ACCEPTABILITY AND OF ALTERNATIVE CLASSROOM TREATMENT STRATEGIES FACTORS AFFECTING TEACHER'S RATINGS by WILLIAM TREEN MCKEE B.A., The U n i v e r s i t y of B r i t i s h Columbia, 1972 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES Department of E d u c a t i o n a l Psychology and S p e c i a l Education We accept t h i s t h e s i s as conforming to the r e q u i r e d standard THE UNIVERSITY OF BRITISH COLUMBIA December, 1984 © W i l l i a m Treen McKee, 1984 *% ~ In p r e s e n t i n g t h i s t h e s i s i n p a r t i a l f u l f i l l m e n t of the requirements f o r an advanced degree at the The U n i v e r s i t y of B r i t i s h Columbia, I agree that the L i b r a r y s h a l l make i t f r e e l y a v a i l a b l e f o r r e f e r e n c e and study. I f u r t h e r agree that permission f o r e x t e n s i v e copying of t h i s t h e s i s f o r s c h o l a r l y purposes may be granted by the Head of my Department or by h i s or her r e p r e s e n t a t i v e s . I t i s understood that copying or p u b l i c a t i o n of t h i s t h e s i s f o r f i n a n c i a l gain s h a l l not be allowed without my w r i t t e n p e r m i s s i o n . Department of E d u c a t i o n a l Psychology and S p e c i a l Education The U n i v e r s i t y of B r i t i s h Columbia 2075 Wesbrook Place Vancouver, Canada V6T 1W5 Date: December, 1984 A b s t r a c t A s c r e e n i n g sample of 107 elementary school teachers completed a 16-item m u l t i p l e - c h o i c e measure of knowledge of b e h a v i o r a l p r i n c i p l e s . Two s u b j e c t groups, each c o n s i s t i n g of 32 r e g u l a r classroom t e a c h e r s , were randomly s e l e c t e d f o r high and low knowledge groups based on scores on the knowledge measure. High and low knowledge group teachers were given random assignment to one of two c l i n i c a l case d e s c r i p t i o n s . Both d e s c r i p t i o n s were of a 9-year o l d boy who i s presented as being very a g g r e s s i v e , and who does not f o l l o w a d u l t i n s t r u c t i o n s . The two cases d i f f e r e d only i n the type of background a t t r i b u t e d to each. One i s d e s c r i b e d as coming to the r e g u l a r classroom as a r e s u l t of 'mainstreaming', having been p r e v i o u s l y i n a s p e c i a l c l a s s s e t t i n g . The other case d e s c r i p t i o n makes no r e f e r e n c e t c mainstreaming or to previous placement. Teachers i n a l l c o n d i t i o n s e v a l u a t e d the a c c e p t a b i l i t y of four a l t e r n a t i v e classroom treatment s t r a t e g i e s f o r c h i l d r e n : M e d i c ation, Time Out from Reinforcement, Reinforcement of Incompatible Behavior, and P o s i t i v e P r a c t i c e . Teachers i n the high and low knowledge groups read the a s s i g n e d case d e s c r i p t i o n , and then r a t e d the a c c e p t a b i l i t y of the treatments i n a 4 x 4 r e p l i c a t e d L a t i n - s q u a r e design using treatment a c c e p t a b i l i t y measures developed by Kazdin (1980a). F o l l o w i n g treatment r a t i n g s , s u b j e c t s completed a q u e s t i o n n a i r e which, i n p a r t , asked s u b j e c t s to rank order the d e s c r i b e d treatments on the b a s i s of l i k e l i h o o d of each being used by the s u b j e c t doing i i the r a t i n g . High knowledge group teachers r a t e d treatments as more ac c e p t a b l e than d i d low knowledge group teachers on the primary dependent measure. Treatments were r e a d i l y d i f f e r e n t i a t e d i n terms of a c c e p t a b i l i t y . Reinforcement was r a t e d more ac c e p t a b l e than Time Out and P o s i t i v e P r a c t i c e , which d i d not d i f f e r from each other i n terms of a c c e p t a b i l i t y . M e d i c a t i o n was r a t e d lower i n a c c e p t a b i l i t y than the other treatments. Treatment a c c e p t a b i l i t y r a t i n g s were not d i f f e r e n t f o r the two case d e s c r i p t i o n s . The r e s u l t s of the ranking of treatments on the Case and Treatment Q u e s t i o n n a i r e g e n e r a l l y f o l l o w e d those of the r a t i n g procedure. The r e s u l t s of the analyses i n d i c a t e that teachers do d i f f e r e n t i a t e treatments i n terms of a c c e p t a b i l i t y using both the r a t i n g and ranking procedures. I t i s a l s o apparent that the high knowledge group teachers tend to r a t e a l t e r n a t i v e classroom treatments as more acc e p t a b l e than do the low knowledge group t e a c h e r s . These f i n d i n g s are d i s c u s s e d , and i m p l i c a t i o n s f o r education and for f u t u r e r e s e a r c h are presented. Table of Contents A b s t r a c t i i L i s t of Tables v i i L i s t of F i g u r e s . . i x Acknowledgement x I . DEVELOPMENT OF THE STUDY 1 A. INTRODUCTION 1 B. BACKGROUND OF THE PROBLEM 4 C. PROBLEM AREA 1 4 1. Knowledge of B e h a v i o r a l P r i n c i p l e s 17 2. Type of Case 20 3. Method of A s s e s s i n g A c c e p t a b i l i t y 26 D. PROBLEM SUMMARY 28 E. PURPOSE OF THE STUDY 29 F. SIGNIFICANCE OF THE STUDY 30 I I . METHODOLOGY 34 A. NATURE OF THE STUDY 34 B. INSTRUMENTATION 35 1. Demographic Q u e s t i o n n a i r e 36 2. Knowledge Measure 36 3. Treatment A c c e p t a b i l i t y Measures 43 4. Case and Treatment Q u e s t i o n n a i r e 49 C. DESIGN OF THE STUDY 53 1. Dependent V a r i a b l e s 53 2. Independent V a r i a b l e s 54 3. Experimental Design ...55 D. PROCEDURE 58 i v 1 . Subjects 58 2. Assignment of Subjects 60 3. Data C o l l e c t i o n 61 E. DATA PREPARATION AND ANALYSIS 62 1. Data P r e p a r a t i o n 62 2. A n a l y s i s of Demographic Q u e s t i o n n a i r e 63 3. Psychometric A n a l y s i s 63 4. A n a l y s i s of Treatment A c c e p t a b i l i t y Ratings .64 5. A n a l y s i s of Case and Treatment Qu e s t i o n n a i r e Responses 70 F. CHAPTER SUMMARY 70 I I I . RESULTS 72 A. SUBJECTS 72 B. PSYCHOMETRIC ANALYSIS 74 1. Knowledge Measure 74 2. Treatment A c c e p t a b i l i t y Measures 74 C. ANALYSIS OF TREATMENT ACCEPTABILITY RATINGS 79 1. Treatment E v a l u a t i o n Inventory 79 2. Semantic D i f f e r e n t i a l 87 3. Summary of Treatment A c c e p t a b i l i t y R e s u l t s ..94 D. CASE AND TREATMENT QUESTIONNAIRE ANALYSIS 98 IV. SUMMARY AND CONCLUSIONS 101 A. SUMMARY OF METHODS AND RESULTS 101 1. Knowledge Group 103 2. C h i l d Case 105 3. Treatment Type 108 B. IMPLICATIONS FOR EDUCATION ...111 v C. IMPLICATIONS FOR FUTURE RESEARCH 114 REFERENCES 117 APPENDIX A 133 APPENDIX B 137 APPENDIX C 1 44 APPENDIX D 147 APPENDIX E 148 APPENDIX F 150 APPENDIX G 1 53 vi L i s t of Tables Table 1 - KBPAC P i l o t Study R e s u l t s 42 Table 2 — C h a r a c t e r i s t i c s of Screening Sample 60 Table 3 — Subject Demographic C h a r a c t e r i s t i c s 7 3 Table 4 - KBPAC Item A n a l y s i s 7 5 Table 5 - KBPAC Test A n a l y s i s 76 Table 6 - TEI Test A n a l y s i s 77 Table 7 — Semantic D i f f e r e n t i a l Test A n a l y s i s 78 Table 8 - Anova For TEI 80 Table 9 — Tukey (HSD) Comparisons Between Treatment Means on the TEI 82 Table 1 0 - Tukey (HSD) Comparisons Between Order Means on the TEI 83 Table 11 - ANOVA for SD E v a l u a t i v e Dimension 88 Table 1 2 — Tukey (HSD) Comparisons Between Treatment Means on the SD E v a l u a t i v e Dimension 90 Table 13 — Tukey (HSD) Comparisons Between Order Means on the SD E v a l u a t i v e Dimension 91 Table 14 — Tukey (HSD) Comparisons Between Sequence Means on the SD E v a l u a t i v e Dimension 91 Table 15 - ANOVA fo r SD Potency Dimension 9 3 Table 16 — Tukey (HSD) Comparisons Between Treatment Means on the SD Potency Dimension 9 4 Table 17 - ANOVA fo r SD A c t i v i t y Dimension 9 5 Table 18 - Tukey (HSD) Comparisons Between Order Means on the SD A c t i v i t y Dimension 96 Table 1 9 — Summary of Tukey (HSD) Comparisons Between Treatment C o n d i t i o n s 9 7 Table 2 0 - Summary of Tukey (HSD) Comparisons Among Orders of P r e s e n t a t i o n 9 7 v i i Table 21 - R e s u l t s of Friedman Two-Way A n a l y s i s of Variance on Ranking of Treatments 99 Table 22 — Nemenyi Pairwise Comparisons Between Mean Treatment Ranks 100 v i i i L i s t of F i g u r e s F i g u r e 1 — Layout of the Experimental Design 57 F i g u r e 2 - LSR E f f e c t s — C x F x B R e s i d u a l s : Reinforcement and P o s i t i v e P r a c t i c e f o r Two Knowledge C o n d i t i o n s .84 F i g u r e 3 - LSR E f f e c t s — C x D x B R e s i d u a l s : Reinforcement and M e d i c a t i o n f o r Two Case D e s c r i p t i o n s 86 i x Acknowledgement I wish both to acknowledge and to express my a p p r e c i a t i o n to a number of i n d i v i d u a l s f o r many c o n t r i b u t i o n s made during the course of t h i s study. F i r s t , I wish to express my s i n c e r e a p p r e c i a t i o n to my res e a r c h s u p e r v i s o r , Dr. Barry Munro, who has pro v i d e d constant support and t h o u g h t f u l a d v i c e , and who has been a model f o r the p u r s u i t - o f academic e x c e l l e n c e throughout our a s s o c i a t i o n . I wish a l s o to thank my r e s e a r c h committee members, Dr. Todd Rogers and Dr. Robert McMahon f o r t h e i r guidance, c o n s t r u c t i v e c r i t i c i s m and generous support throughout the p r o j e c t . The c o n t r i b u t i o n s of my committee are g r a t e f u l l y acknowledged. Two a d d i t i o n a l F a c u l t y members made v i t a l c o n t r i b u t i o n s at c r u c i a l stages i n the study and deserve a s p e c i a l note of thanks. To Drs. G. Jim Johnson and Robert Gonry, a word of a p p r e c i a t i o n f o r t h e i r involvement. An e x p r e s s i o n of thanks a l s o i s due to Drs. Alan Kazdin and Joe Witt f o r t h e i r encouragement (from a f a r ) i n pur s u i n g t h i s study, and f o r the p r o v i s i o n of otherwise u n a v a i l a b l e m a t e r i a l s . A s p e c i a l thanks to Dr. Kazdin f o r a l l o w i n g the use and amendment of re s e a r c h instruments and case and treatment d e s c r i p t i o n s . My a p p r e c i a t i o n a l s o goes to the Burnaby school teachers who gave t h e i r time and energie s to p a r t i c i p a t e i n the study procedures, and to Dr.Blake Ford f o r h i s e f f o r t s to f a c i l i t a t e teacher p a r t i c i p a t i o n in the p r o j e c t . x F i n a l l y , I g i v e t h a n k s t o my w i f e M a r i e , a n d t o my d a u g h t e r C a i t l i n , b o t h of whom ha v e s u p p o r t e d my e f f o r t s u n f a i l i n g l y a nd who have t o l e r a t e d my a b s e n c e s and p r e o c c u p a t i o n s o v e r s e v e r a l y e a r s of p a r t - t i m e g r a d u a t e s t u d y . M a r i e , p a r t i c u l a r l y f o r h e r t i r e l e s s e f f o r t s t o w a r d p e r f e c t i o n , a nd h e r w e l l t i m e d e n c o u r a g e m e n t , h a s made