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The literature on peer-mediated treatment approaches is reviewed, and three types of peer-mediated treatment--proximity, prompt/reinforce, and peer initiation interventions--are identified. The relative efficacy of these interventions is examined, treatment issues are discussed, and directions for future research are considered.
Four questions are asked about the use of social skills training procedures with mentally handicapped people. The first is, 'What are social skills in the context of mental handicap?', and it is suggested that they involve a complex array of perceptual, cognitive, motor and motivational processes, all of which can be disrupted due to various problems common among mentally handicapped people. The second question, 'What changes do social skills training programmes aim to achieve?', leads to the conclusion that most programmes have concentrated on motor, and to some extent on motivational processes, at the expense of perceptuo-cognitive ones. In asking, 'Have the programmes been successful in achieving these changes?', the answer is a guarded 'yes', given the limited aims of most investigators. Generalization to the natural environment has only occasionally been established, though it is often not measured. The fourth question is, 'What is the clinical significance of the changes obtained by such programmes and how can future ones be made more clinically relevant?'. The answer to the first part of the question is that, in general, their clinical utility has not been established. Future programmes could be made more clinically relevant if they were integrated with strategies for producing more benign and stimulating environments for mentally handicapped people.
OBJECTIVE: To test the hypothesis that greater exposure to smoking in films is associated with trying smoking among adolescents. DESIGN: Cross sectional survey of 4919 schoolchildren aged 9-15 years, and assessment of occurrence of smoking in 601 films. SETTING: Randomly selected middle schools in Vermont and New Hampshire, USA. MAIN OUTCOME MEASURE: Number of schoolchildren who had ever tried smoking a cigarette. RESULTS: The films contained a median of 5 (interquartile range 1-12) occurrences of smoking. The typical adolescent had seen 17 of 50 films listed. Exposure to smoking in films varied widely: median 91 (49-152) occurrences. The prevalence of ever trying smoking increased with higher categories of exposure: 4.9% among students who saw 0-50 occurrences of smoking, 13.7% for 51-100 occurrences, 22.1% for 101-150, and 31.3% for >150. The association remained significant after adjustment for age; sex; school performance; school; parents' education; smoking by friend, sibling, or parent; and receptivity to tobacco promotions. The adjusted odds ratios of ever trying smoking for students in the higher categories of exposure, compared with students exposed to 0-50 occurrences of smoking in films, were 1.7 (95% confidence interval 1.2 to 2.4), 2.4 (1.7 to 3.4), and 2.7 (2.0 to 3.8). These odds ratios were not substantially affected by adjustment for parenting style or for personality traits of the adolescent. CONCLUSION: In this sample of adolescents there was a strong, direct, and independent association between seeing tobacco use in films and trying cigarettes, a finding that supports the hypothesis that smoking in films has a role in the initiation of smoking in adolescents.
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Twenty-two anorgasmic women received 20 sessions of a multiple-technique behavioural therapy. The design included blind ratings by two independent assessors, multiple assessment instruments, and a waiting list control group. Treatment was significantly better than no treatment in terms of: (1) the percentage of patients experiencing orgasm during at least 50 per cent of sexual relations; (2) the percentage of women reporting satisfactory sexual relations at least 50 per cent of the time; (3) patients' ratings of positive reactions to various sexual behaviours; and (4) assessors' global clinical ratings. Significant improvement was also noted on the MMPI, IPAT, and Symptom Check List. Improvement was maintained at a follow-up average 9 months later. These results support the impression that a behavioural approach offers much promise in treating female orgasmic dysfunction.
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An alternating treatment comparison was conducted of the relative effectiveness of oral and total communication training models for teaching expressive labeling skills to three echolalic autistic children. The results of this comparison demonstrated that total communication proved to be the most successful approach with each of the subjects. In addition, the replication of these findings both within and across subjects suggest that total communication may be, in general, the most effective of these two training models for teaching basic vocal language skills to echolalic children. A number of hypotheses are presented that may provide a basis for the demonstrated effect.
