Inappropriate Social Behavior Research Articles

Use of a token economy to eliminate excessive inappropriate social behavior in an adult with developmental disabilities

Adults with developmental disabilities frequently have both deficits in appropriate social skills and excesses in inappropriate social behavior (Matson, LeBlanc, & Weinheimer, 1999). Typically, published treatment studies have focused on social skills training procedures that teach and promote the use of new social behaviors. However, only a few studies have focused on management of existing social behaviors that are problematic because they occur excessively or in an inappropriate context (Wright, Herzog, & Seymour, 1992). The current study focuses on management of three types of inappropriate social behavior in a 26-year-old male with moderate mental retardation: inappropriate social interactions, inappropriate sexual behavior, and verbal aggression. A token economy with response cost procedure was implemented using a DRO interval as the basis for earning tokens. Using a multiple-baseline design across behaviors, each of the three types of inappropriate social behavior was successfully treated. After demonstrating the success of the procedure, the DRO interval was increased while maintaining the reductions in inappropriate social behaviors. Appropriate behaviors such as initiating conversation, shaking hands, etc maintained throughout the intervention. Copyright © 2000 John Wiley & Sons, Ltd.

Use of a token economy to eliminate excessive inappropriate social behavior in an adult with developmental disabilities

Use of a token economy to eliminate excessive inappropriate social behavior in an adult with developmental disabilities

Behavioral skills training to remediate deviant social behavior of an adolescent in residential treatment

This case conference paper describes a treatment plan for Mike, an intellectually limited 13-year-old boy with social-skill deficits and social behavior problems who resides in a family-style residential treatment program. Treatment would involve initial training with videotape vignettes for Mike to learn to identify appropriate and inappropriate social behaviors across a variety of typical social situations with peers. Following initial discrimination training, behavioral skills training procedures involving instructions, modeling, rehearsal, praise, and feedback would be implemented with peers in simulated social interactions. Training would include multiple exemplars and would continue until Mike had learned appropriate social behaviors for a wide range of social situations and had exhibited those behaviors in the residential and school settings. Behavioral contingencies would also be implemented by staff for Mike's appropriate and inappropriate social behaviors in the residential and school settings to promote generalization.

Making social competence a habit

We took a decidedly behavioral approach to solving this problem involving adolescent social-skills deficits. Following a functional assessment of both skill deficits and environmental contingencies, we would address the social problems presented in this case as if they were a persistent habit. Treatment would incorporate elements of simplified habit reversal technology, an empirically supported package of techniques for treating persistent habits. After teaching the client to detect, describe, and self-monitor each of the relevant aspects of both appropriate and inappropriate social behaviors, both natural and artificial supporting contingencies would be arranged to teach new or strengthen existing replacement behaviors in appropriate contexts.

Literacy before and after Inclusion in General Education Settings: A Case Study

This 7 year case study describes a young woman with moderate to severe disabilities and her use of literacy (i.e., reading, writing, listening, and speaking) during various stages of her educational career. Her use of literacy is described (a) when she was 15-years-old, after having received special education and related services in self-contained special education classes for 10 years and (b) during the proceeding 7 years, after the location in which she received services was changed to general education settings with nondisabled classmates, first in middle school, then high school, and finally in college. This change in location of services resulted in changes both in her instructional content and in the manner in which instruction and assessment occurred. Concomitantly, observable changes occurred in her social and learning behaviors. Significant changes resulted in the student's reading, writing, listening, and speaking across settings, people, content, and activities. In addition, the student's prior inappropriate social behaviors and refusals to participate in learning activities were replaced with appropriate behaviors in both instructional and social situations. Finally, the implications of the findings from this case study are discussed and recommendations are made for providing effective educational programs for students with moderate to severe disabilities, including literacy development.

