Effects of a nutritional supplement on coprophagia: a study of three cases.

The cases of three individuals with profound mental retardation and long histories of coprophagia (ingestion of feces) were studied to determine if fecal material could be providing a nutrient that was unavailable from a standard institutional diet. In each case the individual was provided with a daily oral supplement of an "elemental diet," which, at twice the dose administered, would provide all the nutrients necessary for sustenance. The frequency of coprophagia was decreased in all three cases when they received the supplemental nutrients as compared to when they were maintained on a balanced institutional diet alone.

Early detection of water intoxication.

1. It has been estimated that between 3% and 6% of patients in psychiatric treatment settings are affected by water intoxication. Water intoxication with consequent hyponatremia can result in disturbing clinical conditions. 2. Early detection is an important factor because of the insidious nature and rapid development of this syndrome. 3. A risk analysis for the early detection of this serious condition has been developed. It is easily administered and effective in categorizing a patient's level of risk.

Training profoundly retarded children to stop crawling.

Many profoundly retarded children continue to crawl even though they can walk. Crawling and walking were viewed as two alternative response modes, both reinforced by movement. Children choose the one mode that is easier and faster for them. A training program was designed to increase the ease and speed of walking relative to that of crawling, and consisted of restraint-for-crawling and priming-of-walking. With the program, four retarded children reduced crawling and began to walk instead. When training was discontinued, two children with moderate walking impairment continued to walk rather than crawl. Two children with severe impairment of walking, however, required the occasional use of the restraint procedure to maintain walking as the dominant mode of locomotion. The program was easily administered, required little time, and was effective for all four children.

Training and maintaining a retarded child's proper eating.

The present study was designed to explore whether motivational procedures are needed to maintain a retardate's continued use of previously trained eating skills. A profoundly retarded child who ate food with her hands was trained by a manual guidance procedure to eat properly with a spoon, but the child still did not use the spoon after having learned to do so. When a motivational-maintenance procedure was applied, the child did begin to eat properly. When maintenance was discontinued, the child returned to eating with her hands. Proper eating returned when maintenance was applied again; when discontinued, the child returned to eating with her hands. These results demonstrate that continued motivational procedures are needed after training to maintain the retardate's continued use of proper eating skills.

Behavioral engineering: two apparatuses for toilet training retarded children.

Daytime incontinence is a major problem for retarded children. A training procedure for eliminating this problem should be facilitated by an apparatus that provided the trainer with an immediate signal when the child voided so that the trainer could react immediately. Two apparatuses were developed for this purpose: a toilet-chair apparatus to signal proper toileting and a portable pants-alarm apparatus to signal wetting of the pants. A reprimand was given when pants wetting occurred whereas positive reinforcement was given for proper toileting. Results with four profoundly retarded children indicated the reliability of the apparatuses in practice and the effectiveness of a toilet training program that used the two apparatuses.