Handbook of Child Behavior Therapy

Issues in Clinical Child Psychology

Series Editors: Michael C. Roberts, University of Kansas-Lawrence, Kansas Lizette Peterson, University of Missouri-Columbia, Missouri

BEHAVIORAL ASPECTS OF PEDIATRIC BURNS Edited by Kenneth J. Tarnowski

CHILDREN AND DISASTERS Edited by Conway F. Saylor

CONSULTING WITH PEDIATRICIANS: Psychological Perspectives Dennis Drotar

HANDBOOK OF ADOLESCENT HEALTH RISK BEHAVIOR Edited by Ralph J. DiClemente, William B. Hansen, and Lynn E. Ponton

HANDBOOK OF CHILD ABUSE RESEARCH AND TREATMENT Edited by John R. Lutzker, Ph.D.

HANDBOOK OF CHILD BEHAVIOR THERAPY Edited by T. Steuart Watson and Frank M. Gresham

HANDBOOK OF CHILDREN'S COPING: Linking Theory and Intervention Edited by Sharlene A. Wolchik and Irwin N. Sandler

HANDBOOK OF DEPRESSION IN CHILDREN AND ADOLESCENTS Edited by William M. Reynolds and Hugh F. Johnston

INTERNATIONAL HANDBOOK OF PHOBIC AND ANXIETY DISORDERS IN CHILDREN AND ADOLESCENTS Edited by Thomas H. Ollendick, Neville J. King, and William Yule

MENTAL HEALTH INTERVENTIONS WITH PRESCHOOL CHILDREN Robert D. Lyman and Toni L. Hembree-Kigin

SCHOOL CONSULTATION: Conceptual and Empirical Bases of Practice William P. Erchul and Brian K. Martens

SUCCESSFUL PREVENTION PROGRAMS FOR CHILDREN AND ADOLESCENTS Joseph A. Durlak

A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact the publisher.

Handbook of Child Behavior Therapy

Edited by

T. Steuart Watson Mississippi State University Starkville, Mississippi

and

Frank M. Gresham University of California, Riverside Riverside, California

Springer Science+Business Media, LLC

Llbrary of Congress Cataloglng-ln-Publlcatlon Data

Handbook of child behavlor therapy / edlted by T. Steuart ~atson and Frank M. Gresham.

p. cm. -- <Issues In cllnical chi ld psychology) Includes blbliographical references and index. ISBN 978-1-4613-7429-9 ISBN 978-1-4615-5323-6 (eBook) DOI 10.1007/978-1-4615-5323-6 1. Sehavior therapy for children. 1. ~atson, T, Steuart.

II. Gresham, Frank M. III. Series. RJ505.S4H346 1997 61S:92'S9142--dc21 97-40442

ISBN 978-1-4613-7429-9

© 1998 Springer Science+Business Media New York Originally published by Plenum Press in 1998 Softcover reprint of the hardcover 1 st edition 1998

AlI rights reserved

CIP

No part of this book may be reproduced, stored in a retrieval system. or transmitted in any form or by any means. electronic. mechanical. photocopying. microfilming. recording. or otherwise. without written permission from the Publisher

To Dorothy, for her unwavering strength and support, and to Mackenzie, Tucker, and Addison, who put life events into proper perspective and who

make it all worthwhile

-T.S.W.

To my son Matt, whose attitude toward life and will to survive stands as a model of inspiration to me and his mother, Laura

-F.M.G.

