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Utilizing probabilistic reinforcement to enhance participation in parent training
h [electronic resource] /
by Errity Jones.
[Tampa, Fla] :
b University of South Florida,
Title from PDF of title page.
Document formatted into pages; contains 66 pages.
(M.A.)--University of South Florida, 2011.
Includes bibliographical references.
Text (Electronic thesis) in PDF format.
ABSTRACT: Parental participation in parent training programs is necessary for success in behavioral parent training. Prior literature has demonstrated probabilistic reinforcement as an effective intervention for improving a wide variety of behaviors. In the present study, a probabilistic reinforcement program (i.e., lottery) was implemented in order to evaluate its efficacy as part of a behavioral parent training program. The behaviors targeted for increase included attendance, participation, homework completion, and performing role-plays or completing in-class assignments for two 10 week Tools for Positive Behavior Change courses. Participants earned lottery tickets for each of the dependent measures, and drawings took place at the end of each class. An alternating treatments design was employed to determine any differences in performance on the dependent measures between baseline and lottery sessions. Results showed that participants attended and participated more with parent training under the conditions of a lottery compared to baseline class sessions although the effect was minimal; furthermore, this effect was observed more clearly for one of the two classes. Further research is needed to explore the effect of a lottery intervention on parent participation in parent training programs.
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Crosland, Kimberly .
x Psychology, Behavioral
t USF Electronic Theses and Dissertations.
Utilizing Probabilistic Reinforcement to Enhance Participation in Parent Training by Errity S. Jones A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts Department of Child and Family Studies Colleg e of Behavioral and Community Sciences University of South Florida Major Professor: Kimberly Crosland Ph.D. Norin Dollard Ph.D. Rose Iovanonne Ph.D. Date of Approval: March 17 2011 Keywords: Parent training, probabilistic reinforcement, parent participation, foster care, behavioral training Copyright 2011 Errity S. Jones
Dedication I dedicate this manuscript to my life partner Ch arlie who motivated me, loved me, and sacrificed for me during this period of my life. I also dedicate this manuscript to my family who have supported me and led me to the path I am on today.
Acknowledgements I would like to thank my advisor, Dr. Kimberly Crosland, for her guidance and support through this experience. I would also like to acknowledge Dr. Norin Dollard and Dr. Rose Iovanonne for their input and feedback Lastly, I would like to thank my research assistants: Randi Robeson and Matt Bond.
i Table of Contents List of Tables ii List of Figures iii Abstract v Introduction 1 BPT Content 1 BPT Outcomes 2 BPT in Child Welfare 3 Behavior Analysis Services Program 4 Reinforcement and Parental Cooperation in Parent Training 5 Me thod 9 Participants 9 Setting and Materi als 9 Tools Training 10 Probabilistic Reinforcement Intervention 12 Target Behaviors and Data Collection 14 Inter Observer Agreement 16 Experimental Design 17 Social Validity 18 Results 19 22 Discussion 24 List of References 34 Appendices 40 Appendix A: Attendance and Participation Data Sheets 41 Appendix B: In Class Assignments 42 Appendi x C: Homework Assignments 45 Ap pendix D: Task Analyzed Tools 52 Appendix E : Social Validity Questionnaire 57
ii List of T ables Table 1. Inter Observer Agreement 17 Table 2 Average Performance per Participant Per Condition 2 3 Table 3. Average Performance for Cohort One and Cohort Two per Dependent Measure 2 4 Table 4. Individual Performance per Dependent Measure per Cohort 2 5
iii List of Figures Figure 1. Average Performance of Cohort One Participants 20 Figure 2 Average Performance of Cohort Two Participants 20 Figure 3. Average Performance of Cohort One Participants per Condition 21 Figure 4. Average Performance of Cohort Two Participants per Condition 21 Figure 5. Participant One Performance 2 6 Figure 6. Participant Two Performance 2 6 Figure 7. Participant Three Performa nce 2 7 Figure 8. Participant Four Performance 2 7 Figure 9. Participant Five Performance 2 8 Figure 10. Participant Six Performance 2 8
iv Abstract Parental participation in parent training programs is necessary for success in behavioral parent training. Prior literature has demonstrated probabilistic reinforcement as an effective intervention for improving a wide variety of behaviors. In the present study, a probabilistic reinforcement program (i.e. lottery) w as implemented in order to evaluate its efficacy as part of a behavioral parent training program. The behaviors targeted for increase include d attendance, participation, homework completion, and performing role plays or compl eting in class assi gnments for two 10 week Tools for Positive Behavior Change course s. Participants earn ed lo ttery tickets for each of the dependent measures, and drawings took place at the end of each class. An alternating treatments design was employed to determine any dif ferences in performance on the dependent measures between baseline and lottery sessions. Results show ed that participants attended and participated more with parent training under the conditions of a lottery compared to baseline class sessions although the effect was minimal; furthermore, this effect was observed more clearly for one of the two classe s. Further research is needed to explore the effect of a lottery intervention on parent participation in parent training programs.
1 Introduction Behavioral parent training (BPT) is a method for teaching parents skills in order to improve child behavior as well as parent child interactions. BPT is parent training that imparts knowledge and skills founded in behavioral principles and procedures to parents. Mos t behavioral parent training programs include the following common or core elements as described by Shaffer, Kotchick, Dorsey, and Forehand (2001): focusing on the parent; emphasizing prosocial behavior; teaching parents to define, identify, and record beh avior; instructing parents in behavioral principles; teaching new parenting skills through didactic instruction, modeling, role playing, and practicing at home; maximizing generalization from the clinic to the home; and, in some cases, introducing parental family, and community risks which may impede acquisition or maintenance of parenting skills and adaptive child behavior. BPT consisting of didactic instruction, modeling, rehearsal, and feedback is commonly referred to in the literature as behavioral ski lls training which has demonstrated efficacy in many studies across different skills and participants (Miltenberger, 2008). Further evidence in support of utilizing behavioral skills training to teach parenting skills comes from Hudson (1982) and Rickert (1988) in which their component analyses of BPT demonstrated that teaching behavioral principles alone (i.e., didactic instruction) was not sufficient for skill acquisition but that skills training, such as modeling and rehearsal, was essential to parental behavior change.
