bluuebunny/crossref_metadata_2025 huggingface dataset:
West Nile Virus Infection Among Pregnant Women in a Northern Colorado Community, 2003 to 2004
Authors: Paisley Jan E. , Hinckley Alison F. , O'Leary Daniel R. , Kramer William C. , Lanciotti Robert S. , Campbell Grant L. , Hayes Edward B.
Published: March 2006

OBJECTIVE. Since West Nile virus (WNV) was first detected in New York in 1999, it has spread across North America and become a major public health concern. In 2002, the first documented case of intrauterine WNV infection was reported, involving an infant with severe brain abnormalities. To determine the frequencies of WNV infections during pregnancy and of intrauterine WNV infections, we measured WNV-specific antibodies in cord blood from infant deliveries after a community-wide epidemic of WNV disease.

METHODS. Five hundred sixty-six pregnant women who presented to Poudre Valley Hospital (Fort Collins, CO) for delivery between September 2003 and May 2004 provided demographic and health history data through self-administered questionnaires and hospital admission records. Umbilical cord blood was collected from 549 infants and screened for WNV-specific IgM and IgG antibodies with enzyme-linked immunosorbent assays, with confirmation by plaque-reduction neutralization tests. Newborn growth parameters, Apgar scores, and hearing test results were recorded.

RESULTS. Four percent (95% confidence interval: 2.4–5.7%) of cord blood samples tested positive for WNV-specific IgG antibodies. No cord blood samples were positive for WNV-specific IgM antibodies. There were no significant differences between infants of seropositive and seronegative mothers with respect to any of the growth parameters or outcomes measured.

CONCLUSIONS. Intrauterine WNV infections seemed to be infrequent. In our study, WNV infection during pregnancy did not seem to affect adversely infant health at birth. Larger prospective studies are necessary to measure more completely the effects of maternal WNV infection on pregnancy and infant health outcomes.
Pubic Hair of Infancy: Endocrinopathy or Enigma?
Authors: Nebesio Todd D. , Eugster Erica A.
Published: March 2006

Pubic hair of infancy is a rare condition that has not been well-characterized. A retrospective chart review of infants <12 months of age who presented to our pediatric endocrine clinics with isolated pubic hair over the last 5 years was performed. Eleven patients were identified (6 male and 5 female). The average age at diagnosis was 8.3 ± 2.0 months. The majority of patients (73%) had pubic hair in an atypical location. Growth pattern, laboratory evaluation, and bone-age radiographs were unremarkable for all the infants. Of the infants that returned for follow-up, pubic hair resolved by the age of 11.0 ± 1.5 months. From our experience and review of the literature, we suggest that isolated pubic hair of infancy is a benign entity. However, long-term follow-up needs to be done to determine if pubic hair of infancy is an atypical variant of premature adrenarche, which may place these patients at risk for later adult disease.
Early Intervention in Low Birth Weight Premature Infants: Results at 18 Years of Age for the Infant Health and Development Program
Authors: McCormick Marie C. , Brooks-Gunn Jeanne , Buka Stephen L. , Goldman Julie , Yu Jennifer , Salganik Mikhail , Scott David T. , Bennett Forrest C. , Kay Libby L. , Bernbaum Judy C. , Bauer Charles R. , Martin Camilia , Woods Elizabeth R. , Martin Anne , Casey Patrick H.
Published: March 2006

OBJECTIVE. To assess whether improvements in cognitive and behavioral development seen in preschool educational programs persist, we compared those in a multisite randomized trial of such a program over the first 3 years of life (INT) to those with follow-up only (FUO) at 18 months of age.

METHODS. This was a prospective follow-up of the Infant Health and Development Program at 8 sites heterogeneous for sociodemographic characteristics. Originally 985 children were randomized to the INT (n = 377) or FUO (n = 608) groups within 2 birth weight strata: heavier low birth weight (HLBW; 2001–2499 g) and lighter low birth weight (LLBW; ≤2000 g). Primary outcome measures were the Peabody Picture Vocabulary Test (PPVT-III), reading and mathematics subscales of the Woodcock-Johnson Tests of Achievement, youth self-report on the Total Behavior Problem Index, and high-risk behaviors on the Youth Risk Behavior Surveillance System (YRBSS). Secondary outcomes included Weschler full-scale IQ, caregiver report on the Total Behavior Problem Index, and caregiver and youth self-reported physical health using the Medical Outcome Study measure. Assessors were masked as to study status.

RESULTS. We assessed 636 youths at 18 years (64.6% of the 985, 72% of whom had not died or refused at prior assessments). After adjusting for cohort attrition, differences favoring the INT group were seen on the Woodcock-Johnson Tests of Achievement in math (5.1 points), YRBSS (−0.7 points), and the PPVT-III (3.8 points) in the HLBW youth. In the LLBW youth, the Woodcock-Johnson Tests of Achievement in reading was higher in the FUO than INT group (4.2).

CONCLUSIONS. The findings in the HLBW INT group provide support for preschool education to make long-term changes in a diverse group of children who are at developmental risk. The lack of observable benefit in the LLBW group raises questions about the biological and educational factors that foster or inhibit sustained effects of early educational intervention.
A Randomized Trial of Home Oxygen Therapy From the Emergency Department for Acute Bronchiolitis
Authors: Bajaj Lalit , Turner Carol G. , Bothner Joan
Published: March 2006

OBJECTIVE. Hypoxia is a common reason for hospital admission in infants and children with acute bronchiolitis. No study has evaluated discharge from the emergency department (ED) on home oxygen. This study evaluated the feasibility and safety of ED discharge on home oxygen in the treatment of acute bronchiolitis.

