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Recent advancements in telecommunication technologies make it possible to conduct a variety of healthcare services remotely (e.g., behavioral-analytic intervention services), thereby bridging the gap between qualified providers and consumers in isolated locations. In this study, web-based telehealth technologies were used to remotely train direct-care staff to conduct a multiple-stimulus-without-replacement preference assessment. The training package included three components: (a) a multimedia presentation; (b) descriptive feedback from previously recorded baseline sessions; and (c) scripted role-play with immediate feedback. A nonconcurrent, multiple-baseline-across-participants design was used to demonstrate experimental control. Training resulted in robust and immediate improvements, and these effects maintained during 1- to 2-month follow-up observations. In addition, participants expressed high satisfaction with the web-based materials and the overall remote-training experience.

Discrete-trial teaching is a strategy frequently used to teach functional skills to individuals with developmental and intellectual disabilities. Research has shown that the within-trial components of the procedure should be administered with ≥90% treatment integrity to facilitate optimal learning. Usually within-trial treatment integrity is measured using whole-session methods such as percentage of trials correctly administered. This study demonstrated one-step Markov transition matrices as a method of assessing within-trial treatment integrity. All components of discrete trials were coded and time-stamped from video recordings of therapist–learner dyads in their typical setting (home or school). Several types of within-trial treatment integrity errors were identified using the Markov transition matrices, error sequences that could not be identified using a percentage correct analysis. Better identification of errors has the potential both to enhance treatment integrity and to gain efficiency by targeted retraining of therapists. Copyright © 2016 John Wiley & Sons, Ltd.

Research has estimated that “sundowning”, an increase in confusion, agitation or challenging behavior later in the day, occurs in 20–40% of people with Alzheimer’s disease (AD). We conducted 8-h continuous measurement of the sundowning behavior of two women with AD who were identified as “sundowners” by staff in a care home. The distribution of behavior corresponded to the description of sundowning for one participant, but not the other. Functional analysis results suggested a possible social positive function for one participant but were unclear for the other. We suggest that sundowning is better defined as a description of the distribution of behavior across a day rather than topographically, because topography and function differ across individuals. We recommend that environmental variables such as staff attention should be measured to determine their effect on behavior and to develop interventions. This study demonstrates an example of a behavior analytic approach to clinical practice in demen...

Duration is a commonly measured dimension of behavior in behavioral research and clinical practice. An approach to studies of measurement in behavior analysis is to simulate streams of behavior from which samples can be extracted. It is therefore important to establish a typical range and distribution of behavioral durations on which simulated behavioral data should be based. We conducted an analysis of behavioral durations reported in the Journal of Applied Behavior Analysis between 2008 and 2012. The range and distribution of data points across different durations will be presented, as well as an analysis of the reliability of the software used to measure each data point. Copyright © 2015 John Wiley & Sons, Ltd.

The behavioural literature on representativeness is able to provide general rules for selecting representative measurement systems. For example, using shorter intervals between observations will, in general, produce more representative samples. However, applied behaviour analysis would benefit from a data-based method of choosing a measurement system based on estimated duration of behaviour, desired representativeness (i.e., acceptable error), and the parameters of a measurement system likely to be practical in a clinical setting. Computer simulations were used to evaluate the effect of varying overall and bout durations on the representativeness of samples extracted using simulated momentary time sampling (MTS). A set of decision rules, in the form of 3D graphs, from which practitioners could select parameters of MTS, based on estimates of the dimensions of the behaviour (bout duration and overall duration) and acceptable error, were developed. The decision rules were applied to whole-week data s...

To date, research on the effects of providing sensory stimulating activities (e.g., multisensory environments) with persons with dementia has been inconclusive. We evaluated the behavioral effects of an occupational therapy program of individualized sensory-based activities (SBAs), in which activities were selected based on individuals’ sensory abilities and preferences. Six participants with severe cognitive impairment (aged 68–90 years) were selected by the staff of a residential dementia facility. The effects of SBA on behaviors considered desirable or undesirable by staff were assessed by behavioral measurement, and results were compared from immediately before SBA with data collected during and after SBA sessions. The results indicate that the use of SBA had immediate effects during the activity, but limited short-term after-effects.