a s i z a b l e c o n t r i b u t i o n t o t h i s s t u d y . x i I. DEVELOPMENT OF THE STUDY A. INTRODUCTION The a c c e p t a b i l i t y and c r e d i b i l i t y of treatment approaches developed from the b e h a v i o r a l psychology paradigm have long been at i s s u e . In the r e l a t i v e l y e a r l y days of behaviorism, Dr. Lo u i s Berman (1927) suggested t h a t : . . . a new, a powerful r e l i g i o n i s growing i n t o m a t u r i t y i n the United S t a t e s as a r e s u l t of a new p s y c h o l o g i c a l movement. I t c a l l s i t s e l f Behaviorism . . . i t may be a s s u r e d l y p r e d i c t e d that laws w i l l be passed and policemen p a i d to make the very name of Behaviorism anathema, (pp. 9-10) The behaviorism to which Berman r e f e r s was, in a h i s t o r i c a l p e r s p e c t i v e , not i n i t s m a t u r i t y , but rather i n i t s i n f a n c y . In h i s P r e s i d e n t i a l Address to the A s s o c i a t i o n f o r Behavior A n a l y s i s (ABA) in 1980, Jack Michael s t a t e d t h a t , P r i o r to 1930 there wasn't much going on . . . . In the p e r i o d from 1930 to 1938, Skinner [B. F. Skinner] put i t a l l together. He managed, w i t h i n that b r i e f but f e r t i l e p e r i o d , to come up with almost a l l of the e s s e n t i a l methods, concepts, and f u n c t i o n a l r e l a t i o n s of our f i e l d as we see i t today. (p. .1 ) Behaviorism has indeed persevered. B e h a v i o r a l approaches to the study of human behavior have evolved and, in f a c t , become p e r v a s i v e (see, f o r example, Benassi & Lanson, 1972; M a r t i n , 1981; O'Leary, 1984; Wilson, 1982). In many ways, however, the p r e d i c t i o n s made e a r l y on by Dr. Berman (1927) have come to pass. Behaviorism, behavior m o d i f i c a t i o n , and a multitude of approaches developed out of the b e h a v i o r a l paradigm are the sub j e c t of enduring p u b l i c i n t e r e s t and s c r u t i n y . These continue to be the subject of 1 2 debate and attempts at r e s o l u t i o n i n s e v e r a l p o l i t i c a l arenas, as we l l as being the i s s u e of l i t i g a t i o n before the c o u r t s , and the subject of i n v e s t i g a t i o n and e v a l u a t i o n i n a number of p r o f e s s i o n a l , academic, and s p e c i a l i n t e r e s t o r g a n i z a t i o n s . Farkas (1981), as we l l as others (Eysenck, 1970, 1971; Eysenck & Beech, 1971), has documented a mul t i t u d e of c r i t i c i s m s of b e h a v i o r a l approaches. Numerous others have made p r e s e n t a t i o n s d i s c u s s i n g these same i s s u e s (Bandura, 1975, 1977; Barnes, Fors & Decker, 1980; Berger, 1979; B e r g i n , 1980; Eber & O'Brien, 1982; Engelhardt & McCullough, 1982; Farnham-Diggory, 1981; Heldman, 1973; Ho l l a n d , 1975; Kazdin, 1979, 1981b, 1981c, 1982; K i t c h e n e r , 1980a, 1980b, 1980c; Krasner, 1976; Marotz, 1983; Roos, 1974; Skinner, 1971; Spece, 1972; Szasz, 1978; T y l e r , 1982; Wolpe, 1978). F i f t y years a f t e r Berman's t e x t , A r n o l d Lazarus (1977) suggested t h a t : " . . . behavior therapy and behavior m o d i f i c a t i o n have a c q u i r e d a bad p r e s s . To r e c e i v e funding many h o s p i t a l s and community agencies have had to drop the l a b e l behavior from t h e i r program p r o p o s a l s " (p. 553). I t would appear that there remain s i g n i f i c a n t concerns with the is s u e of a c c e p t a b i l i t y of b e h a v i o r a l approaches to treatment. Although treatments from a v a r i e t y of o r i e n t a t i o n s are the s u b j e c t of probing and s c r u t i n y on many dimensions of a c c e p t a b i l i t y , s e v e r a l authors have r e c e n t l y c o n s i d e r e d l e g a l and e t h i c a l dimensions of a c c e p t a b i l i t y r e l a t e d to 3 behavior m o d i f i c a t i o n ( C h r i s t i a n , C l a r k , & Luke, 1981; Dipasquale, 1979; Feldman & Peay, 1982; Goldiamond, 1975a, 1975b; I n n i s , 1981; James & A l l o n , 1979; Wherry, 1983; Woods, 1982). A c c e p t a b i l i t y in the context of t h i s l i t e r a t u r e r e l a t e s to development, r e g u l a t i o n , and maintenance of e t h i c a l and l e g a l b e h a v i o r a l treatments. From another, though r e l a t e d p e r s p e c t i v e , Wolf (1978) introduced a dimension of a c c e p t a b i l i t y to be c o n c e p t u a l i z e d as s o c i a l v a l i d i t y . He proposed that behavior a n a l y s t s develop systems and measures for a s k i n g s o c i e t y whether they (behavior a n a l y s t s ) were accomplishing something of s o c i a l importance. Wolf suggested that v a l i d a t i o n occur at three l e v e l s . These i n v o l v e a demonstration o f : 1. The s o c i a l s i g n i f i c a n c e of the treatment g o a l s . 2. The s o c i a l a p p r o p r i a t e n e s s of the treatment procedures. 3. The s o c i a l importance of the treatment e f f e c t s . Stephanie S t o l z (1981) has suggested that t e c h n o l o g i c a l and methodological i n n o v a t i o n s from the b e h a v i o r a l paradigm have experienced l i t t l e widespread adoption by our s o c i e t y p r i m a r i l y because these i n n o v a t i o n s have not been accepted by government p o l i c y makers. Wolf (1978) expressed a s i m i l a r s e n s i t i v i t y to i s s u e s of a c c e p t a b i l i t y of treatments to p a r t i e i p a n t s : . . . that i f the p a r t i c i p a n t s don't l i k e the treatment then they may a v o i d i t , or run away, or complain l o u d l y . And thus, s o c i e t y w i l l be l e s s l i k e l y to use our technology, no matter how p o t e n t i a l l y e f f e c t i v e and e f f i c i e n t i t might be. (p. 206) 4 Other authors i n d i c a t e that treatment procedures with demonstrated e f f e c t i v e n e s s are not being used "because they are simply unacceptable to p a r t i c i p a n t s , care g i v e r s , or consumers" (Witt, Martens, & E l l i o t , 1984, p. 1). Treatments which are o b v i o u s l y and t o t a l l y unacceptable are o f t e n easy to i d e n t i f y . However of more acute concern are treatments which have been demonstrated to be e f f e c t i v e a n d^useful but which gain l i m i t e d acceptance and hence are not used. F i n a l l y , McMahon and Forehand (1983) in a review of consumer s a t i s f a c t i o n l i t e r a t u r e in the b e h a v i o r a l treatment of c h i l d r e n , r e f e r to work by Kazdin (1980a, 1980b, 1981a) which they f e e l "has developed a compelling case f o r the assessment of treatment a c c e p t a b i l i t y on the b a s i s of l e g a l and e t h i c a l i s s u e s and long-term e f f e c t i v e n e s s and g e n e r a l i t y of the procedures." (p. 214) The i s s u e of treatment a c c e p t a b i l i t y has been e s t a b l i s h e d as a l e g i t i m a t e area of i n v e s t i g a t i o n equal i n importance, perhaps, to that of consumer s a t i s f a c t i o n with t h e r a p e u t i c i n t e r v e n t i o n s ( K i e s l e r , 1983). However, in c o n t r a s t to r e s e a r c h i n the l a t t e r area, the l i t e r a t u r e r e l a t e d to treatment a c c e p t a b i l i t y i s f a r l e s s developed. B. BACKGROUND OF THE PROBLEM Few s t u d i e s have been r e p o r t e d which i n v e s t i g a t e the reasons f o r the lac k of acceptance of b e h a v i o r a l methods f o r the classroom treatment of c h i l d r e n ' s problem behavior. T h i s p a u c i t y e x i s t s d e s p i t e the knowledge and p u b l i c lamentation 5 of the 'under u t i l i z a t i o n ' of these methods, and d e s p i t e the overwhelming body of t h e o r e t i c a l and e m p i r i c a l evidence i n support of the e f f e c t i v e n e s s of such methods and procedures (Barlow, 1980; B o u t i l i e r , 1981; Foxx & Jones, 1978; Foxx & Shapiro, 1978; G i l e s , 1983; Kazdin & Hersen, 1980; Kazdin & Wilson, 1978b; Kent & O'Leary, 1976; Kerr & Lambert, 1982; K i r i g i n , Braukmann, Atwater, & Wolf, 1982; Molloy, 1980 ; O l l e n d i c k , Matson, Esveldt-Dawson, & Shapiro, 1980; Pevsner, 1982; Reese, Murphy, & F i l i p c z a k , 1981; Rosenbaum, O'Leary, & Jacob, 1975; Seaton & Aaron, 1978; T r e i b e r & Lahey, 1983; Wilson, 1982). Some i n v e s t i g a t o r s , n o t a b l y Kazdin and Cole (1981), Witt, Moe, Gutkin, and Andrews ( i n p r e s s ) , and Woolfolk, Woolfolk, and Wilson (1977) have proceeded i n the area of g l o b a l e v a l u a t i o n s of behavior m o d i f i c a t i o n and, i n p a r t i c u l a r , the e f f e c t of the ' b e h a v i o r a l ' l a b e l on e v a l u a t i o n s of treatment. These and numerous other s t u d i e s have been d i r e c t e d at a s c e r t a i n i n g the p u b l i c ' s conception of behavior m o d i f i c a t i o n , u sing a l a r g e v a r i e t y of methods, s e t t i n g s and s u b j e c t s . S e v e r a l p r o j e c t s have focused a t t e n t i o n on the a t t i t u d e s held by undergraduate and graduate psychology students toward the use of behavior m o d i f i c a t i o n (e.g., Kazdin & Cole, 1981; Turkat, H a r r i s , & Forehand, 1979; Woolfolk & Woolfolk, 1979; Woolfolk et a l . , 1977). At l e a s t one study (Dubno, H i l l b u r n , Robinson, Sandler, T r a n i , & Weingarten, 1978) has i n v e s t i g a t e d graduate business students' a t t i t u d e s toward behavior 6 m o d i f i c a t i o n i n business o r g a n i z a t i o n s . Another study by B a r l i n g and Wainstein (1979), using a methodology s i m i l a r to Woolfolk and Woolfolk (1979), assessed the a t t i t u d e s of undergraduate and graduate i n d u s t r i a l psychology students. S e v e r a l r e p o r t s have presented r e s u l t s of i n v e s t i g a t i o n s of teachers' a t t i t u d e s toward the implementation of behavior m o d i f i c a t i o n i n e d u c a t i o n a l s e t t i n g s (e.g., Musgrove & Harms, 1975; T h r o l l & Ryan, 1975; Ryan, 1976; Vane, 1972; Wheldall & Congreve, 1980a, 1980b). A f u r t h e r area of i n v e s t i g a t i o n i s r e p o r t e d by Saunders and Reppucci (1978) and r e f e r e n c e i s made to an e a r l i e r study by Saunders (1975) in which superintendants of j u v e n i l e c o r r e c t i o n s i n s t i t u t i o n s and elementary school p r i n c i p a l s were s t u d i e d with r e s p e c t to t h e i r a t t i t u d e s toward behavior modi f i c a t i o n . The r e s u l t s of t h i s l a r g e v a r i e t y of s t u d i e s are i n c o n c l u s i v e . While s e v e r a l authors suggest that a t t i t u d e s toward behavior m o d i f i c a t i o n are i n general negative (Burton, 1981; Kazdin & Cole, 1981; O'Leary, 1984; Saunders & Reppucci, 1978; Stainbrook & Green, 1982; Turkat &-Forehand, 1980a; Turkat et a l . , 1979; Turkat & F e u e r s t e i n , 1978; Woolfolk & Woolfolk, 1979; Woolfolk et a l . , 1977), s e v e r a l o t hers report more p o s i t i v e a t t i t u d e s (Burkhart, Behles, & Stumphauzer, 1976; Frey, 1970; Hickey, 1977; Jeger & McClure, 1979; Ryan, 1976; Vane, 1972; Wheldall & Congreve, 1980a, 1980b. F u r t h e r s t u d i e s report almost n e u t r a l a t t i t u d e s ( B a r l i n g & Wainstein, 1979; Musgrove, 7 1974; T h r o l l & Ryan, 1976). These c o n t r a d i c t o r y f i n d i n g s would suggest that the q u e s t i o n of a t t i t u d e toward behavior m o d i f i c a t i o n has not been answered completely. While i n c o n c l u s i v e in t h i s regard these s t u d i e s have provided v a l u a b l e data f u r t h e r i n g our understanding of the study of a t t i t u d e s toward behavior m o d i f i c a t i o n . There i s some support, however, f o r the n o t i o n that t h i s r e s e a r c h s u f f e r s from some fundamental problems. As Kazdin and Cole (1981) suggest, the behavior m o d i f i c a t i o n under such c o n s i d e r e d s c r u t i n y i n these s t u d i e s may not e x i s t : " r e s e a r c h t y p i c a l l y d i s c u s s e s 'behavior m o d i f i c a t i o n ' as a uniform method of treatment. In f a c t , s e v e r a l very d i f f e r e n t techniques are embraced by behavior m o d i f i c a t i o n and behavior therapy (terms u s u a l l y used synonymously)" (p. 66). Many techniques, c o n s i d e r e d to be examples of behavior m o d i f i c a t i o n , may be ev a l u a t e d d i f f e r e n t l y not only because of a c t u a l d i f f e r e n c e s i n the techniques but a l s o because of d i f f e r e n c e s i n problems and c l i e n t s to which they might be a p p l i e d . I t c o u l d be argued t h a t , i n f a c t , i n d i v i d u a l s may be a s s e s s i n g behavior m o d i f i c a t i o n based on ra t h e r erroneous i n f o r m a t i o n . As re p o r t e d by Turkat and F e u e r s t e i n (1978) and echoed by O'Leary (1984), media coverage of behavior m o d i f i c a t i o n i s f r e q u e n t l y n e g a t i v e , and o f t e n , i n c o r r e c t l y a s s o c i a t e d with such procedures as b r a i n washing, psychosurgery, sensory d e p r i v a t i o n , and water t o r t u r e . Friedman (1975) suggests that the p u b l i c view of a l i n k between behavior m o d i f i c a t i o n and any number of 8 q u e s t i o n a b l e t h e r a p i e s , as w e l l as a c o n f u s i o n between behavior m o d i f i c a t i o n as an end product and as a s p e c i f i c procedure, has caused " a l l the abuses of the psychosurgeons or the psychopharmacologists to be l a i d at the doorstep . . . (p. 47) of behavior m o d i f i c a t i o n . Kazdin and Cole (1981) suggest f u r t h e r that the d i r e c t i o n f o r i n v e s t i g a t i o n s of treatment a c c e p t a b i l i t y should change from that of g l o b a l a c c e p t a b i l i t y to i n v e s t i g a t i o n s of "the f u l l gamut of procedures and the manner in which these might be i n v e s t i g a t e d " (p. 67). What i s suggested, then, i s the study of p a r t i c u l a r procedures with c o n s i d e r a t i o n of the p a r t i c u l a r e f f e c t of such f a c t o r s as the s e t t i n g s i n which the procedure i s to be a p p l i e d , the c l i e n t s and types of problems f o r which these procedures might be a p p r o p r i a t e and the i n d i v i d u a l s who may be i n a p o s i t i o n to i n f l u e n c e d e c i s i o n s regarding t h e i r a p p l i c a t i o n . , or who may, i n f a c t , be the s u b j e c t of t h e i r a p p l i c a t i o n . I n i t i a l e f f o r t s have begun to c r e a t e approaches f o r the study of a c c e p t a b i l i t y of p a r t i c u l a r treatment a l t e r n a t i v e s . C h a r a c t e r i s t i c of these e a r l y s t u d i e s i s a great v a r i e t y i n emphases. One focus has been upon c l i n i c a l or i n s t i t u t i o n a l s e t t i n g s (Kazdin, 1980a; Kazdin, 1980b; Kazdin, 1981). Other s t u d i e s have emphasized student, parent and teacher s a t i s f a c t i o n with p a r t i c u l a r b e h a v i o r a l approaches used i n classroom p r o j e c t s ( B e s a l e l - A z r i n , A z r i n , & Armstrong, 1977; Kent & O'Leary, 1976), the emphasis here being both on the classroom s e t t i n g f o r treatment and the use of a post hoc or 9 consumer e v a l u a t i o n of the treatment(s) employed. Witt and h i s c o l l e a g u e s (Witt, E l l i o t , & Martens, i n press; Witt, Moe, Gutkin, & Andrews, in press; Witt et a l . , 1984) have approached the issue of the a c c e p t a b i l i t y of treatment using classroom teachers as r a t e r s of treatments i n s e v e r a l analogue s t u d i e s . Norton, Austen, A l l e n , & H i l t o n (1983) report on a study comparing teacher and parent e v a l u a t i o n s of the a c c e p t a b i l i t y and e f f e c t i v e n e s s of s e v e r a l b e h a v i o r a l procedures f o r reducing c h i l d r e n ' s d i s r u p t i v e b e h a v i o r s . Foxx and Shapiro (1978) r e p o r t using p r o f e s s i o n a l s and p a r a p r o f e s s i o n a l s , working with developmentally delayed c h i l d r e n , as r a t e r s of treatments. C o n s i d e r i n g these e a r l y s t u d i e s of the a c c e p t a b i l i t y of p a r t i c u l a r treatment a l t e r n a t i v e s , two major approaches can be i d e n t i f i e d . The f i r s t of these i n v o l v e s a post hoc e v a l u a t i o n of the a p p l i c a t i o n of a p a r t i c u l a r set of procedures, or consumer s a t i s f a c t i o n measure, f o l l o w i n g experience with a p a r t i c u l a r approach to treatment. The consumer i n t h i s s o r t of e v a l u a t i o n might be c o n c e p t u a l i z e d as a parent of a c h i l d i n treatment, the teacher or t h e r a p i s t who used the approach, the c h i l d who has been the su b j e c t of treatment or other i n d i v i d u a l s i n v o l v e d i n some way with the a p p l i c a t i o n of a p a r t i c u l a r mode or method of treatment. The second major approach i n v o l v e s i n d i v i d u a l s i n the e v a l u a t i o n of procedures p r i o r to any a p p l i c a t i o n of treatments. These e v a l u a t i o n s of treatment a c c e p t a b i l i t y are commonly based on f a i r l y comprehensive d e s c r i p t i o n s of the 10 i n d i v i d u a l procedure being e v a l u a t e d and would include i n f o r m a t i o n such as the types of cases and s e t t i n g s in which the procedure might be a p p l i e d . McMahon and Forehand (1983) have reviewed much of the l i t e r a t u r e d e a l i n g with consumer s a t i s f a c t i o n i n b e h a v i o r a l treatment of c h i l d r e n . They reviewed s t u d i e s which examine s a t i s f a c t i o n with treatment outcome, t h e r a p i s t s , treatment procedures, and t e a c h i n g format, but suggest that the major p o r t i o n of r e s e a r c h in t h i s area has focused on s a t i s f a c t i o n with t h e r a p i s t and treatment outcome. These authors report f u r t h e r that the most p e r v a s i v e use of consumer s a t i s f a c t i o n measures i s found i n the parent t r a i n i n g l i t e r a t u r e . Other authors have expressed support f o r the i n c l u s i o n of consumer s a t i s f a c t i o n measures in the e v a l u a t i o n of treatments ( B o r n s t e i n & R y c h t a r i k , 1983; G a r f i e l d , 1983; K i e s l e r , 1983; K i r i g i n et a l . , 1982; Lebow, 1982). However, S c h e i r e r (1978) has suggested c a u t i o n i n the i n t e r p r e t a t i o n and use of such consumer m e a s u r e s — a sentiment shared by others ( G a r f i e l d , 1983; K i e s l e r , 1983). Guba ( c i t e d i n S c h e i r e r , 1978) p r o v i d e s the p r o p o s i t i o n t h a t one s i g n i f i c a n t problem with the measurement of c l i e n t s a t i s f a c t i o n i s that " p a r t i c i p a n t s l i k e s o c i a l programs, evaluate them f a v o r a b l y , and t h i n k they are b e n e f i c i a l , i r r e s p e c t i v e of whether measureable b e h a v i o r a l changes take p l a c e toward s t a t e d program g o a l s " (p. 55). McMahon and Forehand (1983) echoed t h i s concern and concluded t h a t : "While many i n v e s t i g a t o r s have i n c l u d e d consumer 11 s a t i s f a c t i o n measures i n t h e i r treatment e v a l u a t i o n s , there are s e r i o u s methodological shortcomings i n the development of these instruments as w e l l as i n t h e i r u t i l i z a t i o n as outcome measures" (p. 222), and recommend that adequate measures be developed before a t t e n t i o n be given to absolute or comparative assessments of consumer s a t i s f a c t i o n . Witt and E l l i o t ( i n press) have reviewed much of the l i t e r a t u r e which has employed the second method of a s s e s s i n g a c c e p t a b i l i t y of treatment a l t e r n a t i v e s . T h i s report focused p r i m a r i l y on m a t e r i a l r e l e v a n t to the a c c e p t a b i l i t y of classroom management s t r a t e g i e s but reviewed the development and a p p l i c a t i o n of t h i s method i n other s e t t i n g s as w e l l . A major c o n c l u s i o n of t h i s review was that s i g n i f i c a n t c o n t r i b u t i o n s to understanding the assessment of treatment a c c e p t a b i l i t y have been made, even though r e s e a r c h i n t h i s area i s at a p i o n e e r i n g stage. K i e s l e r (1983) suggests a d d i t i o n a l y , that i n the study of consumer s a t i s f a c t i o n with treatment, r e s e a r c h e r s have not e s t a b l i s h e d the c l i e n t s ' g eneral a t t i t u d e s or e x p e c t a t i o n f o r treatment p r i o r to e n t e r i n g , and cannot t h e r e f o r e suggest how much of post treatment e v a l u a t i o n r e l a t e s to the treatment experience. T h i s i s a common methodological c r i t i c i s m of such r e s e a r c h (Hargreaves & A t k i s s o n , 1978; Lebow, 1982). K i e s l e r (1983) suggested the need f o r an a d d i t i o n to consumer s a t i s f a c t i o n r e s e a r c h of "the methodological e q u i v a l e n t of an a t t i t u d e p r e t e s t " (p. 228). He suggests support f o r the ' p r e t e s t ' approach employed by Kazdin ( i n p r e s s ) , and that such an 1 2 approach be used to study the p u b l i c p o l i c y aspects of the a c c e p t a b i l i t y of mental h e a l t h s e r v i c e s . Witt and E l l i o t ( i n press) a l s o argue for the v a l i d i t y of the study of treatment a c c e p t a b i l i t y and p a r t i c u l a r l y t h i s approach. They suggest that i n the complex s e t t i n g of school ( f o r example) " i t becomes important and d e s i r a b l e to expand the c r i t e r i a by which v a r i o u s treatments are