An Evaluation of the Emergence of Untrained Academic and Applied Skills After Instruction With Video Vignettes.

Applied behavior-analytic skills are derived from precise, technical, objective operational definitions and exemplars of natural phenomena. In some cases, technical behavior-analytic terminology can be challenging for students and practitioners to learn and apply given a person's individual history with the concepts. One of the conceptual areas of behavior analysis that learners tend to struggle with more than other areas is the functional account of human language or verbal behavior. We used an emergent-responding training protocol with freely available and easy-to-implement web-based learning tools to teach the terms and definitions of Skinner's taxonomy of verbal operants using video exemplars and mixed response forms to six graduate students. We also tested for the emergence of untrained applied clinical skills in the form of collecting data while watching novel real-world video exemplars. We found that the video-based training system reliably resulted in the emergence of untrained responding and generalization to novel stimuli and responses and that the skills were maintained by four out of six participants for 2 weeks. In addition, the applied skills performances of the participants were comparable to students who received traditional training in verbal behavior, slightly lower than the performances of Board Certified Behavior Analysts, and considerably lower than the performances of doctoral-level BCBAs. When compared to other published research that used emergent-responding training protocols, the current study required more training time on average but resulted in better performances during some maintenance probes. A brief conceptual analysis of our data is presented, as well as recommendations for future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40616-020-00140-3.

Comparing Stimulus Equivalence-Based Instruction to a Video Lecture to Increase Religious Literacy in Middle-School Children.

Being familiar with world religions and their diverse practices is referred to as religious literacy. The present study compared the effects of stimulus equivalence-based instruction (EBI) and video lecture (VL) to increase religious literacy in middle-school students; 10 participants were assigned to either the EBI or the VL group. Participants in the EBI group were taught five 6-member equivalence classes using match-to-sample (MTS) software on a computer. Within each class of (1) Judaism, (2) Islam, (3) Christianity, (4) Hinduism, and (5) Buddhism, the visual stimulus members were (A) name of the religion, (B) major religious symbol, (C) sacred text, (D) notable religious figure, (E) name of religious service leader, and (F) notable celebrated holiday. The VL participants were given an opportunity to complete a fill-in written worksheet while viewing a video lecture about the 5 religions using the same stimuli as the EBI group. Participant responding in each group was compared across worksheet, oral, and MTS pretests and posttests. The results showed that 5 of 5 participants in the EBI group formed equivalence classes but only 1of 5 did so in the VL group. Class-consistent responding generalized to oral vignettes to a greater degree for the EBI participants than for the VL participants. In addition, at an approximately 2-week follow-up, EBI participants maintained class-consistent responding to a greater degree than VL participants did. Duration measures showed that even though EBI was more effective, EBI training did require more time than the VL did. Although not explicitly programmed for, social distance survey scores showed that participants improved equally in their ratings of the acceptability of people from other faiths following training, regardless of training type. Thus, EBI may be an effective method to teach schoolchildren about religious literacy.

Surgical Reconstruction Technique of Two Patients With Tarsal Type Preaxial Polydactyly: Two True Prehalluces.

Polydactyly of the foot occurs in 1.7 cases per 1000 live births, comprising 45% of congenital abnormalities of the foot. Most reported cases of polydactyly of the foot are postaxial, and 15% are preaxial; of those, tarsal type preaxial polydactyly (a true prehallux) occurs in only 3% of cases. Because of this rarity, there is minimal literature available to guide management or surgical reconstruction. Two newborns presented with similar tarsal type preaxial polydactylies in the context of multiple congenital anomalies at a single institution. Patient 1 presented at birth with an accessory digit arising medially from the right foot at the medial malleolus. Two weeks later, genetically unrelated, patient 2 presented at birth with an accessory digit arising medially from the right foot at the talus. Both patients underwent resection of the extra digit and reconstruction including transfer of the accessory anterior tibial tendon arising from the preaxial extra digit to the remaining first ray. Two years after surgery, both patients are walking well with preserved dorsiflexion strength. Given the rarity of true prehallux cases, reported surgical treatment and outcomes are lacking. This case demonstrates the management of 2 patients to better guide future patient care. Although nonsurgical treatment with shoewear modification is an option, surgical reconstruction facilitated wearing typical shoes while preserving ambulatory ability. Both patients in this series had an accessory anterior tibial tendon. Surgical transfer of the tendon prevented loss of dorsiflexion strength and foot drop postoperatively.

The Conditions for Ethical Application of Restraints.

Despite the lack of evidence for the effectiveness of physical restraints, their use in patients is widespread. The best ethical justification for restraining patients is that it prevents them from harming themselves. We argue that even if the empirical evidence supported their effectiveness in achieving this aim, the use of restraints would nevertheless be unethical, so long as well-known exceptions to informed consent fail to apply. Specifically, we argue that ethically justifiable restraint use demands certain necessary and sufficient conditions. These conditions are that the physician obtained informed consent for their application, that their application be medically appropriate, and that restraints be the least liberty-restricting way of achieving the intended benefit. It is a further question whether their application is ever medically appropriate, given the dearth of evidence for their effectiveness.