The Effects of Symbolic Modeling and Parent Training on Noncompliance in Hyperactive Children

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1 Western Michigan University ScholarWorks at WMU Dissertations Graduate College The Effects of Symbolic Modeling and Parent Training on Noncompliance in Hyperactive Children George Kahle Henry Western Michigan University Follow this and additional works at: Part of the Psychoanalysis and Psychotherapy Commons Recommended Citation Henry, George Kahle, "The Effects of Symbolic Modeling and Parent Training on Noncompliance in Hyperactive Children" (1985). Dissertations This Dissertation-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Dissertations by an authorized administrator of ScholarWorks at WMU. For more information, please contact

2 THE EFFECTS OF SYMBOLIC MODELING AND PARENT TRAINING ON NONC OMPLIANCE IN HYPERACTIVE CHILDREN by George Kahle Henry A Dissertation Submitted to the Faculty of The Graduate College in partial fulfillment of the requirements for the Degree of Doctor of Philosophy Department of Psychology Western Michigan University Kalamazoo, Michigan August 1985

3 THE EFFECTS OF SYMBOLIC MODELING AND PARENT TRAINING ON NONCOMPLIANCE IN HYPERACTIVE CHILDREN George K ahle H enry, Ph.D. W e stern M ichigan U n iv e r s ity, 1985 T h is s tu d y exam ined th e i n t e r a c t i o n s o f m o th ers w ith t h e i r h y p e r a c tiv e c h i ld r e n d u rin g a s t r u c t u r e d - t a s k p e r io d to d e te rm in e th e e f f e c t s o f a sy m b o lic m odeling and p a r e n t t r a i n i n g in t e r v e n t i o n on c h i ld n o n co m p lia n ce. A n a ly s is o f v id e o ta p e d s e q u e n c e s a c ro s s a l l p h a s e s o f th e s tu d y in d i c a t e d t h a t sy m b o lic m o d elin g v/as n o t a v e ry e f f e c t i v e te c h n iq u e f o r im p ro v in g c o m p lia n ce in h y p e r a c tiv e c h i l d r e n. P h ase one o f p a r e n t t r a i n i n g, w hich ta u g h t m o th ers a p p r o p r i a te a t te n d i n g, ig n o r in g, and re w a rd in g b e h a v io r s, was more e f f e c t i v e th a n sy m b o lic m o d e lin g. P h ase two o f p a r e n t t r a i n i n g, w hich in tr o d u c e d a tim e - o u t c o n tin g e n c y f o r n o n c o m p lia n c e, was th e m ost e f f e c t i v e i n t e r v e n t i o n a s i t r e s u l t e d in s i g n i f i c a n t r e d u c t io n s in c h i l d n o n c o m p lia n c e. D u rin g p h ase two a l l s i x c h i ld r e n r e v e a le d im provem ents i n t h e i r r a t e s o f c o m p lia n c e w ith fo u r re a c h in g s i g n i f i c a n t l e v e l s. S i g n i f i c a n t r e d u c t io n s in la te n c y to com ply w ere e x h ib ite d by fo u r o f th e s i x s u b j e c t s, and a l l s u b je c ts in c r e a s e d t h e i r r a t e s o f t a s k c o m p le tio n w ith two r e a c h in g s t a t i s t i c a l s i g n i f i c a n c e. P a r e n t t r a i n i n g v/hich in c o r p o r a te s a tim e - o u t p ro c e d u re a p p e a rs to o f f e r a p ro m isin g tr e a tm e n t s t r a t e g y f o r n o n co m p lia n ce i n h y p e r a c tiv e c h i ld r e n.

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6 Henry, George Kahle THE EFFECTS OF SYMBOLIC MODELING AND PARENT TRAINING ON NONCOMPLIANCE IN HYPERACTIVE CHILDREN W estern M ichigan University Ph.D University Microfilms International 300 N. Zeeb Road, Ann Arbor, Ml Copyright 1985 by Henry, George Kahle All Rights Reserved

7 R eproduced with permission of the copyright owner. Further reproduction prohibited without permission.

8 PLEASE NOTE: In all cases this material has been filmed in the best possible way from the available copy. Problems encountered with this docum ent have been identified here with a check mark V 1. Glossy photographs or p ag e s 2. Colored illustrations, paper or print 3. Photographs with dark background 4. Illustrations are poor copy 5. Pages with black marks, not original copy 6. Print shows through as there is text on both sides of p a g e 7. Indistinct, broken or small print on several pages 8. Print exceeds margin requirem ents 9. Tightly bound copy with print lost in sp in e 10. Computer printout pages with indistinct print 11. Page(s) lacking when material received, and not available from school or author. 12. Page(s) seem to be missing in numbering only as text follows. 13. Two pages num bered. Text follows. 14. Curling and wrinkled pages 15. Dissertation contains pages with print at a slant, filmed as received 16. University Microfilms International

9 R eproduced with permission of the copyright owner. Further reproduction prohibited without permission.

10 Copyright by George K. Henry 1985

11 ACKNOWLEDGEMENTS I w ish to e x p r e s s my a p p r e c i a t i o n and g r a t i t u d e to D r. R o d e n h iz e r, D r. C re a g e r, D r. B e c k e r, and s t a f f o f th e K alam azoo C h ild G uidance C lin ic f o r t h e i r s u p p o rt and a s s i s t a n c e th ro u g h o u t t h i s p r o j e c t. I w ould l i k e to th a n k Jim K i r k l i n, c h i e f e n g in e e r o f I n s t r u c t i o n a l C om m u n icatio n s, f o r h i s t r u s t and p a t ie n c e i n le n d in g me v id e o ta p e equip m en t and s u p p lie s f o r th e academ ic y e a r so t h a t t h i s s tu d y c o u ld be c o m p le te d. I w ould a l s o l i k e to th a n k D r. P a u l T. M o u n tjo y, my a d v i s o r, who h as p ro v id e d much encouragem ent and s u p p o rt th ro u g h o u t my y e a rs h e re a t W estern M ich ig an U n iv e r s it y. F i n a l l y, I owe many th a n k s to my w if e, K a th le e n, who s tr o n g l y s u g g e s te d t h a t I ta k e tim e o u t f o r s o c i a l a c t i v i t i e s, e s p e c i a l l y d u rin g t h i s l a s t y e a r, as sh e a p p e a rs to h ave a knack f o r k e e p in g my f e e t on th e g ro u n d, w hich i s w here th e y s h o u ld be I G eorge K ahle Henry

12 TABLE OF CONTENTS ACKNOWLEDGEMENTS... i i LIST OF TA BLES... iv LIST OF F IG U R E S... V C h a p te r I. INTRODUCTION... 1 I I. M ETH O D... 7 S u b je c ts P r o c e d u r e...10 B a s e l i n e...10 Sym bolic M odeling P a r e n t T r a i n i n g D ependent V a r i a b l e s R e l i a b i l i t y...22 I I I. RESU LTS S u b je c ts Rmaov R e l i a b i l i t y IV. D IS C U S S IO N...55 APPENDICES BIBLIOGRAPHY... « i i i