Engelman, Altus, and Mathews (1999) evaluated a procedure to ensure that staff checked in with elderly residents in a nursing home and offered activity choices. We report findings of a replication, with some additional components, to increase appropriate activity engagement among 5 residents (aged 77 to 83 years) with severe dementia. Evaluated in a concurrent multiple baseline design across participants that incorporated partial withdrawal phases, activity engagement increased for 3 participants, with modest improvement for 1 other participant. The 4 responders all engaged in a wider variety of activities during intervention.

Deciding on appropriate sampling to obtain representative samples of behavior is important but not straightforward, because the relative duration of the target behavior may affect its observation in a given sampling interval. Work-sampling methods, which offer a way to adjust the frequency of sampling according to a priori or ongoing estimates of the behavior to achieve a preselected level of representativeness, may provide a solution. Full-week observations of 7 behaviors were conducted for 3 students with autism spectrum disorder and intellectual disabilities. Work-sampling methods were used to select momentary time samples from the full time-of-interest, which produced representative samples. However, work sampling required impractically high numbers of time samples to obtain representative samples. More practical momentary time samples produced less representative samples, particularly for low-duration behaviors. The utility and limits of work-sampling methods for applied behavior analysis are discussed.

Often it is assumed that electronic recording by observers necessarily provides better quality data than pen-and-paper methods. Fifteen novice observers recorded rates of responding from 10 role-played video samples using one of three continuous recording input formats: keyboard (laptop), touchscreen (personal digital assistants), or pen-and-paper. We evaluated the quality of the observers' data compared with criterion records using calibration and interobserver agreement algorithms. Results of the calibration analysis revealed that observers in the touchscreen group produced the most consistently accurate and precise data, the keyboard group observers showed wide variation in precision and accuracy, and the pen-and-paper group observers were significantly less precise than the touchscreen group. We conclude that although electronic recording has the potential to be as accurate as, and more precise than, pen-and-paper methods, this is far from guaranteed. Analyses of observers' errors advise recommendations for improving data accuracy and precision when using each method. Copyright © 2014 John Wiley & Sons, Ltd.

The effectiveness of four antecedent treatments for rumination was compared for two individuals with autism, severe intellectual disabilities and long histories (at least 20 years) of rumination. Comparisons of increased meal size, supplemental feedings, fixed-time provision of peanut butter, and liquid rescheduling found liquid rescheduling to be the most effective intervention for both clients. However, within-session analyses, both during intervention and for 30 min after the meal, showed individualized schedules of fluid provision were needed to increase the effectiveness of the treatment.

A token reinforcement program, named ‘Thumbs Up’, was introduced in a residential therapeutic community for drug and alcohol rehabilitation. Sixteen young people aged 14–17 years participated for varying durations. Participants were able to negotiate target behaviors and choose backup reinforcers. We evaluated the program within a multiple baseline design across participants, settings, and behaviors. Improvements occurred in positive verbal statements across settings, timely room cleaning, and leadership responsibilities. Inappropriate statements were also measured and did not change. One staff member was trained in the use of Thumbs Up with positive results. Difficulties with implementing behavioral interventions in a non-behaviorally oriented treatment service were identified. Despite needing refinements, it was concluded that a token reinforcement program can be an effective and acceptable means of improving behavior within a therapeutic community framework. Copyright © 2012 John Wiley & Sons, Ltd.

We replicated and extended previous research on microswitch facilitated choice making by individuals with profound multiple disabilities. Following an assessment of stimulus preferences, we taught 6 adults with profound multiple disabilities to emit 2 different responses to activate highly preferred stimuli. All participants learnt to activate both microswitches. Five participants showed a higher overall level of responding when both switches activating preferred stimuli were available concurrently. After completion of microswitch training, a choice assessment was conducted in which participants had access to 2 microswitches concurrently, with 1 connected to the most highly preferred stimulus and the other to a least preferred stimulus. Choice making behavior was shown in 3 participants and provided support for the preference assessment results. The results of the 3 remaining participants showed that both the most highly preferred and the least preferred stimuli may serve as reinforcers for microswitch activation responses.