2 BPT Content Skills taught to parents include general behavioral principles and procedures such as providing or withholding reinforcement (Eyberg & Matarazzo, 1980; Forehand & King, 1977; O'Dell et al., 1982) as well as specific procedures relevant to the targeted behavior chosen by the parent or researcher (Brightman, Baker, Clark, & Ambrose, 1982; Hampson, Schulte, & Ricks, 1983; Hawkins, Peterson, Schweid, & Bijou, 1966) Some researchers have combined the two techniques: Pevsner (1983) provi ded training on general behavioral principles in addition to specific skills related to the target behavior of interest. In their comprehensive review of the BPT paradigm, Graziano and Diament (1992) reported that parents have been taught skills for a vari ety of different challenging behaviors including noncompliance (i.e., temper tantrums, aggressive behavior, and refusal to comply), hyperactivity, food related problem behaviors such as food refusal, and specific problem behaviors such as enuresis. Other u nique skills acquired in parent training include conducting discrete trials and negotiating conflict situations (Kifer, Lewis, Green, & Phillips, 1974; Lafasakis & Sturmey, 2007) Furthermore, parents have been taught to modify behaviors of typically developing children as well as those diagnosed with autism and/or other dev utility among diverse groups of people and problem behaviors (Graziano & Diament, BPT Outcomes Research in BPT indicates positive outcomes and successes with children of participating parents. In fact, BPT has been shown to be more effective than other types
3 of parent training programs or treatment (Bourke & Nielsen, 1995; Graziano & Diament, 1992; Lundahl, Nimer, & Parsons, 2006; Serketich & Dumas, 1996) Lundahl and colleagues (2006) found that parent training that included behavioral principles showed more positive changes in parental behavior than those programs that did not. Even more striking, parents in BPT was better adjusted after training than 81% of children who received children and parents that participated in BPT were better adjusted on all outcome measures including behavioral observation and parental and teacher reports for children and marital satisfaction, depression, stress and similar measures for parents than those families receiving no treatment or another form of treatment (Serketich & Dumas, 1996). BPT in Child Welfare Among some of the different populations of parents participating in BPT are those in the child welfare system. Both biological and foster parents have part icipated and successfully completed BPT (Berard & Smith, 2008; Hampson et al., 1983; Rose, 1974; Smagner & Sullivan, 2005; Van Camp et al., 2008a; Van Camp et al., 2008b) Similarly, parents identified as child abusers have participated in BPT with positive outcomes (Lundahl et al., 2006) When examining training programs for parents in the child welfare system, Berry (1988) found that biological parents received the most effective training (i.e., behavioral skills training) compared to foster and adoptive parents. Foster and adoptive parents were commonly trained via didactic instruction (i.e., lectures and discussion). For those foster parents trained in BPT, a number of positive results were associated with training including an ability to manage difficult child behavior and
4 increased retention rates in the child welfare system. In a review of parent training for child abusers, Lundahl et al. (2006) determined that incorporating a behavioral theoretical orientation into parent training programs improved outcomes substantially as significant gains were achieved after training in emotional adjustment, child rearing skills, documented abus e, and attitudes toward abuse. Behavior Analysis Services Program The Behavior Analysis Services Program (i.e., BASP) is one exemplar of a program that provided training with in the child welfare system (Stoutimore, Williams, Neff, & Foster, 2008) The BASP was introduced in 1996 to provide an array of services to children and families including the development and utilization of the Tool s for Positive Behavior Change curriculum for classroom and home based caregiver training, individual assessments and interventions for a child or family (e.g., birth, relative, foster care, therapeutic foster care), technical assistance such as consultati ons and on site support for out of home programs (e.g., shelters, group homes, residential treatment facilities), and special assignments including locating and stabilizing missing or runaway children (Stoutimore et al., 2008). Two different curricula wer e utilized for teaching caregivers positive parenting skills including the Tools for Positive Behavior Change and the Essential Tools for Positive Behavior Change ( Tools classes ). These classes were 30 hours and 15 hours, respectively, taking place for thr ee hours each week. Both Tools classes utilized a competency based behavioral skills training for teaching caregivers behavioral instruction, modeling, role playing, and feedback as well as homework assignments and
5 Tools curriculum has demonstrated improved performance in targeted skill s (Berard & Smith, 2008; Van Camp et al., 2008a; Van Camp et al., 2008b) Moreover, skills acquired have also maintained after training between trained parents and their children in the home (Van Camp, 2008b). The Tools curriculum has shown similar promising results with direct care staff a t group facilities for youth in foster care (Crosland et al., 2008a; Cr osland et al., 2008b) Reinforcement and Parental Cooperation in Parent Training Shaffer, Kotchick, Dorsey, and Forehand (2001) stated that success in parent training is dependent upon parental willingness to attend class and comply with treatment includ ing completing homework assignments, reading assigned materials, conducting behavioral observations at home, and practicing skills learned. Unfortunately, attrition and parental participation has been reported as a problem in the Tools for Positive Behavio r Change classes as well as other parent training programs (Forehand, 1983; Van Camp et al., 2008a). In a review of 22 studies, Forehand (1983) expressed that 28% of parents who participated in training dropped out before the completion of the program. In another large study including 247 parent training participants, 34% dropped out leaving 123 participants who completed the program (Van Camp et al., 2008a) Numbers might be larger if those that are referred to training but never make contact are considered Wolfe (1980) found that two thirds of parents referred for court ordered or voluntary parent training declined treatment As shown here, it is clear that there is a need for addressing parental attendance and participation in parent training programs.