13 LIST.OF TABLES T a b le k Page S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r im e n t S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r im e n t S ig n if ic a n t Changes in Mean V alues fo r P a r e n t- C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r im e n t...37 S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r i m e n t....1 S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r i m e n t... S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e rim e n t...50 I n te r o b s e r v e r R e l i a b i l i t y f o r D ependent V a r ia b le s... 5^ LG iv

14 LIST OF FIGURES F ig u re P age 1. L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r Tommy L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r P h i l i p L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r M aggie L a te n c y t o I n i t i a t e C om pliance to M a te rn a l Commands f o r J a c o b L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r S h a v m...ll 6. L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r S r i c...i+8 7. Mean P e rc e n ta g e f o r P a te o f C om pliance V /ith in F iv e S econds o f Command Mean P e rc e n ta g e f o r P a te o f T ask C o m p l e t i o n v

15 CHAPTER I INTRODUCTION H y p e r a c t iv ity i s p r e s e n t l y b e lie v e d to be th e le a d in g r e f e r r a l p ro b le m to c h i l d g u id a n c e c l i n i c s i n t h i s c o u n try. E s tim a te s o f i t s o c c u rre n c e i n th e s c h o o l-a g e p o p u la tio n r a n g e s from ^ (B a r k le y, ). The h y p e r a c tiv e syndrom e i s t y p i c a l l y c h a r a c t e r i z e d by th e p re s e n c e o f s e v e r a l b e h a v io rs in c lu d in g : im p u l s i v i t y, i n a t t e n t i o n, and o v e r a c t i v i t y. In a d d i t i o n, h y p e r a c tiv e c h i ld r e n a r e o f te n d e s c r ib e d by t h e i r p a r e n t s as b e in g n o n c o ra p lia n t, r e q u i r i n g r e p e a te d commands b e f o r e even p a r t i a l, though te m p o ra ry c o m p lia n ce o c c u rs. N oncom pliance i s one o f th e b e h a v io r p ro b le m s t h a t p a r e n t s r e p o r t m ost f r e q u e n t ly (K a ro ly & R o s e n th a l, 1977; F o re h a n d, 1977; F o re h a n d, 1981; P a tt e r s o n & R e id, 1973). B e h a v io rs w hich may be subsum ed u n d er th e c a te g o r y o f n o n co m p lia n ce in c lu d e : n o t d o in g th e re q u e s te d b e h a v io r, p e rfo rm in g i t to o s lo w ly, e x h i b i t i n g lo n g l a t e n c i e s betw een th e r e q u e s t and i n i t i a t i o n o f c o m p lia n c e, s h o r t d u r a tio n o f c o m p lia n c e, p ro m is in g to do i t l a t e r, s t a t i n g a r e f u s a l to com ply, and e n g a g in g i n a co m p etin g re s p o n s e in c o m p a tib le w ith c o m p lia n c e. I n some c a s e s, low co m p lia n c e r a t e s a r e a f u n c tio n o f p a r t i c u l a r a n te c e d e n t c o n d i tio n s su ch a s th e to p o g ra p h y o f

16 th e r e q u e s t d e l iv e r e d. F o r i n s t a n c e, a r e q u e s t p o sed i n a t e n t a t i v e to n e o r one v/hich r e q u i r e s th e p e rfo rm a n c e o f a b e h a v io r c u r r e n t l y n o t i n th e c h i l d 's r e p e r t o i r e o f r e s p o n s e s may o c c a s io n q u ite a d i f f e r e n t r e s p o n s e th a n one s t a t e d f ir m ly, d e c i s i v e l y, and w ith in th e b e h a v io r a l c a p a b i l i t i e s o f th e c h i l d. F u rth e rm o re, s t u d i e s i n th e la b o r a t o r y h av e r e v e a le d t h a t th e co n se q u e n c e s o f r e s p o n d in g, su ch as re w a rd s f o r co m p lia n ce o r p u n ish m e n t f o r n o n c o m p lia n c e, a r e a l s o im p o rta n t v a r i a b l e s t h a t c o n t r o l n o n co m p lia n ce (F o reh an d & K in g, 197K). T h u s, i t l o g i c a l l y f o llo w s t h a t n o n co m p lia n ce may be sh a p e d up and m a in ta in e d as a r e s u l t o f th e q u a l i t y o f p a r e n t - c h i l d i n t e r a c t i o n s w ith in th e fa m ily sy ste m. Some o f th e f i r s t s t u d i e s o f p a r e n t - c h i l d i n t e r a c t i o n s o f h y p e r a c tiv e c h i ld r e n (C am p b e ll, 1973; C am p b ell, 1973; B a r k le y & Cunningham, 1979; Cunningham & B a r k le y, 1979) hav e r e v e a le d a d i f f e r e n t p a t t e r n o f i n t e r a c t i o n e x h i b ite d by m o th ers o f h y p e r a c tiv e c h i ld r e n com pared to th e m o th ers o f n o rm a l o r le a r n in g d is a b le d c h i l d r e n. M others o f h y p e r a c tiv e c h i ld r e n t y p i c a l l y e x h i b it s i g n i f i c a n t l y more a t te m p ts a t c o n t r o l, d i r e c t i o n, and i n g e n e r a l, s t r u c t u r i n g o f t h e i r c h i l d r e n 's b e h a v io r. The m o th ers o f h y p e r a c tiv e c h i l d r e n te n d to g iv e more commands and n e g a tiv e s ta t e m e n ts, and a r e l e s s r e s p o n s iv e to t h e i r c h i l d 's i n t e r a c t i o n s. T hese s t u d i e s s u g g e s t t h a t p a r e n t - c h i l d i n t e r a c t i o n s m ight b e s t be c o n c e p tu a liz e d as a r e c i p r o c a l fe e d b a c k sy ste m in

17 v/hich th e b e h a v io r o f one p e r s o n s e r v e s a s b o th a d i s c r i m i n a t i v e s tim u lu s and a c o n s e q u a tin g e v e n t f o r th e re s p o n s e o f th e o t h e r. T h u s, th e s e q u a l i t a t i v e d if f e r e n c e s i n p a r e n t - c h i l d i n t e r a c t i o n s betv /een h y p e r a c tiv e c h i ld r e n and t h e i r m o th ers may r e i n f o r c e and m a in ta in a h o s t o f n o n c o m p lia n t b e h a v io r s. T h u s, s u c c e s s f u l tr e a tm e n t m ight r e l y upon an i n t e r v e n t i o n s t r a t e g y v/hich im p a c ts on b o th th e c h i l d and th e p a r e n t a s o p posed to tr e a tm e n t f o c u s in g on on ly one member of th e dyad. V /hile m e th y lp h e n id a te ( R i t a l i n ) p r e s e n t l y re m a in s th e tr e a tm e n t o f c h o ic e f o r h y p e r a c t i v i t y, v a r io u s i s s u e s need to be c o n s id e r e d v/hen e v a lu a tin g th e u s e f u ln e s s o f t h i s form o f th e r a p y. T hese i s s u e s in c lu d e th e n e g a tiv e s id e e f f e c t s o f s t i m u l a n t s, i n e f f e c t i v e n e s s, and th e lo n g -te rm c o n se q u e n c e s o f p s y c h o s tim u la n t m e d ic a tio n. A number o f n e g a tiv e s i d e e f f e c t s h ave b ee n found i n 10-20# o f a l l c h i ld r e n g iv e n m e d ic a tio n. The m ost common s id e e f f e c t s a r e in s o m n ia, c o n v u ls io n s, stom ach p a i n s, i r r i t a b i l i t y, lo s s o f a p p e t i t e, in c r e a s e d h e a r t r a t e, p h o t o s e n s i t i v i t y o f th e s k i n, and p s y c h o tic e p is o d e s (C ohen, D ouglas & M organs t e r n, 1971; K a tz, S a r a f, G ittle m a n - K le in A- K le in, ). C o n cern in g th e i s s u e o f i n e f f e c t i v e n e s s, n e a r l y 23% o f a l l h y p e r k i n e tic c h i l d r e n r e c e i v i n g s tim u la n t d ru g s rem ain u n changed o r d e t e r i o r a t e b e h a v io r a ll y ( B a r k le y, 1977; R a p o p o rt, Q uinn, B ra d b a rd, R id d le & B ro o k s, ). A lth o u g h in c o n c lu s iv e, r e c e n t r e s e a r c h i n t o th e lo n g - te rm s id e e f f e c t s

