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Biomedical subjects

J E Carr

Publications and source records attributed to J E Carr.

At least 19 recordsLinked to original sources
PubMed2001

Using real-time recording to enhance the analysis of within-session functional analysis data.

Functional analysis methods have become standard practice for determining the maintaining variables of problem behavior. The analysis of within-session response patterns has been proposed as a useful adjunct to the functional analysis. Many within-session analyses have been conducted on data obtained from interval scoring methods. However, interval methods only provide an estimate of within-session data. The authors briefly describe a real-time recording method and provide a rationale for its use. The authors then provide descriptions of several research studies from their lab in which real-time data were crucial in determining behavioral function from experimental analyses.

Adolescent↗
PubMed2001

Using fixed-time schedules to maintain behavior: a preliminary investigation.

The purpose of this study was to evaluate the potential of fixed-time (FT) schedules to maintain behavior. Two children who had been diagnosed with autism were taught a functional task. Subsequently, three different FT schedules (i.e., yoked, thin, dense) were compared to determine their capacity to maintain task responding. Results suggested that FT schedules may be used to maintain previously acquired behavior.

Autistic Disorder↗
PubMed2001

The reductive effects of noncontingent reinforcement fixed-time versus variable-time schedules.

The effects of fixed-time (FT) and variable-time (VT) schedules on responding were evaluated with 2 adults with mental retardation. Multielement and reversal designs were used to compare the effects of FT and VT schedules in reducing responses previously maintained on variable-ratio reinforcement schedules. The schedules were equally effective in reducing the target behavior.

Adult↗
PubMed2000

Recent advances in the assessment of aberrant behavior maintained by automatic reinforcement in individuals with developmental disabilities.

Many aberrant behaviors exhibited by individuals with developmental disabilities are maintained by "automatic reinforcement". These behaviors are often difficult to treat, with the most effective behavioral interventions often resulting in only moderate success. However, a series of recent studies has advanced our ability to understand and treat these behaviors through the innovative use of behavioral assessment. We review the recent development of three categories of assessments: (a) nonhypothesis-based stimulus preference assessments, (b) hypothesis-based stimulus preference assessments, and (c) hypothesis-based assessments incorporating noncontingent reinforcement and sensory extinction procedures. We consider each category's contribution to both our ability to prescribe effective behavioral interventions and our ability to more fully understand the concept of automatic reinforcement.

Behavior Therapy↗
PubMed2000

Evaluation of a brief multiple-stimulus preference assessment in a naturalistic context.

We evaluated a brief multiple-stimulus preference assessment within the context of an early intervention program for 3 children who had been diagnosed with autism. Subsequent curriculum-based reinforcer evaluations confirmed the predictions of the preference assessments. In addition, eight additional preference assessments that were conducted over a period of 1 month indicated generally stable preferences for 2 of the 3 participants.

Autistic Disorder↗
PubMed1999

On the displacement of leisure items by food during multiple-stimulus preference assessments.

Previous studies have demonstrated that when food and leisure stimuli are combined in multiple-stimulus preference assessments, individuals typically select food more often, although the leisure stimuli also have known reinforcing properties. The purpose of the current study was to replicate this effect and determine its durability by examining the effect after mealtimes. Four adults who had been diagnosed with severe mental retardation were given three initial multiple-stimulus (without replacement) preference assessments (i.e., food, leisure stimuli, and combined). All participants selected food items as the most preferred stimuli in the combined assessments. Combined assessments were then administered immediately before and after the evening meal for each participant for 1 week. The results showed similar data both before and after mealtimes.

Adult↗
PubMed1998

Overview of the treatment of rumination disorder for adults in a residential setting.

Rumination, or the chewing and re-swallowing of regurgitated stomach contents, can be found in up to 10% of institutionalized individuals with severe or profound mental retardation. Serious physical consequences, including death, can result from the disorder. Unfortunately, rumination can be subtle and difficult to observe and often continues untreated. Additionally, the research literature has provided divergent results without clear treatment guidance for clinicians. We present an overview of the history of rumination, a review of the literature on its etiology and treatment, and recommendations for future research.

Adult↗
PubMed1998

On the effects of noncontingent delivery of differing magnitudes of reinforcement.

We conducted a parametric analysis of response suppression associated with different magnitudes of noncontingent reinforcement (NCR). Participants were 5 adults with severe or profound mental retardation who engaged in a manual response that was reinforced on variable-ratio schedules during baseline. Participants were then exposed to NCR via multielement and reversal designs. The fixed-time schedules were kept constant while the magnitude of the reinforcing stimulus was varied across three levels (low, medium, and high). Results showed that high-magnitude NCR schedules produced large and consistent reductions in response rates, medium-magnitude schedules produced less consistent and smaller reductions, and low-magnitude schedules produced little or no effect on responding. These results suggest that (a) NCR affects responding by altering an establishing operation (i.e., attenuating a deprivation state) rather than through extinction, and (b) magnitude of reinforcement is an important variable in determining the effectiveness of NCR.