METHODS. This was a prospective, randomized trial of infants and children with acute bronchiolitis and hypoxia (room-air saturations of ≤87%) aged 2 to 24 months presenting to an urban, academic, tertiary care children's hospital ED from December 1998 to April 2001. Subjects received inpatient admission or home oxygen after an 8-hour observation period in the ED. We measured the failure to meet discharge criteria during the observation period, return for hospital admission, and incidence of serious complications.

RESULTS. Ninety-two patients were enrolled. Fifty three (58%) were randomly assigned to home and 39 (42%) to inpatient admission. There were no differences between the groups in age, initial room-air saturation, and respiratory distress severity score. Of 53 patients, 37 (70%) randomly assigned to home oxygen completed the observation period and were discharged from the hospital. The remaining 16 patients were excluded from the study (6), resolved their oxygen requirement (5), or failed to meet the discharge criteria and were admitted (5). One discharged patient (2.7%) returned to the hospital and was admitted for a cyanotic spell at home after the 24-hour follow-up appointment. The patient had an uncomplicated hospital course with a length of stay of 45 hours. The remaining 36 patients (97%) were treated successfully as outpatients with home oxygen. Satisfaction with home oxygen was high from the caregiver and the primary care provider.

CONCLUSIONS. Discharge from the ED on home oxygen after a period of observation is an option for patients with acute bronchiolitis. Secondary to the low incidence of complications, the safety of this practice will require a larger study.
A Tuberculosis Outbreak in a Private-Home Family Child Care Center in San Francisco, 2002 to 2004
Authors: Dewan Puneet K. , Banouvong Houmpheng , Abernethy Neil , Hoynes Thomas , Diaz Liliana , Woldemariam Melaku , Ampie Theresa , Grinsdale Jennifer , Kawamura L. Masae
Published: March 2006

BACKGROUND. Child care facilities are well known as sites of infectious disease transmission, and California child care facility licensure requirements include annual tuberculosis (TB) screening for on-site adults. In April 2004, we detected an adult with TB living in a private-home family child care center (child care center A).

METHODS. We reviewed patient medical records and conducted a contact investigation. The investigation included all persons at the child care center, the workplace and leisure contacts of the adult patient with TB, and the household contacts of secondary case patients. Contact names were obtained through patient interviews. A positive tuberculin skin test result was defined as induration of ≥5 mm. DNA fingerprints of Mycobacterium tuberculosis isolates were analyzed. Outbreak cases were those that had matching DNA fingerprint patterns or were linked epidemiologically, if DNA fingerprint results were not available.

RESULTS. Between August 2002 and July 2004, we detected 11 outbreak cases, including 9 (82%) among children (<18 years of age). All 11 outbreak patients lived or were cared for at child care center A. The 9 pediatric TB patients were young (<7 years of age), United States-born children of foreign-born parents, and 4 (44%) had positive cultures for M tuberculosis. Including isolates recovered from the 2 adult patients, all 6 M tuberculosis isolates shared identical, 7-band, DNA fingerprint patterns. The contact investigation identified 3 (33%) of the 9 pediatric cases; 2 (22%) presented with illness and 4 (44%) were detected by primary care providers during routine TB screening. Excluding case subjects, 36 (54%) of 67 named contacts had latent TB infection.

CONCLUSIONS. Provider adherence to locally adapted pediatric TB screening recommendations proved critical to outbreak control. TB screening compliance by the child care center and more aggressive source-case investigation by the TB program might have prevented or abated this large pediatric TB outbreak.
Volume and Frequency of Breastfeedings and Fat Content of Breast Milk Throughout the Day
Authors: Kent Jacqueline C. , Mitoulas Leon R. , Cregan Mark D. , Ramsay Donna T. , Doherty Dorota A. , Hartmann Peter E.
Published: March 2006

OBJECTIVE. We aimed to provide information that can be used as a guide to clinicians when advising breastfeeding mothers on normal lactation with regard to the frequency and volume of breastfeedings and the fat content of breast milk.

METHODS. Mothers (71) of infants who were 1 to 6 months of age and exclusively breastfeeding on demand test-weighed their infants before and after every breastfeeding from each breast for 24 to 26 hours and collected small milk samples from each breast each time the infant was weighed.

RESULTS. Infants breastfed 11 ± 3 times in 24 hours (range: 6–18), and a breastfeeding was 76.0 ± 12.6 g (range: 0–240 g), which was 67.3 ± 7.8% (range: 0–100%) of the volume of milk that was available in the breast at the beginning of the breastfeeding. Left and right breasts rarely produced the same volume of milk. The volume of milk consumed by the infant at each breastfeeding depended on whether the breast that was being suckled was the more or less productive breast, whether the breastfeeding was unpaired, or whether it was the first or second breast of paired breastfeedings; the time of day; and whether the infant breastfed during the night or not. Night breastfeedings were common and made an important contribution to the total milk intake. The fat content of the milk was 41.1 ± 7.8 g/L (range: 22.3–61.6 g/L) and was independent of breastfeeding frequency. There was no relationship between the number of breastfeedings per day and the 24-hour milk production of the mothers.

