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Biomedical subjects

E R Christophersen

Publications and source records attributed to E R Christophersen.

At least 55 records · Page 3Linked to original sources

Improving compliance with medical regimens: case study with juvenile rheumatoid arthritis.

There is ample literature to suggest that a high percentage of pediatric patients with chronic diseases fail to comply adequately with their medical regimens. This study examined the effectiveness of a token reinforcement program in improving the compliance of a 7-year-old girl with juvenile rheumatoid arthritis. The parents were taught to manage the program in the home. The patient earned tokens for complying with her treatment regimen and lost tokens when she failed to comply. Tokens were exchanged for routine and special privileges. Compliance with medications, splint wearing, and lying prone was assessed by observation. Baseline data showed low levels of compliance, particularly with splint wearing and prone lying. Introduction of the token reinforcement program resulted in immediate improvement in compliance; improvement was maintained during 10 weeks of follow-up.

Arthritis, Juvenile↗

Increasing the protection of newborn infants in cars.

Recently the American Academy of Pediatrics instituted a major campaign ("The First Ride--A Safe Ride") in order to encourage all parents to use an infant restraint seat for their newborn's first ride in an automobile--the ride home from the hospital. In the present study the effect of the behavior of the hospital staff on parents' use of infant restraint seats was examined. This study involved 30 mother-infant pairs who were selected sequentially from an obstetrics unit and randomly assigned to two groups. A control group was discharged from the obstetrics unit with no particular emphasis on car safety and no loaner restraint seat available. An experimental group was offered a loaner restraint seat at the time of discharge, with a staff person demonstrating how to put the infant into the restraint seat, how to carry the infant in the seat out to the car, and how to fasten the restraint seat in the automobile with the auto lap belt. Correct use of the loaner restraint seat on the first ride home was observed in 67% of the experimental mothers and in none (0%) of the control mothers. Although this difference was no longer significant at four- to six-week follow-up this study points out the short-term impact that hospital staff can have on the parents' use of restraint seats. Additional techniques are needed to maintain parents' use of restraint seats throughout childhood.

Automobiles↗

Suppression of self-injurious behaviour: determining the least restrictive alternative.

In keeping with recent ethical and legal guidelines regarding the use of aversive treatment procedures, a number of alternatives for the treatment of self-injury have been suggested. The present study provides an example of the determination of the least restrictive but most effective treatment with a case of self-injury. Employing a combination of multiple baseline and reversal designs, the effects of DRO, overcorrection, lemon juice, and aromatic ammonia on the rate of self-poking in a profoundly retarded child were examined. DRO and overcorrection were both ineffective. Although lemon juice suppressed and stabilised the rate of poking, aromatic ammonia produced greater suppression. Implications for the testing of treatments for SIB are discussed.

Behavior Therapy↗

Behavioral pediatrics.

The family physician can, through instruction in standard caregiving skills and discussion of parental expectations, prevent or minimize behavioral problems in infants and toddlers. Behavioral problems can be detected early by having parents describe a typical day. When detected early enough, many problems which occur at bedtime, mealtime and when dressing can be managed by the interested physician.

Child↗

Teaching children appropriate shopping behavior through parent training in the supermarket setting.

The shopping behavior of three elementary school-age boys was analyzed and parent-child interactions assessed for one boy and his mother. Estimates of parent of consumer satisfaction with child shopping behavior were also obtained. The effects of a parent-mediated treatment package on child behavior were assessed using a multiple-baseline design. Treatment produced significant increases in appropriate shopping behavior in all three children and parents became increasingly satisfied with improved child behavior. Analysis of data for one mother also revealed that her manner of interacting with her child became more positive.

Behavior Therapy↗

Children's behavior during automobile rides: do car seats make a difference?

The behavior of children riding in automobiles with their mothers was assessed by having an observer accompany them on repeated 15-minute automobile rides. Children riding in car seats exhibited very high levels of appropiate or safe behavior, whereas children not riding in car seats exhibited very low levels of appropriate behavior. When car seats were introduced to those children who previously had not used them, the level of appropriate behavior improved dramatically. These results were maintained at three-month follow-up observations. Prevention or reduction of disruptive child behavior on car rides is an obviously important, but previously unreported, benefit of the use of child restraint seats. This fact might very well be used by the pediatrician to further encourage or persuade parents to purchase and use child restraint seats. The use of a child restraint seat to reduce disruptive behavior during automobile rides is an advantage, beyond the safety aspects, of introducing car seats to young children.

Accidents, Traffic↗

The home point system: token reinforcement procedures for application by parents of children with behavior problems.

Parent-child problems within the home are frequently reported to be instances in which children refuse to help with household chores, bicker among themselves, or engage in verbally inappropriate behavior toward their parents. The present study investigated the effects of a token reinforcement program administered by the parents in ameliorating these problems. Two sets of parents, with a total of five children between the ages of 5 and 10 yr, were taught to administer a token economy within their homes. The parents received instruction in specifying desired social and chore behaviors, communicated these behavioral goals to their children, recorded data on their occurrence, and managed a point system backed with reinforcers normally found in the home. The token reinforcement program was shown to have successfully modified 15 problem behaviors in Family 1 and six in Family 2. In addition, the parents rated all 21 behavior changes as significant improvements. These studies indicated that some cooperative parents need only a small amount of professional help to learn to manage their children's behavior problems with token reinforcement procedures.

Journal Article↗