Biomedical subjects

J M Ducharme

Publications and source records attributed to J M Ducharme.

7 recordsLinked to original sources

PubMed2000

Treatment of maladaptive behavior in acquired brain injury: remedial approaches in postacute settings.

This article describes remedial behavior therapy approaches for the treatment of maladaptive behavioral sequelae to an acquired brain injury (ABI). Remedial approaches are sophisticated and nonintrusive treatment strategies that involve teaching the individual skills or capacities to manage difficult life circumstances. Functional equivalence is one major category of remedial intervention and involves the determination of the behavioral function of the problem behavior and the teaching of an adaptive alternative response or skill cluster that provides the individual with efficient access to that function. Errorless remediation is a second category and entails teaching the individual to tolerate situations associated with problem behavior through hierarchical exposure to increasingly difficult conditions and reinforcement for successful management of those conditions.

Behavior Therapy↗

PubMed2000

Success-based, noncoercive treatment of oppositional behavior in children from violent homes.

OBJECTIVES: Errorless compliance training is a success-based, noncoercive intervention for children with severe oppositional behavior. The strategy involves hierarchical introduction of more demanding parental requests at a gradual pace that greatly reduces noncompliance and obviates the need for constraining consequences (e.g., time-out). In this study, this approach was evaluated as a treatment for severe disciplinary problems in children from violent homes. METHOD: Participants were 15 children (aged 3-10 years) and their mothers. All participants had experienced long-term family violence. Using a multiple-baseline design, the authors trained parents in a group format and conducted observations of child compliance in the home throughout the intervention. RESULTS: Observations indicated improvements in generalized child compliance that were maintained up to 6 months posttreatment. Pre-/post maternal reports indicated significant reductions in maternal perception of child noncompliance, externalizing and internalizing problems, and parenting stress. CONCLUSIONS: Researchers have noted a dearth of empirically supported interventions for children from violent homes. Errorless compliance training may help to fill this void, as it appears well suited to treatment of difficulties encountered by these youngsters and their parents.

Adult↗

PubMed1999

A conceptual model for treatment of externalizing behaviour in acquired brain injury.

This paper describes a conceptual model for treatment of the externalizing behavioural sequelae to an acquired brain injury and discusses relevant research. Use of the model by practitioners should lead to sophisticated and minimally intrusive intervention. In the model, there are two different categories of approaches. The first category is remedial approaches. These interventions are typically used in the post-acute environment for teaching adaptive skills to replace aberrant behaviour patterns. Skills provided with such training allow the individual to self-manage difficult everyday situations effectively, without external control by others. The second category is moderating approaches, which can be used in the acute phase of ABI recovery for management of severe behavioural episodes that may be associated with conditions present at this time, such as agitation and confusion. Moderating approaches can also be used as a prelude to remedial approaches in the post-acute environment when problem behaviours occur at a high frequency or intensity and render the use of remedial approaches difficult.

Acute Disease↗

PubMed1999

Using self-instructional pictorial manuals to teach child-care skills to mothers with intellectual disabilities.

Children of parents with intellectual disabilities (i.e., IQs less than 80, labeled as having mental retardation) are at risk for neglect due to inadequate parenting abilities. Previous studies have shown that these parents are responsive to parent-training packages consisting of instructions, pictorial cues, modeling, feedback, and reinforcement. This study evaluated the effectiveness of self-learning pictorial-parenting manuals in teaching basic child-care skills (diapering, treating diaper rash, bathing, safety) to parents with intellectual disabilities who are monitored by child protection agencies. The manuals alone increased child-care skills (to levels seen in parents without disabilities) in 9 out of the 10 mothers in the study and in 12 of 13 child-care skills. The remaining skill was acquired with the full training package. Follow-up indicated that the acquired skills were maintained for up to 3 years. Mean correct performance with the manual was positively correlated with the trainer's rating of the mother's reading level and acceptance of the manual when the mother was first given the manual. Consumer satisfaction ratings of the manuals were high. These results indicate that many parents with intellectual disabilities may improve their child-care skills without intensive training and that self-instruction may be an easily disseminable and cost-effective way of reducing the risk of child neglect due to parenting skill deficiencies.

Child Abuse↗

PubMed1996

Errorless compliance training, Optimizing clinical efficacy.

Errorless compliance training (e.g., Ducharme & Popynick, 1993; Ducharme, pontes et al, 1994) is a recently evaluated, nonintrusive approach to teaching children to cooperate with the requests of their parents. In this article, I describe the errorless approach and discuss the potential benefits of this technique. A detailed description of procedures that can be used to enhance clinical effectiveness and efficiency under various conditions and with a broad range of clinical populations is also provided.

Behavior Therapy↗

PubMed1992

Comparison of staff training strategies to promote generalized teaching skills.

Two studies compared the effectiveness of different strategies for promoting generalization of staff skills in teaching self-care routines to clients with developmental disabilities. In Study 1, 9 direct-care staff members of group homes were trained sequentially through four conditions; (a) the provision of written instructions, (b) performance-based training using a single client program exemplar and simulated clients (single case training), (c) performance-based training using actual developmentally delayed clients as trainees (common stimuli training), and (d) performance-based training using multiple client program exemplars with simulated clients (general case training). The results indicated that staff members did not reach all generalization criteria until general case training was provided. Because staff members had been trained sequentially through several conditions in Study 1, a second study controlled for potential sequence effects. In Study 2, 7 staff members were trained using only the general case strategy after baseline. All staff members reached generalizations criteria with only general case training, replicating the findings of Study 1. Together, the two studies demonstrated that the general case training strategy was more effective at promoting generalized training effects across clients, settings, and client programs than other commonly used staff training approaches.

Activities of Daily Living↗

PubMed1987

Variables influencing stimulus overselectivity and "tunnel vision" in developmentally delayed children.

Three variables (diagnosis, location of cues, and MA of learners) influencing stimulus control and stimulus overselectivity in autistic children were assessed. Eight autistic and 8 intellectually average children, matched on MA, were trained on two discrimination tasks; one task contained two "within-stimulus" (i.e., physically connected) cues; the other contained the same two cues presented "extra-stimulus" (i.e., physically separate). Generalization gradients were used following training to measure the degree of stimulus control acquired by each cue. Results showed: autistic subjects tended to respond overselectively only in the extra-stimulus condition; MA was positively correlated with breadth of learning; and when autistic children were overselective to one cue, some stimulus control was also acquired by the second cue. The notion of tunnel vision was discussed, as it may represent a "keystone" deficit interfering with stimulus control and learning by autistic children.

Adolescent↗