CONCLUSIONS. Breastfed infants should be encouraged to feed on demand, day and night, rather than conform to an average that may not be appropriate for the mother-infant dyad.
Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality
Authors: Edmond Karen M. , Zandoh Charles , Quigley Maria A. , Amenga-Etego Seeba , Owusu-Agyei Seth , Kirkwood Betty R.
Published: March 2006

BACKGROUND. Breastfeeding promotion is a key child survival strategy. Although there is an extensive scientific basis for its impact on postneonatal mortality, evidence is sparse for its impact on neonatal mortality.

OBJECTIVES. We sought to assess the contribution of the timing of initiation of breastfeeding to any impact.

METHODS. This study took advantage of the 4-weekly surveillance system from a large ongoing maternal vitamin A supplementation trial in rural Ghana involving all women of childbearing age and their infants. It was designed to evaluate whether timing of initiation of breastfeeding and type (exclusive, predominant, or partial) are associated with risk of neonatal mortality. The analysis is based on 10947 breastfed singleton infants born between July 2003 and June 2004 who survived to day 2 and whose mothers were visited in the neonatal period.

RESULTS. Breastfeeding was initiated within the first day of birth in 71% of infants and by the end of day 3 in all but 1.3% of them; 70% were exclusively breastfed during the neonatal period. The risk of neonatal death was fourfold higher in children given milk-based fluids or solids in addition to breast milk. There was a marked dose response of increasing risk of neonatal mortality with increasing delay in initiation of breastfeeding from 1 hour to day 7; overall late initiation (after day 1) was associated with a 2.4-fold increase in risk. The size of this effect was similar when the model was refitted excluding infants at high risk of death (unwell on the day of birth, congenital abnormalities, premature, unwell at the time of interview) or when deaths during the first week (days 2–7) were excluded.

CONCLUSIONS. Promotion of early initiation of breastfeeding has the potential to make a major contribution to the achievement of the child survival millennium development goal; 16% of neonatal deaths could be saved if all infants were breastfed from day 1 and 22% if breastfeeding started within the first hour. Breastfeeding-promotion programs should emphasize early initiation as well as exclusive breastfeeding. This has particular relevance for sub-Saharan Africa, where neonatal and infant mortality rates are high but most women already exclusively or predominantly breastfeed their infants.
Adherence to and Effectiveness of Positive Airway Pressure Therapy in Children With Obstructive Sleep Apnea
Authors: Marcus Carole L. , Rosen Gerald , Ward Sally L. Davidson , Halbower Ann C. , Sterni Laura , Lutz Janita , Stading Pamela J. , Bolduc Daisy , Gordon Nancy
Published: March 2006

OBJECTIVES. Positive airway pressure therapy (PAP) is frequently used to treat children who have obstructive sleep apnea syndrome and do not respond to adenotonsillectomy. However, no studies have evaluated objectively adherence to PAP in children, and few studies have evaluated objectively the effectiveness of PAP. The objective of this study was to determine adherence and effectiveness of PAP (both continuous [CPAP] and bilevel [BPAP] pressure) in children with obstructive apnea.

METHODS. A prospective, multicenter study was performed of children who were randomly assigned in a double-blind manner to 6 months of CPAP versus BPAP. Adherence was measured objectively using the equipment's computerized output. Effectiveness was evaluated using polysomnography.

RESULTS. Twenty-nine children were studied. Approximately one third of children dropped out before 6 months. Of the 21 children for whom 6-month adherence data could be downloaded, the mean nightly use was 5.3 ± 2.5 (SD) hours. Parental assessment of PAP use considerably overestimated actual use. PAP was highly effective, with a reduction in the apnea hypopnea index from 27 ± 32 to 3 ± 5/hour, and an improvement in arterial oxygen saturation nadir from 77 ± 17% to 89 ± 6%. Results were similar for children who received CPAP versus BPAP. Children also had a subjective improvement in daytime sleepiness.

CONCLUSIONS. Both CPAP and BPAP are highly efficacious in pediatric obstructive apnea. However, treatment with PAP is associated with a high dropout rate, and even in the adherent children, nightly use is suboptimal considering the long sleep hours in children.
Pesticide Exposure and Stunting as Independent Predictors of Neurobehavioral Deficits in Ecuadorian School Children
Authors: Grandjean Philippe , Harari Raul , Barr Dana B. , Debes Frodi
Published: March 2006

OBJECTIVES. To examine possible effects on blood pressure, neurological function, and neurobehavioral tests in school-aged children with and without prenatal pesticide exposure in an area where stunting is common.

METHODS. In a community of Northern Ecuador with intensive floriculture and a high female employment rate, we invited 79 children attending the 2 lowest grades of a public school for clinical examinations. In addition to a thorough physical examination, we administered simple reaction time, Santa Ana dexterity test, Stanford-Binet copying, and Wechsler Intelligence Scale for Children-Revised Digit Spans forward. Maternal interview included detailed assessment of occupational history to determine pesticide exposure during pregnancy. Recent and current pesticide exposure was assessed by erythrocyte acetylcholine esterase activity and urinary excretion of organophosphate metabolites.