Obtaining paid employment is beneficial for youth during and following treatment for substance abuse. A training program for acquiring employment was implemented at a residential drug and alcohol rehabilitation facility for nine residents who were near to completing the program. Data are presented from three residents with the most complete data sets. Skills training was provided for completing biographic information on job application forms, job searching by telephone and in person, and job interviews. The training process included behavioral procedures of providing instructions, modeling, role-play, and feedback. Improvements were demonstrated across all behaviors and participants after the training and generalized to real community materials and settings. All participants who remained in treatment also gained real work experience opportunities or regular paid employment. Copyright © 2011 John Wiley & Sons, Ltd.

Functional assessments identified that the grabbing behavior of a 24-year-old man with intellectual disability was maintained by social positive reinforcement, that is, attention. Aggression was more likely to occur when his social environment changed from high to low attention. An intervention that combined extinction with activity choice and noncontingent reinforcement was most effective at reducing grabbing. The intervention and beneficial effects were maintained over 17 months, although staff retraining was required at 6 and 16 months. Retraining was implemented successfully when aggression increased and procedural integrity had declined. Copyright © 2011 John Wiley & Sons, Ltd.

There is no published source that can inform behavioral measurement research about typical response rates measured by continuous recording in applied behavior analysis. The present study was designed to determine the distribution of data on rate of responding reported across a recent 10-volume (1998-2007) sample of research articles from the Journal of Applied Behavior Analysis. Rate of responding was measured for 20 553 datapoints in 360 sets of data (one participant in one graph) presented in 60 research articles. The majority of datapoints showed response rates of less than 1.0 response per minute, with 28.3% at zero. The highest rate reported was 104.5 responses per minute. The maximum response rate in datasets was more than 1.0 response per minute in 96.7% of datasets, indicating that continuous recording has been employed in research in which a relatively high rate of responding was recorded at some time during the study. The data from this report will assist researchers to determine empirically the representativeness of response rates in studies of measurement in applied behavior analysis.

Adolescents in a drug and alcohol treatment facility had behavioral deficits in having essential items ready for organized group adventure activities. Checklists (i.e., textual response prompts) were introduced. The data from five participants showed increases in the percentage of required items ready. Generalization was demonstrated across checklists for different activities, across staff and peer leaders, and a different day of the week. Performance was also maintained when the checklist was removed. It was concluded that the use of checklists can be a reliable and efficient strategy to improve performance in adolescents with a substance abuse history. Copyright © 2010 John Wiley & Sons, Ltd.

The three algorithms most frequently selected by behavior-analytic researchers to compute interobserver agreement with continuous recording were used to assess the accuracy of data recorded from video samples on handheld computers by 12 observers. Rate and duration of responding were recorded for three samples each. Data files were compared with criterion records to determine observer accuracy. Block-by-block and exact agreement algorithms were susceptible to inflated agreement and accuracy estimates at lower rates and durations. The exact agreement method appeared to be overly stringent for recording responding at higher rates (23.5 responses per minute) and for higher relative duration (72% of session). Time-window analysis appeared to inflate accuracy assessment at relatively high but not at low response rate and duration (4.8 responses per minute and 8% of session, respectively).

We reviewed all research articles in 10 recent volumes of the Journal of Applied Behavior Analysis (JABA): Vol. 28(3), 1995, through Vol. 38(2), 2005. Continuous recording was used in the majority (55%) of the 168 articles reporting data on free-operant human behaviors. Three methods for reporting interobserver agreement (exact agreement, block-by-block agreement, and time-window analysis) were employed in more than 10 of the articles that reported continuous recording. Having identified these currently popular agreement computation algorithms, we explain them to assist researchers, software writers, and other consumers of JABA articles.

Functional analysis is the most effective assessment for identifying the maintaining contingencies of aberrant behavior. However, it is suggested that functional analyses are not conducted regularly due to the level of skill required. A multiple baseline design across participants was used to assess if four residential caregivers, with limited experience with applied behavior analysis, could be trained to implement the standard analog functional analysis conditions. The training consisted of a lecture, written information, modeling, rehearsal, and feedback. Results showed that all participants attained percentage correct responding scores above 95% on three consecutive trials following training. One caregiver showed positive generalization of skills to the assessment of another behavioral topography. The result of this study provides further evidence that lay individuals can be trained to assist in conducting functional analyses. Copyright © 2008 John Wiley & Sons, Ltd.

