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Biomedical subjects

M F Cataldo

Publications and source records attributed to M F Cataldo.

At least 37 records · Page 2Linked to original sources
PubMed1985

Behavioral covariation in the treatment of chronic pain.

The successful use of operant procedures to alter behaviors associated with various medical conditions suggests that such behaviors may be learned and that the principles of learning may be applied not only to treatment but also to the study of the pathogenesis of illness behavior. The present study, conducted within an ongoing neuromuscular research project, assessed the covariation of behaviors associated with chronic pain within and across behavioral and drug approaches to treatment. Problems of screaming and five other behaviors (including self-reports of pain) were measured across conditions of varying behavioral contingencies (noncontingent reinforcement vs the removal of reinforcement contingent upon screaming) and varying administration (time since medication and dosage) of Parsidol during attempts to treat the muscle pain of a 24-year-old male with a severe, chronic neuromuscular disorder diagnosed as dystonia musculorum deformans (DMD). Results indicated that: (a) pain behaviors covaried during behavioral and drug conditions even though the behavioral intervention only targeted screaming; (b) effects were greater on nontargeted behaviors during periods that followed rather than preceded drug administration; (c) in contrast to behavioral observation data, physiological measures of neuromuscular activity (EMG) did not differ across conditions. These results suggest that functional response-response relationships exist in patients as the result of their illness experience.

Adult↗
PubMed1985

Rumination syndrome in children treated by increased holding.

Rumination syndrome--the frequent regurgitation of previously ingested food into the mouth where it is chewed--is a common, life-threatening disorder of retarded individuals. Four cases are described in which holding a retarded, ruminating child for 10-15 min before, during, and after meals, was associated with remission of rumination. Simple holding was effective in three; in the fourth, it was necessary to punish the child by putting her into a separate room for 3 min immediately after regurgitation. A within-subject reversal experimental design suggested that holding and not simple distraction was the effective component of the treatment. Treatment benefits were well maintained when the child returned to a home environment in which he or she continued to be held periodically. It is proposed that there are two behavioral etiologies for idiopathic rumination syndrome--social deprivation and reward learning through increased attention for regurgitation. Holding is the treatment of choice for the first type, and punishment with time out may be necessary to suppress regurgitation in the second type.

Child Behavior Disorders↗
PubMed1984

Operant treatment of orofacial dysfunction in neuromuscular disorders.

The popularity and reported success of biofeedback treatment for neuromuscular disorders has occurred despite a lack of research identifying the critical variables responsible for therapeutic gain. In this study, we assessed the degree to which severe neurological dysfunction could be improved by using one of the components present in all biofeedback treatment, contingency management. Three cases of orofacial dysfunction were treated by reinforcing specific improvements reliably detectable without the use of biofeedback equipment. The results showed that contingency management procedures alone were sufficient to improve overt motor responses but, unlike biofeedback treatment, did not produce decreases in the hypertonic muscle groups associated with the trained motor behavior. The findings suggest that sophisticated, expensive biofeedback equipment may not be necessary in treating some neuromuscular disorders and that important clinical gains may be achieved by redesigning the patient's daily environment to be contingently therapeutic, rather than only accommodating the disabilities of the physically handicapped.

Adult↗
PubMed1983

Behavioral variability as a function of noncontingent adult attention, peer availability, and situational demands in three hyperactive boys.

Recommendations about placements for children in need of special education are routinely made and carried out without empirical validation for the efficacy of particular approaches nor the appropriateness of an approach for a particular child. A study was designed to examine a methodological model which focuses on empirically deriving recommendations for the most appropriate teaching situation for any given child requiring special education. Prosocial, problem, and task-related behaviors in three hyperactive boys were assessed in eight prearranged situations: (1) group play with one adult supervising; (2) group play with three adults; (3) group teaching with one adult; (4) group teaching with three adults; (5) individual play with low density noncontingent adult attention; (6) individual play with high density noncontingent adult attention; (7) individual teaching with low density noncontingent adult attention; and (8) individual teaching with high density noncontingent adult attention. Behaviors assessed included adult, peer, and target child attention given and received; compliance; aggression; disruption; task involvement; and percent tasks correctly completed of tasks attempted. Data revealed that the most disruptions and least efficient task performance occurred in the group teaching situation with one adult. The most efficient task performance and fewest disruptions in a teaching situation occurred in the individual teaching setting with high density noncontingent adult attention. In addition, overall mean rates of disruptive behavior were higher in group situations than in individual situations. The data strongly validate the need for carefully selecting educational environments for problem children, and that the behavior of such children is, at least, partially influenced by environmental factors.