RESULTS. All eligible children participated in the study, but 7 children were excluded from data analysis due to other disease or age >9 years. A total of 31 of the remaining 72 children were classified as stunted based on their height for age. Maternal occupational history revealed that 37 children had been exposed to pesticides during development. After confounder adjustment, prenatal pesticide exposure was associated with a higher systolic blood pressure than in the controls. On neurological examination, 14 exposed children and 9 controls showed ≥1 abnormalities. Of 5 neurobehavioral tests, the Stanford-Binet copying test showed a lower drawing score for copying designs in exposed children than in controls. Stunting was associated with a lower score on this test only, and both risk factors remained statistically significant in a multiple regression analysis with adjustment for demographic and social confounders. Increased excretion of dimethyl and diethyl metabolites of organophosphates was associated with increased reaction time and no other outcomes.

CONCLUSION. Prenatal pesticide exposure may cause lasting neurotoxic damage and add to the adverse effects of malnutrition in developing countries. The effects differ from those due to acute pesticide exposure.
Success in the Prevention of Infant Walker–Related Injuries: An Analysis of National Data, 1990–2001
Authors: Shields Brenda J. , Smith Gary A.
Published: March 2006

OBJECTIVE. Here we describe the epidemiologic characteristics and secular trends of infant walker–related injuries among children who are younger than 15 months in the United States.

METHODS. A retrospective analysis was conducted of data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission, 1990–2001. Sample weights that were provided by the National Electronic Injury Surveillance System were used in all analyses to adjust for the inverse probability of case selection and make national projections regarding infant walker–related injuries.

RESULTS. An estimated 197200 infant walker–related injuries occurred among children who were younger than 15 months and treated in US emergency departments from 1990 through 2001. Five percent of these children required admission to the hospital. The number of infant walker–related injuries remained relatively constant from 1990 through 1994, averaging 23000 cases per year. After the introduction in 1994 of stationary activity centers as an alternative to mobile infant walkers and the implementation of the revised American Society for Testing and Materials F977 voluntary infant walker standard in 1997, there was a marked decrease in the number of infant walker–related injuries. Overall, there was a 76% decrease in the number of injuries from 1990 to 2001 from 20900 injuries in 1990 to 5100 in 2001. Soft tissue injuries and lacerations represented 63% of the injuries. Trauma to the head region occurred in 91% of cases. Skull fractures were the most common (62%) type of fracture. Falls down stairs was the mechanism of injury in 74% of cases.

CONCLUSIONS. The adoption of passive injury-prevention strategies, such as use of stationary activity centers as alternatives to mobile infant walkers and redesign of infant walkers to prevent falls down stairs, were associated with a marked decrease in the number of infant walker–related injuries.
Scope of Health Care Benefits for Children From Birth Through Age 21
Authors:   Committee on Child Health Financing
Published: March 2006

The optimal health of children can best be achieved by providing access to comprehensive health care benefits. This policy statement outlines and defines the recommended set of health insurance benefits for children through age 21. These services encompass medical care, critical care, pediatric surgical care, behavioral health services, specialized services for children with special health care needs, and oral health. It replaces the 1997 statement, “Scope of Health Care Benefits for Newborns, Infants, Children, Adolescents, and Young Adults Through Age 21 Years.”
Automated Mechanical Passaging: A Novel and Efficient Method for Human Embryonic Stem Cell Expansion
Authors: Joannides Alexis , Fiore-Hériché Christelle , Westmore Kristine , Caldwell Maeve , Compston Alastair , Allen Nicholas , Chandran Siddharthan
Published: March 2006

There is a need for more standardized methods of maintenance and propagation of human embryonic stem cell (hESC) cultures. Enzymatic passaging currently represents the most widely used method for expansion of hESCs. Although rapid and straightforward, this technique results in variable-sized cell clusters and significant cellular trauma, which may apply selective pressure in long-term culture. Mechanical passaging has the potential advantages of defined colony fragment sizes, reduced cellular trauma, and the possibility of selecting undifferentiated colonies for transfer. However, manual dissection of individual colonies is a prohibitively time-consuming process unsuitable for maintaining large numbers of hESCs without the use of additional chemical means. In this study we report an efficient automated method for mechanically passaging hESCs. We have used this method exclusively to maintain hESCs in long-term undifferentiated culture without the use of enzymatic digestion for longer than 100 days. This automated technique can thus be used routinely to culture hESCs in the laboratory.
PROMOTING AUTOMOBILE SAFETY BELT USE BY YOUNG CHILDREN
Authors: Sowers‐Hoag Karen M. , Thyer Bruce A. , Bailey Jon S.
Published: March 2006

A program using behavioral practice, assertiveness training, and social and contrived reinforcers was developed to establish and maintain automobile safety belt use by young children. Sixteen children (ages 4.8 to 7 years) who never used their safety belts during a 5‐day preexperimental observation period were randomly assigned to two groups of eight each. A multiple baseline design across groups was used to evaluate the effectiveness of the training program. During the 8‐day baseline period for Group 1, no children used their safety belts when unobtrusively observed while being driven from school. During the 26‐day intervention period, the children were buckled up on 96% of the observations. Follow‐up probes conducted 2–3 months after program discontinuance found safety belt use to range from 86% to 100%. For Group 2, the 14‐day baseline safety belt use averaged 6% and increased to a mean of 81% during the 20‐day training and maintenance program. Follow‐up probes 2–3 months later found safety belt use to occur during 75% to 96% of the observations. Parent questionnaires indicated the generalizability and social validity of the program.
EXPANDING THE IMPACT OF BEHAVIORAL STAFF MANAGEMENT: A LARGE‐SCALE, LONG‐TERM APPLICATION IN SCHOOLS SERVING SEVERELY HANDICAPPED STUDENTS
Authors: Parsons Marsha B. , Schepis Maureen M. , Reid Dennis H. , McCarn Joyce E. , Green Carolyn W.
Published: March 2006

