Biomedical subjects

R G Miltenberger

Publications and source records attributed to R G Miltenberger.

At least 37 records · Page 2Linked to original sources

PubMed1996

A simplified habit reversal treatment for pica-related chewing.

In this study the frequency of chewing behavior in a 6-year-old male diagnosed with pica was reduced using a simplified habit reversal procedure. Data were collected on the frequency of chewing behavior, treatment acceptability, parent satisfaction, and social validity of the behavior change. This study represents the first known application of the habit reversal procedure to treat pica-related chewing in a normally intelligent child.

Behavior Therapy↗

PubMed1996

Habits, tics, and stuttering. Prevalence and relation to anxiety and somatic awareness.

This study examines the prevalence of nervous habits, tics and stuttering in 256 college students, as well as the relationship between these behaviors and self-reported general anxiety and awareness of bodily sensations. Improving on previous studies, this study strengthens the operational definition of a nervous habit by using a more stringent operational definition, giving what is arguably a more valid set of prevalence statistics. Participants were asked to complete self-report measures of general anxiety and somatic awareness. Relationships were found between number of nervous habits and tics that participants endorsed and their self-reported awareness of bodily sensations, as well as between number of habits endorsed and self-reported general anxiety. This article concludes with suggestions for future research in the area of nervous habits and motor tics.

Adult↗

PubMed1996

Are persons with nervous habit nervous? A preliminary examination of habit function in a nonreferred population.

In this study, 44 individual were exposed to three conditions (anxiety, bored, and neutral) while being covertly videotaped. The videotapes were then scored for the occurrence of five classes of habits including hair, face, and object manipulation; object mouthing; and repetitive movement of the limbs. Results showed that hair and face manipulation increased during the anxiety condition, whereas object manipulation increased in the bored condition. The implications of this research are discussed.

Adult↗

PubMed1996

Sequential application of major habit-reversal components to treat motor tics in children.

In this study, we sequentially administered up to four components of the habit-reversal treatment to 4 children with motor tics within a multiple baseline design. The habit-reversal components included (a) awareness training; (b) awareness training and self-monitoring; (c) awareness training, self-monitoring, and social support; and (d) awareness training, social support, and the use of a competing response. Results demonstrated that the combined use of awareness training, social support, and competing response training was effective in eliminating motor tics in 2 of 4 children, that awareness training alone was effective for 1 child, and that a combination of awareness training and self-monitoring was effective for the 4th child. The treatment and ensuing improvement were found to be socially valid. We discuss possible explanations for these results and recommend directions for future research.

Awareness↗

PubMed1995

Treatment of a vocal tic by differential reinforcement.

The purpose of this study was to investigate the effectiveness of differential reinforcement of the absence of a chronic vocal tic in a 9-year-old male. This procedure was used after problems in the application of a simplified habit reversal procedure were encountered, and when it became evident that a reinforcement procedure was more acceptable to the patient. Once differential reinforcement was implemented, a substantial decrease (to near zero frequency) in coughing and throat clearing resulted. The reduction of coughing and throat clearing was seen within and outside the treatment session. Treatment effects were maintained after fading the reinforcement and throughout posttreatment (50 weeks).

Awareness↗

PubMed1995

Habit reversal: a review of applications and variations.

Research is reviewed on habit reversal treatment of tics and other nervous habits, and on the components of such treatment. Awareness training and the use of a competing response are found to be its essential components. Studies which evaluate the habit reversal procedure and its variations in the treatment of stuttering are also reviewed.

Awareness↗

PubMed1995

An experimental analysis of facilitated communication.

We evaluated the authorship of messages produced through facilitated communication by 7 adults with moderate or severe mental retardation and their facilitators. The clients had been reported to be communicating fluently through facilitated communication. We controlled the facilitators' access to information to be communicated in two evaluation formats, naming pictures and describing activities. In both formats we conducted three conditions: (a) the facilitator and client had access to the same information, (b) the facilitator did not have access to the picture or activity, and (c) the facilitator was given false information about the picture or activity. The results showed that the clients typed the correct answer only when the facilitator had access to the same information, never typed the correct answer when the facilitator had no information or false information, and typed the picture or activity presented to the facilitator when it was different from the one experienced by the client. These results provide unequivocal evidence for facilitator control of typing during facilitated communication.