Aggression↗
PubMed1983

The class specific effects of compliance training with "do" and "don't" requests: analogue analysis and classroom application.

Two experiments are reported in which the relationship between compliance with "do" and "don't" requests was examined with developmentally disabled children. In Experiment 1, a multiple baseline design across subjects with counterbalanced treatment conditions was used to evaluate a compliance training program composed of four phases: (a) baseline, during which no consequences were delivered for compliance, (b) reinforcement for compliance with one targeted "do" request, (c) reinforcement for compliance with one targeted "don't" request, and (d) follow-up with reinforcement on a variable ratio schedule for compliance with any "do" or "don't" request. Results of probes conducted before and after training within each condition indicated that generalized compliance occurred only with requests of the same type as the target exemplar ("do" or "don't"). In Experiment 2, these results were replicated in a classroom setting. Following collection of baseline probe data on student compliance, a teacher training program was successfully implemented to increase reinforcement of compliance first with one "do" and subsequently with one "don't" request of a target student. Results of multiple baseline probes across "do" and "don't" requests indicated that the teacher generalized and maintained reinforcement of compliance with other requests of the same type and to other students, with a resulting increase in student compliance with the type of requests reinforced. The impact of treatment on both teacher and student behavior was socially validated via consumer ratings. Implications of these findings with respect to response class formation and compliance training programs are discussed.

Autistic Disorder↗
PubMed1981

Compliance training and behavioral covariation in the treatment of multiple behavior problems.

The present study investigated the use of a compliance-training procedure and its effect on untreated deviant child behaviors. Three children, each generally noncompliant to adult requests and with several additional problems, such as crying, aggression, and self-injurious behavior, were trained in the compliance procedure under a multiple-baseline design across therapists. Compliance was defined as the correct response to prespecified requests. Other classes of deviant child behavior were measured continuously throughout the study but not directly reinforced. The results of the study showed that (a) increases in compliance to requests were directly related to the contingencies employed; (b) decreases in untreated deviant behaviors occurred when compliance increased, even though no direct contingencies had been placed on these behaviors; and (c) the relationship between untreated deviant behaviors and compliance appeared to be maintained by a different set of events in each of the three children. The results are discussed in terms of behavioral covariation and generalization.

Aggression↗
PubMed1981

Biofeedback treatment of fecal incontinence in patients with myelomeningocele.

Approximately six hours of biofeedback training was given to eight fecally incontinent children with myelomeningocele in order to establish bowel control. Their ages ranged from five to 15 years. The patients were shown a polygraph tracing of the external anal sphincter while they were being encouraged voluntarily to contract the sphincter when the rectum was distended with progressively larger volumes of air in a balloon. Seven of the eight patients showed normal sensation for rectal distension. Following this training period, five of the children had no incontinent periods, and two of these had discontinued enemas or suppositories. A sixth patient had an 80 per cent reduction in the frequency of incontinence. The remaining two did not benefit. At follow-up between 13 and 24 months later, four children were incontinent once a month or less often; two others were incontinent once per day, a considerable decrease from the pretraining period. The two children who failed to learn were still incontinent at follow-up. These results show that fecally incontinent patients with myelomeningocele can learn to evacuate normally or to reduce soiling after a relatively short period of biofeedback training.

Adolescent↗
PubMed1980

Behavior therapy techniques in treatment of exfoliative dermatitis.

We report here a case study in which behavior therapy techniques were used to treat the persistent and severe scratching of a patient with long-standing exfoliative dermatitis. A multiple-baseline clinical design across different body areas was used to evaluate the behavioral treatment program. This program consisted of (1) training the patient to monitor his scratching behavior and to use an incompatible response and distraction procedure contingent on the occurrence of scratching, and (2) differential attention by the therapist, so that the therapist's attention was contingent on intervals of nonscratching, and the therapist ignored the patient when he did scratch. The results indicated that the program was effective in almost completely eliminating scratching when a variety of therapists were and were not present. This suggests that the procedures used might easily be taught to the nursing staff.