Experimental evaluations of behavioral staff management procedures usually have been limited to relatively small‐scale demonstration studies. We evaluated a large‐scale, long‐term application of a staff management program designed to improve the functional utility of educational services for severely handicapped persons. The intervention, involving a brief in‐service program followed by supervisory prompts and feedback, was implemented by three principals in four schools involving 21 classrooms. Implementation of the management procedures was consistently accompanied by increases in student involvement in functional educational tasks in each classroom. Further, the improved services continued throughout a 2‐year follow‐up period. Staff responses to a questionnaire indicated a high degree of staff acceptance of the management program. Results are discussed in terms of expanding the use of behavioral supervisory procedures from experimental demonstrations to actual adoption by existing human service agencies.
DECREASING DANGEROUS INFANT BEHAVIORS THROUGH PARENT INSTRUCTION
Authors: Mathews Judith R. , Friman Patrick C. , Barone Vincent J. , Ross Linda V. , Christophersen Edward R.
Published: March 2006

One adult and three adolescent mothers with 1‐year‐old infants were taught to reduce their infants' potential for injury in the home. After being taught to increase their positive interactions with their infants, the mothers were taught to child‐proof the home, to use playpen time‐out for potentially dangerous behaviors, and to give positive attention for safe behaviors. A multiple baseline design across subjects was used to evaluate functional control. Potentially dangerous behaviors, observed during 10 min of free play, decreased from variable and, at times, high rates during baseline to stable near‐zero rates after treatment. These target behaviors remained low at a 7‐month follow‐up assessment.
EFFECTS OF CAFFEINE ON CLASSROOM BEHAVIOR, SUSTAINED ATTENTION, AND A MEMORY TASK IN PRESCHOOL CHILDREN
Authors: Baer Ruth A.
Published: March 2006

The effects of caffeine on the behavior of young children is an important issue, as children in our society consume considerable amounts of caffeine, primarily in soft drinks. This study investigated the effects of normative amounts of caffeine on the behavior of 6 normal children in a kindergarten setting. Using a reversal design, counterbalanced for order of conditions, children's behavior was examined during a baseline condition, a caffeinated beverage condition, and a noncaffeinated beverage condition. Measures included direct observation of off‐task and gross motor activity, actometer readings of movement, a Continuous Performance Test, a Paired Associates Learning Test, and teacher ratings of classroom behavior. Results suggest that caffeine exerts only small and inconsistent effects on the classroom behavior of kindergarten children. These results cast doubt on the importance of caffeine as a variable controlling the classroom behavior of normal kindergartners.
THE INFLUENCE OF CHILD‐PREFERRED ACTIVITIES ON AUTISTIC CHILDREN'S SOCIAL BEHAVIOR
Authors: Koegel Robert L. , Dyer Kathleen , Bell Lynn K.
Published: March 2006

One of the characteristics of autistic children is severe social avoidance behavior. We assessed whether the type of activity (child‐preferred vs. activities that were arbitrarily determined by an adult) engaged in during an interaction was correlated with the amount of social avoidance behaviors these children exhibit. Results revealed a negative correlation between appropriate child‐preferred activities and social avoidance behavior. Additional analyses revealed that (a) social avoidance behaviors could be manipulated within a reversal design, and would predictably decrease when the children were prompted to initiate appropriate child‐preferred activities; and (b) these procedures could be used to teach children to initiate child‐preferred activities in community settings, resulting in reductions in social avoidance responses even after the therapist's prompts were completely removed. These data suggest that the manipulation of task variables may influence the severe social unresponsiveness that is characteristic of autistic children.
A NEUROBIOLOGICAL NON ALTERNATIVE: REJOINDER TO LEWIS, BAUMEISTER, AND MAILMAN
Authors: Newsom Crighton , Lovaas O. Ivar
Published: March 2006

Certain misrepresentations of our theory of self‐stimulatory behavior by Lewis, Baumeister, and Mailman (1987) are corrected and several questions raised by the commentators are answered. Their proposed neurobiological alternative is considered briefly and judged to be insufficiently detailed, inadequate in scope, and therefore premature.
EVALUATION OF THE EFFECTIVENESS AND EFFICIENCY OF TWO STIMULUS PROMPT STRATEGIES WITH SEVERELY HANDICAPPED STUDENTS
Authors: Steege Mark W. , Wacker David P. , McMahon Colleen M.
Published: March 2006

