Re-establishing Conversational Skills in Overtly Psychotic, Chronic Schizophrenic Patients

Abstract

A discrete trials procedure incorporating graduated prompts, social and consumable reinforcement, corrective feedback, delay of reinforcement, and a chaining procedure was used to teach four actively psychotic, chronic schizophrenic patients rudimentary conversational skills. In a multiple-baseline design, training was sequentially applied to the target conversational skills of giving a salutation, addressing the trainer by his or her name, making a personal inquiry, and asking a conversational question. Results showed systematic training effects in three of the four subjects. Training gains were reliable but slow, requiring over 70 trials to reach acquisition criterion on certain skills. The fourth subject exhibited only unstable gains on the first target response and minor improvements on the second target response, the latter of which disappeared when training procedures were withdrawn. All subjects displayed spontaneous recovery on the generalization measure of answering a personal inquiry.

A Review of Training Intraverbal Repertoires: Can Precision Teaching Help?

“…Discrete trial training (DTT) procedures have been implemented to develop intraverbal responding. Wong and Woolsey (1989) taught four participants with chronic schizophrenia simple conversational skills. Each target response was trained sequentially with repeated trials.…”

“…While Wong and Woolsey (1989) successfully established intraverbal responding, response and setting generalization are noted limitations of DTT procedures (Maurice, Green, & Luce, 1996). In addition, individuals with schizophrenia have had prior contact to reinforcement contingencies for intraverbal responding.…”

Operant Learning Theory

“…In an analogous fashion, staff members in institutions have been trained to use rein forcement contingencies to manage urinary incontinence in elderly residents (Pinkston, Howe, & Blackman, 1987) and to reduce delusional verbalizations and disruptive behavior (Wong, Woolsey, & Gallegos, 1987), to restore appropriate conversational speech (Wong & Woolsey, 1989), and to improve grooming skills and personal hygiene (Wong, Flanagan, et aI., 1988) in chronic mental patients. Behavioral procedures have also been utilized to teach technical skills to professional staff or interns such as facilitative and supportive ut terances during family therapy (Galant, Thyer, & Bailey, 1991), clinical interviewing skills (Iwata, Wong, Riordan, Dorsey, & Lau, 1982;Schinke, Gilchrist, Smith, & Wong, 1978), management of visits between parents and children in foster care (Kessler & Greene, 1999), behavior management skills to staff in group homes for persons with mental retardation (Schinke & Wong, 1977) and adult day care centers (DeRoos & Pinkston, 1997), and be havior analysis skills to graduate social work students (Dillenburger, Godina, & Burton, 1997).…”

Behavioral Social Work: Past, Present, and Future

“…Social workers have made contributions to the understanding and treatment of anxiety (e.g., Rose, 1990;Steketee, Bransfield, Miller, & Foa, 1989;Thyer, 1987b). Social worker Steven Wong and his colleagues have published many articles describing their work with &dquo;chronic psychiatric patients&dquo; (e.g., Wong, Floyd, Innocent, & Woolsey, 1991;Wong et al, 1987;Wong & Woolsey, 1989), as have a numbers of others in our field (e.g., Bentley, 1990;Hudson, 1978;Stocks, Thyer, & Kearsley, 1987;Thyer, Irvine, & Santa, 1984).…”