We assessed the efficacy of time delay and peer modeling procedures in increasing autistic children's spontaneous verbalizations of affection. Four autistic children were taught to spontaneously say "I like (love) you" in response to a hug from a familiar person and their mother. Generalization from a free play training setting to free play outdoors and at home was assessed. Ancillary social and affection behaviors were also observed. Results indicated that the time delay was a quick and effective procedure for all the children. Peer modeling was unsuccessful in teaching the target behavior.
Gentle teaching and visual screening techniques have been used to control severe behavior problems in persons with mental retardation. An alternating treatments design was used to compare gentle teaching, visual screening, and a task-training condition in the reduction of the high-level stereotypy of 3 persons with mental retardation. Following a baseline phase, a task-training condition using standard behavioral techniques was implemented to establish the effects of training the subjects on the tasks. Results showed a modest decrease in stereotypy. This phase was followed by an alternating treatments phase in which visual screening, gentle teaching, and baseline conditions were compared. Both procedures were superior to the control condition in reducing stereotypic behavior, with visual screening being more effective than gentle teaching. When compared with data from the prior phase, gentle teaching was found to be more effective than task training for 2 subjects but less effective for the 3rd, whose stereotypy increased during gentle teaching. Two succeeding phases in which visual screening was implemented across two and then all three daily conditions reduced stereotypy further to near-zero levels. An additional phase with 1 subject demonstrated that the treatment effects of visual screening were easily replicated across therapists. Mixed and idiosyncratic changes in collateral behaviors occurred. For example, "bonding," the goal of gentle teaching, occurred at the same low levels under both treatments, contrary to the predictions of gentle teaching's proponents. The results indicate that gentle teaching may not be the universal treatment of choice for stereotypy its proponents suggest, and that it requires further empirical evaluation.
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CONTEXT: Viewing smoking and drinking in movies may prompt adolescents to initiate these behaviors. Movies with R ratings contain more smoking than do movies in all other rating categories. OBJECTIVE: To evaluate the extent to which parents restrict the exposure of adolescents to R-rated movies and to determine whether such restrictions are associated with decreased tobacco and alcohol use in adolescents. DESIGN: Cross-sectional, self-administered survey. PARTICIPANTS: Students in grades 5 through 8 enrolled in New Hampshire and Vermont schools. SAMPLING STRATEGY: Fifteen schools in Vermont and New Hampshire were randomly selected from all middle schools with > or = 150 students. OUTCOME MEASURES: Students who had tried smoking cigarettes or tried drinking alcohol without parental knowledge. RESULTS: Of 4544 students surveyed, 18% had tried cigarettes and 23% had tried alcohol. Although 90% were younger than 14 years of age, only 16% were completely restricted from viewing R-rated movies. The prevalence of having tried smoking was 35% for those with no restrictions on viewing R-rated movies, 12% for those with partial restrictions, and 2% for those with complete restrictions. The prevalence of having tried alcohol was 46% for those with no restrictions on viewing R-rated movies, 16% for those with partial restrictions, and 4% for those with complete restrictions. Even after controlling for other factors, including grade, parental disapproval of smoking, maternal supervision, maternal responsiveness, peer and family smoking, and child personality characteristics, children who were completely restricted from viewing R-rated movies were significantly less likely to smoke (relative risk, 0.29; 95% CI, 0.19 to 0.45) or drink (relative risk, 0.30; CI, 0.21 to 0.42) compared with those who had no restrictions on viewing R-rated movies. CONCLUSION: Limiting the exposure of adolescents to R-rated movies may prevent early use of alcohol and tobacco.
General dentists, as well as pediatric dentists, treat many children. Behavior management for children is an integral component of pediatric dental practice. Behavior management techniques have been developed based on empirical evidence indicating the importance of social learning theory to change both the causes and consequences of negative behaviors. This paper addresses the theoretical basis of current approaches in guiding children's behavior during dental settings. The relevance of the theoretical areas to the day-to-day treatment of the patient is emphasized.
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Explore the source record for details and available documents.