In this study we compared the effectiveness and efficiency of two treatment packages that used stimulus prompt sequences and task analyses for teaching community living skills to severely handicapped students. Four severely and multiply handicapped students were trained to perform four tasks: (a) making toast, (b) making popcorn, (c) operating a clothes dryer, and (d) operating a washing machine. Following baseline, each student was exposed to two types of training procedures, each involving a task analysis of the target behavior. Training Procedure 1 (Traditional) utilized a least‐to‐most restrictive prompt sequence. Training Procedure 2 (Prescriptive) utilized ongoing behavioral assessment data to identify discriminative stimuli. The assessment data were used to prescribe instructional prompts across successive training trials. Performance on the tasks was evaluated within a combination multiple baseline (across subjects) and probe (across tasks) design. Training conditions were counterbalanced across subjects and tasks. Results indicated that both training procedures were equally effective in increasing independent task acquisition for subjects on all tasks; however, the prescriptive procedure was the more efficient procedure. DESCRIPTORS: stimulus prompts, behavioral assessment, severely handicapped
SERIOUS DELINQUENT BEHAVIOR AS PART OF A SIGNIFICANTLY HANDICAPPING CONDITION: CURES AND SUPPORTIVE ENVIRONMENTS
Authors: Wolf Montrose M. , Braukmann Curtis J. , Ramp Kathryn A.
Published: March 2006

The past 20 years have been productive ones for the field of applied behavior analysis. A brief review of our own efforts during this period reveals that we have accomplished several but not all of our goals for the Teaching‐Family approach. In this context, we note that the setting of realistic and appropriate goals is important for the field and for society. Moreover, we suggest that the realistic goal for some persons with serious delinquent behavior may be extended supportive and socializing treatment rather than permanent cure from conventional short‐term treatment programs. We base this suggestion on the accumulating evidence that serious delinquent behavior may often be part of a significantly disabling and durable condition that consists of multiple antisocial and dysfunctional behaviors, often runs in families, and robustly eludes effective short‐term treatment. Like other significant disabilities such as retardation, autism, and blindness, the effects of this condition may be a function of an interaction of environmental and constitutional variables.

We argue that our field has the wherewithal to construct effective and humane long‐term supportive environments for seriously delinquent youths. In this regard, we explore the dimensions, rationales, logistics, and beginnings of a new treatment direction that involves long‐term supportive family treatment. We contend that such supportive families may be able to provide long, perhaps even lifetime, socializing influences through models, values, and contingencies that seem essential for developing and maintaining prosocial behavior in these high‐risk youths.
A THINKING AID
Authors: Skinner B. F.
Published: March 2006

Writing a paper is often a process of discovering what you have to say. A small, inexpensive, “three‐dimensional” outline of the paper is a help in guiding the process of discovery. New points can be accurately placed as they appear. The outline grows with the paper. The construction of such an outline is described.
USE OF ESCAPE AND REWARD IN THE MANAGEMENT OF YOUNG CHILDREN DURING DENTAL TREATMENT
Authors: Allen Keith D. , Stokes Trevor F.
Published: March 2006

A reinforced practice procedure was used to facilitate cooperative behavior in five children, aged 3 to 6 years, during dental treatment. In a multiple baseline design across subjects, the children were rewarded with escape, inexpensive stickers, and praise for cooperative behavior in the presence of the sights, sounds, and some sensations of the dental instruments prior to actual dental treatment. Direct observations of disruptive behavior via a 15‐s interval recording system indicated baseline levels as high as 90% were reduced to less than 15% by the final treatment visit. In addition, the procedure was effective in reducing overall heart rate and blood pressure reactivity to dental treatment. All children were rated by the involved dental professionals as more cooperative and relaxed following exposure to reinforced practice.
PRODUCING GENERALIZED JOB INITIATIVE IN SEVERELY MENTALLY RETARDED SHELTERED WORKERS
Authors: McCuller Glen L. , Salzberg Charles L. , Lignugaris/Kraft Benjamin
Published: March 2006

The development of generalized job initiative was examined with three severely retarded men working in an industrial assembly area of a sheltered workshop. Interventions included discrimination training, role‐play training, and self‐monitoring. For each participant, training was applied sequentially to three sets of job initiative behaviors. Intensive training was required to establish the first set of job initiative behaviors; however, the second and third sets of job initiative behaviors were learned with only discrimination training. The discussion summarizes the findings and suggests research needed to develop more powerful learning‐to‐learn paradigms.
SELF‐STIMULATORY BEHAVIOR AND PERCEPTUAL REINFORCEMENT
Authors: Lovaas Ivar , Newsom Crighton , Hickman Carol
Published: March 2006

Self‐stimulatory behavior is repetitive, stereotyped, functionally autonomous behavior seen in both normal and developmentally disabled populations, yet no satisfactory theory of its development and major characteristics has previously been offered. We present here a detailed hypothesis of the acquisition and maintenance of self‐stimulatory behavior, proposing that the behaviors are operant responses whose reinforcers are automatically produced interoceptive and exteroceptive perceptual consequences. The concept of perceptual stimuli and reinforcers, the durability of self‐stimulatory behaviors, the sensory extinction effect, the inverse relationship between self‐stimulatory and other behaviors, the blocking effect of self‐stimulatory behavior on new learning, and response substitution effects are discussed in terms of the hypothesis. Support for the hypothesis from the areas of sensory reinforcement and sensory deprivation is also reviewed. Limitations of major alternative theories are discussed, along with implications of the perceptual reinforcement hypothesis for the treatment of excessive self‐stimulatory behavior and for theoretical conceptualizations of functionally related normal and pathological behaviors.
TEACHING GENERALIZATION OF PURCHASING SKILLS ACROSS COMMUNITY SETTINGS TO AUTISTIC YOUTH USING VIDEOTAPE MODELING
Authors: Haring Thomas G. , Kennedy Craig H. , Adams Mary J. , Pitts‐Conway Valerie
Published: March 2006

