relaxed before treatment, completed significantly more prescribed treatments without complication, and required fewer days in the hospital. These results support the use of modeling and distraction techniques as a cost-effective means of reducing distress and improving patients' compliance with HBO therapy.

A modified habit reversal procedure in a recalcitrant case of trichotillomania.

An 11-year-old girl with a severe and recalcitrant case of trichotillomania was successfully treated with a modified habit reversal procedure. Erosion estimates and serial photographic assessment methods were used to document client progress over a one-year period. Treatment effects were socially validated by attractiveness ratings of 20 same-aged children. Results extend the use of habit reversal procedures to a severe case and address the need for reliable and valid assessment procedures as well as extended follow-up.

Teaching intermittent self-catheterization skills to mentally retarded children.

In an A-B design with replication, the efficacy of a behavioral training program for teaching two mildly retarded children intermittent self-catheterization skills was assessed. Component skills were task-analyzed and trained via a graduated prompting procedure. Results indicated that both children rapidly acquired the component skills necessary to perform self-catheterization in an accurate and nearly independent manner. Benefits of children engaging in their own health-care maintenance are discussed.

Behavior modification in physical therapy.

Behavioral techniques reported to improve ambulation skills among physically handicapped persons include both reward and desensitization procedures. This report describes the application of other behavior modification principles to two patients who resisted physical therapy (PT) designed to educate them in the use of orthopedic assistive devices. Peer modeling was used with case 1, a 2 1/2-year-old girl with complete L4 spina bifida who cried frequently when wearing her brace, and refused to walk except with much assistance. Case 2 was a 21-year-old hemiplegic man seen two years after a severe head injury. Initially, severe tantrum behavior accompanied all demands placed on him. Treatment involved a combination of contingent music for being quiet and contingent aversive auditory feedback for yelling. In both cases clinically significant behavioral changes were observed. Results are discussed with respect to the cost effectiveness of behavioral interventions and the interdisciplinary coordination of rehabilitation team members.