Prader-Willi-like syndrome in a patient with an Xq23q25 duplication

We report on a 24-year old woman with an Xq duplication and findings suggestive of Prader-Willi syndrome (PWS). Her birth weight was at the 3rd centile and her birth length was less than the 3rd centile. She was hypotonic and had a weak cry as an infant. There were no feeding difficulties, although her mother reports that as an infant, she was "small for her age." Excessive weight gain began between 3 and 4 years. The patient's development was delayed and she received special education. She has a history of hiding food. She has a sleep disturbance disorder and inappropriate social behavior. At the age of 24 years her height was below the 5th centile and weight >>95th centile. She has physical findings typical of PWS, skin picking, and speech articulation defects. Cytogenetic analysis showed a 46,X,dup(X)(q23q25) karyotype. Fluorescent in situ hybridization (FISH) studies using a chromosome X painting probe demonstrated that the rearrangement was intrachromosomal. The X-chromosome fold scoring technique was used to determine the X inactivation pattern and indicated that some cells expressed the abnormal X chromosome. Results of FISH studies using the SNRPN probe localized to 15q11q13 and DNA studies using the PW71B and SNRPN probes were normal. The duplicated X chromosome, random X inactivation pattern, and the negative molecular studies for PWS indicate that the abnormal X chromosome is the basis of this patient's phenotype. This patient emphasizes the importance of obtaining a karyotype even when a syndrome diagnosable by molecular methods is strongly suspected.

The Generalization of Social Skills for a Child with Behavior Disorders in the School Setting

ABSTRACT The purpose of this case study was to develop an intervention which would promote the generalization of social skills for a child with an educational classification of behavior disorders (BD). Generalization of social skills is a frequently discussed problem and an outcome that may be of particular importance in the successful inclusion of children with BD in regular education classrooms. One student, previously enrolled in a BD classroom, was identified as having few appropriate social interactions and several interfering inappropriate social behaviors. Various strategies were employed to facilitate the generalization of learned social skills. Results indicate that social skills instruction alone failed to result in generalization. The subsequent use of a group contingency resulted in generalization across behaviors and school settings.

Effects of Holding Students Accountable for Social Behaviors during Volleyball Games in Elementary Physical Education

This study investigated the effects of a semiformal accountability intervention (a modified version of the good behavior game) on the occurrence of appropriate and inappropriate social behaviors, and appropriate skill attempts during a 20-lesson volleyball unit. Participants were 67 students in Grades 4, 5, and 6. Following the collection of baseline data, students received intervention consisting of (a) differential awarding and removing of points for appropriate and inappropriate behavior, (b) public posting of team points, (c) the establishment of daily criteria, (d) a special activity for teams that met the criteria, and (e) an end-of-unit activity for teams that consistently met the criteria. A multiple baseline design across students showed that the intervention was effective in reducing inappropriate social behaviors and increasing appropriate social behaviors, but did not affect the number of correct volleyball skills performed. Results are discussed relative to task systems and social skills.

Social adaptation of children with mild intellectual disability: Effects of partial integration within primary school classes

This study examined the social adaptation of children with mild intellectual disability who were either (a) partially integrated into regular primary school classes, or (b) full-time in separate classes. All of the children were integrated in sport and play activities with the whole school. Consistent with previous research, children with intellectual disability were less socially accepted than were a matched group of control children. Children in partially integrated classes received more play nominations than those in separate classes, but there was no greater acceptance as a best friend. On teachers' reports, disabled children had higher levels of inappropriate social behaviours, but there was no significant difference in appropriate behaviours. Self-assessments by integrated children were more negative than those by children in separate classes, and their peer-relationship satisfaction was lower. Ratings by disabled children of their satisfaction with peer relationships were associated with ratings of appropriate social skills by themselves and their teachers, and with self-ratings of negative behaviour. The study confirmed that partial integration can have negative consequences for children with an intellectual disability.

Mechanism of disinhibition after brain lesions.

