Reduction of tremor severity and disability following behavioral relaxation training.

The effects of behavioral relaxation training (BRT) for the treatment of moderate to severe essential tremor (ET) was evaluated with two older adults, ages 73 and 83, using a single-case design and statistical analysis. Measures included within-session clinician and self-rated tremor severity and disability in activities of daily living (ADL), EMG activity, and daily self-ratings of tremor severity and ADL disabilities. Following a brief 2-4 week baseline period BRT was conducted. Clinically significant reductions of 47-66% in within session clinical and self-rated tremor severity and daily self-ratings were obtained. Statistically significant changes in self- and clinician ratings occurred following BRT. In some cases, EMG activity also declined following intervention. Results at a seven week follow up were mixed and related to continued use of relaxation skills. While the cost ratio (medication: BRT) indicates that relaxation training is more expensive relative to standard medical intervention, cost-benefit to patients off sets the financial difference. Relaxation training may be an efficacious first step in a biobehavioral stepped care treatment model.

Response allocation to concurrent fixed-ratio reinforcement schedules with work requirements by adults with mental retardation and typical preschool children.

The present experiments examined the effect of work requirements in combination with reinforcement schedule on the choice behavior of adults with mental retardation and preschool children. The work requirements of age-appropriate tasks (i.e., sorting silverware, jumping hurdles, tossing beanbags) were manipulated. Participants were presented with their choice of two response options for each trial that varied simultaneously on both work requirement and reinforcement schedule. Results showed that when responding to both choices occurred on the same reinforcement schedule, participants allocated most of their responses to the option with the easier work requirement. When the response option requiring less work was on a leaner reinforcement schedule, most participants shifted their choice to exert more work. There were individual differences across participants regarding their pattern of responding and when they switched from the lesser to the greater work requirement. Data showed that participants' responding was largely controlled by the reinforcement received for responding to each level of work. Various conceptualizations regarding the effects of work requirements on choice behavior are discussed.

Effects of abdominal and thoracic breathing upon multiple-site electromyography and peripheral skin temperature.

Peripheral finger temperature, frontalis and upper trapezius EMG, and self-report of arousal were assessed for four subjects during abdominal and thoracic breathing in a single-subject reversal design. Two subjects displayed significant differences between abdominal and thoracic breathing conditions; one for frontalis EMG, trapezius EMG, and self-report of arousal and one for trapezius EMG. Two subjects showed no significant effects. All subjects reached performance criteria during training sessions. Abdominal breathing performance during reversals was 100% and 92% of sampled breath cycles for the two subjects who showed significant change, and 65% and 42% for the two subjects who showed none. Methodological issues for measurement of breathing patterns and peripheral skin temperature are discussed.

Biobehavioral rehabilitation for older adults with essential tremor.

Essential tremor (ET), the most prevalent movement disorder, has a peak prevalence in the sixth decade of life. ET primarily affects the hands and head. Persons with ET are often significantly disabled in communication, work, leisure, domestic activities, and psychosocial adjustment. Medical intervention for ET is often limited in effectiveness. A biobehavioral rehabilitation model for older adults with ET is described.

Behavioral relaxation training for tremor disorders in older adults.

Two adult men, aged 86 and 63, with essential tremor and Parkinson's-disease-related tremor, respectively, were provided Behavioral Relaxation Training in reclined and upright seated positions. Multiple measures were recorded, including the Behavioral Relaxation Scale (BRS), clinical and self-rated tremor severity, informant ratings, ratings of disability in activities of daily living (ADL), and forearm EMG. Results showed increased relaxation skills on the BRS, with reductions in EMG, tremor ratings, and some ADL disabilities. Upright BRS scores did not change during reclined training, but improved rapidly during upright training. The second man was found to suffer from dyskinesia when he relaxed during baseline, which declined markedly during training. A two-week follow-up indicated that most improvements were maintained by both men. Statistical analyses of data for each man showed significant changes. These results suggest that relaxation may be useful in the treatment of idiopathic and pathologic tremor disorders in older adults.

Teaching parents to conduct behavioral relaxation training with their hyperactive children.

Three boys meeting multiple criteria for hyperactivity received Behavioral Relaxation Training (BRT) in their homes from their parents, under the supervision of the experimenter. BRT involved modeling, prompting, token reinforcement, and praise, for ten overt relaxed behaviors. All children learned to relax to a criterion of at least 80% on the Behavioral Relaxation Scale (BRS), an objective measure of relaxation. Frontalis EMG levels were correlated with BRS scores for two children. Proficiency was maintained at one and three-month follow-ups. All children were removed from medication by follow-up. Parent ratings of hyperactive behavior on two standardized questionnaires showed improvements from baseline to follow-up. Teacher ratings of problem behavior were less consistently positive. The concept of relaxation as a skill rather than a state, and its implications as an alternative to medication therapy, are discussed.