6 Due to the concern for attrition and lack of participation in parent training, researchers have included deposits or incent ives for parents such as a lottery or salary contingent on predetermined behaviors (Muir & Milan, 1982; Pevsner, 1982; Rose, 1974; Smagner & Su llivan, 2005) Fleischman (1979) investigated the efficacy of a parental salary with families of lower socioeconomic status and/or single parent households by randomly assigning a salary to parents contingent on completing treatment assignments including observation, implementing a program with their children, and using time out. Of the four families that did not receive a salary in this study, none completed the program whereas all four of those who received salaries completed the program (Fleischman, 1979) In a preliminary correlational analysis of the use of incentives as part of the BASP Tools positive parenting program, Van Camp (200 4) noted similar effects: When a requirement to complete training was present or incentives were offered such as reimbursement for babysitting and/or a monetary stipend, some increases in attendance levels and some decreases in attrition levels were observ ed. However, this reinforcement systematically manipulate reinforcement and observe the effect on attendance and attrition. In order to understand the impact incentives such as a lottery may have on parental behavior in training, a causal analysis of the effect of parental incentives (i.e., reinforcement) on parental participation is essential. Probabilistic reinforcement (i.e., lottery) has been shown to be very effective i n improving behavior in several studies. Effects on behavior have been investigated in domains such as increasing recycling (Witmer & Geller, 1976), seatbelt use (Rudd & Geller, 1985), attendance at a treatment center ( Gravina, Wilder, White, & Fabian, 200 5),
7 participation at an elderly residential facility (Gallagher & Keenan, 2000), as well as in organizations for work attendance or performance ( Shoemaker & Reid, 1980; Brown & Redmon, 1989; Cook & Dixon, 2005). Lotteries have also been used in areas such as reducing disruptive behavior on school buses (Greene, Bailey, & Barber, 1981) and Martens, Ardoin, Hilt, Lannie, Panahon, & Wolfe, 2002; Muir & Milan, 1982). Particularly, Muir and Milan (1982) investigated the impact a p arental skills. A lottery was implemented for three families during which parents could acquire lottery tickets in order to win prizes such as restaurant menu items, applia nces, toys and their children. An ABAB reversal design showed that when a lottery was prese nt, condition in which a lottery was not in place. In fact, progress made by the children returned to baseline levels when the lottery was withdrawn. Seemingly, the rei nforcement provided to parents in the form of a lottery led to an increase in parental cooperation in language training with their children. Muir and Milan (1982) concluded that a lottery can be an efficacious way to enhance parental programming indicating that a lottery may be an effective intervention to enhance parental cooperation in group parent training. The purpose of this study wa s to extend the literature on parental reinforcement and its influence on parental attendance and participation in BPT. Specifically, the relationship between a probabilistic reinforcement program (i.e., a lottery) and parental
8 participation (including attendance and measures of class participation) was examined with caregivers in the foster care system
9 Method Participa nts The participants were six caregivers over the age of 18 in the child welfare system consisting of primarily biological, foster, and adoptive parents. Of the six participants, there were two biological parents, two foster parents, one adoptive parent, and one relative caregiver. There were two males and four females of which none had completed the training before. Two Tools for Positive Behavior Change classes were taught by a certified behavior analyst and offered by a local foster care/adoption agency A total of 14 students in both classes volunteered, were required, or were recommended to the Tools for Positive Behavior Change course per their treatment plan with the Department of Children and Families. All of the students in both classes participate d in the experimental conditions includin g the lottery; however, only the six participants of the fourteen students who were present for three baseline class sessions and three lottery class sessions were included in the present analysis. Setting and Mate rials The setting consisted of two classroom s provided by the local child welfare agency for teaching the Tools curriculum to a group of caregivers. The classroom contained chairs, a table or tables, and a projector used for presenting the classroom based curriculum. (Latham, 1994) on the first day of class which was used for reading at home and completing homework assignments. In addition, they were provided with a Tools for
10 Pos itive Behavior Change notes on the lecture material shown in class pertaining to the Tool targeted for acquisition that week. Tools Training The Tools for Positive Behavior Change curriculum is covered thoroughly in past research (see Stoutimore et al., 2008 and Van Camp, 2004) ; thus, only a brief overview is is task analyzed into multiple steps. The t ask analysis enables the trainer or co trainer to score the participant based on how many steps are performed accurately. This percentage is the score that is recorded for the pre and post assessments that take place on the first and last session of the c following steps: 1. Tell the child what behavior you liked, 2. Provide a consequence for the behavior that matches the value of the behavior, 3. Provide the positive consequence within three s econds of recognizing the appropriate behavior, 4. Use sincere and appropriate facial expression, tone of voice, and body language, 5. Avoid reacting to junk behavior, and 6. Avoid coercion and punishment. If a particip ant accurately performs all six of th e steps listed above, he or she will score 100%. The Tools are as follows: Stay Close (i.e., use non contingent reinforcement), Use Reinforcement, (i.e., reinforce desirable or appropriate behaviors), Pivot (i.e., extinguish undesirable or inappropriate behavior maintained by attention), Redirect Use Reinforcement (i.e., use differential reinforcement by providing reinforcement for desirable behavior and extinguishing undesirable behavior maintained by attention), Set Expectations (i.e., provide effective contingency management), Use Contracts, (i.e.,