In the previous version of this chapter, we reviewed anecdotal claims, research, and controversies about auditory integration training (AIT) from the earliest published mentions until 2001 (Mudford & Cullen, 2005). Our intention for the present chapter was to update the review to include research published after 2001. However, despite an extensive literature search, we found that no new research has been published on the efficacy or otherwise of AIT. Perhaps would-be researchers of AIT decided, as had we, that research funding would be better allocated to examining treatments with greater potential to provide benefits.

Recent advancements in telecommunication technologies make it possible to conduct a variety of healthcare services remotely (e.g., behavioral-analytic intervention services), thereby bridging the gap between qualified providers and consumers in isolated locations. In this study, web-based telehealth technologies were used to remotely train direct-care staff to conduct a multiple-stimulus-without-replacement preference assessment. The training package included three components: (a) a multimedia presentation; (b) descriptive feedback from previously recorded baseline sessions; and (c) scripted role-play with immediate feedback. A nonconcurrent, multiple-baseline-across-participants design was used to demonstrate experimental control. Training resulted in robust and immediate improvements, and these effects maintained during 1- to 2-month follow-up observations. In addition, participants expressed high satisfaction with the web-based materials and the overall remote-training experience.

Engelman, Altus, and Mathews (1999) evaluated a procedure to ensure that staff checked in with elderly residents in a nursing home and offered activity choices. We report findings of a replication, with some additional components, to increase appropriate activity engagement among 5 residents (aged 77 to 83 years) with severe dementia. Evaluated in a concurrent multiple baseline design across participants that incorporated partial withdrawal phases, activity engagement increased for 3 participants, with modest improvement for 1 other participant. The 4 responders all engaged in a wider variety of activities during intervention.

Deciding on appropriate sampling to obtain representative samples of behavior is important but not straightforward, because the relative duration of the target behavior may affect its observation in a given sampling interval. Work-sampling methods, which offer a way to adjust the frequency of sampling according to a priori or ongoing estimates of the behavior to achieve a preselected level of representativeness, may provide a solution. Full-week observations of 7 behaviors were conducted for 3 students with autism spectrum disorder and intellectual disabilities. Work-sampling methods were used to select momentary time samples from the full time-of-interest, which produced representative samples. However, work sampling required impractically high numbers of time samples to obtain representative samples. More practical momentary time samples produced less representative samples, particularly for low-duration behaviors. The utility and limits of work-sampling methods for applied behavior analysis are discussed.

Twenty-four service providers rated 12 video samples of four service users with whom they were familiar for affective behaviour (i.e. 'like'/'dislike') and confidence (i.e. 'certain'/'uncertain') in their judgement. Each video sample had been recorded as part of a stimulus preference assessment during which a wide range of specific stimuli were presented to each service user. Each video sample was presented twice in a counterbalanced design either with contextual information, i.e. what the presented stimulus was (C) or without such information, i.e. context free (CF). The observers showed considerable individual variation in their judgements, largely uninfluenced by the availability or otherwise of contextual information. However, as a group, observers significantly distinguished between video samples with regard to affective communication (determined through multiple analyses of variance) and the pattern of judgements, i.e. the relative judgement of positive or negative affect, from one sample to another. This showed a good level of consistency between observers (determined through principal components analysis). The impact of contextual information was not apparent for all video samples. However, contextual information significantly influenced judgements in four samples, typically making them more extreme; for example, a response indicative of positive affect in the CF situation became more positive when contextual information was provided, indicating that the stimulus was one that the participant was thought to like.

A man with profound mental retardation and multiple topographies of severe self-injurious behavior (SIB) had been receiving contigent shock for SIB for 2 years before the study started. Shock was being delivered with a handheld shock stick (Hot Shot Sabre Six), which produced burns to the man's skin. SIB rate, without a shock contingency, was 10 responses/min. The Therapeutic Shock Device (TSD), worn by the client and remotely operated by a radio frequency signal, provided superior control of SIB (0.02 responses/min) compared with the shock stick (0.06 responses/min) without causing tissue damage. TSD treatment was introduced in a mixed multiple baseline design across times, settings, and behaviors. The client did not appear to find the TSD aversive. To the contrary, his behaviors indicated that he preferred to wear it. The TSD appeared to provide a substitute for restraint, the hypothesized reinforcer for the man's most frequent form of SIB.