e v a l u a t e d and to examine not only e f f e c t i v e n e s s but a l s o the p e r c e p t i o n s of i n d i v i d u a l s w i t h i n a system concerning the a p p l i c a t i o n and e f f e c t s of treatment" (p. 4 - 5 ) . Witt and E l l i o t i n d e s c r i b i n g f u t u r e d i r e c t i o n s f o r r e s e a r c h i n t h i s area suggest that e m p i r i c a l support i s needed to e s t a b l i s h the a c c e p t a b i l i t y of v a r i o u s treatments, and that research w i l l need to e l u c i d a t e s p e c i f i c f e a t u r e s of treatments (and presumably of those who r a t e the treatments) which c o n t r i b u t e to e v a l u a t i o n s of treatment a c c e p t a b i l i t y . They suggest f u r t h e r that r e s e a r c h focus on implementation of classroom i n t e r v e n t i o n s by teachers and on v a r i a b l e s which may i n c r e a s e the p r o b a b i l i t y that an i n t e r v e n t i o n w i l l be used. T h i s appears to be a v a l u a b l e d i r e c t i o n f o r study s i n c e a major source f o r treatment s e l e c t i o n and f o r implementation i n the school s e t t i n g i s the classroom teacher of the c h i l d i d e n t i f i e d i n need of some change. The major p o r t i o n of r e p o r t e d s t u d i e s of treatment a c c e p t a b i l i t y to date have employed as r a t e r s undergraduate psychology students, not consumers or p r o s p e c t i v e consumers of the procedures being r a t e d . More i d e a l r a t e r s would i n c l u d e classroom and s p e c i a l education 1 3 teachers, students in both r e g u l a r and s p e c i a l education s e t t i n g s , those who c o n s u l t d i r e c t l y with t e a c h e r s , and others who d i r e c t l y i n f l u e n c e the kinds of treatments which might be implemented--faculties of education and d i s t r i c t i n s e r v i c e and s p e c i a l s e r v i c e personnel, f o r example. Witt et a l . (1984) and others (Baer & B u s h e l l , 1981; Witt, Hannefin, & Martens, in press; Wolf, 1978) have expressed concern that many e f f e c t i v e treatment procedures remain unused because they appear unacceptable to i n d i v i d u a l s who are i n a p o s i t i o n to e f f e c t d e c i s i o n s r e g a r d i n g s e l e c t i o n of treatments. Kazdin ( i n press) suggests that a c c e p t a b i l i t y of treatments has begun to r e c e i v e a t t e n t i o n because of the " i n c r e a s e d p a r t i c i p a t i o n of the c o u r t s , p r o f e s s i o n a l o r g a n i z a t i o n s , and i n s t i t u t i o n a l review committees i n the l e g a l and e t h i c a l i s s u e s r a i s e d by treatment" (p. 6). Des p i t e the overwhelming volume of l i t e r a t u r e and e m p i r i c a l evidence which e x i s t s to support the e f f e c t i v e n e s s of most b e h a v i o r a l treatment methods, the l i n k between the development of e f f e c t i v e procedures and the widespread acceptance and implementation of these procedures has not been made. The problem may be one of b u i l d i n g " b e t t e r b r i d g e s from r e s e a r c h to s t a t e h o s p i t a l s [and s c h o o l s ] " ( S t o l z , 1981, p. 503), or one of b e t t e r 'marketing' of e f f e c t i v e s t r a t e g i e s (Witt & E l l i o t , i n p r e s s ) , or of changing the kinds of l a b e l s used ( K e l l y , 1950; Woolfolk et a l . , 1977). More r e a l i s t i c a l l y perhaps, the problem may r e q u i r e the development of a methodology f o r 1 4 a s c e r t a i n i n g those v a r i a b l e s r e l e v a n t to e v a l u a t i o n such that procedures might be developed, t r a i n i n g given, or i n f o r m a t i o n disseminated which w i l l l e a d to b e t t e r treatment being implemented in classrooms (as w e l l as other s e t t i n g s ) . C. PROBLEM AREA I n i t i a l i n v e s t i g a t i o n s of treatment a c c e p t a b i l i t y have i d e n t i f i e d a host of f a c t o r s which appear to a f f e c t e v a l u a t i o n r a t i n g s . These f a c t o r s i n c l u d e : the e f f e c t i v e n e s s and a p p r o p r i a t e n e s s of the treatment in g e n e r a l , and f o r the p a r t i c u l a r type of c l i e n t i n q u e s t i o n ; the type of i n t e r v e n t i o n ; the method of a s s e s s i n g a c c e p t a b i l i t y (e.g., unidimensional or m u l t i d i m e n s i o n a l assessment [Lebow, 1982]); p r a c t i c a l implementation i s s u e s such as time and r e s o urces, and who w i l l perform the i n t e r v e n t i o n ; the t h e o r e t i c a l o r i e n t a t i o n of the treatment; c l i e n t or r a t e r c h a r a c t e r i s t i c s ; and the language and l a b e l s attached to the treatment(s) under c o n s i d e r a t i o n . A major p o r t i o n of the treatment a c c e p t a b i l i t y r e s e a r c h p r e s e n t l y a v a i l a b l e can be a t t r i b u t e d to the work of Alan Kazdin and h i s c o l l e a g u e s at the School of Medicine, U n i v e r s i t y of P i t t s b u r g h . A p a r t i c u l a r c o n t r i b u t i o n has been the development of a methodology for such study. Using the Treatment E v a l u a t i o n Inventory (TEI) (Kazdin, 1980a), a v a r i e t y of s u b j e c t s have r a t e d the a c c e p t a b i l i t y of v a r i o u s treatments and comparisons have been made between treatments based on these e v a l u a t i o n s . A d d i t i o n a l l y Kazdin's work has 1 5 explored the e f f e c t s of s e v e r a l f e a t u r e s of treatment l i k e l y to e f f e c t e v a l u a t i o n s : s e v e r i t y of problems (Kazdin, 1980a), s p e c i f i c f e a t u r e s of a s i n g l e mode of treatment (1980b), degree of e f f e c t i v e n e s s of treatment and s e v e r i t y of s i d e e f f e c t s (1981a), who r a t e s the treatment (Kazdin, French, & S h e r i c k , 1981), and s u b j e c t s and e f f e c t i v e n e s s (Kazdin, in p r e s s ) . The f i r s t assumption u n d e r l y i n g comparisons w i t h i n t h i s context i s that i n d i v i d u a l s w i l l r a t e each treatment presented based on the s t i m u l u s m a t e r i a l s and r e a c t a c c o r d i n g to h i s or her own p e r c e p t i o n s about that treatment. The second major assumption in t h i s r e s e a r c h i s that the experimental design can c o n t r o l f o r such extraneous v a r i a b l e s as the e f f e c t of r a t i n g any p a r t i c u l a r treatment before or a f t e r any other treatment. The r e s e a r c h r e p o r t e d by Kazdin and h i s c o l l e a g u e s support these assumptions in a general way, and suggest that with t h i s approach i n d i v i d u a l s can provide v a l i d treatment a c c e p t a b i l i t y r a t i n g s . Witt and h i s c o l l e a g u e s have developed the I n t e r v e n t i o n Rating P r o f i l e (IRP) (Witt et a l . , 1984) and the C h i l d r e n ' s I n t e r v e n t i o n R a t i n g P r o f i l e (CIRP) ( E l l i o t , W i t t , & G a l v i n , 1983, c i t e d i n , Witt & E l l i o t , i n press) which are q u i t e s i m i l a r to the TEI developed by Kazdin, but which use language and items d i r e c t e d more for use with t e a c h e r s and c h i l d r e n i n classroom s e t t i n g s . While Kazdin's s t u d i e s have employed a repeated measures r e p l i c a t e d L a t i n Square design, where each su b j e c t r a t e s each treatment, W i t t ' s s t u d i e s have 16 employed l a r g e numbers of s u b j e c t s , each r a t i n g a s i n g l e case-treatment combination i n a simple f a c t o r i a l d e s i g n . In t h i s way Witt and h i s c o l l e a g u e s have made comparisons among a l t e r n a t i v e i n t e r v e n t i o n s and i n v e s t i g a t e d s e v e r a l f e a t u r e s thought to a f f e c t treatment a c c e p t a b i l i t y : p o t e n t i a l r i s k s to t a r g e t c h i l d , teacher time r e q u i r e d , e f f e c t on non-target c h i l d r e n , l e v e l of s k i l l r e q u i r e d f o r implementation, m a t e r i a l s r e q u i r e d (Witt, E l l i o t , & Martens, i n press; Witt et a l . , 1984); how treatments are presented (Witt, Moe, Gutkin, & Andrews, i n p r e s s ) ; problem type and s e v e r i t y (Witt, 1983); and r a t i n g s provided by c h i l d r e n ( E l l i o t et a l . , i n p r e s s ) . The assumptions u n d e r l y i n g the approach employed by Witt and h i s c o l l e a g u e s are that i n d i v i d u a l s have some abso l u t e f e e l i n g s about a p a r t i c u l a r treatment combination d e s c r i b e d , and that these f e e l i n g s can be q u a n t i f i e d f o r the purpose or comparison u s i n g the IRP. S e v e r a l of the r e p o r t e d s t u d i e s on treatment a c c e p t a b i l i t y are suggestive of a r e l a t i o n s h i p between r a t i n g s obtained and s e v e r a l other f a c t o r s such as, teacher's l e v e l of knowledge of b e h a v i o r a l p r i n c i p l e s and type of case to which treatment i s a p p l i e d . These f a c t o r s have not been s a t i s f a c t o r i l y i n v e s t i g a t e d i n any re p o r t to date. The i m p l i c a t i o n s f o r such i n v e s t i g a t i o n s , p a r t i c u l a r l y of the f i r s t of these f a c t o r s , f o r teacher p r e s e r v i c e and i n s e r v i c e t r a i n i n g and f o r c o n s u l t a t i o n are c l e a r . 