11 provide written or contractual contingency management), and Time Out (i.e., use extinction for undesirable or inappropriate behavior). Although Time Out was included in the original curriculum, a Cool Down p rocedure was taught in place of this tool in the current research study at the discretion of the Tools trainer. Cool Down was t aught as a self management tool or coping skill for parents to model and teach to their children. The Tools are taught using a b ehavioral skills training (BST) procedure which consists of didactic instruction, modeling, rehearsal, and feedback (Miltenberger, 2008). In class, this occurred in the form of lecturing, modeling the Tool, providing the opportunity for rehearsal by role p laying, and supplying feedback to the caregivers. Specifically, in class role plays were conducted by the trainer or co trainer with the participants in which the trainer or co trainer played the role of the child and the participant played the role of the parent. Thus, the participant practiced the Tool with the trainer to ensure competency. In addition to role playing with the trainers, participants sometimes had the opportunity to role play with each other. Session o ne provided a course overview, a pret est skills assessment for each participant, and an introduction to the research study. The research study took place during sessions t wo through t en. Session t wo taught caregivers how to avoid coercion and punitive behavior management strategies. Sessions t hree through e ight consisted of the Tools for Positive Behavior Change including Stay Close ( s ession t hree), Use Reinforcement and Pivot ( s ession f our), Redirect Use Reinforcement ( s ession f ive), Set Expectations ( s ession s ix), Use a Contract ( s ession s e ven), and Cool Down ( s ession e ight). Session n ine taught caregivers how to conduct an antecedent behavior consequence assessment (ABC assessment). Session t en was used for the post training
12 skills assessment wherein the Stay Close tool was used for scoring the role play dependent measure as described in more detail below. Probabilistic Reinforcement Intervention Each class session met once per week for a period of 10 weeks for 3 hours each time. Data was collected in nine of these classes (sessions two thr ough ten as denoted above and classe s one through nine as denoted by the graph s ) In the beginning of class a discussion regarding practicing at home and assigned homework from the week prior was conducted. Afterward, the Tool(s) learned from the previous w eek was reviewed in the form of discussion between the trainer and participants. Following the review, the Tool for the current week was taught through a combination of lecture, modeling, and role playing as described above. Classes ended with participants filling out a feedback form. Announcements were made regarding the lottery either in the beginning or middle and/ or middle of class. A lthough the objective was to make these announcements in the beginning of class, a nnouncements were made in the middle of class rather than in the beginning of class on days when the trainer immediately began class without allowing time for the lottery announcement which may have been disruptive to the flow of class Announcements were also made in the middle of class in addition to the beginning of class on days when attendees arrived late so that they were informed of the conditio n for that class session. At the end of class,
13 with a document outlining the lo ttery schedule and how they could earn lottery tickets on the second day of class after consent forms were signed and returned. as Although the trainer provided ongoing verbal p ositive feedback for attendance and participation as she would typically do, tangible reinforcers were not delivered. Thus, no systematic reinforcement system was in pl ace for these sessions. During intervention sessions, reinforcement in the form of a lottery was utilized. Lottery tickets were handed out at the end of each class by the primary researcher for each target behavior. A total of five lottery tickets could be acquired by each individual each class session which corresponded to the following t argeted behaviors: attendance (worth two lottery tickets), homework completion (worth one lottery ticket), participation (worth one lottery ticket), and role pl aying or an in class assignment (worth one lottery ticket). Generally, class sessions required a role play to earn the fifth lottery ticket; however, in class assignments wer e used on class sessions two seven eight and nine rather than in class role plays because task analyzed role plays were not conducted during these classes. One lottery ticke t was chosen at random by drawing a winning lottery ticket at the end of each class session. Those participants who left early were not eligible to win a prize. The winner was provided with three possible prizes to choose from including gift certificates f or gas, groceries, and/or restaurant s worth 25 dollars. Winners were free to take the gift certificate immediately upon drawing their ticket at the end of each class session in which the lottery was in place
14 In addition to the contingencies for individu als, a group contingency was established such that if all members of the class attended, participated, completed homework, and completed in class assignments or role plays to criterion (i.e., 80% or above), two lottery winners were drawn as opposed to one. This was planned to occur for every class in which all members earned five lottery tickets; however, two winners were drawn only once which took place on the first lottery session for Cohort One. Target Behaviors and Data Collection The dependent variab le was a composite behavioral score reflecting parental attendance and participation. This composite score corresponded to the total number of lottery tickets earned on lottery session s or the total number of tickets earned on baseline sessions (baseline t ickets were assigned as points since tickets were n ot handed out to participants during baseline). During baseline sessions, participants were not informed of when they earned points; the composite behavioral score was calculated for purposes of data analy sis in order to compare performance in baseline to performance during the lottery intervention Tickets on lottery days and points on baseline days were earned for the following behaviors: attendance, homework completion, participation, and role playing or an in class assignment. Attendance was defined as arriving to class within 10 minutes of class beginning and staying within 10 minutes of class ending. For attendance, one lottery ticket was provided for arriving within 10 minutes of class starting while another point was earned for staying within 10 minutes of class ending. Attendance was scored using a 10 minute interval recording method wherein participants were marked as present or not (a yes/no measure) for the first and last 10 minutes of class ( see Appendix A). During lottery