Adult↗

PubMed1995

Long-term follow-up of a behavioral treatment for stuttering in children.

We report 3.5-year follow-up data from children who participated in a study that evaluated a behavioral treatment for stuttering. Six of 7 subjects continued to be at or below the criterion of 3% stuttered words. Stuttering increased for 1 subject, but remained far below his baseline level. Social validity data are also reported.

Adolescent↗

PubMed1994

What makes extinction work: an analysis of procedural form and function.

We examined methods for determining how extinction should be applied to different functions of self-injurious behavior (SIB). Assessment data indicated that the head banging of 3 children with developmental disabilities was maintained by different reinforcement contingencies: One subject's SIB was positively reinforced by attention from adults, the 2nd subjects SIB was negatively reinforced by escape from educational tasks, and the 3rd subject's SIB appeared to be automatically reinforced or "self-stimulatory" in nature. Three functional variations of extinction--EXT (attention), EXT (escape), and EXT (sensory)--were evaluated, and each subject was exposed to at least two of these variations in reversal or multiple baseline designs. Reductions in SIB were observed only when implementation of "extinction" involved the discontinuation of reinforcement previously shown to be responsible for maintaining the behavior. These results highlight important differences among treatment techniques based on the same behavioral principle (extinction) when applied to topographically similar but functionally dissimilar responses, and further illustrate the practical implications of a functional analysis of behavior disorders for designing, selecting, and classifying therapeutic interventions.

Attention↗

PubMed1994

Analysis of a high-probability instructional sequence and time-out in the treatment of child noncompliance.

This study evaluated the effectiveness of high-probability requests and time-out as treatments for noncompliance that appeared to be maintained by contingent attention in 2 developmentally normal children. The introduction of high-probability requests increased compliance for 1 child but not the other. Time-out was effective with both children, and improvements in compliance were maintained at an 8-week follow-up.

Behavior Therapy↗

PubMed1993

Analysis of a simplified treatment for stuttering in children.

We investigated the effectiveness of a simplified program for the treatment of stuttering in children. The simplified treatment included awareness training, in which the subjects learned to detect every occurrence of stuttering; training a response incompatible with stuttering, which involved relaxation and regulation of air flow over the larynx when speaking; and social support, which involved parent-delivered prompts and praise of children's use of the techniques in everyday environments. Eight children were treated in their homes with the simplified treatment, in a multiple baseline across subjects design, and all reached the criterion level of less than 3% words stuttered. In addition, the reduction in stuttering generalized to the school setting and was maintained at posttreatment (10 to 13 months). The subjects' rates of speech remained stable throughout baseline and treatment. Pretreatment and posttreatment ratings by the parents showed that they found treatment to be both acceptable and credible. Finally, social validity measures revealed a noticeable improvement in the subjects' speech to parents and speech pathologists.

Behavior Therapy↗

PubMed1993

Teaching parents with mental retardation: knowledge versus skills.

An educational program for parents (N = 5) with mild mental retardation was evaluated to assess whether knowledge gains resulted in corresponding skill acquisition. Generalization of parenting skills to the home environment following behavioral skills training procedures was also examined. Parenting knowledge was assessed as subjects responded to descriptions of parenting situations. Parenting skills were assessed in home observations. Following baseline, a knowledge training procedure was implemented in a small group format. A behavioral skills training procedure was then implemented in a small group training format. Finally, individual behavioral skills training was provided in the home setting. Although knowledge training produced sizable increases in the knowledge measure, neither it nor the behavioral group training produced increases in parenting skills. However, following training in the home, each of the parenting skills increased substantially. The results were discussed with regard to the problem of generalization, and future research was proposed.

Adult↗

PubMed1991

Assessing the acceptability of behavioral treatments to persons with mental retardation.

Individuals with mild to moderate mental retardation living in community residential settings (Experiment 1) or an institutional setting (Experiment 2) rated the acceptability of differential reinforcement and time-out applied to a mild and a severe behavior problem. Using analogue methodology similar to previous treatment acceptability studies (e.g., Miltenberger, Lennox, & Erfanian, 1989; Tarnowski, Rasnake, Mulicke, & Kelly, 1989), and a simplified rating scale developed for persons with mental retardation, community-based subjects rated differential reinforcement as more acceptable than time-out for the mild problem, whereas institutionalized subjects rated time-out as more acceptable than differential reinforcement when applied to the severe problem. These results were discussed and future research suggested.