A 31-year-old man, a New Zealander with severe developmental disability, engaged in life-threatening operant vomiting. His therapists and two consultant behavior analysts recommended applying for a Court order to evaluate treatment that included the short-term use of contingent shock. In Court, others gave expert testimony that positive procedures alone would be sufficient and effective. Following the Court's decision against contingent shock, professionals who were responsible for ensuring compliance with the decision did not identify a nonaversive intervention. Consequently, the client was subjected to an intrusive medical procedure (chronic nasogastric intubation) and a severely restricted environment. This intervention was continued for 1 year. Problems that resulted from conflicting expert testimony on treatment alternatives are discussed.

We start with a review of the history and methods of determining evidence for practice in medicine as the evidence-based practice movement started in that discipline, and has led the way for other human services. Psychologists, especially those working for children and young people, tend to work collaboratively with other professionals. We sample those professionals' views on evidence-based practice. The generalizability to psychology of methods for evidence-based decision making in medicine is questioned. Next we examine criteria for determining the strength of evidence for interventions in clinical applications of psychology. These criteria are notably different to those employed in medicine, particularly concerning the relative value to the evidence base of research in psychology that has employed methods distinct from medicine (e.g., small-N experimental design research). The controversies concerning treatment guidelines derived from empirically supported treatments are outlined briefly. The extent to which special considerations exist regarding treatment selection for children and adolescents is then discussed. Finally, we highlight some of the aspects of evidence-based practice in psychology that require further work by researchers and clinicians. Keywords: applied behavior analysis; children; clinical psychology; evidence-based practice; small-N designs

The quality of measurement systems used in almost all natural sciences other than behavior analysis is usually evaluated through calibration study rather than relying on interobserver agreement. We demonstrated some of the basic features of calibration using observer-measured rates of free-operant responding from 10 scripted 10-min calibration samples on video. Five novice and 5 experienced observers recorded (on laptop computers) response samples with a priori determined response rates ranging from 0 to 8 responses per minute. Observer records were then compared with these predetermined reference values using linear regression and related graphical depiction. Results indicated that all of the observers recorded rates that were accurate to within ±0.4 responses per minute and 5 were accurate to within ±0.1 responses per minute, indicating that continuous recording of responding on computers can be highly accurate and precise. Additional research is recommended to investigate conditions that affect the quality of direct observational measurement of behavior.

Music played through headphones was noted to reduce the disruptive chanting and speech-like vocalizations of a 68-year-old man who lived in a secure dementia unit. We conducted a variety of assessment procedures, including a functional analysis ‘alone’ condition, to identify why this simple intervention may have been effective for this individual. The data suggest that music provided an alternative source of auditory stimulation to that produced by automatically reinforced vocal behavior. Copyright © 2010 John Wiley & Sons, Ltd.

It is often reported that children with ASD do not readily generalize and maintain skills. As such it is of particular importance that practitioners specifically address these issues when developing interventions. This chapter will review and discuss generalization and maintenance within the current ABA research.

Publisher Summary Any behavior performed to excess in frequency or intensity, and beyond the immediate resources available for effective treatment, can be called challenging behavior. The most frequently cited examples of challenging behaviors are aggressive, self-injurious, antisocial, offensive, disruptive, and destructive behaviors. Challenging behavior has a range of negative effects for the individual performing the behaviors and for those around them. Physical injuries, increased risk of isolation, neglect, and abuse from others are some of the consequences for the individual. Challenging behavior not only interferes with adaptive behavior instruction for the person and others around them, but it also decreases the range of options in living, educational, and working environments. This chapter samples the recent research literature regarding challenging behaviors in which the participants were identified by the researchers as being diagnosed with an ASD, i.e., autism, pervasive developmental disorders (PDD), or PDD-NOS (Not Otherwise Specified). Recent research using a variety of methods shows that people with ASDs are more vulnerable than others with similar levels of intellectual disability to developing challenging behaviors. People with ASD and more severe deficits in communication skills are more likely than others to develop self-injurious behavior. Also, challenging behaviors most often associated with ASDs did not change significantly over 12 years from ages 9 to 21 years.