15 sessions, participants were provided with two lottery tickets at the end of class for being present in both the first and last 10 minute intervals of class. Homework completion was defined as turning in the assigned homework i n the participant guide from the week prior with no questions left unanswered. Thus, homework was not considered complete if one or more blanks were present (see Appendix C) Homework was scored as completed or not (a yes/no measure) In session seven par ticipants were instructed to create a contract for homework completion rather than complete a worksheet in the participant guide Contracts were considered complete d homework assignments if they included at least two of the following dimensions: a target b ehavior, the consequence earned/not earned, a review time, and/or a start and end date. Sessions two and nine also differed from the other class sessions such that the consent form and social validity survey counted as homework for these sessions, respecti vely. During lottery sessions, participants were provided with one lottery ticket at the end of class for turning in a completed homework assignment. Participation was defined as contributing to group discussion in the form of a verbal statement or questi on or engaging in a demonstrative role play for the class. Participation was scored as occurred or not occurred (a yes/no measure), and participants were provided with one lottery ticket at the end of class for their contribution to class (see Appendix A) Role playing was defined as playing the role of the parent in a scenario presented by the trainer while the trainer or co trainer played the role of the child. Role playing was scored as a yes/no measure wherein participants earned a lottery ticket if th ey performed 80% or more of the task analyzed steps accurately (see Appendix D)
16 In class assignment was defined as completing the in class assignment worksheet during the time allotted in class leaving no questions left unanswered. Thus, the assignment w as not scored as complete if one or more blanks were present (see Appendix B) I n class assignments were worksheets provided to participants in their participant guide. However, during s ession seven and s ession eight instructions were provided for partici pants to complete their in class assignments as opposed to their completing a worksheet For s ession seven participants were asked to create a contract including short and long term expectations and short and long term consequences. The assignment was c onsidered complete if all parts of the contract were included. For s ession eight participants were asked to choose a location for Cool Down what beh aviors would prompt the use of Cool Down and the age of the child the caregiver planned to implement Cool Down with. The assignment was considered complete if the caregiver included at least one of these items. In class assignments were scored as completed or not (a yes/no measure), and participants were given one lottery ticket at the end of class for comple ting in class assignments. Interobserver agreement Interobserver agreement (IOA) was calculated by comparing the scores collected by two trained researchers on attendance, homework completion, role playing, and participation. Lottery tickets were earned on lottery collected for 66% of class sessions (six of the nine class sessions). For attendance and participation, a secondary observer was present in class to collect data on these behaviors. Similarly, a primary and secondary researcher scored independently while the role plays were conducted. For homework completion and in class assignments, the
17 permanent products were reviewed by a secondary researcher outside of cla ss. An IOA each of the dependent measures across the nine classes which was calculated by dividing agreements by agreements plus disagreements and multiplying by 100. The av erage IOA score across all participants was 95.35%. Table 1 outlines all of the IOA scores including all participants and dependent measures. The IOA scores for all six participants range from 89.59% and 100% on average Table 1 Interobserver Agreement Participant 1 Participant 2 Participant 3 Participant 4 Participant 5 Participant 6 Attendance 100% 91.67% 100% 100% 100% 87.5% Participation 100% 100% 100% 75% 100% 100% Homework 87.5% 100% 100% 100% 100% 100% In Class Assignments or Role Plays 1 00% 66.67% 80% 100% 100% 100% Overall IOA Score 96.88% 89.59% 95% 93.75% 100% 96.88% Experimental Design An alternating treatments design (ATD) was used to evaluate the impact of a probabilistic reinforcement program on parental cooperation (i.e., depe ndent measures) for two classes of caregivers learning the Tools for Positive Behavior Change (Hayes, Barlow, & Nelson Gray, 1999). A probabilistic reinforcement program (i.e., lottery) was
18 employed every other session for Cohort One starting with a lotte ry session. For Cohort Two the order was counterbalanced such that it began with a baseline session. Social Validity Participants responded to a survey reg ard ing the lottery on session nine that counted as their homework completion If the partici pant wa s absent on session nine the surv ey was completed on session ten (Appendix E )
19 Results Figure 1 shows the average composite behavioral score of Cohort One participants for all dependent measures for each class session Average behavioral scores in lotte ry sessions range d from 4.1 to 5 while scores in baseline sessions range d from 3 to 4.33. Figure 3 shows the average behavioral score per experimental condition across participants: 3.58 in baseline class sessions and 4.10 in lottery class sessions. Figu re 2 shows the average composite behavioral score of Cohort Two participants for all of the dependent variables for each class session Average behavioral scores for each dependent variable range d from 3.67 to 4.67 in lottery sessions and 2.5 to 5 in basel ine sessions. Figure 4 shows the average performance per experimental condition across participants: 4.00 during baseline and 4.21 during intervention. Table 2 describes the average performance per participant per condition. Scores observed during baseli ne range d from 2.00 to 4.75. Scores observed during intervention range d from 3.00 to 5.00. As seen in the table, average composite behavioral scores during the lottery were higher than those acquired during baseline sessions. With the exception of p articip ant f our, all six of the participants, on average, performed better during the lottery class sessions as compared to baseline class sessions.
20 Figure 1. Average Performance of Cohort One Participants. The average composite behavioral score acquired by Co hort One participants for attendance, participation, homework completion, and role plays. The squares represent the behavioral score/lottery tickets acquired during the lottery condition. The diamonds represent the behavioral score acquired during baseline or class as usual sessions. Figure 2. Average Performance of Cohort Two Participants. The average composite behavioral score acquired by Cohort Two participants for attendance, participation, homework completion, and role pla ys. The squares represent the behavioral score/lottery tickets acquired during the lottery condition. The diamonds represent the behavioral score acquired during baseline or class as usual sessions.
21 Figure 3. Average Performance of Cohort One Participan ts per Condition. The average composite behavioral score acquired by Cohort One participants across all dependent measures and class sessions. Figure 4. Average Performance of Cohort Two Participants per Condition. The average composite behavioral score acquired by Cohort Two participants across all dependent measures and class sessions.