Activities of Daily Living↗

PubMed1990

Teaching self-protection skills to persons with mental retardation.

A curriculum for teaching self-protection skills to eight adults with mild mental retardation was evaluated. The curriculum, which was presented in a small-group format across nine 25 to 30 minute sessions, uses instructions, modeling, rehearsal, feedback, and praise to teach skills needed to discriminate and safely respond to abduction and sexual abuse situations. Self-protection skills were assessed in in situ simulations involving solicitations from adults. Results showed that all but one subject learned the criterion skills and maintained them at a 6-month follow-up. Strengths and limitations of the study were discussed and future research directions suggested.

Adult↗

PubMed1989

The treatment of muscle tics with dissimilar competing response practice.

Prior research has shown that muscle tics can be suppressed by the performance of a competing response contingent on the occurrence of the muscle tics. In an effort to determine whether the topography of the competing response was important to the muscle tic suppressing effects of contingent competing response practice, we evaluated the effects of a competing response that was topographically dissimilar to the muscle tic. Three subjects engaged in dissimilar competing responses contingent on the occurrence of a muscle tic; 2 of these subjects subsequently engaged in similar competing response practice. The results showed a decrease in objective measures of muscle tic frequency with the introduction of dissimilar competing response practice for each subject; subsequent exposure to similar competing response practice for 2 subjects resulted in no additional decrement in the level of muscle tics. These results suggest that the topography of the competing response may not be crucial for the suppression of muscle tics. Discrepancies between the objective measures of muscle tics and self-recorded measures are noted and discussed.

Journal Article↗

PubMed1989

Acceptability of alternative treatments for persons with mental retardation: ratings from institutional and community-based staff.

The acceptability of four behavior modification procedures to direct-care and supervisory staff members of community-based (Experiment 1) and institutional (Experiment 2) facilities for persons with mental retardation was evaluated. Using the Treatment Evaluation Inventory (Kazdin, 1980a), staff members rated differential reinforcement of other behavior (DRO), time-out, overcorrection, and contingent shock, each applied to a mild and a severe behavior problem. Results from both experiments showed that treatments were rated according to their restrictiveness; DRO was most acceptable, followed by time-out, overcorrection, and shock. There was also a problem by treatment interaction in each experiment. No differences were found between the ratings of direct-care and supervisory staff members in either study. Results were discussed in relation to previous treatment acceptability research.

Adult↗

PubMed1988

Evaluation of an instructions and modeling procedure for training behavioral assessment interviewing.

Ten undergraduate psychology majors served as participants in two experiments training behavioral assessment interviewing skills. In the first study four participants received training with instructions and audio and written modeling in a multiple baseline across participants design. All participants increased interviewing performance substantially with training. The second study was conducted to evaluate the written instructional material alone. After baseline interviews all six remaining participants received training with instructions in a multiple baseline across participants fashion. For four participants who did not increase interview performance to 90% correct with instructions, the modeling component was added as a third phase. By the end of a subsequent feedback phase all participants increased their performance to 90% or better. Social validation measures of participants' interviewing performance were than added to evaluate process-related variables in the interview.

Audiovisual Aids↗

PubMed1988

Evaluation of home-based programs for teaching personal safety skills to children.

We evaluated the efficacy of a commercially available program, the Red Flag, Green Flag Prevention Book, used by parents to teach their children personal safety skills. Children's knowledge and skills regarding the prevention of sexual abuse and abduction were assessed prior to, during, and after training. In one group, training consisted of parents using the prevention book to train their children. Parents of children in the second group used the prevention book with added instructions. Children who did not achieve criterion performance after training with the prevention book received behavioral skills training provided by the experimenter. All children acquired safety skills following behavioral skills training. Follow-up probes 2 months later showed skill maintenance among the older children. Parents reported satisfaction with the procedures and no signs of behavioral or emotional problems following the follow-up probe.

Journal Article↗