The representativeness of behavioral observation samples with durations of less than the whole time of interest was investigated. A real-time recording system was developed to quantify the behavior of 5 profoundly mentally retarded physically handicapped adult students in an institutional training setting. Behavior was observed using six mutually exclusive and exhaustive categories during 2.5-hr observation sessions. Sample observation sessions with durations ranging from 15 to 135 min were computer simulated from the whole-session (150-min) records. It was found that the representativeness of these samples, when compared to whole-session records, was a function of the relative duration of the behavioral categories and of sample duration. The occurrence of relatively high-duration behaviors (lasting for more than 50% of the session) was estimated to within 20% error by samples of less than 60 min, but low-duration behaviors (1 to 3% of the session) were inadequately quantified even from 135-min samples. Increasing irregularity of bouts of behavior in the low-duration behaviors is suggested as the cause of the functions obtained. Implications of the findings for applied behavior analysis are discussed, with the recommendation that the adequacy of observational session durations be empirically assessed routinely.

WHAT IS AUDITORY INTEGRATION TRAINING? Auditory integration training (AIT) is a procedure in which acoustically modified music is played to a person for 10 hours. Two 30-minute sessions per day, several hours apart, are conducted for 10 days in a fortnight. Commercial popular music with wide frequency range is used. Output from a compact disk player is connected to a box (AIT device, i.e., Audiokinetron, Audio Tone Enhancer/Trainer, or Ears Education and Retraining System) containing electronic circuitry that can modify the signal in two ways, modulation and narrow-band filtering. Modulation entails random clipping of frequencies above or below 1000 Hz for random durations between .25s and 2.0s. Filtering is reduction of volume for frequencies at which the individual recipient has hyperacute (unusually sharp) hearing as determined from prior audiological testing. The client wears headphones connected to the output from the AIT device. There are alterations made during the course of treatment in some dimensions of the musical stimuli, for example, changing volume levels for individual ears and in narrow-band filtering (Berkell, Malgeri, & Streit, 1996). These variables in AIT procedure have not been studied and are not mentioned further in this chapter.

Little is known about the progress of autistic children following specific interventions in England. Nor do we know how frequently standardized assessments are used to monitor progress or to evaluate specific educational interventions. The reports of 75 children with autism, for whom special educational provision had been determined by a local education authority, were reviewed. Parents were interviewed and educational psychologists were contacted for details of any norm-referenced assessments. Of these children, 39 percent had no standardized assessments before education authorities determined their provision, and only 9 percent had follow-up assessments that could be used to evaluate progress. Children with autism in the UK rarely have sufficient assessments to allow an objective evaluation of their progress. There is currently no standardized assessment protocol to prescribe a specific educational intervention, to evaluate the progress of children or to make comparisons between interventions. We recommend the development of such a protocol.

Parent-managed behavioral interventions for young children with autism are under-researched. We analyzed data from 66 children served by 25 different early intervention consultants. After a mean of 31.6 months of intervention IQ scores had not changed (N = 22). Vineland adaptive behavior scores had increased significantly by 8.9 points (N = 21). No children aged > 72 months attained normal functioning, i.e., IQ > 85 and unassisted mainstream school placement (N = 42). Progress for 60 children across 12 months was found for mental age (5.4 months), adaptive behavior (9.7 months), and language (5.1 months). The interventions did not reproduce results from clinic-based professionally directed programs. The effectiveness of the parent-managed intervention model as it has developed and the adequacy of professional services in that model are discussed.

Early intensive behavioral intervention for autism has attracted controversy since Lovaas (1987) reported that 47% of his experimental group attained normal functioning. We summarize child and program data from 75 children receiving EIBI in the UK. The majority of children (57%) started treatment later than in Lovaas (1987), and 16% did not exceed his minimum IQ criterion. Children experienced fewer hours of treatment (mean of 32 hours vs. 40 hours per week), and their programs received relatively infrequent supervision. 21% of programs received supervision from individuals currently accredited as competent to provide Lovaas's treatment. No child started early enough, and received 40 hours per week, and had accredited supervision. Due to these variations from his model, Lovaas (1987) findings are unlikely to be replicated for this sample of children.