Contributors

Keith D. Allen • Division of Pediatric Psychol­ogy, Munroe-Meyer Institute for Genetics and Re­habilitation, and University of Nebraska Medical Center, Omaha, Nebraska 68198-5450

Robert T. Ammerman • Allegheny General Hospital, Department of Psychiatry, MCP. Hahne­mann School of Medicine, Allegheny University of the Health Sciences, Pittsburgh, Pennsylvania 15212

Phillip J. Belfiore • Education Division, Mercy­hurst College, Erie, Pennsylvania 16546

Brad Donohue • Center for Psychological Studies, Nova Southeastern University, Fort Laud­erdale, Florida 33314

George J. DuPaul • School Psychology Pro­gram, Lehigh University, Bethlehem, Pennsylvania 18015-4793

V. Mark Durand • Department of Psychology, University at Albany, State University of New York, Albany, New York 12222

Patrick C. Friman • Father Flanagan's Boys' Home, Boys Town, Nebraska 68010; and Creighton University School of Medicine, Omaha, Nebraska 68178-0001

Peter Gernert-Dott • Department of Psychol­ogy, University at Albany, State University of New York, Albany, New York 12222

Frank M. Gresham • School of Education, Uni­versity of California-Riverside, Riverside, California 92521-0102

Kathryn E. Hoff • School Psychology Pro­gram, Lehigh University, Bethlehem, Pennsylvania 18015-4793

Jeffrey M. Hutchinson • Education Division, Mercyhurst College, Erie, Pennsylvania 16546

Kevin M.Jones • Father Flanagan's Boys'Home, Boys Town, Nebraska 68010

Christopher A. Kearney • Department of Psy­chology, University of Nevada-Las Vegas, Las Vegas, Nevada 89154-5030

Katina M. Lambros • School of Education, University of California-Riverside, Riverside, Cali­fornia 92521-0102

Jeff Laurent • Department of Psychology, Illi­nois State University, Normal, Illinois 61790-4620

Thomas R. Linscheid • Division of Psychol­ogy/Pediatrics, Children's Hospital/The Ohio State University, Columbus, Ohio 43205

Amy B. Mace • School Psychology Program, Lehigh University, Bethlehem, Pennsylvania 18015-3094

F. Charles Mace • The University of Pennsyl­vania and Children's Seashore House, Philadelphia, Pennsylvania 19104

Eileen Mapstone • Department of Psychology, University at Albany, State University of New York, Albany, New York 12222

Judith R. Matthews • Division of Pediatric Psychology, Munroe-Meyer Institute for Genetics and Rehabilitation, and University of Nebraska Medical Center, Omaha, Nebraska 68198-5450

Joan Mayfield • Division of Pediatric Psychol­ogy, Munroe-Meyer Institute for Genetics and Re­habilitation, and University of Nebraska Medical Center, Omaha, Nebraska 68198-5450

vii

viii CONTRIBUTORS

Janice McAllister • Division of Pediatric Neu­rology, University of Nebraska Medical Center, Omaha, Nebraska 68198-2165

Colleen M. McMahon • School of Education, University of California-Riverside, Riverside, Cali­fornia 92521-0102

Raymond G. Miltenberger • Department of Psychology, North Dakota State University, Fargo, North Dakota 58105

Jodi Mindell • Department of Psychology, St. Joseph's University, Philadelphia, Pennsylvania 19131-1395

George H. Noell • Department of Psychology, Louisiana State University, Baton Rouge, Louisiana 70803-5501

Lizette Peterson • Department of Psychology, University of Missouri -Columbia, Columbia, Mis­souri 65211

Kirsten I. Potter • Department of Psychology, Illinois State University, Normal, Illinois 61790-4620

Patrick R. Progar • The University ofPennsyl­vania and Children's Seashore House, Philadelphia, Pennsylvania 19104

Sheri L. Robinson • School Psychology Pro­gram, Mississippi State University, Mississippi State, Mississippi 39762

Lisa Saldana • Department of Psychology, Uni­versity of Missouri-Columbia, Columbia, Missouri 65211

Mark D. Shriver • Division of Pediatric Psy­chology, Munroe-Meyer Institute for Genetics and Rehabilitation, and University of Nebraska Medical Center, Omaha, Nebraska 68198-5450

Christopher H. Skinner • School Psychology Program, Mississippi State University, Mississippi State, Mississippi 39762

