Document Detail

Using differential reinforcement to treat functional hypophonia in a paediatric rehabilitation patient.
MedLine Citation:
PMID:  9744027     Owner:  NLM     Status:  MEDLINE    
Behaviour analysis studies have demonstrated the use of operant procedures for treating symptoms of psychiatric disorders. These symptoms are usually caused or maintained by a variety of variables including specific organic mechanisms, yet most can be modified by environmental social contingencies. In this case study, data is presented on a 16 year-old male admitted to a rehabilitation hospital following the onset of polymyositis. This patient also presented with functional hypophonia and met the DSM-IV diagnostic criterion for a conversion disorder. In conjunction with the medical team and a speech pathologist, a behavioural programme was developed and implemented to shape and differentially reinforce increasingly complex vocalizations. Results were evaluated using a moving treatment, multiple baseline across responses design. Differential reinforcement in the form of written and verbal feedback was effective in shaping normal speech. The protocol was applied comprehensively across staff and settings. Results are discussed in terms of basic behavioural research on 'learned non-use'.
A Amari; K J Slifer; R C Sevier; J Spezio; C L Tucker
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric rehabilitation     Volume:  2     ISSN:  1363-8491     ISO Abbreviation:  Pediatr Rehabil     Publication Date:    1998 Apr-Jun
Date Detail:
Created Date:  1998-11-20     Completed Date:  1998-11-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9709256     Medline TA:  Pediatr Rehabil     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  89-94     Citation Subset:  IM    
Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD 21209, USA.
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MeSH Terms
Conversion Disorder / complications*
Polymyositis / complications*
Reinforcement (Psychology)*
Speech Disorders / etiology*,  psychology,  rehabilitation*
Speech Therapy / methods*

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