A token system for a class of underachieving hyperactive children

Using an App-Based Token Economy to Increase Engagement in Daily Living and Vocational Tasks with Adults with Developmental Disabilities

The token economy is an evidence-based practice that improves outcomes across populations, settings, and behaviors. Nonetheless, their complex nature frequently leads to ineffective implementation. In addition, little is known about the extent to which token economies are effective for increasing engagement in adults with disabilities. Therefore, we conducted a multiple probe across participants to evaluate the effectiveness of a token economy using an app (i.e., Class Dojo) to increase engagement with daily living and vocational tasks in adults with disabilities. All participants increased their engagement with tasks following the introduction of the intervention and maintained higher than baseline levels of engagement up to 6 weeks after the intervention ended. Staff members completed an anonymous survey to indicate their perception of the feasibility and effectiveness of the intervention. Social validity results indicated that some staff members found the intervention effective, but time-consuming and challenging.

Attention Deficit-Hyperactivity Disorder

Attention deficit-hyperactivity disorder (ADHD) is a common problem among school-aged children wherein a student exhibits significant difficulties with attention span, impulse control and activity level. Since children with ADHD often display these symptoms on a chronic basis resulting in impaired behavior control and academic productivity, the classroom environment must be modified to enhance their adjustment. Several contingency management procedures for teacher use are briefly discussed in this paper including token reinforcement programs, contingency contracting, response cost, time-out from positive reinforcement and home-based contingency management programs. When used in conjunction with other treatment modalities (e.g. stimulant medication, parent training in behavior modification), these classroom intervention strategies often lead to significant improvements in on-task behavior, work completion, behavioral control and accuracy on academic assignments.

Interventions to address the academic impairment of children and adolescents with ADHD

There exists a strong link between ADHD and academic underachievement. Both the core behavioral symptoms of ADHD and associated executive functioning deficits likely contribute to academic impairment. Current evidence-based approaches to the treatment of ADHD (i.e., stimulant medication, clinical behavior therapy and classroom behavioral interventions) have demonstrated a robust impact on behavioral variables such as attention and disruptive behavior within classroom analogue settings; however, their efficacy in improving academic outcomes is much less clear. Although surprisingly few treatment outcome studies of ADHD have attempted to incorporate interventions that specifically target academic outcomes, the studies that are available suggest that these interventions may be beneficial. The state of the treatment literature for addressing academic impairment in children and adolescents with ADHD will be reviewed herein, as well as limitations of current research, and directions for future research.

Use of a token reinforcement system to promote appropriate behavior at a pediatric burn summer camp

Child behavior management can be an important concern in conducting summer camps for pediatric burn patients, because many of these patients have a history of significant behavioral difficulties. To be efficient, a flexible camp-wide behavior management system, such as a token economy, would be ideal. In this article we discuss the concept and principles of a token reinforcement system and outline how this intervention was applied to our pediatric burn summer camp across 2 consecutive years. We also provide a description of modifications made for the second camp, based on counselor ratings of and our experience with the token system during the first camp. Results from counselor assessments indicated that after using the token system, counselors' perceptions of its utility (eg, effective in decreasing problem behavior in campers, useful in making behavior management easier) increased significantly across both years.

Empirically supported psychosocial treatments for attention deficit hyperactivity disorder

Reviews and evaluates psychosocial treatments for attention deficit hyperactivity disorder (ADHD) in children and adolescents according to Task Force Criteria (Lonigan, Elbert, & Johnson, this issue). It is concluded that behavioral parent training and behavioral interventions in the classroom meet criteria for well-established treatments. Cognitive interventions do not meet criteria for well-established or probably efficacious treatments. Issues regarding the evaluative process are discussed and future directions for psychosocial treatment for ADHD are outlined.

Peer tutoring for children with attention deficit hyperactivity disorder: effects on classroom behavior and academic performance

We investigated the effects of classwide peer tutoring (CWPT) on the classroom behavior and academic performance of students with attention deficit hyperactivity disorder (ADHD). Typical instructional activities were contrasted with CWPT for 18 children with ADHD and 10 peer comparison students attending first- through fifth-grade general education classes. CWPT led to increases in active engagement in academic tasks along with reductions in off-task behavior for most participants. Of students with ADHD, 50% exhibited improvements in academic performance in math or spelling during CWPT conditions, as measured by a treatment success index. Participating teachers and students reported a high level of satisfaction with intervention procedures. Our results suggest that peer tutoring appears to be an effective strategy for addressing the academic and behavioral difficulties associated with ADHD in general education settings.

An examination of the "dosage" effects of both behavior therapy and methylphenidate on the classroom performance of two ADHD children

Within the context of two case studies, the effects of two doses of methylphenidate (MPH) and behavioral interventions of varying potency are examined independently and jointly. Whereas studies of dose effects of MPH exist in the current literature, studies of different "doses" of behavior therapy-that is, interventions that vary in potency--are rare. This article uses a within-subjects design to demonstrate the importance of examining different doses of both types of treatments in determining the maximally effective treatment for a given child. The importance of considering individual differences is emphasized throughout this article as response to treatment among Attention-Deficit Hyperactivity Disorder children is quite variable. Case 1 illustrates the importance of evaluating medication response within the context of differing doses of behavior therapy; Case 2 demonstrates that difficult-to-manage cases are sometimes manageable using potent doses of both treatments simultaneously.

The effects of behavioral parent training on families with young hyperactive children

We sought to assess, through two case-studies, the strengths and limitations of a time-limited, family-based behavioral intervention for preschool-aged children with attention-deficit-hyperactivity disorder (ADHD). The families completed a ten week child management training program and attended a number of follow-up sessions. Changes in parent and child functioning were assessed with a variety of rating scales, interviews, and data collected by parents at home on targeted behavior problems. Improvements were found in parents' confidence in their child management ability and knowledge of behavioral principles, in certain child behavior problems, in parental ratings of hyperactivity, and in the parent-child relationship. Implications of the findings for the treatment of young children with hyperactivity are discussed.