22 Table 3 outlin es average performance for Cohort One and Cohort Two per dependent measure. Average attendance scores for both Tools classes r ange d from 1.40 to 1.84 during baseline classes. During lottery classes, attendance scores range d from 1.58 to 1.67. Participation scores fall between .74 and 1.00, on average, during baseline and .87 and .92, on average, during intervention. Average homew ork completion scores range d from .03 to .08 during baseline sessions and .53 and .75 during lottery sessions. On average, in class assignment and role play behavioral scores range between .42 and .60 during baseline and .58 and .73 in intervention. Tabl e 4 indicates the composite behavioral score earned by each participant for each dependent variable per class session. Participation was not included in the table as all participants with the exception of p articipant s ix participated in every class session except when absent thus earning their one point or lottery ticket for participation. Specifically, participant s ix did not participate during two class sessions when present. Individual data indicate similar results compared to group results as displayed in Figures 5 10. Cohort One participants included participants one, two, and three. Participant one appeared to perform better during lottery sessions compared to baseline sessions. Similarly, participants two and three seemed to acquire higher behavioral scores during lottery sessions although this effect is clearer f or the first four class classes Cohort Two participants included participants four, five, and six. Participants four and five performed similarly across conditions indicating no difference between baseline and lottery sessions. Conversely, participant six acquired higher composite behavioral scores during lottery sessions with the exception of the sixth class.
23 Table 2 Average performance per Participant per Condition Based on the answers provided on the social validity questionnaire, a ll cooperate in class. Overall, par ticipants had favorable a ttitudes regarding the lottery. Cohort One Base line Lottery Mean Difference Participant One 3.75 5.00 1.25 Participant Two 3.75 3.80 .05 Participant Three 3.25 4.50 1.25 Cohort Two Baseline Lottery Mean Difference Participant Four 4.75 4.25 .50 Participant Five 4.60 5.00 .40 Participant Six 2.00 3.00 1.00
24 Table 3 Average performance for Class One and Class Two per Dependent Measure Discussion Average baseline and lottery performance across participants and classes demonstrated that participants attended and cooperated more in parent training under the conditions of a lottery compared to baseline class sessions (see Figures 3 and 4) although the effect is minimal The positive effect of a lottery can be observed most clearly from Cohort formance. There are several potential reasons for the difference in performances between Cohort One and Cohort Two. Cohort One was a mixed class full of adoptive, foster, and biological male and female parents, some of which were required or recommended to take the class while some of them were there volunt arily. The participants in Cohort One interacted relatively infrequently compared to Cohort Two, and these participants discussed the lottery with each other and praised the winn er when their ticket was d rawn. Dependent Variables Class One Class Two Baseline Lottery Baseline Lottery Attendance 1.84 1.67 1.40 1.58 Participation 1 .87 .74 .92 Homework Completion .08 .53 .03 .75 In Class Assignments or Role Plays .42 .73 .60 .58
25 Table 4 Individual Performance per Dependent Measure per Class *Highlighted data are lottery sessions. AB indicates an absence from class. Class One Class Two Participants Class Session 1 2 3 4 5 6 Class One Attendance 2 2 2 2 2 AB Homework 1 1 1 1 1 AB In Class 1 1 1 1 1 AB Class Two Attendance 2 2 2 2 2 2 Homework 1 0 0 1 1 0 In Class 0 1 1 0 1 0 Class Three Attendance 2 2 2 2 2 1 Homework 1 1 1 1 1 0 In Class 1 1 1 1 1 0 Class Four Attendance 2 2 1 2 2 AB Homework 0 0 0 1 1 AB In Class 0 1 0 0 1 AB Class Five Attendance AB 1 AB 2 2 AB Homework AB 0 AB 1 1 AB In Class AB 0 AB 0 1 AB Class Six Attendance 2 2 2 1 2 1 Homework 0 0 0 1 1 0 In Class 0 0 0 1 1 0 Class Seven Attendance 2 2 2 2 2 1 Homework 1 0 0 1 1 0 In Cla ss 1 1 1 1 1 1 Class Eight Attendance 2 1 2 2 2 1 Homework 1 1 1 1 1 1 In Class 1 1 0 1 1 1 Class Nine Attendance 2 2 2 AB 2 1 Homework 1 0 0 AB 0 0 In Class 1 0 1 AB 1 0
26 Figure 5 Participant One Performance. The average composite behavioral score acquired by Participant One for all dependent measures The squares represent the behavioral sc ore/lottery tickets acquired during the lottery condition. The diamonds represent the behavioral score acquired during baseline or class as usual sessions. Figure 6 Participant Two Performance. The average composite behaviora l score acquired by Participant Two for all dependent measures The squares represent the behavioral score/lottery tickets acquired during the lottery condition. The diamonds represent the behavioral score acquired during baseline or class as usual session s.
27 Figure 7 Participant Three Performance. The average composite behavioral score acquired by Participant Three for all dependent measures The squares represent the behavioral score/lottery tickets acquired during the lotte ry condition. The diamonds represent the behavioral score acquired during baseline or class as usual sessions. Figure 8 Participant Four Performance. The average composite behavioral score acquired by Participant Four for all dependent measures The squares represent the behavioral score/lottery tickets acquired during the lottery condition. The diamonds represent the behavioral score acquired during baseline or class as usual sessions.
28 Figure 9 Participant Five Performance. The average composite behavioral score acquired by Participant Five for all dependent measures The squares represent the behavioral score/lottery tickets acquired during the lottery condition. The diamonds represent the beha vioral score acquired during baseline or class as usual sessions. Figure 10 Participant Six Performance. The average composite behavioral score acquired by Participant Six for all dependent measures The squares represent the behavioral score/lottery tickets acquired during the lottery condition. The diamonds represent the behavioral score acquired during baseline or class as usual sessions.
29 Cohort Two consisted of all females the majority of which were taking the class volu ntarily (i.e., actively seeking new parenting skills as stated in their social validity surveys). Cohort Two was h eld in a smaller room than Cohort One contributing to a more inviting and intimate atmos phere. The participants in Cohort Two tended to arrive early and engage in discussion amongst themselves and with the trainer although little discussion occurred regarding the lottery itself. In Cohort Two, it is possible that the influence of social positive reinforcement in the form of social interaction an d camaraderie played a larger role in motivating the parents to engage in the targeted behaviors across conditions such that a minimal difference between baseline and lottery class sessions was observed. T his may have differed from Cohort One wherein the l ottery intervention may have had more of an influence on the targeted behaviors than the social positive reinforcement from peers. With the exception of classes five and nine composite behavioral scores under the conditions of a lottery were much higher than under the baseline conditions for Cohort One. The particular environmental variables present during these particular classes should assist the reader in underst anding this variability. Class n ine was the final class and it is believed that an abolishing operation was present for participants such that most of the students would earn their certificate of completion for training regardless of attending the last day wherein only the post assessments took place. Class f ive took place two weeks af ter class f our due to an extended holiday break (Thanksgiving holiday) Only three of seven students attended class, one of which was a participant in this study; the remaining participants in the current study were absent from class. In addition, all thre e students performed poorly during this class session.