Jeffrey Sprague • College of Education, Uni­versity of Oregon, Eugene, Oregon 97403

Heather Elise Sterling • School Psychology

Program, Mississippi State University, Mississippi State, Mississippi 39762

George Sugai • College of Education, Univer­sity of Oregon, Eugene, Oregon 97403

Judith A. Sylva • School of Education, Univer­sity of California-Riverside, Riverside, California 92521-0102

Cheryl A. Tillotson • Department of Psychol­ogy, University of Nevada-Las Vegas, Las Vegas, Nevada 89154-5030

Timothy R. Vollmer • The University of Penn­sylvania and Children's Seashore House, Philadel­phia, Pennsylvania 19104

Hill Walker • College of Education, University of Oregon, Eugene, Oregon 97403

William J. Warzak • Department of Psychol­ogy, Munroe-Meyer Institute for Genetics and ~e­habilitation, and University of Nebraska Medlcal Center, Omaha, Nebraska 68198-5450

T. Steuart Watson • School Psychology Pro­gram, Mississippi State University, Mississippi State, Mississippi 39762

Donald A. Williamson • Department of Psy­chology, Louisiana State University, Baton Rouge, Louisiana 70803-3103

Joseph C. Witt • Department of Psychology, Louisiana State University, Baton Rouge, Louisiana 70803-5501

Leslie G. Womble • Department of Psychology, Louisiana State University, Baton Rouge, Louisiana 70803-3103

Douglas W. Woods • Department of Psychol­ogy, Western Michigan University, Kalamazoo, Michigan 49008

Kathleen Zelis • Center for Psychological Studies, Nova Southeastern University, Fort Laud­erdale, Florida 33314

Nancy L. Zucker • Department of Psychology, Louisiana State University, Baton Rouge, Louisiana 70803-3103

Preface

The genesis of this book occurred several years ago in Seattle on the veranda of a Chilean cafe overlook­ing Pikes Place Market during a National Associa­tion of School Psychologists conference. We were discussing, along with several other behavioral school psychologists, how the field of child behavior analysis and therapy has experienced rapid growth over the past forty years, but lamenting that books in the area did not reflect the advancements made in the assessment and treatment of a wide variety of prob­lem behaviors evidenced by children. That is not to say that there are no good books available to the child behavior therapist. In fact, most readers of this book undoubtedly have bookshelves lined with noteworthy volumes on this very topic. What was missing, in our opinion, was a book reflecting the relationship be­tween assessment and treatment, more specifically functional assessment/analysis, and describing the process a clinician uses when treating a particular be­havior problem.

Without diminishing the contributions of the many excellent books on child behavior therapy currently available, it seems that most have fol­lowed a formula or "cookbook" approach. That is, the authors give a brief introduction to the topic, discuss possible etiologies and contributing factors, and then review the assessment and treatment liter­ature on that topic. Although there is nothing patently wrong with this approach, it seems to com­municate the wrong message to the reader; namely that the function of a behavior is less important than knowing what treatment to implement. We believe that effective treatment arises from a process: iden­tifying the problem behavior, discerning the func­tion of a behavior, formulating an intervention, and evaluating that intervention. In essence, effective intervention is more than just knowing what has worked in the past. Thus, the aim of this book is to

provide readers with not only the "what to do" of child behavior therapy, but the "how to do it" as well. Each of the chapters guides the reader through the clinical decision-making process, from identify­ing a problem to evaluating the effectiveness of a chosen intervention.

One of the difficulties in assembling an edited book is ensuring a high degree of continuity and similarity between chapters, without infringing on the individual writing style of the authors. This book is certainly no exception. To help with conti­nuity, we provided the authors with an outline to use as a guide as they prepared their manuscripts. The operative word here is "guide." Authors were free to alter the outline but not so dramatically as to violate the basic premise of the book. For example, preven­tion of injuries is an extremely important social concern for anyone involved in the care and treat­ment of children. It is not, however, a traditional area where a behavior therapist would intervene in a clinical setting. Therefore, the outline we provided did not readily accommodate the information on this topic. It was then up to the chapter authors (Sal­dana and Peterson, in this case) to modify the head­ings as necessary while maintaining as much integrity as possible with the original intent of the book. Thus, in comparing the structure of the chap­ters, the reader will notice that authors have taken a degree of liberty in describing the assessment and treatment process and in deciding what information goes under each major heading.