Electromyographic biofeedback and rest position training of masticatory muscles in myofascial pain-dysfunction patients.

Twenty-four women outpatients with myofascial pain-dysfunction were divided into three groups of eight. All received bilateral masseter electromyographic biofeedback training. One group received biofeedback only; one group received additional instructions and modeling to place their jaw in the "rest" position; and one group was given a prosthetic guide that spaced the incisors 6.8 mm apart. Two 15-minute training sessions were conducted at a 1-week interval, with posttreatment assessment 2 weeks later. The instruction and prosthesis groups obtained significantly greater electromyographic reductions in masseter activity and increases in mandibular range of motion compared with the biofeedback-only group. Subjects with pain obtained a significant reduction in therapist and self-report pain ratings. The results suggest that short-term biofeedback treatment may be meaningfully augmented by procedures that place the mandible in the rest position.

Generalization of EMG biofeedback training.

Five young adults received audio biofeedback training to reduce trapezius EMG levels while they engaged in reading in an office, seated at a table. A multiple-baseline-across subjects design was employed in two separate studies. After training, all subjects demonstrated reduced EMG levels while reading in a home or library setting. The first study suggested that subjects reduced EMG levels by minimizing movements and altering their postures; the second study systematically demonstrated changes in such behavior, which was correlated with EMG levels. The data provide evidence that EMG biofeedback resulted in response generalization across several motoric classes, and in stimulus generalization from the training setting to the natural environment. The importance of assessing generalization is discussed.

Relaxation training as a treatment for chronic headaches in an individual having severe developmental disabilities.

We have assessed effects of a simplified relaxation training on the frequency of headaches and consumption of analgesic headache medication in an adult male with severe developmental disabilities as well as chronic mixed headaches. The subject received Behavioral Relaxation Training (BRT) after a baseline period during which frequency of headache complaint, analgesic medication consumption, and independent relaxation behaviors were monitored. BRT consists of the utilization of modeling, prompting, feedback, and positive reinforcement in order to establish and maintain the subject's participation in 10 overt relaxed postures. The behaviors were learned to at least an 80% proficiency during a 10-minute alternating self-regulatory (1 min)/corrective feedback (1 min) relaxation phase across several sessions. Headache complaints were reduced by 48% and analgesic medication consumption by 51% as assessed during a 2-month posttreatment evaluation. These results should be considered not only as support of BRT as a viable method of relaxation training but also as a suggestion that BRT and other self-regulatory treatment should be considered for use with individuals having moderate to severe developmental disabilities.

Behavioral relaxation training with hyperactive children.

Three boys meeting multiple criteria of hyperactivity were trained to emit ten specific relaxed behaviors by means of Behavioral Relaxation Training (BRT). Dependent measures included the Behavioral Relaxation Scale (BRS), frontalis electromyogram (EMG), the Conners Parent Symptom Questionnaire, and self-report. A multiple-probe design across subjects was employed, plus a reversal between recliner and beanbag chair for each subject. BRT was effective in producing high levels of relaxed behaviors and low EMG levels in the office setting, particularly in conjunction with the beanbag chair, with some reduction of hyperactivity scores on the Conners. Subsequent training in each child's home by his mother was accompanied by further reductions in parent-reported symptoms and low EMG levels, which were maintained at a 1-month follow-up.

A behavioral analysis of diaphragmatic breathing and its effects on peripheral temperature.

Three young women volunteers were trained through instructional feedback in two breathing procedures: diaphragmatic, derived from Eastern meditative techniques, and thoracic, involving opposite maneuvers. A single-subject reversal design was employed. Physiograph recordings of diaphragmatic expansion and mouth breathing provided the basis for feedback. Peripheral (digital) temperature was time-sampled at 1-min intervals and linear regression lines were fitted to the data. Temperature decreased throughout "normal" (baseline) breathing, probably due to warm outdoor and cool indoor temperatures. For two subjects, temperature during diaphragmatic breathing was generally stable; temperature during thoracic breathing showed significant decreases and did not differ from normal breathing. Within-session reversals showed dramatic changes in temperature as a function of breathing technique, which were maintained at follow-up, for these subjects. Temperature was more labile and decreased regardless of breathing procedure for the third subject. These data support a relationship between respiratory and vasomotor activity, and suggest that breathing strategy may be an uncontrolled variable in temperature biofeedback. It is further suggested that diaphragmatic breathing may facilitate temperature biofeedback or other types of relaxation training.