Disinhibition syndromes, ranging from mildly inappropriate social behavior to full blown mania, may result from lesions to specific brain areas. Several studies in patients with closed head injuries, brain tumors, stroke lesions, and focal epilepsy have demonstrated a significant association between disinhibition syndromes and dysfunction of orbitofrontal and basotemporal cortices of the right hemisphere. Based on the phylogenetic origin of these cortical areas and their main connections with dorsal regions related to visuospatial functions, somatosensation, and spatial memory, the orbitofrontal and basotemporal cortices may selectively inhibit or release motor, instinctive, affective, and intellectual behaviors elaborated in the dorsal cortex. Thus, dysfunction of these heteromodal ventral brain areas may result in disinhibited behaviors.

Probable neuroleptic induced tardive dyskinesia in association with combined SSRI and risperidone treatment

The goals of this study were to investigate the prevalence and initial symptoms of the late-onset schizophrenia (LOS: >40 years) and very-late-onset schizophrenia-like psychosis (VLOSLP: >60 years) nosological groups proposed by the International Late-Onset Schizophrenia Group.This was a retrospective, cross-sectional, chart review study.The study was conducted at Centre Hospitalier Robert-Giffard (CHRG), Quebec City, Canada.The medical records of inpatients from the CHRG who presented with psychotic symptoms were analyzed.Positive and negative symptoms were scored using the SAPS and SANS. Groups' symptoms were compared using χ2, Fisher's exact tests, t tests, and exact Mann-Whitney tests. An exact conditional logistic regression analysis was performed to determine which clinical characteristics were the most predictive of the groups' classification.Among the 1,767 unique, first-admission medical records reviewed, 23 (1.3%) inpatients developed their first psychotic symptoms at the age of 40–59 years old (LOS), and 13 (0.7%) at the age of 60 years and above (VLOSLP). LOS patients were more apathetic and presented more abnormal psychomotor activity than the VLOSLP. Persecutory delusions, auditory hallucinations, inappropriate social behavior, formal thought disorders and anhedonia were frequent in the two groups. A logistic regression model including psychomotor abnormalities was statistically relevant to predict the belonging to LOS group.LOS and VLOSLP are rare. Abnormal psychomotor activity can properly differentiate VLOSLP and LOS. The nosological model proposed by the International Late-Onset Schizophrenia Group is at least partially supported by the present data.

Schizophrenic symptoms, tardive dyskinesia and its association with cognitive functioning

The goals of this study were to investigate the prevalence and initial symptoms of the late-onset schizophrenia (LOS: >40 years) and very-late-onset schizophrenia-like psychosis (VLOSLP: >60 years) nosological groups proposed by the International Late-Onset Schizophrenia Group.This was a retrospective, cross-sectional, chart review study.The study was conducted at Centre Hospitalier Robert-Giffard (CHRG), Quebec City, Canada.The medical records of inpatients from the CHRG who presented with psychotic symptoms were analyzed.Positive and negative symptoms were scored using the SAPS and SANS. Groups' symptoms were compared using χ2, Fisher's exact tests, t tests, and exact Mann-Whitney tests. An exact conditional logistic regression analysis was performed to determine which clinical characteristics were the most predictive of the groups' classification.Among the 1,767 unique, first-admission medical records reviewed, 23 (1.3%) inpatients developed their first psychotic symptoms at the age of 40–59 years old (LOS), and 13 (0.7%) at the age of 60 years and above (VLOSLP). LOS patients were more apathetic and presented more abnormal psychomotor activity than the VLOSLP. Persecutory delusions, auditory hallucinations, inappropriate social behavior, formal thought disorders and anhedonia were frequent in the two groups. A logistic regression model including psychomotor abnormalities was statistically relevant to predict the belonging to LOS group.LOS and VLOSLP are rare. Abnormal psychomotor activity can properly differentiate VLOSLP and LOS. The nosological model proposed by the International Late-Onset Schizophrenia Group is at least partially supported by the present data.

Prenatal cocaine exposure affects social behavior in Sprague-Dawley rats.