1 7 1. KNOWLEDGE OF BEHAVIORAL PRINCIPLES The work of Jeger and McClure (1979); Norton et a l . (1983); Musgrove and Harmes (1975); Frey (1970); Robinson and Swanton (1980); and McMahon, Forehand, and G r i e s t (1981) i s a l l suggestive of more p o s i t i v e a t t i t u d e s toward b e h a v i o r a l techniques with i n c r e a s e s in knowledge of such approaches. S e v e r a l a d d i t i o n a l s t u d i e s have reported e m p i r i c a l support f o r such a r e l a t i o n s h i p . Wheldall and Congreve ( 1 980a) found i n a study of 116 mature i n s e r v i c e student teachers that the more they knew about behavior m o d i f i c a t i o n the more p o s i t i v e were t h e i r a t t i t u d e s . T h i s was a l s o supported by a r e t e s t s t u d y . f o l l o w i n g i n s t r u c t i o n i n behavior m o d i f i c a t i o n . These f i n d i n g s support those of Musgrove (1974) and T h r o l l and Ryan (1976) where p o s i t i v e a t t i t u d e s toward behavior m o d i f i c a t i o n were r e l a t e d to higher scores on measures of knowledge about behavior m o d i f i c a t i o n . No s i g n i f i c a n t r e l a t i o n s h i p was found i n any of these s t u d i e s between t e s t scores and age, experience or sex, although p r e v i o u s exposure to behavior m o d i f i c a t i o n had a h i g h l y s i g n i f i c a n t e f f e c t . Hickey (1977) r e p o r t s a s i g n i f i c a n t and p o s i t i v e c o r r e l a t i o n between scores on an a t t i t u d e to behavior m o d i f i c a t i o n s c a l e and scores on a knowledge measure using a sample of 30 p u b l i c high school c o u n s e l o r s . Hickey found that i n a d d i t i o n to the knowledge f a c t o r , sex and p e r c e i v e d socioeconomic l e v e l of school i n which s u b j e c t s work a f f e c t e d a t t i t u d e r a t i n g s . Females, and teachers from higher socioeconomic schools expressed more 18 p o s i t i v e a t t i t u d e s toward behavior m o d i f i c a t i o n . Young and P a t t e r s o n (1981), i n a study i n v o l v i n g 475 undergraduate students and 67 f a c u l t y members, i n d i c a t e s e v e r a l f i n d i n g s of i n t e r e s t . In general these f i n d i n g s are s i m i l a r to those above with more p o s i t i v e a t t i t u d e s toward behavior m o d i f i c a t i o n being a s s o c i a t e d with higher knowledge scores on a performance based measure of knowledge. However s u b j e c t s who l a b e l e d themselves as informed or very informed about behavior m o d i f i c a t i o n d i d not d i f f e r from the s e l f - l a b e l e d p o o r l y informed and very p o o r l y informed in t h e i r o v e r a l l performance on the knowledge task. Merrett and Wheldall (1982) report that i n a study i n v o l v i n g 110 student teachers i n a course i n behavior m o d i f i c a t i o n i n t e a c h i n g , those students who had taken a course i n behavior m o d i f i c a t i o n r e c e i v e d higher grades on v a r i o u s measures of t e a c h i n g performance and that there was a s i g n i f i c a n t change i n a t t i t u d e s toward b e h a v i o r a l t e a c h i n g methods. Se v e r a l other authors have a l l u d e d to such p o s i t i v e r e l a t i o n s h i p s of a t t i t u d e and knowledge of or f a m i l i a r i l y with techniques of behavior m o d i f i c a t i o n (Camplese, O'Bruba, & Hale, 1979; Knapp & D e l p r a t o , 1980; Lambert, 1976; L u i s e l l i , 1981; M i l l e r , 1981; Reppucci, 1977). Two e m p i r i c a l s t u d i e s r e p o r t no r e l a t i o n s h i p between knowledge l e v e l and a t t i t u d e . Burkhart et a l . , (1976) in a study i n v o l v i n g nine j u v e n i l e p r o b a t i o n o f f i c e r s f a i l e d to f i n d d i f f e r e n c e s i n a t t i t u d e toward behavior m o d i f i c a t i o n on a semantic d i f f e r e n t i a l between a t r a i n e d and c o n t r o l group. 19 The t r a i n e d group scored higher on a t e s t of b e h a v i o r a l competency but d i d not d i f f e r s i g n i f i c a n t l y on a [30 item, m u l t i p l e c h o i c e ] behavior knowledge measure. M a r h o l i n , T a y l o r , and Warren (1978) report on a study of 47 undergraduate students i n s p e c i a l education which i n d i c a t e s no d i f f e r e n c e between high and low behavior m o d i f i c a t i o n t e s t s c o r e r s on r a t i n g s of behavior m o d i f i c a t i o n . Furthermore, and d e s p i t e the r e v e a l e d d i f f e r e n c e s among s u b j e c t s i n t h e i r knowledge of concepts, s u b j e c t s d i d not d i f f e r i n t h e i r p e r c e p t i o n s of t h e i r competence i n the use of behavior m o d i f i c a t i o n techniques with c h i l d r e n . Three i s s u e s become evident i n reading t h i s l i t e r a t u r e r e l a t i n g knowledge and a t t i t u d e s toward behavior m o d i f i c a t i o n . The f i r s t of these i s that while the m a j o r i t y of s t u d i e s i n d i c a t e a p o s i t i v e r e l a t i o n s h i p , few re p o r t using v a l i d a t e d and comprehensive measures of both knowledge and a t t i t u d e . T h i s would i n d i c a t e a p o s s i b l e m ethodological shortcoming of these s t u d i e s . The second i s s u e i s one expressed by Kazdin and Cole (1981) and d e t a i l e d e a r l i e r : that s t u d i e s of g l o b a l e v a l u a t i o n s of behavior m o d i f i c a t i o n f a l l s hort of i d e a l i n that such a u n i t a r y concept may not be an a p p r o p r i a t e t a r g e t f o r study. The t h i r d i s s u e i s the lack of agreement amoung s t u d i e s on the r e l a t i o n s h i p which may e x i s t . With these i s s u e s being unresolved the q u e s t i o n of knowledge of b e h a v i o r a l p r i n c i p l e s being a f a c t o r i n the assessment of a c c e p t a b i l i t y of b e h a v i o r a l approaches to treatment has not been adequately researched. I t appears 20 necessary then to i n v e s t i g a t e d i r e c t l y the e f f e c t of knowledge of b e h a v i o r a l p r i n c i p l e s as a f a c t o r in the rated a c c e p t a b i l i t y of s p e c i f i c treatments. Such an i n v e s t i g a t i o n must employ a v a l i d a t e d methodology for e s t a b l i s h i n g both l e v e l s of knowledge and d i f f e r e n c e s i n degree of a c c e p t a b i l i t y of treatments. 2. TYPE OF CASE In 1954 the U. S. Supreme Court a r r i v e d at the d e c i s i o n i n Brown v. Board of Education of Topeka which e s t a b l i s h e d the concept that e d u c a t i o n a l o p p o r t u n i t i e s f o r c h i l d r e n are t i e d to success in l i f e . In 1971 and 1972 two f u r t h e r landmark cases one, i n v o l v i n g the Pennsylvania A s s o c i a t i o n f o r Retarded C h i l d r e n (PARC) and the other M i l l s v. D i s t r i c t of Columbia, e s t a b l i s h e d the r i g h t s f o r a l l handicapped c h i l d r e n to a f r e e a p p r o p r i a t e p u b l i c e d u c a t i o n . These d e c i s i o n s culminated, i n 1975, i n P u b l i c Law 94-142 which mandated, in d e t a i l , r i g h t s and s e r v i c e s f o r a l l c h i l d r e n r e g a r d l e s s of handicap in U. S. s c h o o l s ( P o l l a c k & S u l z e r - A z a r o f f , 1981). The recent adoption in Canada of a new Charter of R i g h t s guarantees c h i l d r e n s i m i l a r r i g h t s , although r i g h t s to s e r v i c e s are not d e t a i l e d or mandated to the same extent as i n the U. S. l e g i s l a t i o n . With the advent of these l e g a l o b l i g a t i o n s the i s s u e of mainstreaming and p r o v i d i n g f o r c h i l d r e n the ' l e a s t r e s t r i c t i v e ' e d u c a t i o n a l o p p o r t u n i t i e s has developed. As a r e s u l t r e g u l a r classroom teachers are now c h a l l e n g e d to meet the needs of not only a 21 gr e a t e r number of c h i l d r e n but a l s o of a group of c h i l d r e n with a grea t e r v a r i e t y of s p e c i a l needs. Both the general p u b l i c and the teaching p r o f e s s i o n have r e g i s t e r e d p a r t i c u l a r concern about student behaviors which are d i s r u p t i v e and d e t r i m e n t a l to classroom f u n c t i o n i n g and student l e a r n i n g (Baer, G o o d a l l , & Brown, 1983; Lindsey & F r i t h , 1983). Baer et a l . (1983) reviewed work by Wickman (1938) and S t o u f f e r and Owen (1955) which suggested that teachers were mostly concerned about d i s r u p t i o n s i n classroom order (Wickman, 1938) or i n f r a c t i o n s of r u l e s and r o u t i n e s and s i m i l a r forms of classroom misbehavior ( S t o u f f e r & Owen, 1955). Teachers i n the Baer et a l . (1983) study l i s t e d p h y s i c a l l y dangerous behaviors, d i s r u p t i o n s to l e a r n i n g and c h a l l e n g e s to the teacher's a u t h o r i t y as the three most s e r i o u s problems t e a c h e r s face today. I t i s reasonable to assume that those students whose behaviors c o n t r i b u t e to tea c h e r s ' concerns w i l l be the source of d i f f e r e n t i a l teacher r e a c t i o n s . Lewin, Nelson, & T o l l e f s o n (1983) and others (Brophy & Good, 1974; Silberman, 1969; 1971) have i n f a c t presented data to suggest that classroom teachers r e j e c t those c h i l d r e n who e x h i b i t d i s r u p t i v e b e h aviors. Teachers, parents, and the p u p i l s themselves don't o f t e n agree e i t h e r on the s e r i o u s n e s s of the problems or on the assignment of r e s p o n s i b i l i t y f o r the problems. Adelman, T a y l o r , F u l l e r , and Nelson (1979) found that students view t h e i r problems as l e s s severe than t h e i r parents view the problem and that teachers r a t e the 22 students' problems even more s e v e r e l y than do the par e n t s . Guttmann (1982) found that p u p i l s tend to blame a l l others ( t e a c h e r s , parents, other c h i l d r e n , the c h i l d ' s environment) more than the c h i l d h i m s e l f . Teachers tend to blame the misbehaving c h i l d f i r s t ( p s y c h o l o g i c a l problems, need to l e t o f f steam, d e s i r e to gain s t a t u s with c l a s s m a t e s ) , and the parents second (bad example at home, parents' l e v e l of e d u c a t i o n ) . They tend to play down the importance of reasons a s s o c i a t e d with other c h i l d r e n and, most pronouncedly, reasons a s s o c i a t e d with teachers themselves. Parents tend to a s s i g n blame evenly to the c h i l d h i m s e l f , t e a c h e r s , other c h i l d r e n and to themselves as par e n t s . Since the e a r l y work of Haring (1974) suggested that teacher a t t i t u d e s were in s t r u m e n t a l i n determining the fu t u r e adjustment of students, many i n v e s t i g a t o r s have attempted to i d e n t i f y the sources of a t t i t u d e s toward the handicapped (Brophy & Good, 1974; Fo s t e r & Ysseldyk, 1976; Hughes, Kauffman, & Wallace, 1973; Necco, 1970; Sa f r a n , Sa f r a n , & Orlansky, 1982). I n v e s t i g a t o r s i n the t h i s area are not i n unanimous agreement re g a r d i n g the e f f e c t of teacher expectancies i n e v a l u a t i n g students' b e h a v i o r . Safran et a l . , (1982) s t a t e that some evidence suggests that negative s t e r e o t y p e s b i a s teacher expectancies a g a i n s t mainstreamed students, while others d i s a g r e e . S a f r a n et a l . , (1982) suggest from t h e i r work that the way i n f o r m a t i o n about a c h i l d i s presented w i l l i n f l u e n c e t e a c h e r s ' a t t i t u d e s toward that c h i l d . Thus the kind of i n f o r m a t i o n 23 with which the teacher i s presented and a t t i t u d e of the r e c e i v i n g teacher w i l l have an e f f e c t on the kinds of goals e s t a b l i s h e d , and p o s s i b l y the methods employed in a c h i e v i n g those g o a l s . Much has been w r i t t e n s t r e s s i n g the n e c e s s i t y of s e l e c t i o n of a p p r o p r i a t e goals and the design and implementation of those goals i n the most e f f e c t i v e , e f f i c e n t and p r o f e s s i o n a l l y a p p r o p r i a t e manner p o s s i b l e ( C a r r e r r a & Adams, 1970; Hochbaum, 1980; O'Leary & O'Leary, 1977; Sapon-Shevin, 1982; Sheldon-Wildgen & R i s l e y , 