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Biomedical subjects

T J Page

Publications and source records attributed to T J Page.

27 records · Page 2Linked to original sources
PubMed1983

Reduction of food theft and long-term maintenance of weight loss in a Prader-Willi adult.

Behavioral interventions have had limited success in managing the chronic hyperphagia and obesity that are of presumed organic etiology in Prader-Willi syndrome. Thus, frequent foraging for food and covert consumption continue to be health-threatening problems for many Prader-Willi individuals. This case study was designed to replicate methods for assessment and treatment of food theft. A token program based on differential-reinforcement-of-other-behavior and response-cost eliminated theft in three hospital settings. Prior to discharge, the program was expanded to include contingencies on exercise behavior and weight loss, and staff from the subject's group home residence were trained to implement a modified program in the natural environment. Reduced food theft and continued weight loss were maintained in the group home and an apartment-living arrangement. A total of 81 lb (37 kg) was lost during a 2-yr period.

Adult↗
PubMed1983

Assessment and reduction of food stealing in Prader-Willi children.

A common behavior problem among Prader-Willi children is inappropriate foraging for food. Theft and subsequent consumption often go undetected and contribute to morbid obesity in many of these individuals. In this study an observational methodology was developed to assess food stealing in two children with Prader-Willi syndrome. The children were observed to steal food at a high rates under baseline conditions in three hospital settings. Subsequent treatment, based on differential reinforcement of other behavior (DRO), consisted of reinforcement of nonstealing at the end of progressively lengthening intervals, and was implemented in multiple baseline fashion across both subjects and settings. Results showed that both subjects' stealing rapidly ceased in treated settings, but failed to show generalization to untreated settings. Follow-up data collected in one setting after termination of active intervention reflected continued nonoccurrence of food stealing, although long-term weight data were not encouraging. Results are discussed in terms of their methodological contribution to the study and treatment of Prader-Willi syndrome.

Behavior Therapy↗
PubMed1982

Pyramidal training: a large-scale application with institutional staff.

This study evaluated an indirect method of training 45 institutional direct care staff to conduct behavioral programs. Three supervisors were trained to improve teaching behaviors (instructions, prompts, and consequence) used by the direct care staff while working with severely and profoundly handicapped residents. In addition to training, daily feedback was provided to supervisors regarding performance of their staff. Results of a multiple baseline analysis across teaching behaviors (instructions, prompts, and consequences) and content areas (communication and gross motor skills) showed that providing training and feedback to supervisors resulted in increases in correct teaching behavior by direct care staff. However, teaching behavior newly learned in one content area (communication) did not generalize to the other area (gross motor skills). Data collected on resident behavior showed small but noticeable improvement in terms of correct responses and attending behavior during programming. Results are discussed in terms of the benefits of a pyramidal approach to training institutional staff.

Adolescent↗
PubMed1981

Teaching the handicapped to eat in public places: acquisition, generalization and maintenance of restaurant skills.

This study examined classroom-based instruction in restaurant skills for handicapped persons. Three male students were taught each of four skill components in sequential order: locating, ordering, paying, and eating and exiting. Training was implemented in a multiple baseline design across subjects and consisted of modeling and role playing in conjunction with photo slide sequences and a simulated ordering counter. The use of a menu containing general item classes and a finger matching procedure for identifying errors in the delivery of change greatly reduced the reading and math skills necessary to enter and complete the program. Periodic probes were conducted in a McDonald's restaurant prior to, during, and up to one-year following the termination of training. In addition, two probes (overt and covert observation) were conducted in a Burger King restaurant to assess further generalization to a location different from the one depicted throughout training. Results showed that students' performance on restaurant probes improved as a result of training, generalized to novel settings, maintained over an extended period of time, and was comparable to that of a normative sample of nonretarded persons.

Adolescent↗
PubMed1981

Evaluating a supervision program for developing and maintaining therapeutic staff-resident interactions during institutional care routines.

This study evaluated a program to teach and maintain language training interactions between institutional staff and profoundly handicapped children during a routine care task. Following baseline observations of bath sessions, staff were sequentially taught in multiple baseline fashion to vocalize more during the bath, praise child vocalizations, imitate sounds, and provide sound prompts. Procedures included a brief in-service meeting followed by a series of supervisory prompts and feedback. Results indicated that staff acquired the interaction skills in the bath sessions and that the skills generalized to another direct care task, dressing. The number of days on which components of supervision were implemented decreased from 47% of all days during the experimental conditions to 19% of the days during a 19-week maintenance period with no decrease in staff behavior. The interactions were shown not to interfere with the quality of the direct care task nor to increase the amount of time necessary to complete it. Also, some increases were noted for child vocalization frequencies. The advantages of providing therapeutic interactions during care routines are discussed along with the need for staff management techniques with long-term maintenance value.

Child↗
PubMed1980

The effects of interspersal training versus high-density reinforcement on spelling acquisition and retention.

This study investigated the effects of interspersing known items during spelling instruction on new words for three mentally retarded students. Following a baseline consisting of the presentation of 10 test words per session, a multielement design was implemented. During interspersal training sessions, previously mastered words were presented alternately with each of 10 test words. During high-density reinforcement sessions, 10 test words were presented and additional reinforcement was provided for task-related behaviors. Throughout all conditions, test words were deleted and replaced after meeting a mastery criterion. Periodic retention tests were administered over mastered words and a cumulative retention test was administered at the end of the experiment. Results showed that high-density reinforcement did facilitate performance over baseline; however, intersperal training was superior to the other conditions in terms of both acquisition rate and short- and long-term retention. In addition, students preferred the interspersal condition when offered a choice.

Achievement↗
PubMed1978

Public transportation training: in vivo versus classroom instruction.

This study evaluated a classroom program to teach public transportation usage (bus-riding skills) to retarded persons. Based on a task analysis of specific skills, five retarded male students were taught each of the components of locating, signalling, boarding and riding, and exiting a bus. These skills were taught sequentially, using training procedures consisting of role playing, manipulating the actions of a doll on a simulated model, and responding to questions about slide sequences. Before, during, and after training, subjects were tested on generalization probes in the classroom and in the natural environment. Results of a multiple-baseline design across subjects indicated that up to 12 months after termination of training, each subject exhibited appropriate bus-riding skills on actual city buses. Two other subjects were trained on each skill component in vivo, on city buses, in order to compare the relative effectiveness and efficiency of classroom versus in vivo training. Both of these subjects acquired appropriate bus-riding skills; however, the in vivo training procedure was both more time consuming and expensive than classroom training. These findings further demonstrate the effectiveness and practicality of properly designed classroom training procedures for teaching community survival skills to retarded persons.

Journal Article↗
PubMedDate not supplied

Teaching pedestrian skills to retarded persons: generalization from the classroom to the natural environment.

Little attention has been given to teaching adaptive community skills to retarded persons. In this study, five retarded male students were taught basic pedestrian skills in a classroom- Training was conducted on a model built to simulate city traffic conditions. Each subject was taught five specific skills involved in street crossing in sequence, viz. intersection recognition, pedestrian-light skills, traffic-light skills, and skills for two different stop-sign conditions. Before, during, and after training, subjects were tested on generalization probes on model and under actual city traffic conditions. Results of a multiple-baseline design acorss both subjects and behaviors indicated that after receiving classroom training on the skills, each subject exhibited appropriate pedestrian skills under city traffic conditions. In addition, training in some skills appeared to facilitate performance in skills not yet trained.

Activities of Daily Living↗