Children prenatally exposed to cocaine are reported to exhibit inappropriate social behavior, including aggression. We have recently observed a similar phenomenon in rats prenatally exposed to cocaine. Pregnant females were injected twice daily with 15 mg/kg cocaine hydrochloride or saline on gestation days 1-20. Offspring were tested for social behavior towards two unfamiliar, untreated rats of the same age and sex. Cocaine-treated males (90 PND) took longer to reciprocate contact and cocaine-treated females (60 PND) spent more time rough grooming unfamiliar females. Male cocaine offspring (180 PND) tested for aggression exhibited an increased frequency and duration and decreased latency to chase an intruder. ACTH was lower in cocaine-treated males (150-180 PND) following plus-maze exposure or exposure to an unfamiliar male. Our data indicate that prenatal cocaine treatment in rats increases fear or aggression responses, dependent on sex and stimulus situation.

A Social Skills Training Program for Preschoolers with Developmental Delays

This investigation was designed to assess a social skills training program with 32 developmentally delayed preschoolers. Subjects were evaluated in an unstructured play session, matched for levels of appropriate and inappropriate social behaviors, and assigned to either a treatment or control condition. The treatment group (N = 16) was presented with a 6-week protocol involving positive reinforcement, modeling, rehearsal, feedback, and time out. Controls (N = 16) received no instruction beyond regular classroom activities during the 6 weeks. The two groups were reevaluated in a posttest session and again in a generalization setting where two peers with developmental delays (not included in either experimental condition) were included. Prosocial behaviors were successfully taught and maintained in generalization settings. Efforts to reduce inappropriate behaviors were less successful. A test of social validity via teachers' ratings of videotapes of pretest and posttest assessments was also conducted. Implications for generalization and social validity research are discussed.

“What did you say?” Using review of tape-recorded interactions to increase social acknowledgements by trainees in a community-based vocational program

Dana and Rick, two adults with developmental disabilities enrolled in a restaurant training program, had poor prospects for long-term employment because of inappropriate social behavior. They often made no response, mumbled inaudibly, or made a negative remark when spoken to by their supervisors or other employees. Each trainee's Individual Vocational Plan (IVP) included goals of prompt and polite acknowledgment of coworker initiations. Previous efforts to improve Dana and Rick's acknowledging behavior had been unsuccessful. Throughout the study, each trainee's responses to 20 verbal initiations by coworkers (i.e., requests, questions, corrective feedback, praise, and social comments) were recorded during each of two observation periods per workshift. Throughout one of the observation periods during the intervention phases, the trainees carried in their work aprons a small, audio cassette recorder that recorded their interactions with coworkers. The primary intervention consisted of a preworkshift meeting in which the trainee and experimenter reviewed five randomly selected interactions recorded during the previous day's shift. The review included self-evaluation, praise, corrective feedback, and role-play. A multiple baseline across subjects design showed each trainee acknowledged a greater number of coworker initiations as a function of the intervention. Each trainee also acknowledged more coworker initiations during the second observation period when the tape recorder was never worn. In a subsequent intervention phase, Dana reviewed her tape-recorded interactions prior to randomly selected shifts. Rick's acknowledgments increased to a socially valid level when the review procedure was supplemented with graphic feedback. Both trainees continued to acknowledge their coworkers' initiations at levels equal to nondisabled restaurant employees when they no longer wore the tape recorder during a final phase and during follow-up observations 4 to 8 weeks later.