1982; S t o l z , 1978; Wray & S t e e r , 1980). The b a s i c i s s u e i n t h i s l i t e r a t u r e i s that c l i e n t s , and in p a r t i c u l a r c h i l d r e n , have the r i g h t to the best p o s s i b l e assessment of needs (from a p p r o p r i a t e p e r s p e c t i v e s ) and the j u d i c i o u s s e l e c t i o n of treatment procedures f o r the best i n t e r e s t s of the c l i e n t . I m p l i c i t i n t h i s i s the understanding that i n d i v i d u a l s charged with the duty of s e l e c t i n g treatment s t r a t e g i e s w i l l i n f a c t pay heed to d i f f e r e n c e s between p r e s e n t i n g problems and thus s e l e c t treatment approaches d i f f e r e n t i a l l y . In the recent l i t e r a t u r e r e l a t e d to treatment a c c e p t a b i l i t y the i s s u e s of problem type and problem s e v e r i t y as w e l l as f a c t o r s r e l a t e d to the p r e s e n t i n g problem are not s a t i s f a c t o r i l y r e s o l v e d . Lambert (1976); E l l i o t , W i t t , & Martens ( i n p r e s s ) ; E l l i o t , W i t t , & G a l v i n ( i n p r e s s ) ; and Wollersheim, M c F a l l , Hamilton, Hickey, & Bordewick (1980) have found no s i g n i f i c a n t e f f e c t on r a t i n g s of a c c e p t a b i l i t y of treatment where d i f f e r e n t p r e s e n t i n g 24 p r o b l e m s a r e c o n s i d e r e d . G a r g i u l o and Y o n k e r (1983) r e p o r t m i x e d r e s u l t s , h o w e v e r , i n a s s e s s i n g t e a c h e r s ' a t t i t u d e s t o w a r d t h e h a n d i c a p p e d v e r s u s t h e n o n - h a n d i c a p p e d . T h e y f o u n d no d i f f e r e n c e b e t w e e n s e l f - r e p o r t m e a s u r e s o f i n s e r v i c e r e g u l a r , p r e s e r v i c e r e g u l a r , p r e s e r v i c e s p e c i a l , a n d i n s e r v i c e s p e c i a l e d u c a t o r s . H o w e v e r , p h y s i o l o g i c a l m e a s u r e s s u g g e s t e d g r e a t d i f f e r e n c e s be tween g r o u p s , f a v o r i n g more p o s i t i v e a t t i t u d e s t o w a r d h a n d i c a p p e d s t u d e n t s on t h e p a r t o f i n s e r v i c e s p e c i a l e d u c a t o r s . R e f l e c t i n g t h i s c o n t r a d i c t i o n a r e t h e r e s u l t s r e p o r t e d by K a z d i n (1980a, 1980b , 1981a) w h i c h c o n s i s t e n t l y i n d i c a t e t h a t s e v e r i t y o f p r e s e n t i n g p r o b l e m a f f e c t s r a t i n g s o f a c c e p t a b i l i t y o f t r e a t m e n t s . W i t t , E l l i o t , a n d M a r t e n s ( i n p r e s s ) ; W i t t e t a l . , (1984) f o u n d a m i n i m a l b u t s i g n i f i c a n t e f f e c t f o r p r o b l e m s e v e r i t y on a c c e p t a b i l i t y o f t r e a t m e n t s . Young a n d P a t t e r s o n (1981) f o u n d t h a t s t u d e n t s r e g a r d e d b e h a v i o r m o d i f i c a t i o n more a p p r o p r i a t e f o r s e r i o u s t h a n f o r m i n o r p r o b l e m s . T u r k a t e t a l . , (1979) a n d M a r h o l i n e t a l . , (1978) f o u n d t h a t d i f f e r e n t i a l a c c e p t a n c e o f b e h a v i o r m o d i f i c a t i o n was a t t r i b u t a b l e t o p r o b l e m t y p e . G u t k i n , S i n g e r , a n d Brown (1980) f o u n d a m o d e r a t e p o s i t i v e c o r r e l a t i o n b e t w e e n p e r c e i v e d p r o b l e m s e v e r i t y a n d t e a c h e r p r e f e r e n c e f o r r e f e r r a l r a t h e r t h a n c o n s u l t a t i o n s e r v i c e s . In an i m p l e m e n t a t i o n a n d e v a l u a t i o n s t u d y o f n o n d i r e c t i v e a n d t o k e n s c h o o l p r o g r a m s , M a n n a r i n o a n d D u r l a k (1980) r e p o r t t h a t t h e t y p e o f p r o b l e m p r e s e n t e d f a c i l i t a t e d i m p l e m e n t a t i o n o f s e r v i c e s . 25 The work of Kazdin and h i s c o l l e a g u e s (Kazdin, 1980a, 1980b, 1981a, in press; Kazdin et a l . , 1981) in a c c e p t a b i l i t y of treatments has i n a l l cases employed two stimulus case d e s c r i p t i o n s i n order to "assess the p o s s i b i l i t y that treatment e v a l u a t i o n s of the students were based upon, or r e s t r i c t e d t o , unique c h a r a c t e r i s t i c s of the stimulus m a t e r i a l " (Kazdin, 1980a, p. 263). In t h i s regard Kazdin r e f e r s to the arguments presented by Maher (1978) which c a u t i o n simply that " i f we wish to g e n e r a l i z e to p o p u l a t i o n s of s t i m u l i , we must sample from them" (p. 646). In an attempt to sample d i f f e r e n t p o p u l a t i o n s of s t i m u l i Kazdin has employed cases which vary on the important dimensions of p s y c h i a t r i c or b e h a v i o r a l problems; s e t t i n g s where problems occur; as w e l l as age, gender and i n t e l l e c t u a l c h a r a c t e r i s t i c s of the cases d e s c r i b e d . Based on the Maher (1978) work c r i t i c i s m might be l e v e l e d at the approach Kazdin has employed i n that the c r i t i c a l s t i m u l u s v a r i a b l e s may not be sampled and secondly that such " s c r i p t s " (Maher, 1978, p. 695) may i n f a c t not represent ' r e a l ' people. In other words, these may not be a sample from the p o p u l a t i o n to which g e n e r a l i z a t i o n i s to be made. Maher suggests that our h e s i t a t i o n i n g e n e r a l i z i n g from a s i n g l e s timulus case i s i n c r e a s e d s u b s t a n t i a l l y by the prospect of g e n e r a l i z i n g from a case that i s not known to have e x i s t e d at a l l . In a study a s s e s s i n g the a c c e p t a b i l i t y of time-out procedures Norton et a l . , (1983) s u b s t a n t i a l l y r e p l i c a t e d 26 e a r l i e r work by Kazdin (1980b). Although i n c o n t r a s t to the Kazdin study, Norton et a l . (1983) c o n t r o l l e d f o r p a r t i c u l a r case s t i m u l i and found age of c h i l d d e s c r i b e d a f f e c t e d r a t i n g s of both e f f e c t i v e n e s s and a c c e p t a b i l i t y . In support of Kazdin's f i n d i n g s , however, other stimulus f e a t u r e s such as sex of the c h i l d , and l o c a t i o n where behavior occurred d i d not a f f e c t r a t i n g s of a c c e p t a b i l i t y or e f f e c t i v e n e s s . I t i s s t i l l u n c l e a r , however, whether such stimulus f e a t u r e s as w r i t t e n background i n f o r m a t i o n w i l l a f f e c t teachers r a t i n g s of the a c c e p t a b i l i t y of i n t e r v e n t i o n s . Safran et a l . , (1982) using s e v e r a l case types found that background i n f o r m a t i o n on hearing impaired and normal c h i l d r e n a f f e c t e d teachers' p e r c e p t i o n s of student behaviors. However, t h i s f i n d i n g d i d not extend to the case of the a c t i n g - o u t c h i l d . I t i s necessary, then, to i n v e s t i g a t e f u r t h e r the e f f e c t of background i n f o r m a t i o n on teachers' r a t i n g s of the a c c e p t a b i l i t y of treatments, i n p a r t i c u l a r to e s t a b l i s h these e f f e c t s i n l i g h t of the present emphasis on mainstreaming of c h i l d r e n who e x h i b i t a v a r i e t y of problem b e h a v i o r s . 3. METHOD OF ASSESSING ACCEPTABILITY The two predominant rep o r t e d methods for r a t i n g the a c c e p t a b i l i t y of treatments are the Treatment E v a l u a t i o n Inventory (TEI) (Kazdin, 1980a) and the I n t e r v e n t i o n Rating P r o f i l e (IRP) (Witt, E l l i o t , & Martens, in p r e s s ) . A t h i r d method d e s c r i b e d i n a recent study (Norton et a l . , 1983) 27 used a s i n g l e item r a t i n g s c a l e to assess the r e l a t i v e a c c e p t a b i l i t y of v a r i o u s time-out procedures. While t h i s study employed a r e l a t i v e l y simple measure, the r e s u l t s support those of Kazdin's (1980b) study. These f i n d i n g s would suggest that i n v e s t i g a t i o n s of the methodology for a s s e s s i n g a c c e p t a b i l i t y may be f r u i t f u l . In many classrooms and c l i n i c a l c o n s u l t a t i o n or treatment s e t t i n g s the i n d i v i d u a l charged with s e l e c t i n g a p a r t i c u l a r treatment f o r implementation does so not by c o n s i d e r i n g the a c c e p t a b i l i t y of a s i n g l e treatment approach i n i s o l a t i o n , but ra t h e r by comparing and c o n t r a s t i n g a number of p o s s i b l e o p t i o n s and s e l e c t i n g that one which appears to have the 'best f i t ' , given the present s i t u a t i o n . The assumption here i s that an i n d i v i d u a l c o n f r o n t e d with a problem s i t u a t i o n (which i s m u l t i - d i m e n s i o n a l ) w i l l employ some i m p l i c i t p e r s o n a l c r i t e r i a to evaluate a l l a l t e r n a t i v e s and s e l e c t an a p p r o p r i a t e treatment. The range of a l t e r n a t i v e s which would be co n s i d e r e d would f i r s t l y be r e s t r i c t e d by the i n d i v i d u a l ' s knowledge of a l t e r n a t i v e s and secondly by the c r i t e r i a used i n e v a l u a t i n g those known a l t e r n a t i v e s . While i t may be reasonable to accept the above assumption, both the Witt and the Kazdin s t u d i e s have gone to c o n s i d e r a b l e lengths to a v o i d the very process of d i r e c t comparisons among treatment a l t e r n a t i v e s . Witt has h i s s u b j e c t s look at a s i n g l e treatment only and makes comparisons among a l t e r n a t i v e treatments using grouped data. 28 Kazdin has each subject evaluate each of three or four treatments but attempts to p r o v i d e s t a t i s t i c a l c o n t r o l through experimental design f o r any c a r r y o v e r (or comparison e f f e c t ) . Both of these approaches have y i e l d e d v a l u a b l e inf o r m a t i o n toward our understanding of s e v e r a l dimensions of treatment a c c e p t a b i l i t y but i t i s important to c o n s i d e r whether these or some other approach might generate more r e l e v a n t and g e n e r a l i z a b l e data. An a l t e r n a t i v e approach might allow f o r the e v a l u a t i o n of treatment a l t e r n a t i v e s through the d i r e c t and e x p l i c i t comparison of treatments along s i m i l a r dimensions as i n v e s t i g a t e d i n the previous r e s e a r c h . Such an approach has not r e c e i v e d a t t e n t i o n i n the r e s e a r c h l i t e r a t u r e to date and an a p p r o p r i a t e methodology has not as yet been developed. D. PROBLEM SUMMARY In the review of l i t e r a t u r e r e l a t e d to treatment a c c e p t a b i l i t y three problem areas were i d e n t i f i e d . There e x i s t s a la c k of systematic i n v e s t i g a t i o n of the e f f e c t of knowledge of b e h a v i o r a l p r i n c i p l e s on teachers' r a t i n g s of