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The modification of disruptive behaviors by a group of trainable mentally retarded adults
J. Behov.
Ther.
& Exp.
Psychiot.
Vol. 7,pp.299-300.
Perpamon Press, 1976. Printed inGreat Britain.
THE MODIFICATION BY A GROUP
OF DISRUPTIVE OF TRAINABLE
RETARDED MICHAEL
Chapman
MENTALLY
ADULTS*
KLEIN,? ROBERT J. PALUCKS
The Margaret
BEHAVIORS
School
and PATRICIA BERESFORD
and Hunter
College,
C.U.N.Y.
Summary-A group of mentally retarded residents was trained to implement a 24-hr treatment program for a disruptive, severely retarded adult male. The group (N =: 12) met with the subject each morning under a staff member’s guidance to discuss the dibruptive behaviors and to arrange contingency contracts which they subsequently implemented throughout the day. Disruptive behaviors decreased from a baseline mean of 5 per day to 0 after I2 days of treatment, and remained at 0 for 10 follow-up days. These results suggest that behavioral management programs are effective on a 24-hr basis using groups of the trainable mentally retarded as change agents. program due to shift changes were acknowledged. Since particular residents of the school were more continuously available than particular staff, the present program was designed using the residents themselves as the therapeutic agents. Ralph’s treatment WCS carried out by a pre-existing group (N = 12, Mean I.Q. = 55.3) of mentally retarded residents called the Resident Reinforcers (R.R.s). Their paid iobs (reuorted in Paluck et al.. 1972) involved behavior modification sessions with ‘other ‘individual residents. The group met each morning with Ralph and one of the authors (M.K.) to discuss Ralph’s behavior wjith him and arrange contingency contracts. One contract involved his early morning behaviors. A.R.R. checked with staff whether Ralph had gotten out of bed prior to 7:00 a.m. or had stolen anything during the night. Coffee (a primary reinforcer for Ralph) was ofTered to him in the group if no early morning disruptions were substantiated. Some R.R.‘s also checked with staff about Ralph’s behavior after specific 3-hr time periods during the waking day. If no disruptions were reported, the R.R. dispensed a particular concrete reward (money, candy etc.) plus social reinforcement in the form of 10 min of conversation at the end of the 3-hr interval. These individual sessions were also discussed at the meeting and additional social reinforcement was given when appropriate. Finally, Ralph was assigned various jobs like cleaning the meeting room, which were designed to reinforce behavior incompatible with the disruptive behavior. These contingency contracts were explained to Ralph
Tti~ USE of retarded people as modifiers of their peers’ behavior is a well-documented therapeutic procedure (Craighead and Mercatoris, 1971). A number of different strategies have been employed, among which are peer teaching (Whalen and Henker, 1971), dispensing of contingent reward to individuals (Drabman and Spitalnik, 1973; Paluck, O’Neill and Bisordi, 1972), and rewarding social interaction (Paluck, Klein and Barocas, 1974). Such studies typically report success in modifying behavior during the programmed periods. No efforts have been reported, however, in 24-hr programming with retarded people as therapeutic agents; nor have efforts been reported using a group of retarded individuals as the therapeutic agent for a single individual. The present case reports such a 24-hr group treatment program for a disruptive mentally retarded adult using techniques of contingent reward and peer pressure.
THE
SUBJECT
The subject, Ralph, was a 29-yr-old severely retarded male (I.Q. below 50). His two most disruptive behaviors were leaving his bed early in the morning in a manner which woke up other residents and stealing frequently during this period and throughout the day.
TREATMENT A staff-implemented token economy was initially rccommended, but difficulties in managing such a 24-hr
*Supported by The Margaret Chapman School, C. Douglas Bannester, Jr., Executive Director, 5 Bradhurst Hawthorne, New York 10532. We also wish to thank Constance Helland for her assistance in editing. TNow at the Department of Psychology, University of Vermont, Burlington, Vermont 05404. Reprints upon request. :Presently at the University of Houston at Clear Lake City. 299
Avenue, available
300
MICHAEL KLEIN, ROBERT J. PALUCK and PATRICIA BERESFORD
by the R.R.‘s, guided by the R.R. supervisor. The R.R.‘s seemed to be able to convey these explanations to Ralph. Such group discussions and contingency contracts also seemed to exert peer pressure to suppress Ralph’s disruptive behaviors.