Many radical behaviorists or applied behavior analysts who read a couple of the chapters in this book will undoubtedly be offended by the occa­sional use of the "c" word: cognitive. Those who will be offended are reminded to say "intraverbal behavior" every time they read "cognitive" to re­duce the unpleasantness associated with this word.

ix

x PREFACE

At first, we were tempted to inform authors to ei­ther avoid "cognitive" or recast the information in behavioral terms. We resisted this impulse for sev­eral reasons: (1) as long as the information is em­pirical, it should not be summarily discarded; (2) it does not harm behavior analysts to read chapters from a less than radical behavioral perspective so that they may learn what is happening outside their field; and (3) it allows the behavior analyst to rein­terpret what the authors have written, thus strength­ening their verbal repertoire regarding behavior analysis.

The organization of a book is important for many reasons, the primary reason being that it pro­vides a conceptual context that communicates to the reader what the authors/editors deem important. The organization of this book attempts to commun­icate the notion of the importance of ecological considerations in the identification, assessment, treatment, and evaluation of child behavior prob­lems. Thus, we grouped problem behaviors into the settings where the problem is usually manifested! identified, assessed, treated, and evaluated, all the while realizing that such clear distinctions do not often exist. We also included a "Foundations" sec­tion that provides basic information in important adjunctive areas of child behavior therapy: behav­ioral assessment, single subject research designs, and behavioral consultation. Without a working knowledge of the information within each of these adjunctive areas, the behavior therapist is little more than a technician implementing a prescribed treat­ment protocol.

The two overriding themes of this book are functional assessment/analysis and behavioral con­sultation. We stress functional assessment in addi­tion to experimental functional analysis with the acknowledgment that practitioners will use the for­mer most of the time as opposed to the latter. Func­tional assessment/analysis provides a methodology

by which to identify the variables that are related to a specific problem so that the likelihood of treat­ment effectiveness is greatly enhanced. Behavioral consultation is a process that one uses when work­ing with parents, teachers, or other behavior change agents to deliver psychological services, including functional analysis. We hope that by presenting as­sessment and treatment from a behavioral consulta­tion perspective, where functional analysis is the primary methodology for designing interventions, both experienced and novice behavior therapists will learn new skills and approaches for a wide ar­ray of child problems.

Completing a book requires inordinate amounts of time, energy, and assistance and credit to many individuals. Our foremost appreciation is extended to the chapter authors who delivered manuscripts that exceeded our expectations in terms of quality and innovativeness. Our editor, Mariclaire Cloutier, first approved the prospectus and saw the potential in a book espousing a different method and ap­proach for treating child behavior problems. Mari­claire dispensed valuable advice to a relative novice (TSW) and was also extremely patient and consid­erate when intervening circumstances made com­pletion of this book difficult. Lizette Peterson and Michael Roberts, co-editors of Plenum's Issues in Clinical Child Psychology series, helped to orga­nize and shape the content into a meaningful and coherent text for the reader. We sincerely thank our behavioral colleagues in school psychology, pedi­atric psychology, and child-clinical psychology for their support of this idea and for their many sugges­tions. Finally, we thank our families for their en­during support and encouragement, not only for completing the project, but for making it easier for us to produce a quality book.