the a c c e p t a b i l i t y of s e l e c t e d treatment a l t e r n a t i v e s , although r e s e a r c h suggests a r e l a t i o n s h i p . Present r e s e a r c h i s a l s o i n c o n c l u s i v e r e g a r d i n g the e f f e c t of type of case on such r a t i n g s . While r e s e a r c h evidence does e x i s t s u b s t a n t i a t i n g the comparison of a c c e p t a b i l i t y of v a r i o u s treatment a l t e r n a t i v e s i t i s not c l e a r whether the present methodology i s e i t h e r the most e f f i c i e n t or i s intended to 29 be a c l o s e approximation of the c l i n i c a l decision-making process. E. PURPOSE OF THE STUDY R e f l e c t i n g the problems i d e n t i f i e d , the purpose of the present study was to q u e s t i o n the e f f e c t on the a c c e p t a b i l i t y of a l t e r n a t i v e classroom treatment procedures of c e r t a i n experimental and subject v a r i a b l e s . The i n i t i a l q u e s t i o n addressed i n the study was to determine whether p r a c t i c i n g elementary school teachers d i f f e r e n t i a t e , in terms of a c c e p t a b i l i t y , a l t e r n a t i v e classroom treatment procedures which might be a p p l i e d with c h i l d r e n ' s problem behaviors. The second q u e s t i o n was whether l e v e l of knowledge of b e h a v i o r a l p r i n c i p l e s a f f e c t s the way i n which i n d i v i d u a l s assess the a c c e p t a b i l i t y of s e l e c t e d classroom treatment procedures. The t h i r d q u e s t i o n was whether c e r t a i n stimulus c h a r a c t e r i s t i c s of the presented case d e s c r i p t i o n a f f e c t the a c c e p t a b i l i t y of treatment r a t i n g s which teachers p r o v i d e . The f o u r t h q u e s t i o n was whether an a l t e r n a t i v e method of a s s e s s i n g a c c e p t a b i l i t y w i l l r e f l e c t the f i n d i n g s e s t a b l i s h e d using the TEI. I t was the f i n a l i n t e n t of t h i s study to e s t a b l i s h data from a sample of l o c a l teacher s u b j e c t s which might be compared, i n a gen e r a l way, with data e s t a b l i s h e d i n s i m i l a r i n v e s t i g a t i o n s c a r r i e d out i n other s e t t i n g s . 30 F. SIGNIFICANCE OF THE STUDY Classroom teachers appear to have been given or to have taken a major r e s p o n s i b i l i t y f o r i d e n t i f y i n g c h i l d r e n who are e x h i b i t i n g problem behaviors, of i n i t i a t i n g assessment procedures and s e l e c t i n g and implementing treatments a p p r o p r i a t e to the s e t t i n g and to the c h i l d so i d e n t i f i e d . The q u a l i t y of implementation and even the s e l e c t i o n of a p p r o p r i a t e procedures appears to depend a great deal upon the i n d i v i d u a l teacher's knowledge of and views toward the ar r a y of p o s s i b l e a l t e r n a t i v e s . Beyond the f a c t that t eachers' p e r c e p t i o n s of classroom i n t e r v e n t i o n s are v a l u a b l e i n t h e i r own r i g h t , the r e l a t i o n between these p e r c e p t i o n s and other v a r i a b l e s i s a l s o of some importance ( G a r f i e l d , 1983). An i n d i v i d u a l ' s s u b j e c t i v e e v a l u a t i o n of a treatment may e f f e c t whether i t i s implemented p r o p e r l y , whether i t i s e f f e c t i v e (or p e r c e i v e d to be e f f e c t i v e ) , the length of time i t w i l l be used or whether i t w i l l even be used at a l l . W itt & E l l i o t , i n p r e s s , p. 25) Although the study of treatment a c c e p t a b i l i t y has r e c e i v e d some recent research a t t e n t i o n , major r e s e a r c h q u e s t i o n s and problems remain. One need i s f o r data on the g e n e r a l i t y of f i n d i n g s on d i f f e r e n t i a l e v a l u a t i o n s of treatment procedures on the b a s i s of a c c e p t a b i l i t y . I f , using the present r e s e a r c h methodology, i t can be e s t a b l i s h e d that i n d i v i d u a l s ( i n t h i s case teachers) do d i f f e r e n t i a t e procedures, then i t may be p o s s i b l e to i d e n t i f y s a l i e n t v a r i a b l e s r e l a t e d to the procedures, or perhaps to the i n d i v i d u a l s e v a l u a t i n g treatments. P a r t i c u l a r treatments or f e a t u r e s of some treatments may then be i d e n t i f i e d and amended i n ways which might enhance t h e i r a c c e p t a b i l i t y without compromising t h e i r 31 e f f e c t i v e n e s s . It may be a l s o that i d e n t i f i c a t i o n of c e r t a i n subject v a r i a b l e s may suggest changes i n f u t u r e d i r e c t i o n s fo r c u r r i c u l u m and practicum experiences f o r student teachers, as w e l l as i n s e r v i c e t r a i n i n g f o r p r a c t i c i n g t e a c h e r s . The m a j o r i t y of p u b l i s h e d r e s e a r c h to date on treatment a c c e p t a b i l i t y has employed undergraduate and graduate psychology students as s u b j e c t s . I t must be e s t a b l i s h e d , t h e r e f o r e , whether present or p o t e n t i a l consumers of classroom treatment procedures (e.g., teachers) respond i n a fa s h i o n s i m i l a r to that e s t a b l i s h e d i n other s t u d i e s by other p o p u l a t i o n s . In t h i s study an attempt was made to analyse consumers' r a t i n g s of a c c e p t a b i l i t y of treatments and to i d e n t i f y other f e a t u r e s of both treatments and s u b j e c t s which a f f e c t those r a t i n g s . By examining other f a c t o r s such as i n d i v i d u a l s ' degree of knowledge of b e h a v i o r a l p r i n c i p l e s , or l e v e l of t r a i n i n g , the study may suggest ways i n which teacher p r e p a r a t i o n , treatment p r e s e n t a t i o n , or i n f a c t , treatment design might be a l t e r e d . The goal of such a l t e r a t i o n s would be the development and use of e f f e c t i v e and a c c e p t a b l e treatments. I d e a l l y , i n the study of treatment a c c e p t a b i l i t y , the body of knowledge ought to be e s t a b l i s h e d by having r e a l teachers who are f a c i n g r e a l problems with r e a l c h i l d r e n s e l e c t from among a l l the a l t e r n a t i v e treatment procedures those procedures which they f e e l ' f i t ' b e st. A l l such 32 s e l e c t i o n s c o u l d be recorded i n c l u d i n g any s a l i e n t problem, teacher, or subject v a r i a b l e s . The a p p l i c a t i o n of these procedures c o u l d be monitored and s t u d i e s c a r r i e d out on such e f f e c t s as i n t e g r i t y of a p p l i c a t i o n , e f f e c t i v e n e s s of procedure, and e f f e c t on non-target c h i l d r e n , to name a few. In t h i s way i t might be e s t a b l i s h e d over a long p e r i o d of time and probably at great expense, more d i r e c t and b e l i e v a b l e evidence both about a c c e p t a b i l i t y of treatments and the many f a c t o r s which c o n t r i b u t e to treatment a c c e p t a b i l i t y . Although t h i s approach may be i d e a l i n terms of the wealth of data i t would produce, the resea r c h c o s t s would seem to be p r o h i b i t i v e . The next best approach then must be that approach which most n e a r l y approximates the i d e a l ( i . e . , the most n a t u r a l i s t i c ) but which does not have the attendant p r o h i b i t i v e c o s t s . I t may be that a more n a t u r a l i s t i c procedure f o r a s s e s s i n g a c c e p t a b i l i t y of treatments can be d e v i s e d which w i l l y i e l d u s e f u l data at no gr e a t e r research c o s t s than are p r e s e n t l y expended i n the study of a c c e p t a b i l i t y of treatments. I t i s important and worthwhile, p a r t i c u l a r l y i n any new re s e a r c h area, to e s t a b l i s h a body of data on s u b j e c t and s e t t i n g g e n e r a l i t y . Thus systematic r e p l i c a t i o n (Sidman, 1960) of c u r r e n t r e s e a r c h i s a v i a b l e and important purpose of study. T h i s study w i l l attempt to e s t a b l i s h through an examination of the q u e s t i o n s r a i s e d above whether f i n d i n g s developed i n d i v e r s e other s e t t i n g s and using other types of s u b j e c t s (Kazdin, 1980a, 1980b, 1981, i n p r e s s ; Kazdin et 33 a l . , 1 9 8 1 ; W i t t & M a r t e n s , i n p r e s s ; W i t t , M o e , G u t k i n , & A n d r e w s , i n p r e s s ) c a n b e g e n e r a l i z e d t o o t h e r p o p u l a t i o n s a n d s e t t i n g s . I I . METHODOLOGY The purpose of t h i s chapter i s to d e s c r i b e the method fol l o w e d to address the resea r c h q u e s t i o n s posed i n the prev i o u s chapter. The chapter begins with a broad overview of the nature of the study, f o l l o w e d by more complete d e s c r i p t i o n s of the ins t r u m e n t a t i o n and experimental design, the s u b j e c t s of the study, and the experimental and data p r e p a r a t i o n procedures. F i n a l l y , an o u t l i n e of the data a n a l y s i s procedure i s presented. The r e s u l t s of these analyses f o l l o w i n Chapter Three. A. NATURE OF THE STUDY T h i s i s p r i m a r i l y a causal-comparative study but makes use of procedures of experimental and a n a l y t i c survey methodologies. B r i e f l y , a s c r e e n i n g sample of vol u n t e e r elementary school teachers completed an instrument intended to assess t h e i r l e v e l of knowledge of b e h a v i o r a l p r i n c i p l e s as a p p l i e d to c h i l d r e n . A study sample of r e g u l a r c l a s s elementary school teachers was s e l e c t e d from the s c r e e n i n g sample on the b a s i s of the knowledge measure r e s u l t s and the demographic data s u p p l i e d . Study s u b j e c t s were presented with one of two c h i l d case d e s c r i p t i o n s which d i f f e r e d i n terms of the h i s t o r y of treatment the c h i l d had experienced. One c h i l d was d e s c r i b e d as having a h i s t o r y of s p e c i a l c l a s s assignment with i n t e n s i v e teacher support in a s t r u c t u r e d s e t t i n g . In the d e s c r i p t i o n of the other case no mention i s made of p r i o r treatment. Subjects were presented with 34 35 w r i t t e n d e s c r i p t i o n s of four treatments which might be a p p r o p r i a t e f o r a p p l i c a t i o n i n a classroom with a c h i l d such as the one presented in the case d e s c r i p t i o n . F o l l o w i n g the reading of each treatment, s u b j e c t s rated the a c c e p t a b i l i t y of the treatment on a four p a r t treatment a c c e p t a b i l i t y measure. When a l l four treatment r a t i n g s were completed s u b j e c t s responded to a f i n a l measure designed to s o l i c i t r e a c t i o n s to the case d e s c r i p t i o n , the r e l a t i v e a c c e p t a b i l i t y of the treatments and s u b j e c t i v e responses to treatment needs f o r the c h i l d d e s c r i b e d . The primary focus of the study was upon d i f f e r e n c e s i n treatment r a t i n g s p r o v i d e d by te a c h e r s , with respect to the teac h e r s ' knowledge l e v e l , the case d e s c r i b e d and the p a r t i c u l a r treatments presented. B. INSTRUMENTATION In a d d i t i o n to a demographic q u e s t i o n n a i r e completed by a l l s u b j e c t s , the present study employed three measurement instruments: an i n i t i a l knowledge measure, a four p a r t measure of treatment a c c e p t a b i l i t y , and a f i n a l q u e s t i o n n a i r e intended to s o l i c i t other i n f o r m a t i o n r e l e v a n t to the case d e s c r i p t i o n and to treatment r a t i n g s . A d e s c r i p t i o n of each of the instruments and the method of s c o r i n g s u b j e c t responses f o l l o w s . 