30 Participant t wo was the sole participant present on this particular class session, and he showed up late to class (earning only one lottery ticket for attendance), and he did not earn a ticket for home work completion nor his in class assignment. Class f believed to have taken place due to extraneous variab les taking place outside of class that were not under the control of the primary researcher. These extraneous variables may have inclu de d forgetting about attending class, forgetting to complete homework, and/or losing motivation to come to class after a long break. It is important to note that lottery scores would be higher than the scores listed (see Table 3) if class f ive data were no t included in the analysis. Table 3 shows t he average performance for Cohort One per dependent mea sure. Upon removal of data for class f ive, average lottery scores for attendance, participation, homework completion, and in class assignments/role plays woul d be 2, 1, .67, and .92, respectively. Comparing these scores to their baseline counterparts of 1.84, 1, .08, and .42, it is clear that a potential effect is observed for attendance, homework completion, and in class assignments/role plays if c lass f ive data are not considered in the analysis. It appears that the lottery had the most influence on two of the four dependent variables: homework completion and in class assignments/role plays (see Table 3). Future research is needed to conclusively determine whether homework completion and in class assignments/role plays can be influenced with a lottery intervention. However, it may be useful for researchers to implement a lottery intervention for homework completion and in class assignments/role playing alone as these behaviors appear to be most influenced by a lottery in the current study.
31 Although the present study does not provide a convincing demonstration of the efficacy of a lottery intervention in parent training, it is evident that all of the participa nts enjoyed the lottery based on their answers to the social validity questionnaire. Most of the participants indicated they liked the lottery and believed it motivated them to engage in the target responses. In addition, most of the participants would hav e preferred to have a drawing every class session. However, w hen asked if they would have preferred to have a lottery every class session. I t is not clear why these participants did not prefer to have a lottery session each class based on the data collected. Only one participant disagreed that the lottery motivate d him to participate in class Perhaps he was motivated by other individual variables as he considered himself a participant two verbally expressed his disappointment regarding his not winning a lottery prize over the duration of the study. Overall, based on the results of the social validity questionnaire, a lottery intervention appears to be a worthwhile intervent ion that participants like and find motivating. Several limitations exist in the present study that should be accounted for in future research. First, the operational definitions of the target behaviors may have influenced whether an effect was observed fo r the lottery or not. For example, participants earned one point in baseline sessions or one lottery ticket in lottery sessions for participation as defined as contributing to group discussion in the form of a verbal statement or question or engaging in a demonstrative role play for the class. As a result, participants only had to contribute once to earn their point or lottery tickets. However, a lottery intervention may have more of an influence on participation if participation was defined differently, po ssibly requiring several instances of participation in order to earn a lottery ticket. It is
32 possible that the lotter y intervention had more influence on homework completion and in class assignments/role plays compared to the other dependent measures since these behaviors required more response effort A second limitation concerns the lottery rules and expectations. In the present investigation, students could earn a lottery ticket for each of the behaviors independently; subsequently, students could win th e lottery prize for having only attended, for example, without engaging in any other target response. Thus, an abolishing operation could potentially influence student behavior such that motivation to engage in all or some of the behaviors would decrease s ince students could win the lottery prize by earning only one ticket (or two tickets for attendance) for one behavior. Considering the influences on choice as outlined by Miltenberger (2008), it is apparent that students will most likely choose the route o f less response effort in order to earn the same reinforcer. Although all lottery winners in this study earned three or more lottery tickets, if researchers or trainers are interested in seeing a higher percentage of all of the target behaviors during lott ery sessions (as opposed to homework completion and in class assignments alone), it may be beneficial to require participants to engage in all or some of the behaviors in order to earn a lottery ticket. F uture research might require participants to earn al l five lottery tickets corresponding to the dependent measures targeted in the current study or engage in more than one target response to be eligible for the drawing so that a stronger contingency exists between engaging in all or some of the targeted beh aviors and earning an opportunity to win the lottery. A third limitation in the present investigation is the possibility of multiple treatment interference. Among behavior analytic researchers, it is well known that
33 multiple treatment interference includi ng sequential confounding, carryover effects, and the alternation effect may threaten internal validity when employing an alternating treatments design (Hayes, Barlow, & Nelson Gray, 1999). In order to control for this, it is best to ensure that participan ts are fully aware of the lottery schedule. In the current study, the lottery system was explained thoroughly on the first day of class and reminders were given during each class. However, it is recommend ed that future studies consider testing participant s on their knowledge of the lottery expectations and the lottery schedule P articipants could be tested once after they are informed of the lottery schedule and expectations or in the beginning of each class session so that a measure of treatment integrit y is available for analysis. Another limitation includes the small sample size and the diversity among both classes. The present study included two biological parents, two foster parents, one adoptive parent, and one relative caregiver Individual differe nces in performance motivation to attend and participate in class. Although this sample size was too small to determine differences in performance between types of parents or caregivers, it may be empirically worthwhile to investigate whether a lottery influences only certain types of parents. In conclusion, the present study demonstrated that a lottery may have a positive effect on parental behaviors such as attendance, p articipation, homework completion, and in class assignments/role plays. Due to the variab ility present in the data, the present study suggests that the current investigation be replicated for further exploration of a r in parent training
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41 Appendix A: Attendance and Participation Data Sheets Attendance 1 2 3 4 5 6 6:00 6:10 Y N Y N Y N Y N Y N Y N 8:50 9:00 Y N Y N Y N Y N Y N Y N Participants Participation
42 Appendix B: In Class Assignments
45 Appendix C: Homework Assignments
52 Appendix D : Task Analyzed Tools
53 Use Reinforc ement Tool Checklist Participant Name: _________________________________________________________ _____ Behavior Analyst: ________________________________________Date: ________________ Step Yes No N/A Comments 1. Tell the child what behavior you liked (if this is appropriate). 2. Provide a consequence for (Circle those provided): the behavior that matches Social Interaction the value of the behavior. Verbal praise Appropriate touch Tangible item Privil ege Break from task 3. Provide the positive consequence within 3 seconds of recognizing the appropriate behavior (if possible). 4. Use sincere and appropriate facial expression, tone of voice and body languag e. 5. Avoid reacting to junk behavior. 6. Avoid coercion & punishment. 1 The Stay Close components must be used within 3 seconds of the caregiver responding to the appropriate behavior. If used after 3 seconds or not at all, score language after the first 3 seconds. If the observation is a competency check off, caregiver should tell you how they would make sure the consequence is reinforcing without prompting. Overall Comments: (Circle any oercive used: sarcasm/teasing; criticism; threats; arguing; questioning; logic; despair, pleading, hopelessness; force; taking away privileges/items/allowance; one up m an ship; silent treatment; telling on them to others. Be specific.)