Three young autistic adults were trained to purchase items. Training was conducted in one setting with concurrent generalization probes taken in three community stores. Training in one setting failed to produce generalization to the three probe settings. Generalization training, which consisted of viewing videotapes of models who purchased items in the probe settings and answering questions about the models' responses, was then introduced. Training with the videotapes resulted in generalization to the three community stores. Results of the use of videotapes as a cost‐effective means to program generalization in community training programs are discussed.
A COMPARISON OF TWO INTERVENTION ROLES: PEER MONITOR AND POINT EARNER
Authors: Stern George W. , Fowler Susan A. , Kohler Frank W.
Published: March 2006

Two fifth‐grade students' high levels of off‐task and disruptive behavior decreased rapidly during an intervention in which they were appointed peer monitors or point earners. The children worked in dyads in which one child served as a peer monitor and the other child earned points from his or her monitor for good behavior. Points were accumulated as part of a group contingency. We introduced the two appointments in an independent math period and alternated the appointments across days. The peer monitor and point earner roles, when alternated on an every‐other‐day basis, were equally effective in reducing the students' inappropriate behavior. Furthermore, their behavior during intervention fell well within the range of inappropriate behavior levels exhibited by classmates. The speed with which both students completed their math problems increased during both appointments. The accuracy of their academic work, however, varied; one student improved slightly and the other student decreased slightly in accuracy.
BEHAVIORAL MOMENTUM IN THE TREATMENT OF NONCOMPLIANCE
Authors: Mace F. Charles , Hock Michael L. , Lalli Joseph S. , West Barbara J. , Belfiore Phillip , Pinter Elizabeth , Brown D. Kirby
Published: March 2006

Behavioral momentum refers to the tendency for behavior to persist following a change in environmental conditions. The greater the rate of reinforcement, the greater the behavioral momentum. The intervention for noncompliance consisted of issuing a sequence of commands with which the subject was very likely to comply (i.e., high‐probability commands) immediately prior to issuing a low‐probability command. In each of five experiments, the high‐probability command sequence resulted in a “momentum” of compliant responding that persisted when a low‐probability request was issued. Results showed the antecedent high‐probability command sequence increased compliance and decreased compliance latency and task duration. “Momentum‐like” effects were shown to be distinct from experimenter attention and to depend on the contiguity between the high‐probability command sequence and the low‐probability command.
TEACHERS' INSTRUCTIONS AND CHILDREN'S COMPLIANCE IN PRESCHOOL CLASSROOMS: A DESCRIPTIVE ANALYSIS
Authors: Atwater Jane B. , Morris Edward K.
Published: March 2006

This study presents a methodology for collecting detailed naturalistic data on preschool teachers' instructions and children's compliance and a descriptive analysis of variables related to instruction rate and compliance probability. In preschools, teachers and children were observed across a variety of classroom activities. Kindergarten and first‐grade teachers also were observed to permit a comparison of instructional behavior between preschool and early elementary settings. Among teachers, instructions varied in frequency but displayed consistencies in form. For example, teachers more often phrased instructions as imperatives than as questions or declaratives and directed more instructions to individuals than to groups. Teachers' instructional behavior varied across preschool activities and between preschool and elementary grades. Children's compliance was related to the context of an instruction, but not to its form. In addition to providing information about naturally occurring instructional events, the results illustrate the effects of context on teacher and child behavior and suggest directions for future descriptive and experimental research.
PROMPTING ONE LOW‐FAT, HIGH‐FIBER SELECTION IN A FAST‐FOOD RESTAURANT
Authors: Wagner Jana L. , Winett Richard A.
Published: March 2006

Evidence increasingly links a high‐fat, low‐fiber diet to coronary heart disease and certain site cancers, indicating a need for large‐scale dietary change. Studies showing the effectiveness of particular procedures in specific settings are important at this point. The present study, using an A‐B‐A‐B design and sales data from computerized cash registers, replicated and extended previous work by showing that inexpensive prompts (i.e., signs and fliers) in a national fast‐food restaurant could increase the sales of salads, a low‐fat, high‐fiber menu selection. Suggestions also are made pertinent to more widespread use of the procedures.
RESPONSE REDUCTION THROUGH THE SUPERIMPOSITION OF CONTINUOUS REINFORCEMENT: A SYSTEMATIC REPLICATION
Authors: Wylie A. Michael , Grossmann J. A.
Published: March 2006

Prior clinical research suggests that superimposition and subsequent removal of a schedule of continuous reinforcement (CRF) may be a viable rate‐decreasing procedure in that an extinction‐like condition is arranged. The arrangement of similar conditions in the laboratory, however, resulted in the quick recovery of baseline rates. Lever‐pressing patterns of eight male rats maintained by different schedules of variable‐ratio and variable‐interval food reinforcement were examined in an A‐B‐A experimental design of CRF food superimposition and removal. Responding was substantially reduced during the superimposition of CRF. Upon removal of the superimposed schedule, responding quickly approached presuperimposition baseline rates.
EXPERIMENTAL EVALUATION OF PUBLIC POLICY: THE CASE OF STATE LEGISLATION FOR CHILD PASSENGER SAFETY
Authors: Seekins Tom , Fawcett Stephen B. , Cohen Stanley H. , Elder John P. , Jason Leonard A. , Schnelle John F. , Winett Richard A.
Published: March 2006

