Use of the Alternating Treatment Design to Evaluate Intervention in Low Vision Rehabilitation

This article illustrates the use of the alternating treatment design to assess the effectiveness of individualized interventions in low vision rehabilitation. The design was used to determine if enlarging copy with a photocopier and adding contrast would be effective in reducing the amount of time a visually impaired student required to read a map and graph. Two levels of magnification were compared to determine the level of intervention to be provided.

Behavioral interventions to reduce maladaptive responding in youth with dual sensory impairment. An analysis of direct and concurrent effects

Many persons who have multiple sensory, physical, and developmental disabilities display behaviors that interfere significantly with adaptive functioning and social acceptance. In this investigation, the efficacy of multiple component behavioral interventions for reducing maladaptive responding exhibited by two individuals with dual sensory impairment and profound mental retardation was evaluated. Results indicated that differential reinforcement of other behavior (DRO) approaches were not effective in either case. However, when deceleration procedures (overcorrection or brief physical restraint) were added, target behaviors decreased quickly. Also, interventions were faded in such a way that gains were maintained for 6 months with only minimal effort by staff. Ongoing assessment of concurrent effects of behavior reduction strategies revealed increases in time on task or amount of work completed, even though these responses were not targeted specifically. Yet negative side effects (e.g., increases in self-stimulation) also were documented, highlighting the importance of evaluating multiple behaviors during intervention. Finally, despite the fact that objective assessments led to positive conclusions regarding treatment efficacy, ratings of baseline and treatment behavior samples by independent judges showed overall improvement in only one case. These findings suggest the need for multifaceted evaluation to determine the utility of interventions in applied settings.

Improving Mealtime Behaviors of a Multihandicapped Child Using Behavior Therapy Techniques

In the present study, inappropriate mealtime behaviors of a multihandicapped child were modified via behavior therapy techniques. The subject was a blind, mentally retarded, behaviorally disordered, 10-year-old girl who was hospitalized for severe self-injurious behavior. Mealtime target behaviors included appropriate head and hand positions (essentially, absence of eye-poking, face-hitting and other self-injurious behavior) as well as napkin and utensil use. Two treatments were implemented: 1) audiotapes of favorite stories were played during the mealtime sessions which were turned off during inappropriate or self-injurious behavior; 2) praise (plus access to food) for appropriate napkin and utensil use begun once desired sitting posture had been established. Assessment of trainer behavior showed good compliance with treatment procedures, suggesting the feasibility of implementing the treatment program in other settings.