Family stressors in traumatic brain injury: A two-year follow-up

A review of the literature suggests that psychosocial disability in traumatic brain-injured (TBI) individuals and distress in families continues long after the initial injury. In this study the relationship of family stress to a number of factors was studied longitudinally. Caregivers of 51 TBI inpatients were interviewed at rehabilitation admission and by phone at 6, 12, and 24 months postinjury. Caregivers' most common complaints about their relatives were a lack of involvement in leisure activities, fatigue, slowness, and forgetfulness. Increasingly severe temper outbursts, anxiety, and self-centeredness were reported over time. Aggressiveness was reported by caregivers as moderate or severe in 31% of cases by 2 years postinjury. Of all complaints, only reports of inappropriate social behavior decreased over time. Despite caregivers' increasing complaints about their relatives, there were no trends toward greater self-reported stress over time. At the 2-year assessment, stress was significantly higher for caregivers of those with an at risk psychosocial history, and for those without sufficient funds for services. Caregivers reporting financial strain increased 22% from rehabilitation admission. Forty-seven percent of caregivers had altered or given up their jobs at 1 year postinjury, and 33% at 2 years postinjury. Although self-perceived measurements of stress did not increase over time, caregivers reported notable increases in medication use and substance use, and decreases in employment and financial status over the 2-year time period. When spouse and parent caregiver responses were compared, spouses reported a consistently greater number of behavioral problems, which increased in severity over time. Those behaviors associated with mood disturbances predominated.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of Cognitive-Behavioral Training on Angry Behavior and Aggression of Three Elementary-Aged Students

Inappropriate social behaviors of elementary-aged students may negatively affect their opportunity to be successful in school and contribute to adjustment problems as adolescents and adults. Specifically, anger and aggression in children have accounted for a high number of children being referred to special education programs. A multiple baseline design was used across students to investigate the effectiveness of cognitive-behavioral training in reducing angry behavior and aggression of three elementary-aged special education students placed in a multi-categorical resource room. Results indicated that the students were able to learn the strategy and that the intervention produced a decreased level of undesired behavior. Maintenance data demonstrated that all three students were able to maintain decreased levels of anger and aggression over time. Recommendations are made for future studies.

The effects of modeling and praise on self-initiated behavior across settings with two adolescent students with autism

The purpose of this research was to determine if modeling and verbal reinforcement (praise) could increase appropriate social and work-related behaviors of two high school adolescents with autism. The effects of modeling and praise were examined in school, work, and community environment of the participants. A multiple baseline design across skills and students was employed. Results indicated that modeling and praise were effective in increasing each student's appropriate social and work-related behaviors. Questionnaires administered to teachers, a job trainer, a communication disorder specialist, paraprofessionals, co-workers, and parents indicated positive change in each of the subject's behavior. These data suggest that a natural intervention, such as modeling and praise, may positively influence the inappropriate social and work related behaviors that are characteristic of adolescents with autism.

Therapist-Initiated Patient Transfer in the Residency Training Setting

Therapist-initiated transfers of dynamic psychotherapy patients, precipitated by the need for residents to have a broad exposure to varied services, are common phenomena in residency training settings. Both the transferring therapist and the patient may experience these transfers as distressing. The inexperienced therapist may initiate inappropriate transfers, incomplete terminations, or social behavior toward the patient. A case example is presented and discussed in light of the relevant literature. Recommendations for prophylactic measures include education, strong supervisory support to explore countertransference issues, and the use of a case conference at points of transfer.

Treatment of a constellation of inappropriate sexual and social behaviors in a 20 year old man with Down's Syndrome

In 1983, a Down's Syndrome male (I.Q. 72) “AB” who resided in a community residence was charged by local police with “Exposing” his genitalia, as a result of an incident of exhibitionism. Upon investigation by the New Jersey Division of Mental Retardation (a State of New Jersey Agency now named the New Jersey Division of Developmental Disabilities), it was found that AB had a constellation of inappropriate sexual and social behaviors. A treatment plan was designed by a State Psychologist, a private Psychologist, a State Special Educator, a State Social Worker, and residential staff, with the full cooperation of AB's parents. The treatment approach combined traditional psychotherapy, a token economy plan, and vigorous social skills training. AB has been followed for 7 years and the treatment plan has been modified a number of times, as AB's behavior has continued to improve. Over the 7 years, AB has not had any more arrests on sexual charges and his overall social behavior has shown marked improvement.