54 Pivot Tool Checklist Participant Name: _______________________________________________________________________ Behavior Analyst: ______________________________________________Date: __________________ Step Yes No N/A Comments 1. Say nothing about the junk 1 2. Do nothing to react to the junk behavior (for example: of the room, cross your arms, stare.) 2 3. Actively attend to another child, person, or activity. (For example: Read a book or praise another child for behaving appropriately.) 4. Once the child who displayed junk behavior behaves appropriately, provide rei nforcement for the appropriate behavior (social interaction, praise, touch, item, and privilege, break from task) within 10 seconds of recognizing the appropriate behavior of this child. 5. Stay cool. No C oercive. 1,2 However, if the caregiver realizes they have responded to the junk behavior and stops the response, note this in the Comments column and reinforce the acknowl edgment and correction. Overall Comments: (Circle any oercive used: sarcasm/teasing; criticism; threats; arguing; questioning; logic; despair, pleading, hopelessness; force; taking away privileges/items/allowance; one up man ship; silent treatment; tellin g on them to others. Be specific.)
56 Set Expectations Tool Checklist Participant Name: _______________________________________________________________________ Behavior Analyst: ___________________________________ ___________Date: ________ Step Yes No N/A Comments Part I. Set the Expectations Set the stage 1 1. Time (away from the behavior) 2. Place (uninterrupted) 3. Set positive tone 4. State the expectation clearly and specifically (when, where, what, how). 5. Briefly reflect the chil feelings (empathy), if necessary (for example, 2 6. Briefly explain the benefits of this expectation, only if the child asks. 3 Part II: Set the Consequences 7. State clearly the consequences for meeting and not meet ing the expectation. 8. Negotiate as necessary. 4 9. Ask the child to restate the behavior and the consequences. 10. Acknowledge and restatement. 11. Avoid reacting to junk behavior of the child, if necessary. 12. Stay cool throughout the process (no c oercive) 1 Ask participant to describe when, where, and how setting expectations is occurring (i.e., time, place, tone). 2 An empathy statement is only necessary if the child is upset with the expectation. 3 If the child does not ask, h ave the caregiver explain to you the benefits. Score yes if the reason for 4 Score No: If the child gave the caregiver an opportunity to negotiate, score does the child off until later. Score Yes: If the caregiver negotiates when asked and gives a different consequence t han on the original plan OR if the caregiver negotiates without a definite consequence (e.g., Score N/A: If the child did not give the caregiver an opportunity Overall Comments: (Were any oercive used: sarcasm/teasing; criticism; threats; arguing; questioning; logic; despair, pleading, hopelessness; force; taking away p rivileges/items/allowance; one up man ship silent treatment; telling on them to others? Be specific.)
57 Appendix E : Social Validity Questionnaire 1. Did you like the lottery? Strongly Agree Agree Disagree Strongly Disagree 2. Would you prefer to have ha d a lottery for every class session? Strongly Agree Agree Disagree Strongly Disagree 3. Do you believe the lottery motivated you to attend class, participate, complete homework, perform role plays, and/or complete in class assignments? Strongly Agree Agree Disagree Strongly Disagree 4. Is there anything about the lottery you did not like? Strongly Agree Agree Disagree Strongly Disagree 5. Would you consider yourself a highly motivated parent or caregiver including being highly involved in cla ss and activities, practicing the Tools every week at home, and having a strong desire to improve upon current parenting skills?
58 Strongly Agree Agree Disagree Strongly Disagree 6. Please circle the descriptor that suits you best: Adoptive parent(s) F oster parent(s ) Biological Parent(s) 7. Please circle the descriptor that suits you best: Voluntarily completing the Tools class Required to complete the Tools class 8. How were you referred to this class? Please circle as many as appropriate: Requi red by case plan Recommended by case plan Hoping to adopt/foster In order to adopt/foster Actively seeking new parenting skills For my job 9. Please place a checkmark or an X next to the descriptor(s) that suits you best. You may choose more than one:
59 10. Please estimate your annual income: $10,000 20,000 $20,000 30,000 $30,000 40,000 $40,000 50,000 $60,000 70,000 $70,000 80,000 $80,000 90,000 $90,000 + 11. Please share any further comments you may have regarding the lottery: