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Biomedical subjects

James K Luiselli

Publications and source records attributed to James K Luiselli.

8 recordsLinked to original sources

Effects of behavior-contingent and fixed-time release contingencies on frequency and duration of therapeutic restraint.

Reducing therapeutic restraint is a desirable outcome for programs that serve individuals who exhibit challenging behaviors. This study investigated the effects of modifying the criterion for release from therapeutic restraint on frequency and duration. Release from restraint was changed from a behavior-contingent criterion (restraint terminated when a specified duration of calm behavior was demonstrated) to a fixed-time criterion (restraint terminated when a predetermined duration elapsed independent of behavior) with one child and two adolescents with acquired brain injury and difficult-to-manage behaviors. For all three students, the duration of time they were exposed to therapeutic restraint decreased with the fixed-time release criterion, whereas the frequency of restraint did not change. Practical implications of these results and future research opportunities are discussed.

Adolescent↗

Clinical peer review: description of a comprehensive model in behavioral healthcare.

This article describes a comprehensive model of clinical peer review that was established at a large behavioral healthcare organization serving children, adolescents, and adults with developmental disabilities. The purpose of peer review is to provide routine evaluation of practice standards that will produce the highest quality of habilitative care. The major components of peer review address (a) clinical support and administration, (b) intervention policies and procedures, (c) case consultation, (d) utilization of extraordinary procedures, (e) performance improvement projects, and (f) communication at all levels of the organization. This article discusses implementation of the model, including examples and illustrations, and factors that contribute to positive outcome. This approach to peer review represents a systems methodology that can be adopted by behavioral healthcare and human service organizations to build an in-house program of clinical quality improvement. It is a necessary first step in the large-scale implementation of behavioral services.

Adolescent↗

Descriptive assessment of sleep patterns among community-living adults with mental retardation.

There is little information about the sleep patterns of adults who have mental retardation and are supported in the community. In the present study, direct-care staff recorded sleep behaviors of 59 adults residing in 16 suburban group homes. Based on direct observation and measurement procedures, the adults averaged 7.9 hours of sleep each evening and had low incidence of sleep problems. Sleep duration was not influenced by age, gender, degree of mental retardation, or psychiatric status. Adults taking antidepressant medication (SSRI) had fewer hours of sleep. We discuss implications of these findings and factors contributing to healthy sleep hygiene among community-living adults with mental retardation.

Adult↗

Antecedent analysis of therapeutic restraint in children and adolescents with acquired brain injury: a descriptive study of four cases.

Therapeutic restraint is sometimes required as a component of clinical intervention for persons who have serious behaviour disorders. However, there are few studies that describe empirically the conditions under which restraint is utilized. This project was a retrospective analysis of incident reports on the application of therapeutic restraint with four students (ages 10-16 years) who had acquired brain injury and attended a community-based programme of education and neurorehabilitation. Specifically, situations and interactions were examined that were in effect immediately prior to the implementation of restraint. This antecedent analysis identified several common influences, as well as effects that were unique to individual students. The role of antecedent events as "precipitants" to restraint and respective treatment implications are discussed.

Adolescent↗

Evaluating student discipline practices in a public school through behavioral assessment of office referrals.

Office discipline referrals are a common practice in public schools to address students' problem behaviors. The authors report two descriptive studies in a public elementary-middle school to illustrate frequency of office referrals as an evaluative data source. Study I was a behavioral assessment of office referrals to determine the types of discipline problems confronting school personnel and the distribution of referrals among teachers, students, and grade level. In Study II, a fifth-grade class that had the most office referrals in the school received whole-class and individual-student interventions that produced a decrease in the number of referrals. These findings support use of office referrals as a readily available index by which to identify school discipline problems, design interventions, and evaluate outcome.

Behavior Therapy↗

Improving student bus-riding behavior through a whole-school intervention.

We describe a multicomponent intervention to improve bus-riding behavior of students attending an urban public school. The intervention was developed with technical assistance consultation that emphasized collaboration among students, school personnel, and bus drivers. The primary intervention procedures were identifying appropriate behaviors during transportation ("bus rules"), training bus drivers to deliver positive reinforcement, and rewarding student performance through a weekly school-based lottery. Disruptive bus behaviors, as measured by discipline referrals and suspensions, decreased with intervention relative to baseline phases in an ABAB reversal design. These positive results were maintained over the long term, with school personnel assuming responsibility for intervention in the absence of ongoing consultation.

Behavior Therapy↗