Behavioral relaxation training and assessment.

Behavioral Relaxation Training (BRT), a set of ten overt behaviors directly taught by prompting and performance feedback, was compared with frontalis EMG Biofeedback (BIO), Progressive Muscle Relaxation (PMR), and a Music "attention focusing" (MUS) control, on five dependent measures of relaxation, in four groups of volunteers for a "stress-reduction" project. The dependent measures consisted of the Behavioral Relaxation Scale (BRS), frontalis EMG, finger temperature, skin conductance level, and self-report. BRS scores decreased in BRT, BIO, and PMR, but not MUS groups. EMG decreased in the BRT and BIO groups, but not in PMR or MUS. BRT retained its improvements at 4-6 week follow-up. All groups reported similar improvements on the self-report scale, Temperature and skin conductance were not systematically related to training procedures. Significant correlations between BRS and EMG were obtained.

Electromyographic analysis of relaxed postures.

Six male volunteers assumed either "relaxed" or "unrelaxed" postures, as defined by a Behavioral Relaxation Scale, in seven areas of the body. Electromyographic (EMG) levels in the muscle groups associated with each area were determined for both categories of postures. In all instances, the "relaxed" postures produced significantly lower EMG levels than the "unrelaxed" postures. This indicates that the Behavioral Relaxation Scale is a valid behavioral measure of relaxation. Also, it supports other studies which have shown that direct training in emitting relaxed postures is an effective means of achieving relaxation.

Human performance on conjunctive fixed-interval fixed-ratio schedules.

Eighteen young adults performed a lever-pulling task for money. Subjects were initially exposed to a fixed-interval 80-second schedule and subsequently to one of three conjunctive schedules in which the added fixed-ratio requirement was set at either 10, 80, or 120 responses. Three fixed-interval response patterns emerged: high constant rate, intermediate rate, or low rate, with most subjects displaying the last. Conjunctive performance was related to the subjects' prior fixed-interval patterns and the conjunctive ratio requirements. Low-rate subjects tended to optimize reinforcement (maximum reinforcers for minimum responses) on conjunctive schedules. Response rate was directly related to ratio requirements. Subjects' performance closely corresponded to their verbal statements of the contingencies.

Human fixed-interval performance with concurrently programmed schedules: A parametric analysis.

Young adults pressed a lever for points, exchangeable for money, programmed on concurrent schedules in which one component was a fixed-interval and the other component either a fixed-ratio (Experiment 1) or a differential-reinforcement-of-low-rate (Experiment 2). Two general patterns of fixed-interval responding, postreinforcement pause or constant rate, occurred in both experiments as a function of the parameter values of each component. Also patterns of interaction between the component schedules developed, in which responding or point delivery on one component appeared to be discriminative for responding on the other component. Once a pattern of responding was established, it tended to persist when the parameter values of the schedule were changed. On many schedules, subjects with an experimental history responded differently than did naive subjects, although certain schedule values were resistant to the history effects. The role of verbal strategies in mediating history effects was discussed.

The fixed-interval scallop in human affairs.

"Fixed-interval scalloping" is used to describe certain everyday patterns of behavior in textbooks and other educational communications. This is a misleading use of the term. It implies that the behavior is accounted for by the schedule, when, in fact, many other variables are operating. This paper reviews eleven such variables and the research evidence on them. These variables provide a more adequate account of complex behavior and point up areas of limited knowledge requiring further research in both laboratory and applied settings. Extrapolating from basic research on human fixed-performance suggests that there are phenomena of mutual interest to both basic and applied behavior analysts.

Effects of concurrent schedules on human fixed-interval performance.

Young adults performed a lever-pressing task for money on two schedules of reinforcement: concurrent fixed-interval 1 min-differential-reinforcement-of-low-rate 20-sec, and concurrent fixed-interval 1-min-fixed ratio 100 responses. All subjects were trained on both schedules. Fixed-interval performance concurrent with the differential reinforcement procedure was characterized by high constant rates with no post-reinforcement pauses. Fixed-interval performance concurrent with fixed ratio was characterized by low rates and lengthy post-reinforcement pauses. These results differ from those obtained in prior studies on the effects of conditioning history upon subsequent fixed-interval performance. The prior work, using non-concurrent procedures, had shown that fixed-interval performance following differential reinforcement of low rates was characterized by post-reinforcement pauses and low rates, while fixed-interval performance following fixed ratio exhibited high constant rates and no post-reinforcement pause. The present results suggest that alternative concurrent contingencies are another major determinant of human fixed-interval performance.