The goal of the current case study was to illustrate evidence-based cognitive-behavioral treatment (CBT) for an adolescent female with comorbid major depressive disorder, generalized anxiety disorder, attention deficit hyperactivity disorder, suicidal ideations, and a history of multiple involuntary hospitalizations. Multimodal assessment of the child’s symptoms was conducted, including parent, teacher, and child self-report, academic data, and hospital records to inform case conceptualization. Treatment included a combination of psychoeducation, cognitive restructuring, positive self-talk, relaxation skills, and the support of a school-based personal aide. Significant improvements with inattentive, anxiety, and depressive symptoms were reported, with gains being maintained at 1 year follow-up. In addition to a reduction of reported psychosocial problems, treatment benefits also included a decrease in classroom disruptions, improvement in academic performance, and withdrawal of paraprofessional support at school. This study illustrates the use of school-based CBT strategies coupled with additional focused Tier 4 behavior supports as an efficacious treatment for youth with significant comorbidity.
Incremental rehearsal (IR) has consistently been shown to improve students' math fact retention and fluency (Maki et al., Journal of Behavioral Education 30:534-558, 2021). However, less is known about how intervention modifications may support longer-term skill maintenance. The purpose of this study was to compare traditional IR with a modified IR (shuffle IR; ShIR) in which known multiplication facts were shuffled between sequences using a cumulative acquisition design with six fourthand fifth-grade students. All participants retained and maintained more facts in IR and ShIR compared to a control condition. However, IR or ShIR did not consistently result in greater retention than the other, with three students demonstrating greater retention in the IR condition and three students demonstrating greater retention in the ShIR condition. Most participants demonstrated greater fact maintenance in the ShIR condition than in the IR condition. All participants made fewer intervention session errors in the condition in which they retained more multiplication facts.
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