The use of a brief movement restriction procedure to eliminate severe inappropriate behavior

The Three-Level Synthesis of Standardized Single-Subject Experimental Data: A Monte Carlo Simulation Study

Previous research indicates that three-level modeling is a valid statistical method to make inferences from unstandardized data from a set of single-subject experimental studies, especially when a homogeneous set of at least 30 studies are included ( Moeyaert, Ugille, Ferron, Beretvas, & Van den Noortgate, 2013a ). When single-subject data from multiple studies are combined, however, it often occurs that the dependent variable is measured on a different scale, requiring standardization of the data before combining them over studies. One approach is to divide the dependent variable by the residual standard deviation. In this study we use Monte Carlo methods to evaluate this approach. We examine how well the fixed effects (e.g., immediate treatment effect and treatment effect on the time trend) and the variance components (the between- and within-subject variance) are estimated under a number of realistic conditions. The three-level synthesis of standardized single-subject data is found appropriate for the estimation of the treatment effects, especially when many studies (30 or more) and many measurement occasions within subjects (20 or more) are included and when the studies are rather homogeneous (with small between-study variance). The estimates of the variance components are less accurate.

The association for behavior analysis international position statement on restraint and seclusion

A task force authorized by the Executive Council of the Association for Behavior Analysis International (ABAI) generated the statement below concerning the techniques called restraint and seclusion. Members of the task force independently reviewed the scientific literature concerning restraint and seclusion and agreed unanimously to the content of the statement. The Executive Council accepted the statement, and it was subsequently approved by a two-thirds majority vote of the general membership. It now constitutes official ABAI policy. The position statement is posted on the ABAI Web site (www.abainternational.org/ABA/statements/RestraintSeclusion.asp). The purpose of the position statement is to provide guidance to behavior analysts and other professionals interested in the position of ABAI on these controversial topics. In extreme cases, abuses of procedures erroneously used in the name of behavior analysis are not defensible. On the other hand, behavior analysts acting ethically and in good faith are provided with guidelines for sound and acceptably safe practice. To the extent that behavior-analytic positions influence public policy and law, this statement can be presented to officials and lawmakers to guide informed decision making. At the conclusion of the document, a bibliography is provided of articles and presentations considered by one or more task force members in developing the position statement.

Effects of behavior-contingent and fixed-time release contingencies on frequency and duration of therapeutic restraint

Reducing therapeutic restraint is a desirable outcome for programs that serve individuals who exhibit challenging behaviors. This study investigated the effects of modifying the criterion for release from therapeutic restraint on frequency and duration. Release from restraint was changed from a behavior-contingent criterion (restraint terminated when a specified duration of calm behavior was demonstrated) to a fixed-time criterion (restraint terminated when a predetermined duration elapsed independent of behavior) with one child and two adolescents with acquired brain injury and difficult-to-manage behaviors. For all three students, the duration of time they were exposed to therapeutic restraint decreased with the fixed-time release criterion, whereas the frequency of restraint did not change. Practical implications of these results and future research opportunities are discussed.

On the status of knowledge for using punishment implications for treating behavior disorders

In this paper, we review basic and applied findings on punishment and discuss the importance of conducting further research in this area. The characteristics of responding during punishment and numerous factors that interact with basic processes are delineated in conjunction with implications for the treatment of behavior disorders in clinical populations. We conclude that further understanding of punishment processes is needed to develop a highly systematic, effective technology of behavior change, including strategies for improving the efficacy of less intrusive procedures and for successfully fading treatment.

Scatolia: psychosis to protest

This paper presents the case of a female patient in a special hospital who engaged in faecal smearing whilst in seclusion. A management investigation followed a complaint by a Nurse Manager regarding the reluctance of staff to clean the room whilst the patients remained disturbed. The investigation team adopted a triangulated method of interviews, literature review, survey and case presentations to study the issues involved. The results presented here suggest the emergence of similar issues from both the interview commentary and the tabulated data from the survey. There appears an intricate and complex dilemma facing those managing situations involving scatolic behaviour. There are issues of concern from diverse organizational settings that overlap between those persons who engage in scatolia who may be deemed mentally impaired, psychiatrically disordered, or protest behaviour.

Physical restraint procedures for managing challenging behaviours presented by mentally retarded adults and children

This paper reviews the published research literature on the use of physical restraint with mentally retarded adults and children. Research on three types of restraint is included. One type involves one or more person(s) holding another. A second method is where a mechanical device is fitted to limit movement or reduce injury. The third type is where the person voluntarily applies a personal or mechanical restraint. The following conclusions emerged: (a) there are numerous processes which contribute to the outcomes associated with restraint, and these are poorly understood; (b) different processes mediate the outcomes for contingent and noncontingent restraint; (c) both noncontingent and contingent restraint can result in long-term reductions in target behaviours, especially when fading procedures are employed (noncontingent restraint) and where staff or carers are involved in the treatment plan (contingent restraint); (d) self-restraint seems to be maintained by the reinforcing effects of the restraint procedure or by escape from the aversive consequences of self-injury; (e) there are (negative) reinforcing consequences for staff who use restraint procedures in service settings; (f) and both staff and clients risk injury, especially from emergency or unplanned restraint.

Side effects of therapeutic punishment on academic performance and eye contact

The effects of therapeutic punishment delivered following inappropriate behavior on the academic responding and eye-to-face contact of 2 persons with developmental handicaps was examined using a counterbalanced alternating treatment design. Each subject was sequentially taught by two therapists each day. While one of the therapists taught the subject, the second therapist stood in close proximity directly behind the subject. During baseline, neither therapist delivered punishment following inappropriate behavior. During the treatment condition, one of the therapists delivered all punishment regardless of whether she was teaching or standing behind the subject. The therapist who delivered all punishment for 1 subject did not deliver any punishment for the other subject. During the last condition, the therapist delivering all punishment was reversed for 1 of the subjects. The results indicated that the task being taught was mastered by each subject only when the therapist delivering punishment was teaching. Data collected also indicated that each subject made more eye-to-face contact when the therapist delivering all punishment was teaching. Although neither therapist had to deliver punishers often, punishment had to be administered less often when the therapist teaching the subject was also the therapist delivering punishment.