RESULTS Disruptive behaviors, detined as stealing at any time 01 leaving his bed before 7:00 a.m., were estimated by supervisory personnel to be approximately 5 per day over a period of several months. The accuracy of this estimate was validated from the l-week baseline period in which the mean number of disruptions per day was 5.00 (SD =m I .41). The recording was compiled from the daily records of both treatment and educational staffs. Disruptive behavior decreased from the 5 per day baseline mean to 0 on the twelfth day of treatment. Disruptive behavior remained at 0 for the subsequent 10 days. Throughout the 10 day follow-up period, Ralph’s behavior lacked any of the previous disruptions. Furthermore, he became a participant in other R.R. social functions and maintained his jobs responsibly. Anecdotal evidence also supports other changes in Ralph. He participated in more classroom activities and was generally regarded as being more friendly to those with whom he came in contact. After 6 months, Ralph remained integrated in the classroom setting and showed only infrequent disruptive stealing. The specific contingencies surrounding his stealing behavior had been terminated, but he continued to be reinforced for bchaviors incompatible with stealing. The group members seemed to gain from this proce-
dure as well. Instances of disruptions within the R.R. group, while previously low, were nonexistent during the period of the study. Ultimately, the success of any behavior moditication program depends upon the capability of maintaining consistent reward contingencies in the subject’s environment. The results of this study show that a group of retarded residents have the ability to maintain such reward contingencies on a 24-hr basis.
REFERENCES W. and MERCATORIS M. (1973) Mentally retarded residents as paraprofessionals: a review, Am. J. ment. Def: . 73. 339-447. DRABMANR. and SP~TALNIK R. (1973) Training a retarded child as a behavioral teaching assistant, J. Behv. The,..
CRAIGHEAD
& Exp. Psyhiat.
4,269-272.
PALUCK R. J., KLEIN M. S. and BAROCASP. B. (1974) Differential rehabilitation of groups of withdrawn retarded males using verbal and playful therapists. Paper presented at the annlId meeting of the American Psychological Association, New Orleans. PALUCKR. J., O’NEILL S. and BISORD~E. (1972) Resident reinforcers as behavior modifiers of other retarded residents: four case studies. Paper presented at the American Association on Mental Deficiency meeting, Montreal, Canada. WHALENC. and HENKER B. (1971) Pyramid therapy in a hospital for the retarded: Methods, program evaluation and long-term effects, Am. J. mew. Def. l&414434.
Ther.
& Exp.
Psychiot.
Vol. 7,pp.299-300.
Perpamon Press, 1976. Printed inGreat Britain.
THE MODIFICATION BY A GROUP
OF DISRUPTIVE OF TRAINABLE
RETARDED MICHAEL
Chapman
MENTALLY
ADULTS*
KLEIN,? ROBERT J. PALUCKS
The Margaret
BEHAVIORS
School
and PATRICIA BERESFORD
and Hunter
College,
C.U.N.Y.
Summary-A group of mentally retarded residents was trained to implement a 24-hr treatment program for a disruptive, severely retarded adult male. The group (N =: 12) met with the subject each morning under a staff member’s guidance to discuss the dibruptive behaviors and to arrange contingency contracts which they subsequently implemented throughout the day. Disruptive behaviors decreased from a baseline mean of 5 per day to 0 after I2 days of treatment, and remained at 0 for 10 follow-up days. These results suggest that behavioral management programs are effective on a 24-hr basis using groups of the trainable mentally retarded as change agents. program due to shift changes were acknowledged. Since particular residents of the school were more continuously available than particular staff, the present program was designed using the residents themselves as the therapeutic agents. Ralph’s treatment WCS carried out by a pre-existing group (N = 12, Mean I.Q. = 55.3) of mentally retarded residents called the Resident Reinforcers (R.R.s). Their paid iobs (reuorted in Paluck et al.. 1972) involved behavior modification sessions with ‘other ‘individual residents. The group met each morning with Ralph and one of the authors (M.K.) to discuss Ralph’s behavior wjith him and arrange contingency contracts. One contract involved his early morning behaviors. A.R.R. checked with staff whether Ralph had gotten out of bed prior to 7:00 a.m. or had stolen anything during the night. Coffee (a primary reinforcer for Ralph) was ofTered to him in the group if no early morning disruptions were substantiated. Some R.R.‘s also checked with staff about Ralph’s behavior after specific 3-hr time periods during the waking day. If no disruptions were reported, the R.R. dispensed a particular concrete reward (money, candy etc.) plus social reinforcement in the form of 10 min of conversation at the end of the 3-hr interval. These individual sessions were also discussed at the meeting and additional social reinforcement was given when appropriate. Finally, Ralph was assigned various jobs like cleaning the meeting room, which were designed to reinforce behavior incompatible with the disruptive behavior. These contingency contracts were explained to Ralph
Tti~ USE of retarded people as modifiers of their peers’ behavior is a well-documented therapeutic procedure (Craighead and Mercatoris, 1971). A number of different strategies have been employed, among which are peer teaching (Whalen and Henker, 1971), dispensing of contingent reward to individuals (Drabman and Spitalnik, 1973; Paluck, O’Neill and Bisordi, 1972), and rewarding social interaction (Paluck, Klein and Barocas, 1974). Such studies typically report success in modifying behavior during the programmed periods. No efforts have been reported, however, in 24-hr programming with retarded people as therapeutic agents; nor have efforts been reported using a group of retarded individuals as the therapeutic agent for a single individual. The present case reports such a 24-hr group treatment program for a disruptive mentally retarded adult using techniques of contingent reward and peer pressure.
