Improving needed food intake of profoundly handicapped children through effective supervision of institutional staff

1983

101

The present study evaluated a participative management approach for increasing the frequency of interactions between institutional staff and severely/profoundly retarded residents. The participative management approach involved teaching staff how to use self-monitoring, standard setting, self-evaluation, and self-reinforcement procedures. These procedures were then used by staff with minimal involvement of supervisory personnel. Although supervisors provided feedback and praise to staff for using these self-management behaviors, feedback and praise were never dispensed contingent on staff interactions with residents. Results indicated that during the participative management program there was an increase in staff interactions that were contingent on appropriate resident behavior. The increase in this type of staff interaction was accompanied by an increase in appropriate resident behavior. Follow-up data on both staff and resident behaviors, although showing moderating trends, suggested generally good maintenance of the initial behavior changes. Acceptability data suggested that staff were quite receptive to the program. The advantages of participative management procedures for improving staff performance in residential settings are discussed.

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

A Participative Management Approach for Improving Direct‐care Staff Performance in an Institutional Setting

Burgio

Whitman

1983

101

“…As a result of neuromuscular dysfunction, these individuals are nonambulatory and are often quite small for their chronological age (Rice, McDaniel, Stallings, & Gatz, 1967), have little or no control over their movements (Guess et al, 1988), and appear to have minimal or no physical potential to allow for independence in performing self-care routines (Bailey, 1981). Third, persons with profound multiple handicaps usually have frequent medical complications relating to, for example, seizure disorders (Guess et al, 1988) and physical difficulties with food ingestion (Korabek, Reid, & Ivancic, 1981). In short, these individuals are totally dependent on caregivers for their survival. Perhaps the best way to understand the degree of disability-and subsequent difficulty that trainers face-with persons who have profound multiple handicaps is to consider how researchers who have studied this population during the last 40 years have described them (Landesman-Dwyer & Sackett, 1978).…”

Section: Focus Of Review Individuals With Profound Multiplementioning

confidence: 99%

“…In short, these individuals are totally dependent on caregivers for their survival. Perhaps the best way to understand the degree of disability-and subsequent difficulty that trainers face-with persons who have profound multiple handicaps is to consider how researchers who have studied this population during the last 40 years have described them (Landesman-Dwyer & Sackett, 1978). Various descriptors used in this regard have included "vegetative" (Bailey & Mey-erson, 1969;Fuller, 1949), "crib-bound" (Bailey & Meyerson, 1969), "hopelessly devastated" (Landesman-Dwyer & Sackett, 1978), "highly deviant organism" (Rice et al, 1967), "subtrainable" (Bailey, 1981) and "deprived organism" (Piper & MacKinnon, 1969 (Green et al, 1988;Haskett & Hollar, 1978 (Correa, Poulson, & Salzberg, 1984;Korabek et al, 1981). Levels of alertness also vary considerably across and within days, as indicated by the repeated observation that client response to teaching paradigms frequently is highly variable and that clients sometimes fall asleep during teaching sessions (Brownfield & Keehn, 1966;Deiker & Bruno, 1976;Haskett & Hollar, 1978).…”

Section: Focus Of Review Individuals With Profound Multiplementioning

confidence: 99%

Teaching Persons With Profound Multiple Handicaps: A Review of the Effects of Behavioral Research

Phillips

Green

1991

Self Cite

The behavioral research on teaching individuals who have profound multiple handicaps is reviewed. The primary focus is on determining the degree to which behavioral research has demonstrated the teaching of meaningful skills to this population. Results of the review indicate that investigations have demonstrated, albeit inconsistently, that behavior change has resulted from contingency management interventions with persons who have profound multiple handicaps. However, there is little evidence that such interventions have resulted in meaningful behavior change according to currently accepted criteria for beneficially affecting the quality of life of persons with serious handicaps. Potential explanations for the lack of such evidence are offered, induding the relative lack of research attention given to this issue, the possible ineffectiveness of the components of the technology applied, and possible ineffective application of the potentially effective technology. Suggestions for future research are discussed in terms of developing more effective educational and habilitative services for persons with profound multiple handicaps. In particular, we suggest research on a wider variety of behavioral teaching procedures, providing more comprehensive evaluations of the applications of procedures and developing treatment programs that do not focus solely on traditional skill acquisition.DESCRIPTORS: profound multiple handicaps, developmental disabilities, behavioral research methodology Since the early 1960s, one of the most significant areas of impact of applied behavioral research has been developmental disabilities. Hundreds of investigations have reported the successful use of behavioral procedures to improve adaptive functioning and decrease maladaptive behaviors of persons who have developmental disabilities (see Matson & Mulick, 1983;Whitman, Scibak, & Reid, 1983, for selected reviews). However, although the overall impact of applied behavioral research in this area has been quite significant, there is one population of persons with developmental disabilities for whom the impact has not been dear. Specifically, the utility of behavioral procedures for affecting adaptive behavior change among individuals who have profound mental and physical handicaps has been seriously questioned (Landesman-Dwyer & Sackett, 1978;Rainforth, 1982 (Guess et al., 1988). The most common descriptor used with standardized quantification is profound mental retardation (Grossman, 1983). However, profound mental retardation as a diagnostic dassification includes a very heterogeneous group of persons with a wide range of skills and disabilities (Bailey, 1981;Rainforth, 1982). Our concern is with those persons whose handicaps are so debilitating that they fall at the extreme lower end of the continuum of profound mental retardation and who also possess profound physical impairments, such that no existing standardized intelligence tests are applicable (cf. Bailey, 1981).We will refer to the population of concern here as individuals who have ...

“…An evaluation of staff acceptance (Kazdin, 1980) of the program was also included. However, whereas previous evaluations of acceptability of staff management programs have relied on staff verbal reports (Burgio, Whitman, & Reid, 1983;Greene, Willis, Levy, & Bailey, 1978;Korabek, Reid, & Ivancic, 1981;Quilitch, 1978;Quilitch, de Longchamps, Warden, & Szczepaniak, 1977), the current project evaluated verbal reports of acceptability and whether or not staff actually engaged in a reportedly acceptable activity when given a choice to do so.…”

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confidence: 99%

Peer Training of Safety‐related Skills to Institutional Staff: Benefits for Trainers and Trainees

Pol

Fuqua

1983

A peer training program, in which experienced staff trained new staff, was evaluated as a method for teaching and maintaining safety-related caregiver skills in an institutional setting for the developmentally disabled. Three sets of safety-type skills were assessed in simulated emergency situations: responding to facility fires, managing aggressive attacks by residents, and assisting residents during convulsive seizures. Using a multiple-baseline research design, results indicated that the peer training program was an effective method of training the three types of emergency skills to new direct care staff. The program also appeared effective in improving the skills of the peer trainers. Perhaps most importantly, results indicated that if experienced staff functioned as peer trainers for particular emergency skills, then their proficiency in those skills maintained over time whereas their proficiency declined in emergency skills for which they did not act as peer trainers. Social validity information collected from available staff 23 months after the program was completed supported the utility of the training in terms of staff responses during actual emergencies. Also, acceptability measures indicated that staff liked participating in the program. However, some inconsistencies between staff verbal reports and performance-based measures of acceptability were noted. Results are discussed regarding the overall effectiveness of the peer training program, the importance of maintenance strategies for safety-related skills, and the need for multidimensional analyses of staff acceptability in staff training/management research.