18 o f m e th y lp h e n id a te and d ex tro am p h etam in e tr e a tm e n t h as r e v e a le d a 75-83/4 s u p p r e s s io n o f e x p e c te d y e a r l y grow th ( S a f e r & A lle n, 1975; S a f e r, A lle n & B a r r, 1972). H ow ever, g row th s u p p r e s s io n h a s b een r e p o r t e d to reb o u n d fo llo w in g w ith d ra w a l o f d ru g s ( S a f e r e t a l., ). T hese s e r io u s c o n c e rn s a s s o c ia te d w ith th e u s e o f p s y c h o s tim u la n t m e d ic a tio n s e t s i n m o tio n a p l e t h o r a o f e t h i c a l c o n s id e r a tio n s w hich e x e r t i n c r e a s i n g p r e s s u r e on h e a lth c a re p r a c t i t i o n e r s to i n v e s t i g a t e and d is c o v e r more e f f i c a c i o u s and s o c i a l l y a p p r o p r i a te m ethods o f m anaging b e h a v io r p ro b le m s a s s o c ia te d v /ith h y p e r a c tiv e c h i l d r e n, r'o n m e d ic a l a p p ro a c h e s, su ch as b e h a v io r th e r a p y and b e h a v io r m o d if ic a tio n may o f f e r a p ro m is in g a l t e r n a t i v e. T h e ra p e u tic te c h n iq u e s f o r h y p e r a c t i v i t y may be d iv id e d i n t o two m ajor c a t e g o r i e s : m e d ic a l and n o n m e d ical m anagem ent. B e h a v io r a l management o f h y p e r a c t i v i t y i s p r e s e n t l y th e m ost f r e q u e n t ly u s e d n o n m e d ical ap p ro ach (B ru n a a g e -A g u a r, F o reh an d & C im in e ro, 1976). B e h a v io r a l tr e a tm e n t a p p ro a c h e s h av e em ployed su ch te c h n iq u e s as d i f f e r e n t i a l re in f o r c e m e n t o f o th e r b e h a v io r (T w ardosz & S a jw a j, ), w ith d ra w a l o f p o s i t i v e r e in fo rc e m e n t (S a c h s, 1973)» and punishm ent (G ilan d as 8t B a ll, 1975)* W hile sy m b o lic m o d e lin g i n th e form o f v id e o ta p e h as b e e n u sed s u c c e s s f u l l y in th e tr e a tm e n t o f a w ide ra n g e o f c h i l d r e n s ' p ro b le m s in c lu d in g p h o b ia s (L e w is, 197^5 K o rn h ab er & S c h ro e d e r, )j s o c i a l i s o l a t i o n (E v e rs -P a s q u a le &

19 S herm an, )5 a t t e n t i v e n e s s ( K e lle r & C a r ls o n, k ), and im p ro v in g o r a l h y g ie n e (M urray & S p s t e in, ), o n ly one s tu d y (C o p e la n d, 1977) u t i l i z e d v id e o ta p e fe e d b a c k a s an i n t e r v e n t i o n s t r a t e g y w ith h y p e r a c tiv e c h i l d r e n. A m ajor s o u rc e o f s o c i a l l e a r n i n g i s th e ab u n d a n t and v a r i e d s y m b o lic m o d e lin g p ro v id e d by t e l e v i s i o n, f i l m s, and o th e r v i s u a l m e d ia. I t h a s b ee n d e m o n stra te d t h a t b o th c h i ld r e n and a d u l ts a c q u ir e a t t i t u d e s, e m o tio n a l r e s p o n s e s, and new ways o f b e h a v in g th ro u g h film e d and t e l e v i s e d m o d e lin g (B a n d u ra, 1973; L i e b e r t, H eale & D av id so n, 1973). No s t u d i e s to d a te hav e i n v e s t i g a t e d th e e f f e c t s o f sy m b o lic m o d e lin g, i. e., v id e o ta p e, on n o n com p lia n ce i n h y p e r a c tiv e c h i l d r e n. T h e r e f o r e, one o b je c tiv e o f th e p r e s e n t s tu d y was to i n v e s t i g a t e th e e f f e c t s o f sy m b o lic m o d e lin g on n o n co m p lia n ce i n h y p e r a c tiv e c h i ld r e n. Some a t t e n t i o n h a s b ee n d e v o te d to i d e n t i f y i n g th e ty p e s o f p e o p le who a r e m ost re s p o n s iv e to m o d e lin g i n f l u e n c e s. T hose who la c k c o n fid e n c e and s e l f - e s t e e m, who a r e d e p e n d e n t, and who have b ee n f r e q u e n t ly re w a rd e d f o r i m i t a t i v e b e h a v io r a r e e s p e c i a l l y p ro n e to a d o p t th e b e h a v io r o f s u c c e s s f u l m odels (B an d u ra, ). A cco rd in g t o B a rk le y (1981) low s e lf - e s t e e m i s a f r e q u e n t, th o u g h l i t t l e s t u d i e d, e m o tio n a l pro b lem o f te n c h a r a c t e r i z i n g h y p e r a c tiv e c h i l d r e n. T h u s, th e y may p ro v e to be q u ite s u s c e p t i b l e to m o d e lin g i n f l u e n c e s. I t was e x p e c te d t h a t s y m b o lic m o d e lin g w ould s i g n i f i c a n t l y re d u c e each c h i l d 's