THE
SUBJECT
The subject, Ralph, was a 29-yr-old severely retarded male (I.Q. below 50). His two most disruptive behaviors were leaving his bed early in the morning in a manner which woke up other residents and stealing frequently during this period and throughout the day.
TREATMENT A staff-implemented token economy was initially rccommended, but difficulties in managing such a 24-hr
*Supported by The Margaret Chapman School, C. Douglas Bannester, Jr., Executive Director, 5 Bradhurst Hawthorne, New York 10532. We also wish to thank Constance Helland for her assistance in editing. TNow at the Department of Psychology, University of Vermont, Burlington, Vermont 05404. Reprints upon request. :Presently at the University of Houston at Clear Lake City. 299
Avenue, available
300
MICHAEL KLEIN, ROBERT J. PALUCK and PATRICIA BERESFORD
by the R.R.‘s, guided by the R.R. supervisor. The R.R.‘s seemed to be able to convey these explanations to Ralph. Such group discussions and contingency contracts also seemed to exert peer pressure to suppress Ralph’s disruptive behaviors.
RESULTS Disruptive behaviors, detined as stealing at any time 01 leaving his bed before 7:00 a.m., were estimated by supervisory personnel to be approximately 5 per day over a period of several months. The accuracy of this estimate was validated from the l-week baseline period in which the mean number of disruptions per day was 5.00 (SD =m I .41). The recording was compiled from the daily records of both treatment and educational staffs. Disruptive behavior decreased from the 5 per day baseline mean to 0 on the twelfth day of treatment. Disruptive behavior remained at 0 for the subsequent 10 days. Throughout the 10 day follow-up period, Ralph’s behavior lacked any of the previous disruptions. Furthermore, he became a participant in other R.R. social functions and maintained his jobs responsibly. Anecdotal evidence also supports other changes in Ralph. He participated in more classroom activities and was generally regarded as being more friendly to those with whom he came in contact. After 6 months, Ralph remained integrated in the classroom setting and showed only infrequent disruptive stealing. The specific contingencies surrounding his stealing behavior had been terminated, but he continued to be reinforced for bchaviors incompatible with stealing. The group members seemed to gain from this proce-
dure as well. Instances of disruptions within the R.R. group, while previously low, were nonexistent during the period of the study. Ultimately, the success of any behavior moditication program depends upon the capability of maintaining consistent reward contingencies in the subject’s environment. The results of this study show that a group of retarded residents have the ability to maintain such reward contingencies on a 24-hr basis.
REFERENCES W. and MERCATORIS M. (1973) Mentally retarded residents as paraprofessionals: a review, Am. J. ment. Def: . 73. 339-447. DRABMANR. and SP~TALNIK R. (1973) Training a retarded child as a behavioral teaching assistant, J. Behv. The,..
CRAIGHEAD
& Exp. Psyhiat.
4,269-272.
PALUCK R. J., KLEIN M. S. and BAROCASP. B. (1974) Differential rehabilitation of groups of withdrawn retarded males using verbal and playful therapists. Paper presented at the annlId meeting of the American Psychological Association, New Orleans. PALUCKR. J., O’NEILL S. and BISORD~E. (1972) Resident reinforcers as behavior modifiers of other retarded residents: four case studies. Paper presented at the American Association on Mental Deficiency meeting, Montreal, Canada. WHALENC. and HENKER B. (1971) Pyramid therapy in a hospital for the retarded: Methods, program evaluation and long-term effects, Am. J. mew. Def. l&414434.