Adult↗
PubMed1979

A behavior analysis approach to high-rate myoclonic seizures.

Epilepsy represents a serious medical and social problem. In the majority of cases, seizures are successfully managed by a variety of anticonvulsant medications, even though these drugs may potentiate significant physical and developmental side effects. A small group of studies to date have offered evidence that behavioral procedures can successfully manage some seizure disorders and are particularly desirable treatment choices when seizure disorders are intractable to drug management or when drug side effects are to be avoided. The present case adds to this small but growing group of studies in that it demonstrates the use of behavioral procedures in the analysis and treatment of high-rate myoclonic seizures. Seizures were evaluated on a hospital ward and in a controlled experimental setting. The data indicated a variable rate of seizures across days and activities and a reduction of seizure frequency in the controlled setting when time-out was made contingent on seizures. A program of contingent rest' was then applied on the hospital ward that demonstrated a reduction in myoclonic seizure frequency and the apparent prevention of several grand mal episodes. An observer calibration procedure showed high correspondence between behaviorally and physiologically recorded seizures. A discussion of issues in behavioral medicine research follows.

Behavior Therapy↗
PubMed1979

Behavioral assessment for pediatric intensive care units.

Two studies were conducted to analyze behaviors of staff and patients on a Pediatric Intensive Care Unit (PICU). In the first study, behavioral observation procedures were employed to assess patient state, physical position, affect, verbal behaviors, visual attention and activity engagement, and staff verbal behavior. On the average, one-third of the patients were judged to be conscious and alert but markedly nonengaged with their environment. In the second study, a member of the hospital staff provided alert patients with individual activities to determine whether a simple environmental manipulation could positively affect behavior of children in intensive care. Employing a reversal design, the activity intervention was found to increase attention and engagement and positive affect, and to decrease inappropriate behavior. Both studies demonstrate that behavioral assessment procedures can provide an empirical basis for designing PICU routines affecting children's psychosocial status, and, thus, complement current procedures designed to provide quality medical care.

Adolescent↗
PubMed1978

Experimental analysis of EMG feedback in treating dystonia.

Recent clinical reports have suggested that electromyographic feedback offers promise as a palliative therapy for neuromuscular disorders. This study utilized a single-subject experimental analysis to evaluate the effects of EMG feedback training on a 20-year-old man with adult-onset idiopathic dystonia to achieve control of orofacial dysfunctions. Feedback training produced reductions in levels and variability of tension in facial and forearm muscles, as measured by EMG. Reliable blind observations of facial control indicated that feedback training enabled the patient to produce normal facial relaxation in extraclinical environments.

Adult↗
PubMed1978

Experimental analysis of EMG feedback in treating cerebral palsy.

Three subjects diagnosed as having severe choreoathetoid cerebral palsy were trained in the use of EMG feedback procedures. Both between- and within-session controls, including reversals of baseline, attempted muscle control with feedback, and muscle control without feedback, were employed to analyze the contribution of feedback procedures to improvements in muscle control. The data (1) indicate that feedback enhanced muscle control and (2) provide evidence of generalization of feedback effects to no-feedback conditions and untrained muscles.

Adult↗
PubMed1977

Considerations in the analysis and treatment of dietary effects on behavior: a case study.

Scientific and public interest in the effects of diet of behavior disorders has recently increased. This paper argues that (1) the experimental analysis of behavior offers an effective scientific methodology for assessing the effects of dietary substances on behavior problems, and that (2) such analysis permits behavioral consequences to be considered as an alternative treatment to dietary control. A case study of a 9-year-old retarded boy with autistic behaviors is presented. Suspected dietary substances were demonstrated to be effective influences on the child's behavior, whereas a simple behavior modification program improved his problem behaviors. Also discussed are issues and problems which arise in research on dietary effects on behavior and in selection of effective and ethical treatments.

Behavior Therapy↗