Auditory integration training and a control treatment were provided for 16 children with autism in a crossover experimental design. Measures, blind to treatment order, included parent and teacher ratings of behavior, direct observational recordings, IQ, language, and social/adaptive tests. Significant differences tended to show that the control condition was superior on parent-rated measures of hyperactivity and on direct observational measures of ear-occlusion. No differences were detected on teacher-rated measures. Children's IQs and language comprehension did not increase, but adaptive/social behavior scores and expressive language quotients decreased. The majority of parents (56%) were unable to report in retrospect when their child had received auditory integration training. No individual child was identified as benefiting clinically or educationally from the treatment.

The dexamethasone suppression test (DST) was administered to 40 adults with severe and profound mental retardation. All participants were free from known conditions which may have given misleading results from cortisol assay. Of nine participants who showed symptoms possibly indicating depression the DST results concurred in two cases (i.e. there were two true-positives). However there were four or five (depending on criteria adopted) false-positive DST results. There did not appear to be a consistent behavioural profile for positive DST responders. With sensitivity to possible depression estimated at 22%, and a diagnostic confidence of

Guess, Roberts, Behrens, and Rues (1998) presented reliability data from recordings of behavior state using a 13-category coding system. Interobserver agreement was reported at 63% to 91% across categories. In an attempt at replication, we found lower levels of reliability (0% to 80%). To determine the reasons for different results, we obtained measurements of behavior states from video-recordings by five of Guess et al.'s observers. Again, replication was unsuccessful. Obtained mean percentage agreement on occurrence for individual behavior states and participants ranged across observer pairs from 0% to 58% (kappa range was 0 to .64). Some possible reasons for failures to replicate are discussed.

Continuous observational recording was used to measure behavior state of 3 adults with profound and multiple disabilities. Observations were made over 56.7 hours, including 21.9 hours with two observers recording independently. Overall percentage agreement was satisfactory (i.e., exceeded 80%). Agreement on occurrence was, however, generally unsatisfactory at a mean of 63.5%, with 5 of 16 Subject x State Agreement Indices over 80%. Percentage disagreement on occurrence, a previously unreported measure, was computed to quantify sources of disagreement. The agreement data were superimposed on participants' behavior state profiles to demonstrate how conclusions can be drawn from the data, despite their generally inadequate reliability. This approach to interobserver agreement and presentation of data is suggested for researchers investigating entities that are not directly amenable to observation.

Gentle Teaching,a philosophy of treatment selection in reducing the maladaptive behaviours of mentally retarded people, has recently received considerable publicity in New Zealand. Gentle Teaching suggests methods to reduce or eliminate problem behaviours of mentally retarded people which do not involve the use of punishment procedures. A comparison with current ‘mainstream’ behaviour analysis is presented to assist evaluation and critical review of the prescriptions and empirical validity of Gentle Teaching an analysis of the rationale and data presented as evidence for excluding punishment procedures suggests that the rationale is flawed and die current evidence is meagre. It is concluded that recommendation for the adoption of this philosophy is premature. At this stage, it seems wise not to abandon the Least Intrusive Treatment model for selecting strategies to reduce problem behaviour.

The acceptability of three treatments for the maladaptive, but not injurious, repetitive stereotyped behaviour of a mentally retarded child was evaluated. Evaluation was conducted by questionnaires to two groups of staff (nurses and teachers) at two New Zealand institutions for mentally retarded people. A differential reinforcement procedure was found to be most acceptable. A visual screening procedure was judged as being more than moderately acceptable by nurses but less than moderately acceptable by teachers. When visual screening and reinforcement were combined in a treatment package and a rationale for so doing was provided, acceptability was increased significantly for both groups of staff. Teachers rated visual screening, when explicitly prescribed with differential reinforcement, as more than moderately acceptable. The implications of the finding of differential rating of acceptability across and within occupational groups was discussed.