Observations of children in automobiles were made in seven states before and after implementation of legislation requiring use of child passenger safety devices. Increases in safe seating for children covered by state laws and children under 1 year old were observed in three of the five states implementing legislation during this study. Decreases in safe seating for these age groups were observed in two states, however. Increases in safe seating for children from 1 to 5 years old were observed in four of these five states. Although methodological limitations require cautious interpretation, these data suggest the impact child safety seat laws may have on compliance. Implications of this research for policies on child passenger safety and the importance of exploiting naturally occurring public experiments are discussed.
TEACHING SELF‐PROTECTION TO CHILDREN USING TELEVISION TECHNIQUES
Authors: Poche Cheryl , Yoder Paul , Miltenberger Raymond
Published: March 2006

This study compared the effectiveness of a videotape training program with other methods of teaching children self‐protection to prevent child abduction. Subjects were kindergarten and first‐grade students. Four experimental conditions were presented: videotape with behavior rehearsal, videotape only, a standard safety program, and no training. Acquisition of self‐protective behaviors was measured at posttraining and follow‐up by having confederate adults entice the children near their schools and homes. Results revealed that the videotape program with behavior rehearsal was highly effective in teaching children safe responses to potential abductors. The standard safety program was effective with fewer than half of the children. Three fourths of the children who received no training immediately agreed to go with the confederate suspects. The videotape program can be easily used with groups of young children in a classroom setting.
PROMOTING SAFETY BELT USE AMONG STATE EMPLOYEES: THE EFFECTS OF PROMPTING AND A STIMULUS‐CONTROL INTERVENTION
Authors: Rogers Richard W. , Rogers JoEllen S. , Bailey Jon S. , Runkle William , Moore Berne
Published: March 2006

This study assessed the effects of dashboard stickers and signature sheets on safety belt use among occupants of state‐owned vehicles in three Florida agencies. The stickers and signature sheets contained information regarding a regulation requiring safety belt use and a consequence of a 25% reduction in benefits for noncompliance if the driver were to become involved in an accident. Safety belt use significantly increased during the intervention phase in all three agencies and maintained variable but high levels for 5 months. In Agency 1 and Agency 2 (stickers plus signature sheets) safety belt use increased from averages of 10.8% and 9.4% during baseline to 57.4% and 47.0%, respectively, during intervention. In Agency 3 (stickers only) the rates of safety belt use averaged 9.7% during baseline and 38.0% during intervention. Some increases in private vehicle use were observed. A substantial reduction in workers' compensation claim costs was shown for the target agencies with some reductions also shown in the nontarget agencies.
THE BEHAVIORAL IMPACT OF AN ADVERTISING CAMPAIGN TO PROMOTE SAFETY BELT USE
Authors: Cope John G. , Moy Sheryl S. , Grossnickle William F.
Published: March 2006

Safety belt use was observed at one restaurant during McDonald's “Make It Click” promotional campaign. Following baseline, the program was monitored without intervention. During the final 2 weeks of the campaign an incentive strategy was added providing a large soft drink contingent on safety belt use. Safety belt use did not change from baseline levels before the incentive phase. The rate of belt use increased under contingent reward and declined during follow‐up. The effects of a verbal prompt could not be assessed because of the almost nonexistent use of the “Make It Click” stickers throughout the study.
EFFECTS OF ENVIRONMENTAL DESIGN AND POLICE ENFORCEMENT ON VIOLATIONS OF A HANDICAPPED PARKING ORDINANCE
Authors: de Balcazar Yolanda Suarez , Fawcett Stephen B. , Balcazar Fabricio E.
Published: March 2006

This study presents two experiments that evaluate strategies to reduce violations of a handicapped parking ordinance. The first experiment compared effects of upright versus ground handicapped parking signs on percentage of intervals in which cars were parked illegally. Introducing upright signs produced an immediate reduction in the percentage of intervals of inappropriate use of parking spaces. The second experiment examined effects of a police enforcement program on percentage of intervals of inappropriate use of parking spaces and frequency of inappropriately parked cars. Results showed consistent reductions in percentage of intervals of inappropriate use and number of inappropriately parked cars compared with a control site where no enforcement program was introduced. Implications of the research data for law enforcement and public policy are discussed. DESCRIPTORS: law enforcement, handicapped parking, environmental design
TRAINING YOUNG PARENTS TO IDENTIFY AND REPORT THEIR CHILDREN'S ILLNESSES
Authors: Delgado Laura E. , Lutzker John R.
Published: March 2006

We developed a comprehensive training program to teach young parents what symptoms to look for to judge the severity of their children's illnesses, what to do at home to comfort their children, and when to consult their children's physician or take them for emergency treatment. Three pairs of subjects received training that included written handouts, verbal instructions, modeling, positive practice, and verbal reinforcement. Skill acquisition was assessed by a behavioral test in which parents assessed, treated, or reported a simulated illness in a child. Written materials when used alone did not improve the parent's ability to identify and report children's illnesses. Modeling and role‐playing followed by positive practice were successful in teaching these parents skills that were maintained for 3 months without additional training or instruction.