Adult↗
PubMed1996

A brief behavior therapy protocol for Tourette syndrome.

The purpose of this study was to examine the efficacy of a brief behavior therapy protocol for Tourette Syndrome. The nasal tic frequency of a 9-year-old male was assessed using a nine-session protocol with alternating treatments and reversal-design components. The results indicated that the participant's tics were reduced by approximately 70%. The behavior change was successfully maintained at a one-month follow-up. Social validity and consumer satisfaction measures confirmed the social significance of the behavior change.

Awareness↗
PubMed1996

The standard deviation as an informative measure of variability in reporting interobserver agreement means.

The range is the measure of variability typically presented with the means of interobserver agreement scores of behavioral data. However, the range by itself yields little information about the individual interobserver agreement scores before they were averaged. The standard deviation, on the other hand, is a measure of variability that provides the researcher and reader with information regarding the dispersion of scores, allowing a more thorough interpretation of the interobserver agreement mean. The case is presented for the adoption of the standard deviation as an adjunct to the range in reporting the mean of interobserver agreement scores.

Behavior Therapy↗
PubMed1996

A functional-analytic approach to the diagnosis of a transient tic disorder.

The diagnostic utility of functional analyses has been demonstrated with a variety of behaviors including tics. Whereas previous analyses have focused on the discovery of maintaining variables to aid in treatment prescription, we employed a functional analysis to confirm a clinical diagnosis. An 11 year old male student, who had not been previously diagnosed with a tic disorder, exhibited multiple vocal tic-like behaviors which had persisted over a period of time. Teacher reports conflicted regarding the possible etiology of these behaviors. Hence, a functional analysis was conducted in the classroom to determine if the behaviors were maintained by operant variables. Our hypothesis stated that the occurrence of vocal behaviors across experimental conditions would strongly indicate the presence of a tic disorder. The functional analysis included the following conditions: attention, escape, alone, freeplay, and high sensory stimulation. We used a multi-element design to evaluate the effects of the different stimulus conditions on vocal-behavior frequency. Data indicated the student exhibited vocal behaviors in all conditions. However, the behaviors were partially exacerbated in the attention and escape conditions. Results supported the diagnosis of a transient tic disorder affected by operant variables.

Attention↗
PubMed1995

Competing responses for the treatment of Tourette syndrome and tic disorders.

A brief history of the competing response practice treatment for motor and phonic tic reduction is presented, as well as a basic explanation of the procedure. A table defining the competing responses of various tics that have been systematically studied over the past twenty years is also presented. This table is designed to be a reference tool for clinicians and researchers in the treatment of Tourette syndrome and tic disorders.

Awareness↗
PubMed1988

A biopsychosocial model of medical student distress.

Medical student distress was examined in two consecutive first-year classes (N = 312) in September, before they interacted with the school regimen, and again in May before exams. Anxiety means were one SD above the normative mean for nonpatients at both times. The number of students reporting a significant level of depression doubled from September (N = 36) to May (N = 78). The correlation of distress in September and May was .40, indicating that for many students distress was enduring. A biopsychosocial model of initial distress explained more variance (36%) in the cross-validation sample than did any one variable alone. Distressed students had higher Type A scores. Also, anger held in was a risk factor for distress in students with a family history of cardiovascular disease (CVD). Students who hold anger in may experience prolonged stress which, coupled with a family history of CVD, could make them psychobiologically vulnerable to distress.

Adaptation, Psychological↗
PubMed1984

Medical school pressures and their relationship to anxiety.

This study examined the relative importance of medical school pressures according to their relationship with symptoms of anxiety, as evaluated by a standardized/normative measure of anxiety. As many as 206 (34 per cent) of the total sample (N = 605) of students reported symptoms of anxiety above the median of a normative population of psychiatric outpatients. Using multiple regression, six medical school experiences significantly accounted for 36 per cent of the variance in anxiety scores. These included: perceived threat, mastering knowledge, anonymity, little time for personal activities, peer competition, and long hours. These results are important for two reasons. Contrary to the traditional belief that stressful experiences are necessary for future medical practice, research suggests that stress and anxiety are major causes of cognitive dysfunction. The identification of those experiences that are most anxiety provoking should help therapists and educators to develop intervention strategies in order to reduce anxiety and increase the quality of medical education.

Adult↗