Comparison of Operant and Traditional Treatment of Severely Retarded Pre-Schoolers in an Outpatient Setting

Abstract

The project investigated the comparative efficacy of out-patient traditional and operant behavior modification treatment programs for 16 brain-damaged and profoundly retarded young children. Children were matched in pairs and assigned at random to one of two programs. Both consisted of eight weely-30 minute sessions with mothers observing, actively participating, and receiving on-the-job training as appropriate to their group. Four traditional "developmental" therapists were observed during therapy sessions. Without their knowledge, an assessment was made of the extent to which, wittingly or otherwise, behavioral principals were employed. With no explanation of why they were being observed, they were given four hours of behavioral training. The therapists were then told to continue in their customary fashion with eight children (traditional treatment groups) but to apply their developmental techniques in a specifically behavioral fashion with an additional eight children (operant group). The same two observers observed and reassessed therapists in the second and fifth sessions with respect to their uses of target specification and contingent reinforcement. All children were given the Vineland and Gesell developmental scales prior to and following the eight treatment sessions (over a three month period). To demonstrate that changes in the behavioral group were a consequence of the operant training, individual behaviors were modified either sequentially or in multiple baseline fashion. When learning reached a ceiling, a new target was introduced. Significant changes were found on the Vineland and on all five Gesell scales for the operant group. Change rates to treated behaviors in the traditional treatment group were impossible to record because of poorly defined targets and inconsistent presentation. However, a significant group change was found on two Gesell developmental subscales (social and adaptation). Overall group changes were found to be significantly higher in the operant than in the traditional condition. Following training, therapists employed behavioral principles significantly more frequently and effectively in the operant group. In the traditional treatment sessions, the therapists began to use contingent reinforcement almsot as frequently as in the operant condition. However, in the traditional group target specification was low. Implications of these findings for training paraprofessionals in operant behavior modification are discussed.