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Biomedical subjects

C S Holburn

Publications and source records attributed to C S Holburn.

9 recordsLinked to original sources
PubMed1992

Compliance and quality in residential life. Rhetoric and realities in today's ICF/MR: control out of control.

Contrasts between the rhetoric of quality assurance and the realities of poor quality in today's ICFs/MR were explored. Comparative studies have shown that ICFs/MR provide the poorest quality of life for persons with mental retardation. The ICF/MR operational model was described here as paper-oriented, failure-based, and insensitive to the effects of its own practices. Recommendations, including the establishment of local control, a less-direct relation between funding and rule compliance, and alternate forms of program evaluation and monitoring, were made.

Activities of Daily Living↗
PubMed1990

Rules: the new institutions.

Despite the pervasive philosophy of normalization and the more recent emphasis on "quality assurance," service provision in today's Medicaid-funded residential environment has become more regulation-oriented and less person-oriented. In this article, this argument was presented in the context of rule-governed versus contingency-shaped behavior of caregivers. The culpable process was identified as the coercive enforcement of inaccurate rules, which precludes responsive staff action and generates adverse consequences. The impenetrable system of rules was compared to the "old institutions," and solutions were advanced to bring staff members more in contact with the natural contingencies of teaching and caring.

Education of Persons with Intellectual Disabilitie↗
PubMed1986

Effects of response satiation procedures in the treatment of aerophagia.

A contingent response that previously increased self-injurious air-swallowing (aerophagia) by a profoundly mentally retarded woman (Holburn & Dougher, 1985) was shown to decrease her air-swallowing when the response was presented in accord with the response deprivation/satiation hypothesis, which suggests that any free-operant response can serve as a reinforcer or a punisher depending upon specific contigency arrangements. The results offer an explanation for the earlier increase in air-swallowing.

Adult↗
PubMed1986

Aerophagia: an uncommon form of self-injury.

Aerophagia is a rarely recognized self-injurious behavior that consists of repetitive air swallowing with consequent belching, flatulence, and abdominal distention. The condition causes serious medical problems and can result in death. Possible causes of aerophagia and some attempts to treat it were reviewed briefly.

Aerophagy↗
PubMed1986

Maladaptive behavior merits fair treatment: a response to Seltzer and Krauss.

This response is a reaction to a study by Seltzer and Krauss (1984), in which dichotomous measurement of the behavior-problem variable gave rise to some potentially misleading implications about community-placement planning. Some difficulties in measuring this complex variable were reviewed and a more functional behavior assessment advocated. The problem of maladaptive behavior as an obstacle to deinstitutionalization has not yet been resolved.

Deinstitutionalization↗
PubMed1985

Behavioral attempts to eliminate air-swallowing in two profoundly mentally retarded clients.

Attempts were made to eliminate the aerophagia (pathological air-swallowing) exhibited by two profoundly retarded clients in a state residential institution. In Experiment 1, a positive-practice overcorrection procedure (coactive mouth-covering) tripled the frequency of a female's air-swallowing and subsequent time-out failed to reduce it below free-operant levels. In Experiment 2, further unsuccessful attempts were made to reduce air-swallowing by the same subject using additional time-out procedures. For a second subject (Experiment 3), increased durations of positive-practice overcorrection produced corresponding reductions in air-swallowing. After physical opposition to treatment, overcorrection was withdrawn, resulting in near-baseline responding. Multiple baselines in each experiment showed no transfer effect. Findings were discussed with reference to investigators who reported negative side-effects of overcorrection and overcame them through continued experimental analysis.

Adult↗
PubMed1984

Alterable correlates of extrinsic and intrinsic job satisfaction at a state residential facility.

A cross-section of employees at a state residential facility for mentally retarded persons was administered a composite questionnaire to assess factors associated with job satisfaction. Using a multivariate statistical approach, we examined two measures of job satisfaction (extrinsic and intrinsic) in relation to employee perceptions of organizational climate and selected job characteristics. Unique multiple regression analyses indicated that constraining conformity, decision frequency, and clarity of supervisor instructions were related to both measures of job satisfaction; organizational clarity, reward, and satisfaction with materials were related only to extrinsic satisfaction; and organizational standards and degree of resident contact were related only to intrinsic job satisfaction. Differences in variable contributions "ignoring" and controlling for other variables were emphasized. Variables were ranked according to their importance in predicting job satisfaction. Investigators are encouraged to consider the distinction between extrinsic and intrinsic job satisfaction in future research.

Humans↗