Providing Independent Recreational Activities to Reduce Stereotypic Vocalizations in Chronic Schizophrenics

Abstract

We evaluated the effects of minimally supervised, independent recreational activities on stereotypic vocal behavior in two chronic schizophrenic patients. In baseline sessions, subjects were observed during unstructured free time in the psychiatric ward. In treatment sessions, therapists presented preferred recreational materials (magazines, models, and art projects), verbally prompted on-task behavior every 20 min, and, in one condition, administered contingent tokens. Independent recreational activities reduced medium-rate self-talk in one subject and high-rate mumbling in a second subject by 60%-70%. Results were the same with or without contingent tokens. Apparent selfmaintaining characteristics of these vocal responses are discussed.DESCRIPTORS: independent recreational activities, hallucinatory behavior, stereotypic vocalizations, schizophrenic inpatients Repetitive and nondirected vocalizations are among the peculiarities that mark chronic psychiatric patients (Paul & Lentz, 1977). These inappropriate responses have been modified in a few behavioral investigations. Using a 10-min sedusionary time-out, Haynes and Geddy (1973) intermittently punished "hallucinatory" speech in a schizophrenic woman on the hospital ward, reducing it by about half. Alford, Fleece, and Rothblum (1982) Bellack, 1977), and while listening to a radio or watching television (Magen, 1983).Stereotypic behavior in retarded clients is well recognized; one intervention that has been applied with this population consists of presenting recreThe authors thank

Effects of structured ward activities on appropriate and psychotic behaviof of chronic psychiatric patients

“…These results support earlier findings in which recreational activity replaced specific stereotypies of individual patients (e.g., Wong et al 1987). The present research also documented large increases in the amount of appropriate behavior emitted by patients during structured activities.…”

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“…In some residents, disruptive vocalization may serve as a source of self‐stimulation, ie an attempt to compensate for the low ambient environmental stimulation common in nursing homes. For these residents, treatment can focus on compensating for understimulation by providing the resident with additional activities, 22 music provided via headphones, or an audio amplification device. This latter device, developed for individuals with hearing impairments, not only provides the needed amplification of audio stimuli but has the added benefit of allowing the resident to experience the aversive nature of his/her own loud vocalizations.…”

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