T. Steuart Watson Frank M. Gresham

Contents

I. Foundations of Child Behavior Therapy ............ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

1. Behavioral and Functional Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 FRANK M. GRESHAM AND KATINA M. LAMBROS

2. Designs for Evaluating Behavior Change: Conceptual Principles of Single Case Methodology ........................................................ 23 FRANK M. GRESHAM

3. Toward a Behavior Analytic Approach to Consultation ................................. 41 GEORGE H. NOELL AND JOSEPH C. WITI'

II. School-Based Problems ......................................................... 59

4. Preventing Academic Skills Deficits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 CHRISTOPHER H. SKINNER

5. Enhancing Academic Achievement through Related Routines: A Functional Approach ....... 83 PHILLIP J. BELFIORE AND JEFFREY M. HUTCHINSON

6. Attention/Concentration Problems ................................................. 99 GEORGE J. DUPAUL AND KATHRYN E. HOFF

7. Speech Disfluencies ............................................................. 127 RAYMOND G. MILTENBERGER AND DOUGLAS W WOODS

8. School Attendance .............................................................. 143 CHRISTOPHER A. KEARNEY AND CHERYL A. TILLOTSON

III. Home-Based Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163

9. Teaching Parenting Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 MARK D. SHRIVER

10. Child Physical Abuse and Neglect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183 BRAD DONOHUE, ROBERT T. AMMERMAN, AND KATHLEEN ZELIS

xi

xii CONTENTS

11. Sleep Problems ................................ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 203 V. MARK DURAND, JODI MINDELL, EILEEN MAPSTONE, AND PETER GERNERT-DOTI

12. Preventing Injury in Children: The Need for Parental Involvement. . . . . . . . . . . . . . . . . . . . . . .. 221 LISA SALDANA AND LIZETIE PETERSON

13. Elimination Disorders in Children. . .. .. . .. .. .. .. . . . . .. . .. .. . . . .. . .. .. . .. .. . . . . . . . .. 239 PATRICK C. FRIMAN AND KEVIN M. JONES

Iv. MedicallPediatric Problems ..................................................... 261

14. Behavior Management of Recurrent Pain in Children KEITH D. ALLEN AND JUDITH R. MATIHEWS

15. Central Nervous System Dysfunction: Brain Injury, Postconcussive Syndrome,

263

and Seizure Disorder ............................................................ 287 WILLIAM J. WARZAK, JOAN MAYFIELD, AND JANICE McALLISTER

16. Chronic Illness in Childhood: A Hypothesis-Testing Approach. . . . . . . . . . . . . . . . . . . . . . . . . .. 311 COLLEEN M. McMAHON, KATINA M. LAMBROS, AND JUDITH A. SYLVA

17. Cognitive Behavior Therapy for Eating Disorders ..................................... 335 DONALD A. WILLIAMSON, LESLIE G. WOMBLE, AND NANCY L. ZUCKER

18. Behavioral Treatment of Feeding Disorders in Children THOMAS R. LINSCHEID

357

V. Cross-Setting Problems ......................................................... 369

19. Anxiety-Re1atedDifficulties ...................................................... 371 JEFF LAURENT AND KiRSTEN I. POTIER

20. A Behavior Analytic Approach for Treating Depression ................................ 393 T. STEUART WATSON AND SHERI L. ROBINSON

21. Assessment and Treatment of Self-Injury . .. . . . .. . .. . . . . . . . . . . .. . . . . . . . . . . . . . .. . . . . .. 413 F. CHARLES MACE, TIMOTHY R. VOLLMER, PATRICK R. PROGAR, AND AMY B. MACE

22. Habits and Tics ................................................................. 431 T. STEUART WATSON AND HEATHER ELISE STERLING

23. Antisocial Behavior in Schools .................................................... 451 JEFFREY SPRAGUE, GEORGE SUGAI, AND HILL WALKER

24. Social Skills Training with Children: Social Learning and Applied Behavioral Analytic Approaches. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 475 FRANK M. GRESHAM

CONTENTS xiii

25. Current Issues in Child Behavior Therapy. .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . .. 499 T. STEUART WATSON AND FRANK M. GRESHAM

Index............................................................................. 505

Handbook of Child Behavior Therapy