20 la te n c y to com ply to p a r e n t a l commands, and s i g n i f i c a n t l y in c r e a s e each s u b j e c t 's r a t e o f s u c c e s s f u l t a s k c o m p le tio n. W hile v id e o ta p e p ro c e d u re s have been u se d in t r a i n i n g p a r e n t s in more a p p r o p r i a te c h i ld b e h a v io r m anagement p ro c e d u re s (F la n a g a n, Adams & F o re h a n d, 1979; O 'D e ll, M ahoney, H o rto n & T u r n e r, 1979)? r e l a t i v e l y few have em ployed v id e o ta p e fe e d b a c k w ith p a r e n t s o f h y p e r a c tiv e c h i ld r e n (Furm an & F e ig h n e r, 1973). No s t u d i e s to d a te h ave i n v e s t i g a t e d th e com bined e f f e c t o f sy m b o lic m odeling and p a r e n t t r a i n i n g on n o n com p lia n ce in h y p e r a c tiv e c h i ld r e n. T h e r e f o r e, a s eco n d o b je c tiv e o f th e p r e s e n t s tu d y was to e x p lo re th e com bined e f f e c t s o f s y m b o lic m o d e lin g w ith h y p e r a c tiv e c h i ld r e n and a b e h a v io r a l management program f o r th e p a r e n t s c o m p rise d o f v id e o ta p e fe e d b a c k, m o d e lin g, i n s t r u c t i o n s, and b e h a v io r a l r e h e a r s a l on th e q u a l i t y o f p a r e n t - c h i l d i n t e r a c t i o n s. I t was e x p e c te d t h a t th e f i r s t p h a se o f p a r e n t t r a i n i n g w ould r e s u l t g e n e r a lly in a s i g n i f i c a n t im provem ent in th e q u a l i t y o f p a r e n t - c h i l d i n t e r a c t i o n s, and s p e c i f i c a l l y in s i g n i f i c a n t r e d u c tio n s i n la te n c y to com ply and s i g n i f i c a n t in c r e a s e s in each c h i l d 's r a t e o f t a s k c o m p le tio n. P h ase two o f t r a i n i n g was e x p e c te d to r e s u l t in s i g n i f i c a n t r e d u c t io n s i n la te n c y to com ply and s i g n i f i c a n t im provem ents in th e r a t e o f c o m p le tin g ta s k s f o r each c h i ld com pared to p h a s e one v a l u e s.

21 CHAPTER II METHOD S u b je c ts S ix h y p e r a c tiv e c h i l d r e n, f iv e boys and one g i r l, ag e s if y e a rs v /ith a mean age o f 7.3 y e a rs o ld, and t h e i r m o th ers p a r t i c i p a t e d. One f a t h e r beg an th e s tu d y, b u t w ith d re w b e c a u se o f a jo b o f f e r in a n o th e r c i t y, w h ile a n o th e r m other and h e r so n d id n o t co m p lete th e s tu d y b e c a u se tim e l i m i t s f o r th e s tu d y had e x p ire d. C h ild re n who w ere g iv e n a p rim a ry d ia g n o s is o f a t t e n t i o n d e f i c i t d is o r d e r w ith h y p e r a c t i v i t y by th e c l i n i c p s y c h i a t r i s t a t th e K alam azoo C h ild G uidance C l i n i c, and who w ere d e s c r ib e d by t h e i r m other a s n o n c o rn p lia n t w ere s e l e c t e d f o r s tu d y. S u b je c t 1 (Tommy) was a 6 y r - o ld w h ite m ale d e s c r ib e d by h i s p a r e n t s as " n o n c o rn p lia n t, p h y s i c a l l y a g g r e s s iv e, and a t t e n t i o n - s e e k i n g." He w ould f r e q u e n t ly i n t e r r u p t h i s p a r e n t s when th e y w ere u s in g th e te le p h o n e, a t m e a ltim e s, and i n p u b lic p l a c e s. He w ould a l s o f r e q u e n t ly t r i p and push h i s y o u n g er s i s t e r, and n o t fo llo w th ro u g h w ith p a r e n t a l r e q u e s t s, e. g., p u t t i n g on h i s p a ja m a s, p ic k in g up h i s t o y s. Tommy was on,20mg o f R i t a l i n and 25mg o f M e l l a r i l f o r th e d u r a t io n o f th e s tu d y. The m e d ic a tio n s w ere a d m in is te r e d a p p ro x im a te ly th r e e h o u rs b e f o r e each s e s s i o n. 7

22 S u b je c t 2 ( P h i l i p ) was an 8 i y r - o ld w h ite m ale r e p o r t e d by h i s m other a s " n o n c o rn p lia n t, v e r b a l l y a b u s iv e, and p h y s i c a l l y a g g r e s s iv e." He w ould v e r b a l l y r e f u s e to com ply w ith m a te rn a l commands, and f r e q u e n t ly y e l le d a t and h i t h i s m other and 13 y r - o ld s i s t e r. H is p a r e n t s had b een d iv o rc e d f o r f i v e y e a r s, and P h i l i p was c u r r e n t l y v i s i t i n g h i s f a t h e r t h r e e days each w eek. P h i l i p b eg an th e s tu d y on 20mg o f P i t a l i n SR w hich was a d m in is te r e d a p p r o x im a te ly fo u r h o u rs b e f o r e each s e s s i o n. At th e end o f th e b a s e l i n e p h a s e h i s m e d ic a tio n was w ith d ra w n upon th e r e q u e s t o f h i s m o th e r. T h e r e f o r e, d a ta re c o r d e d i n th e p o s t - b a s e l i n e p h a s e s r e f l e c t p a r e n t - c h i l d i n t e r a c t i o n s in d e p e n d e n t o f th e in f l u e n c e o f p s y c h o s tim u la n t m e d ic a tio n. S u b je c t 3 ( E r i c ) was a L-? y r - o ld w h ite m ale d e s c r ib e d by h i s m other a s " n o n c o rn p lia n t, p h y s i c a l l y a g g r e s s iv e and o v e r a c tiv e." E r ic was an a d o p te d f o s t e r c h i l d. H is b i o l o g i c a l m o th er e x p e rie n c e d m u l tip l e p s y c h i a t r i c i n s t i t u t i o n a l i z a t i o n s. E r ic e x h i b ite d g ran d m al s e iz u r e s when o n ly a c o u p le o f m onths o ld, and had e x p e rie n c e d a number o f g ra n d m al and p e t i t mal s e iz u r e s s in c e t h a t tim e r. He was ta lc in g th r e e m e d ic a tio n s f o r th e d u r a t io n o f th e s tu d y w hich in c lu d e d : 50mg o f M e l l a r i l, th r e e tim e s d a i l y, ; LOmg o f D i l a n t i n, fo u r tim e s d a i l y, and 3 mg o f D epakene, th r e e tim e s a d a y. E ric r e c e iv e d a l l th r e e m e d ic a tio n s a p p ro x im a te ly one h o u r b e f o r e ea ch s e s s i o n.

23 9 S u b je c t if (Shavrn) was a 10- y r - o ld w h ite m ale r e p o r t e d by h i s m other a s " n o n c o rn p lia n t, w h in y, and v e r b a l l y a b u s iv e." He w ould become v e r y q u a rre ls o m e w ith h i s m other and w ould r e s o r t to "b ab y t a l k " when i n t e r a c t i n g w ith h e r. S h aw n 's p a r e n t s had b een d iv o r c e d f o r f o u r y e a rs and h i s m other r e m a r r ie d. Shawn was ta k in g 25mg o f M e l l a r i l and 20mg o f R i t a l i n f o r th e d u r a t io n o f th e s tu d y. The M e l l a r i l was a d m in is te r e d a p p r o x im a te ly e i g h t h o u rs b e f o r e each s e s s i o n, w h ile th e R i t a l i n was g iv e n 30 m in u te s p r i o r to b e g in n in g e a ch s e s s i o n. S u b je c t 5 (J a c o b ) was a 7 y r - o ld w h ite m ale r e p o r t e d by h i s g ran d m o th er a s " n o n c o rn p lia n t, e m o tio n a lly d i s t a n t, and d e s t r u c t i v e." J a c o b 's f a t h e r was c u r r e n t l y s e r v in g a p r is o n te r m, and h i s m o th er d ie d from i n j u r i e s s u s t a in e d i n an a u to m o b ile a c c i d e n t. A cco rd in g t o h i s g ran d m o th er J aco b w ould n o t t o l e r a t e a f f e c t i o n a t e p h y s ic a l c o n t a c t from o t h e r s, e. g., h o ld in g and r o c k in g. lie was a l s o d e s c r ib e d to be im p u ls iv e, i. e., a c t i n g w ith o u t t h i n k in g. Ja c o b was on 20mg o f R i t a l i n SR th ro u g h o u t th e s tu d y w hich was a d m in is te r e d a b o u t f o u r h o u rs b e f o r e each s e s s i o n. F i n a l l y, s u b j e c t 6 (M aggie) was a 7z y r - o ld w h ite fem a le d e s c r ib e d by h e r p a r e n t s a s " n o n c o rn p lia n t, and v e r b a l l y and p h y s i c a l l y a b u s iv e w ith s i b l i n g s and p e e r s. " M other r e p o r t e d a h i s t o r y o f r e c u r r e n t e a r i n f e c t i o n s and p r e s e n c e o f a m ild sp e e c h d i s o r d e r, i. e., th e im p o s itio n o f an " s " sound a t th e b e g in n in g o f w o rd s. M aggie was

24 10 c u r r e n t l y g iv e n 25 mg o f M e l l a r i l and 20mg o f R i t a l i n SP a p p ro x im a te ly one h o u r b e f o r e d a t a c o l l e c t i o n. B oth m e d ic a tio n s w ere i n e f f e c t f o r th e d u r a t io n o f th e s tu d y. P ro c e d u re The p r e s e n t s tu d y em ployed an ABC e x p e rim e n ta l d e s ig n w ith tw o d i f f e r e n t i n t e r v e n t i o n p h a s e s. F o llo w in g in fo rm ed c o n s e n t and p r i o r to th e c o l l e c t i o n o f b a s e l in e d a ta each p a r e n t u n d erw en t an i n i t i a l b e h a v io r a l a s s e s sm e n t in t e r v ie w. The p u rp o s e o f th e i n t e r v ie w was t o g a th e r in f o r m a tio n r e l e v a n t to th e c h i l d 's d e v e lo p m e n ta l h i s t o r y, i d e n t i f i c a t i o n, s p e c i f i c a t i o n, and p r i o r i t i z a t i o n o f p ro b le m b e h a v io r s, and c o m p le tio n o f a r e in f o rc e m e n t s u rv e y i n o rd e r to i d e n t i f y p o t e n t i a l s o u r c e s o f re w a rd s f o r each c h i l d. A ls o, a t t h i s tim e ea ch p a r e n t was g iv e n a P a r e n t Q u e s tio n n a ir e to co m p le te (C o n n o rs, 1973) so a s to o b ta in p r e tr e a tm e n t l e v e l s o f h y p e r a c t i v i t y and p a r e n t a l r a t i n g s o f th e c u r r e n t l e v e l o f th e c h i l d 's b e h a v io r a l f u n c t io n in g. B a s e lin e The b a s e l in e p h a s e (A) was i n e f f e c t f o r fo u r c o n s e c u tiv e w eeks. B e h a v io r a l o b s e r v a tio n s we r e m ade, b u t t h e r e w ere no e x p e rim e n ta l m a n ip u la tio n s. Each b a s e l in e s e s s i o n c o n s is te d o f a 1 0 -m in u te f r e e - p l a y p e r io d fo llo w e d by a f iv e - m in u te s t r u c t u r e d - t a s k s i t u a t i o n. P r i o r to th e f r e e - p l a y p e r io d each p a r e n t was i n s t r u c t e d to : " I n t e r a c t

25 w ith y o u r c h i l d, u s in g any o f th e m a te r i a ls a v a i l a b l e, as you m ig h t a t home i f you had some s p a r e tim e and,w ere n o t e x p e c tin g to be i n t e r r u p t e d." The r e s e a r c h e r th e n l e f t th e p a r e n t and c h i l d a lo n e to p la y. A v a r i e t y o f to y s and gam es, e. g., v/ooden b lo c k s, b o o k s, an S tc h - a - S k e tc h b o a rd, c ra y o n s, c o lo r in g b o o k, c o n s tr u c tio n p a p e r, s c i s s o r s, p a s t e, ta p e, and c la y v/ere p r o v id e d i n th e o b s e r v a t io n room f o r th e d y ad. O b s e rv a tio n s o f th e 1 0 -m in u te p la y p e r io d v/ere co n d u c te d v i a a t e l e v i s i o n c o n s o le i n an a d j a c e n t room. The c o n s o le was c o n n e c te d d i r e c t l y to th e v id e o ta p e cam era v/hich was u n o b tr u s iv e ly p o s itio n e d i n a f a r c o rn e r o f th e o b s e r v a tio n room b e h in d a s m a ll b o o k c a se. F o llo w in g th e 10 m in u te s o f p la y a 25 v /a tt g re e n l i g h t b u lb, w hich was lo c a te d i n a c o rn e r o f th e room n e a r c e i l i n g l e v e l, was b r i e f l y f la s h e d on th e n tu r n e d o f f. T h is s tim u lu s s ig n a l e d th e o n s e t o f th e s t r u c t u r e d - t a s k c o n d i tio n to th e p a r e n t, and p ro m p ted th e p a r e n t to g iv e th e c h i l d th e f i r s t command. The g re e n l i g h t was f la s h e d on and o f f a t one m in u te i n t e r v a l s f o r th e d u r a t io n o f th e f iv e - m in u te s t r u c t u r e d - t a s k c o n d i tio n. Each tim e th e g re e n l i g h t f la s h e d th e p a r e n t was r e q u i r e d to g iv e t h e i r c h i ld a new command. Commands w ere ty p e d on 3x5 in d e x c a rd s and p r e s e n te d to each p a r e n t p r i o r to each s e s s i o n. The commands p rom pted. th e c h i l d to c a r r y o u t a v a r i e t y o f t a s k s, e. g., ta lc in g o f f and p u t t i n g on h i s s h o e s, c le a n in g up th e f l o o r, p u t t i n g

26 12 away a l l th e t o y s, w a lk in g a lo n g a b la c k l i n e on th e f l o o r, s i t t i n g i n a c h a i r, e t c. A ll s t r u c t u r e d - t a s k s i t u a t i o n s w ere v id e o ta p e d, w h ile f r e e - p l a y p e r io d s w ere n o t r e c o r d e d. The p u rp o s e o f th e 1 0 -m in u te f r e e - p l a y p e r io d was to a c c lim a te th e p a r e n t and c h i l d to th e en v iro n m e n t o f th e o b s e r v a tio n room, and t h e r e f o r e was n o t v id e o ta p e d. The p u rp o s e o f th e s t r u c t u r e d - t a s k c o n d i tio n was to a s s e s s th e q u a l i t y o f th e p a r e n t - c h i l d i n t e r a c t i o n s and to d e te rm in e th e d e g re e o f n o n co m p lia n ce to p a r e n t a l commands p r i o r to t r e a tm e n t. Sym bolic M odeling F o llo w in g th e i n i t i a l b a s e l in e p h a s e, th e f i r s t tr e a tm e n t i n t e r v e n t i o n, sy m b o lic m o d e lin g, c o m p ris in g th e seco n d p h a se (B) o f th e s tu d y, w ent i n t o e f f e c t. T h is i n t e r v e n t i o n p h a se was s i m i l a r to th e b a s e l in e p h a se i n t h a t each p a r e n t and c h i l d w ere r e q u i r e d to engage i n a 1 0 -m in u te f r e e - p l a y p e r io d and a f iv e - m in u te s t r u c t u r e d - t a s k c o n d i tio n. H ow ever, f o llo w in g th e 1 0 -m in u te f r e e - p l a y p e r io d th e i n v e s t i g a t o r e n te r e d th e o b s e r v a tio n room and i n v i t e d th e c h i l d to accom pany him to an a d j a c e n t room to view " s o m e th in g on T.V.." Each c h i ld was p o s itio n e d d i r e c t l y i n f r o n t o f th e t e l e v i s i o n s c r e e n and i n s t r u c t e d t o w atch th e T.V.. They w ere in fo rm e d t h a t a f t e r v ie w in g th e T.V. se q u e n c e th e y w ould be a s k e d s e v e r a l q u e s tio n s a b o u t w hat th e y saw on T.V., and t h a t f o r each q u e s tio n answ ered

27 c o r r e c t l y th e y w ould r e c e iv e a n i c k e l. The p u rp o s e o f t h i s c o n tin g e n c y was to e n s u re t h a t each c h i l d was a t te n d i n g to th e T.V. a s i n a t t e n t i v e n e s s i s a symptom w hich f r e q u e n t ly acco m p an ies h y p e r a c t i v i t y. A ls o, t h i s fo rm a t a llo w e d th e i n v e s t i g a t o r to q u ic k ly check as to w h e th e r th e c h i l d was a b le t o e x t r a c t th e m essage o r r u l e, i. e., " I s h o u ld do w hat mom a s k s me to d o." Each c h i l d was shown a one m in u te v id e o ta p e d se q u e n c e d e p i c tin g a same s e x, a g e - e q u iv a l e n t m odel e x h i b i t i n g a p p r o p r i a te c o m p lia n t b e h a v io r in re s p o n s e to a d u l t commands. Each c h i l d m odel on th e v id e o ta p e d s e q u en ce e m itte d f i r s t - p e r s o n, s e l f - g u i d i n g s ta te m e n ts w h ile c a r r y i n g o u t th e r e q u e s te d b e h a v io r. R e s e a rc h s u p p o rt e x i s t s d e m o n s tra tin g t h a t f i r s t - p e r s o n comments by v id e o ta p e m odels a r e more e f f e c t i v e th a n n a r r a t i v e, th i r d - p e r s o n comments i n p ro d u c in g b e h a v io r change in o b s e r v e r s (J a k ib c h u k & S m e r ig lio, ). Ilo d e l c o n seq u e n c e s hav e b een e x t e n s iv e l y r e s e a r c h e d (T h e le n & R e n n ie, ). A lthough m odeled b e h a v io r can be a c q u ir e d by o b s e r v a tio n a lo n e, re w a rd s a r e c r i t i c a l i f o b s e rv e d b e h a v io r i s t o be p e rfo rm e d and m a in ta in e d o v er tim e. V ic a rio u s r e in f o rc e m e n t i s i n d i c a t e d when o b s e rv e r s i n c r e a s e b e h a v io r f o r w hich th e y h ave s e e n o th e r s re w a rd e d. As B an d u ra (1977) p o in t s o u t, re w a rd e d m o d e lin g i s more e f f e c t i v e th a n m o d e lin g a lo n e. I f th e outcom e e x p e rie n c e d by th e m odel i s v a lu e d by th e o b s e r v e r th e n th e g r e a t e r

28 Imp r o b a b i l i t y th e o b s e rv e r w i l l e n a c t th e m odeled b e h a v io r on some f u tu r e o c c a s io n u n d e r s i m i l a r s tim u lu s c o n d i tio n s. T h u s, each one m in u te v id e o ta p e d seq u e n c e u sed i n th e sy m b o lic m o d e lin g p h a s e, and th r o u g h o u t th e l a s t p h a se o f th e s tu d y, d e p i c te d a m odel r e c e iv in g v a lu e d re w a rd s c o n tin g e n t upon com p ly in g to p a r e n t a l commands. Fach v id e o ta p e m odel r e c e iv e d a n ic k e l fo llo w in g c o m p lia n ce as a l l o b s e rv in g c h i l d r e n w ere r e p o r t e d by t h e i r p a r e n t s to v alu e money. F o llo w in g o b s e r v a tio n o f th e m odeled seq u e n c e each, h y p e r a c tiv e c h i l d was a sk e d f iv e q u e s tio n s : 1) "7/hat d id th e m o th er a s k th e c h i l d to do?" 2) M77hat d id th e c h i ld do?" 3 ) "7/hat d id th e c h i l d s a y w h ile d o in g w hat m other a s k ed?" if) "Y/hat d id th e m o th er s a y to th e c h i l d a f t e r he d id w hat sh e a sk e d? " and 5) "Y/hat d id th e c h i ld g e t f o r d o in g w hat m o th er ask e d? " I f th e c h i l d s u c c e s s f u l l y met th e c r i t e r i o n o f a n s w e rin g fo u r o u t o f f i v e q u e s tio n s c o r r e c t l y, th e n he o r sh e was r e u n i t e d w ith th e m other in th e o b s e r v a tio n room. I f th e c h i l d d id n o t m eet th e e s t a b l i s h e d c r i t e r i o n, t h e n '- ' he o r s h e was r e q u i r e d to view th e v id e o ta p e seq u e n c e a seco n d tim e. A g a in, th e c h i l d was a sk ed th e same f iv e q u e s tio n s. T h is p ro c e d u re c o n tin u e d u n t i l th e c h i ld s u c c e s s f u l l y met th e e s t a b l i s h e d c r i t e r i o n. F o llo w in g r e u n io n o f th e c h i ld v /ith th e m other i n th e o b s e r v a t io n room th e f iv e - m in u te s t r u c t u r e d - t a s k c o n d itio n was i n e f f e c t. A g ain, a s i n b a s e l i n e, each m other p r e s e n te d

29 f i v e d i f f e r e n t commands a t a p p ro x im a te ly o n e -m in u te i n t e r v a l s a s s ig n a l e d by th e g re e n l i g h t. A ll s t r u c t u r e d - t a s k i n t e r a c t i o n s b etw e en p a r e n t and c h i l d w ere v id e o ta p e d. P a r e n t T ra in in g F o llo w in g fo u r tr e a tm e n t s e s s i o n s w ith sy m b o lic m o d e lin g a lo n e a seco n d tr e a tm e n t c o n d i tio n, p a r e n t t r a i n i n g (C ), was a p p lie d c o n c u r r e n tly w ith sy m b o lic m o d e lin g o v e r th e f i n a l p h a s e o f th e s tu d y. P r i o r to i n i t i a t i n g p a r e n t t r a i n i n g each p a r e n t was r e q u e s te d to c o m p le te a q u e s tio n n a ir e ( O 'D e l l, T a r le r - B e n lo lo & F ly n n, 1979) i n o r d e r to m easu re know ledge o f b e h a v io r a l p r i n c i p l e s a s a p p lie d to c h i l d r e n. The p a r e n t t r a i n i n g p h a s e c o n s is te d o f two s e q u e n c e s. The f i r s t se q u e n c e was c o m p rised o f two s e s s i o n s and beg an w ith th e r e s e a r c h e r re v ie w in g th e q u e s tio n n a ir e w ith each p a r e n t and p r o v id in g a r a t i o n a l e f o r th e c o r r e c t a n s w e rs. N e x t, t h r e e t a r g e t b e h a v io r s o r p a r e n t in g s k i l l s w ere ta u g h t t o each p a r e n t and in c lu d e d : a t t e n d i n g, ig n o r i n g, and re w a rd in g. " A tte n d s " a r e e s s e n t i a l l y a ru n n in g com m entary on th e c h i l d 's a c t i v i t y o r a p p r o p r i a te i n - s e s s i o n b e h a v io r, and as s u c h, p r o v id e a more c o n s ta n t s o u rc e o f a t t e n t i o n th a n re w a rd s. A tte n d in g r e q u i r e d each p a r e n t to v e r b a l l y d e s c r i b e th e c h i l d 's o n g o in g - b e h a v io r, e. g., " Y o u 're s ta c k in g th e b lo c k s," o r "H ere comes th e t r u c k." When

30 a t te n d i n g each p a r e n t was i n s t r u c t e d n o t to a s k q u e s ti o n s, g iv e commands, t r y t o d i r e c t, t r y to s t r u c t u r e o r i n t e r r u p t, o r t r y to tu r n i t i n t o a te a c h in g s e s s i o n, b u t r a t h e r to u se a t te n d i n g o n ly to d e s c r i b e a p p r o p r i a te c h i l d b e h a v io r. Ig n o r in g was u s e d to d e c r e a s e th e c h i l d 's in a p p r o p r ia te b e h a v io r by f o llo w in g th e s e g u id e lin e s : 1) no eye c o n ta c t o r v e r b a l cu es a s each p a r e n t was i n s t r u c t e d to tu r n a t l e a s t 9 0 * away from th e c h i l d, 2) no v e r b a l c o n t a c t as each p a r e n t was t o l d n o t to t a l k o r a t te n d to th e c h i ld when he o r s h e d id so m e th in g in a p p r o p r i a t e, and 3 ) wo p h y s ic a l c o n t a c t f o llo w in g i n a p p r o p r i a t e c h i l d b e h a v io r. R ew arding was im p lem ented by each p a r e n t i n th e form o f v e r b a l p r a i s e c o n tin g e n t upon th e c h i l d 's i n i t i a t i o n o f co m p lia n ce in re s p o n s e to p a r e n t a l commands. P a r e n ts w ere i n s t r u c t e d to f o llo w th e s e g u id e lin e s when re w a rd in g t h e i r c h i l d f o r a p p r o p r i a te c o m p lia n t b e h a v io r: 1) rew ard th e c h i l d im m e d ia te ly upon th e i n i t i a t i o n o f c o m p lia n c e, 2) re w a rd th e c h i l d im m e d ia te ly fo llo w in g te r m in a tio n o f th e ta s k r e q u e s t e d, 3 ) re w a rd s s h o u ld be c o n s i s t e n t l y a p p lie d a f t e r e v e ry t a s k c o m p le te d, and re w a rd s sh o u ld be ta s k s p e c i f i c. A tte n d in g and ig n o r in g w ere e m itte d by each p a r e n t i n b o th th e f r e e - p l a y and s t r u c t u r e d - t a s k c o n d i tio n s th ro u g h o u t th e e n t i r e p a r e n t t r a i n i n g p h a s e. R ew arding was a p p lie d o n ly d u rin g th e s t r u c t u r e d - t a s k s i t u a t i o n f o r a p p r o p r i a te c o m p lia n t b e h a v io r.

31 The f i r s t s e q u e n c e o f p a r e n t t r a i n i n g c o n s is te d o f d i d a c t i c i n s t r u c t i o n s, t h e r a p i s t m o d elin g o f a p p r o p r i a te a t t e n d i n g, i g n o r i n g, and re w a rd in g b e h a v io r, fo llo w e d by b e h a v io r a l r e h e a r s a l by each p a r e n t w ith c o r r e c t i v e fe e d b a c k p ro v id e d by th e r e s e a r c h e r. The m ajor p u rp o s e o f th e f i r s t two w eek s e q u e n c e o f p a r e n t t r a i n i n g was to change th e p a t t e r n o f p a r e n t - c h i l d i n t e r a c t i o n s from a n e g a tiv e to a more p o s i t i v e e x c h a n g e. P a r e n ts w ere i n s t r u c t e d to p r a c t i c e a l l t h r e e new s k i l l s ta u g h t in th e f i r s t se q u e n c e f o r a t l e a s t 15 m in u te s d a i l y w ith t h e i r c h i l d. The p u rp o s e o f t h i s b etw e en s e s s i o n homework a s s ig n m e n t was to f a c i l i t a t e p o s i t i v e b e h a v io r change i n each p a r e n t - c h i l d r e l a t i o n s h i p. The s e c o n d s e q u e n c e o f th e p a r e n t t r a i n i n g p h ase c o n s is te d o f fo u r s e s s i o n s d u rin g w hich th r e e new p a r e n t s k i l l s w ere ta u g h t: 1) how to g iv e commands, 2) n o t r e p e a t i n g commands, and 3 ) u s in g a tim e - o u t p r o c e d u r e. The m ajo r p u rp o s e o f t h i s se c o n d sequen ce was to d e c re a s e th e r a t e o f n o n co m p lia n ce to p a r e n t a l commands. T h roughout t h i s se c o n d s e q u e n c e each p a r e n t c o n tin u e d to p r a c t i c e th e t h r e e s k i l l s ta u g h t i n t h e f i r s t s e q u e n c e o f t r a i n i n g, i. e., a t t e n d i n g, ig n o r i n g, and r e w a rd in g. In g iv in g commands each p a r e n t was ta u g h t to f i r s t g e t th e c h i l d 's a t t e n t i o n by c a l l i n g th e c h i l d 's f i r s t name and p a u s in g u n t i l eye c o n t a c t was e s t a b l i s h e d. Then i n a f irm and s l i g h t l y lo u d e r th a n u s u a l to n e o f v o ic e g iv e

32 18 one s p e c i f i c command. N e x t, a f t e r th e command was p r e s e n te d each p a r e n t was i n s t r u c t e d t o c o u n t s i l e n t l y to t e n. 3ach p a r e n t was t o l d n o t t o i s s u e a d d i t i o n a l w o rd s, s ta t e m e n ts, o r any v e r b a l i z a t i o n u n t i l th e c h i l d b eg an to com ply. I f a f t e r c o u n tin g s i l e n t l y to te n th e c h i l d had n o t i n i t i a t e d c o m p lia n ce th e n th e p a r e n t was to is s u e a w a rn in g : " I f... t h e n..., 1' e. g., " I f you do n o t p ic k up th e t o y s, th e n you w i l l hav e to s i t i n th e c h a ir i n th e c o r n e r.! Each p a r e n t th e n c o u n te d s i l e n t l y to te n f o llo w in g th e w a rn in g. I f th e c h i l d i n i t i a t e d co m p lia n c e f o llo w in g th e w arn in g s ta te m e n t th e n th e p a r e n t p r a i s e d th e c h i l d. I f th e c h i ld s t i l l f a i l e d to b e g in co m p ly in g to th e p a r e n t a l command a f t e r th e w a rn in g th e n a tim e - o u t (TO) p ro c e d u re was im p lem en ted. I n c a r r y i n g o u t th e TO p ro c e d u re each p a r e n t was i n s t r u c t e d to ta k e th e c h i l d f ir m ly by th e hand and p la c e him o r h e r i n th e c h a ir lo c a te d i n th e c o rn e r o f th e room. The p a r e n t th e n re s p o n d e d by s a y in g, " S in c e you d id n o t do a s I a s k e d, you h ave to s i t i n th e c h a ir u n t i l I s a y you ca n g e t u p. Each p a r e n t was a d v is e d n o t to p ro v id e a r a t i o n a l e o r a rg u e w ith th e c h i l d w h ile ta k in g th e c h i ld t o TO, o r w h ile th e c h i l d was i n TO. The c h i ld was r e q u i r e d t o re m a in i n TO f o r t h r e e m in u te s. R e le a s e from TO was c o n tin g e n t upon s i t t i n g q u i e t l y i n th e c h a ir f o r 15 seco n d s a f t e r th e t h r e e m in u te s had e x p ir e d. The p a r e n t w ould th e n r e t u r n to th e c h a i r, rem ove th e c h i l d, and r e p e a t th e o r i g i n a l command. Once th e o r i g i n a l command was r e p e a te d

33 th e n th e e n t i r e se q u e n c e o f e v e n ts beg an a g a in w ith th e p a r e n t s i l e n t l y c o u n tin g to te n f o r c o m p lia n ce to be i n i t i a t e d. T h u s, th e c h i l d c o u ld n o t a v o id com p ly in g to a p a r e n t a l command i f th e TO p ro c e d u re was c o n s i s t e n t l y and c o r r e c t l y c a r r i e d o u t c o n tin g e n t upon n o n c o m p lia n c e. A b a c k -u p p ro c e d u re f o r a c h i l d le a v in g th e TO c h a ir p r e m a tu re ly was a l s o i n e f f e c t. The f i r s t tim e t h i s h appened th e p a r e n t was to s a y, " I f you g e t o f f th e c h a ir a g a in, I w i l l s p an k y o u." T h is w a rn in g was o n ly g iv e n o n c e. I f th e c h i ld th e n l e f t th e c h a i r a g a in b e f o r e p a r e n t a l r e l e a s e from TO he o r sh e was r e t u r n e d to th e TO c h a i r and g iv e n two s p an k s on th e b o tto m w ith an open h a n d. The c h i ld was th e n p la c e d b ack i n th e TO c h a ir and th e p a r e n t r e p e a te d th e w arning. P a r e n t t r a i n i n g was c o n d u c te d i n a room a d ja c e n t to th e o b s e r v a tio n room a t th e c l i n i c, and was i n e f f e c t f o r th e l a s t e ig h t w eeks o f th e s tu d y. P a r e n t t r a i n i n g was c a r r i e d o u t p r i o r to ea c h s e s s i o n s 1 0 -m in u te f r e e - p l a y p e r i o d. D u rin g p a r e n t t r a i n i n g each c h i l d was i n s t r u c t e d to p la y a lo n e i n th e o b s e r v a t io n room. A f te r th e p a r e n t t r a i n i n g s e s s i o n th e p a r e n t was r e u n i t e d w ith h e r c h i ld and a llo w e d 10 m in u te s o f f r e e - p l a y. F o llo w in g th e f r e e - p l a y p e r io d th e c h i ld view ed a n o th e r v id e o ta p e d s e q u e n c e w ith th e i n v e s t i g a t o r, and th e n was r e t u r n e d to h i s o r h e r m o th er f o r th e f iv e - m in u te s t r u c t u r e d - t a s k c o n d i tio n w hich was v id e o ta p e d. F o llo w in g th e end o f th e s eco n d sequen ce o f

34 p a r e n t t r a i n i n g,e a c h p a r e n t co m p leted a n o th e r P a re n t Q u e s tio n n a ir e to p r o v id e a p o s ttr e a tm e n t m easure o f h y p e r a c t i v i t y and o v e r a l l b e h a v io r a l f u n c t io n in g o f each c h i l d. 20 D ependent V a r ia b le s An o b s e r v a tio n c o d in g sy ste m was d e v e lo p e d w hich a llo w e d f o r th e c o n tin u o u s r e c o r d in g o f 17 d i f f e r e n t p a r e n t and c h i ld b e h a v io r s o p e r a t i o n a l l y d e fin e d a s f o llo w s : 1. A tte n d (A ): V e rb a l com m entary o f o n g o in g c h i l d b e h a v io r. 2. C om pliance (Coin): P h y s i c a l c o n ta c t w ith th e o b je c t o f th e command w ith in fiv e seconds of end of command. 3. E x t in c t io n ( E x t): No i n t e l l i g i b l e re s p o n s e f o r th e e n t i r e 10 seco n d i n t e r v a l. A. L a te n c y (L ): Time from end o f command to p h y s ic a l c o n t a c t w ith th e o b je c t o f p a r e n t a l command. 3. n e g a tiv e N o n v erb al ( I TV) : T a n tru m s, s p a n k in g, p in c h, h i t, k ic k, th ro w t h i n g s, s h o v e, p ush o r yank on th i n g s. 6. N e g a tiv e V e rb a l (-V ): D ir e c t d is a p p r o v a l o r c r i t i c i s m, w h in in g, c r y i n g, s w e a rin g, n o, d o n 't, s t o p, q u i t, t h a t ' s n o t r i g h t, t h a t ' s a l l w rong, t h a t i s n o t c o n tin g e n t upon c h i ld n o n com p lia n ce to p a r e n t a l command. 7. Ilo n com p lian ce (NCom): No p h y s ic a l c o n ta c t w ith th e o b je c t o f th e command w ith in f iv e s e c o n d s o f end o f th e command. 8. O th e r (O th e r ) : Any o th e r form o f b e h a v io r t h a t does n o t