36 1 . DEMOGRAPHIC QUESTIONNAIRE The demographic q u e s t i o n n a i r e (see Appendix A) was completed by a l l teachers p r i o r to a l l other study procedures. C h a r a c t e r i s t i c s surveyed i n c l u d e d s u b j e c t s ' sex, age, l e v e l of e d u c a t i o n a l degree or t r a i n i n g , years of t e a ching experience, and grade l e v e l of c h i l d r e n taught. Subjects were a l s o asked to i n d i c a t e whether they had any s p e c i a l t r a i n i n g i n c h i l d management, and to f u r t h e r c a t e g o r i z e any such exp e r i e n c e s . Teachers' responses on the q u e s t i o n n a i r e were intended to provide a means of both c h a r a c t e r i z i n g the study p o p u l a t i o n and s c r e e n i n g s u b j e c t s on the b a s i s of r e q u i r e d c h a r a c t e r i s t i c s ( i . e . , r e g u l a r classroom teachers s t a t u s ) . S c o r i n g the Demographic Q u e s t i o n n a i r e Teachers' responses to the q u e s t i o n n a i r e were coded f o r sex, years of experience, age i n years, grade l e v e l taught, and l e v e l of p r o f e s s i o n a l education (teacher c e r t i f i c a t i o n o nly, earned degree p l u s c e r t i f i c a t i o n , graduate degree p l u s c e r t i f i c a t i o n ) . Responses to the f i n a l q u e s t i o n of s p e c i a l t r a i n i n g were coded as yes or no. 2. KNOWLEDGE MEASURE A m o d i f i e d (16-item) v e r s i o n of the Knowledge of B e h a v i o r a l P r i n c i p l e s as A p p l i e d to C h i l d r e n (KBPAC) (O ' D e l l , T a r l e r - B e n l o l o , & F l y n n , 1979) was used to assess understanding and a p p l i c a t i o n of b a s i c b e h a v i o r a l p r i n c i p l e s with c h i l d r e n . In the development of the KBPAC, 70 items 37 were generated based on b e h a v i o r a l p r i n c i p l e s found expressed i n four widely r e c o g n i z e d t e x t s on the management of c h i l d r e n ' s behavior (Becker, 1971; H a l l , 1971; P a t t e r s o n & G u l l i o n , 1968, P a t t e r s o n , 1971). These 70 items were ad m i n i s t e r e d to a sample of 147 persons r e p r e s e n t i n g both l a y and p r o f e s s i o n a l people with a wide v a r i e t y of experience with behavior m o d i f i c a t i o n . O'Dell et a l . r e p o r t a Kuder-Richardson r e l i a b i l i t y c o e f f i c i e n t of 0.94 and an odd-even s p l i t - h a l f c o r r e l a t i o n of 0.93 f o r t h i s v e r s i o n of the KBPAC. F i f t y items which a t t a i n e d the h i g h e s t p o i n t - b i s e r i a l c o r r e l a t i o n with t o t a l score ( a l l > 0.30, mean=0.49) were r e t a i n e d f o r the f i n a l v e r s i o n . While items in the f i n a l v e r s i o n d i d not cover a l l p r i n c i p l e s found i n the c i t e d t e x t s the authors sugggested that the 50 items together provided a reasonable sampling of the content of i n t e r e s t . O ' Dell et a l . r e p o r t using the KBPAC in two s t u d i e s i n v o l v i n g v o l u n t e e r s u b j e c t s i n a 5-hour c h i l d management t r a i n i n g workshop. In both s t u d i e s odd-even s p l i t - h a l v e s of the instrument were a d m i n i s t e r e d pre and post t r a i n i n g . The f i r s t group of v o l u n t e e r parents demonstrated an i n c r e a s e from 48% to 85% c o r r e c t on the a l t e r n a t e form. Four other samples of undergraduate u n i v e r s i t y s u b j e c t s , one t h i r d of whom were psychology students, were pr o v i d e d with the same t r a i n i n g experience. T h i s a d d i t i o n a l sample of 91 respondents i n c r e a s e d pre/post t r a i n i n g from 57% to 85% c o r r e c t u s i n g the a l t e r n a t e form. 38 A m o d i f i e d 45-item v e r s i o n of the KBPAC was used i n a study i n which the e f f e c t of i n c o r p o r a t i n g formal t r a i n i n g in s o c i a l l e a r n i n g p r i n c i p l e s i n b e h a v i o r a l parent t r a i n i n g was i n v e s t i g a t e d (McMahon, Forehand, & G r i e s t , 1981). F i v e items from the KBPAC which d i d not r e f l e c t content a p p r o p r i a t e to the purpose of the study were not used i n the m o d i f i e d v e r s i o n . In t h i s study the KBPAC r e f l e c t e d s i g n i f i c a n t d i f f e r e n c e s i n the d e s i r e d d i r e c t i o n between groups who had t r a i n i n g only and t r a i n i n g p l u s i n s t r u c t i o n i n s o c i a l l e a r n i n g p r i n c i p l e s . Other s t u d i e s have repo r t e d development of instruments s i m i l a r i n purpose and design to that of the KBPAC (Marholin, T a y l o r , & Warren, 1978; Milne, 1982). The f i n d i n g of s i m i l a r r e s u l t s i n these s t u d i e s suggests the v a l i d i t y of the approach used i n the KBPAC to assess knowledge of b e h a v i o r a l p r i n c i p l e s as a p p l i e d to c h i l d r e n . Furtkamp, G i f f o r t , and S c h i e r s (1982) have examined two 10-item p a r a l l e l forms of the KBPAC f o r use i n r e s e a r c h or e v a l u a t i o n s e t t i n g s . These shortened v e r s i o n s were developed in r e a c t i o n to the l e n g t h of time (30-60 minutes) r e q u i r e d f o r most s u b j e c t s to complete the f u l l KBPAC. A sample of 164 Mental Health T e c h n i c i a n t r a i n e e s completed the 50-item KBPAC. From the r e s u l t s of t h i s sample item p o i n t - b i s e r i a l c o r r e l a t i o n s were used to determine the 20 items which best p r e d i c t e d t o t a l score f o r the t e s t . O v e r a l l , the mean item p o i n t - b i s e r i a l c o r r e l a t i o n was 0.296 (S.D.=0.157) and the median was 0.297. The range 0.693 (from -0.153 to =0.540). 39 The twenty items s e l e c t e d ranged from C.540 to 0.383. These items were then randomly assigned to form the two ten-item v e r s i o n s . These v e r s i o n s were administered to a sample of 111 t r a i n e e s f o l l o w i n g a course i n basic behavior m o d i f i c a t i o n , and item and t e s t a n a l y s i s completed on t h e i r responses. The authors found that reducing the l e n g t h of the t e s t had l i t t l e impact on the i n t e r n a l c o n s i s t e n c y of the t e s t s (Kuder-Richardson 20 of 0.862 f o r the 50-item v e r s i o n , and 0.735 and 0.765 f o r the two ten-item v e r s i o n s ) . The c o r r e l a t i o n between the two forms, determined from the responses of Mental Health T e c h n i c i a n t r a i n e e s , was 0.65 (r 2=0.423, F ( 1 , 1 0 9 ) = 8 0 . 1 7 , 2 < 0.001). When c o r r e c t e d f o r a t t e n u a t i o n , the estimated c o r r e l a t i o n of true s cores on the t e s t s i s 0.87. Furtkamp et a l . (1982) concluded that r e s e a r c h r e s u l t s supported use of these two v e r s i o n s as p a r a l l e l forms. For the purpose of the present study a f u r t h e r r e v i s e d v e r s i o n of the KBPAC was developed. Based on the f i n d i n g of O'Dell et a l . (1979) and Furtkamp et a l . (1982), a 16-item v e r s i o n of the KBPAC was prepared. While Furtkamp et a l . (1982) r e p o r t s a t i s f a c t o r y r e s u l t s from the two 10-item v e r s i o n s , they a l s o suggest that some of the items used i n the two forms may need reworking. Although a l l items d i s c r i m i n a t e d in the r i g h t d i r e c t i o n s e v e r a l a t t a i n e d p o i n t - b i s e r i a l c o r r e l a t i o n s l e s s than 0.30 with the t o t a l t e s t . A d d i t i o n a l l y , both 10-item v e r s i o n s a t t a i n e d r e l i a b i l i t i e s below that f o r the 50-item v e r s i o n (0.86) and 40 below the d e s i r e d l e v e l of 0.80. A p p l i c a t i o n of the Spearman-Brown formula (Nunnally, 1970) with the r e l i a b i l i t i e s obtained i n the Furtkamp et a l . study (1982) i n d i c a t e d that i f t e s t items homogenous with e i t h e r v e r s i o n were added to i n c r e a s e t e s t length to 15 or 16 items, the d e s i r e d l e v e l of r e l i a b i l i t y might be a t t a i n e d ( f o r 16 items Form A r e l i a b i 1 i t y = 0 . 8 2 , f o r 16 items Form B r e l i a b i l i t y = 0 . 8 4 ) . From the 20 items r e t a i n e d by Furtkamp et a l . (1982), those 16 items which e x h i b i t e d p o i n t - b i s e r i a l c o r r e l a t i o n c o e f f i c i e n t s g r e a t e r than 0.30 with t o t a l t e s t score were s e l e c t e d f o r the new v e r s i o n of the KBPAC. T h i s s e l e c t i o n e l i m i n a t e d three items from Form A and one from Form B ( p o i n t - b i s e r i a l c o r r e l a t i o n s of 0.19, 0.22, 0.27 and 0.29). The newly r e v i s e d form together with the two 10-item v e r s i o n s developed by Furtkamp et a l . (1982) were adm i n i s t e r e d to samples of students (n=95) r e g i s t e r e d i n f i v e undergraduate e d u c a t i o n a l psychology c l a s s e s at the U n i v e r s i t y of B r i t i s h Columbia. Within c l a s s , each v e r s i o n of the r e v i s e d KBPAC was randomly d i s t r i b u t e d so that approximately equal numbers of s u b j e c t s completed each v e r s i o n . Each subject completed one v e r s i o n only. A d m i n i s t r a t i o n time f o r the 10-item v e r s i o n s was approximately 4-5 minutes, the 16-item v e r s i o n t a k i n g 3-4 minutes l o n g e r . Student responses to each v e r s i o n of the KBPAC were analysed u s i n g the Laboratory of Education Research Test 41 A n a l y s i s Package (LERTAP) (Nelson, 1974). T h i s t e s t a n a l y s i s procedure provides both item and t o t a l t e s t a n a l y s i s . Examination of r e s u l t s from t h i s a n a l y s i s r e v e a l e d that a l l item p o i n t - b i s e r i a l c o r r e l a t i o n s f o r the 16-item KBPAC exceeded 0.30 (range 0.31 to 0.69, mean .51). Item r e s u l t s of the 10-item v e r s i o n s were l e s s s a t i s f a c t o r y (Form A range 0.23 to 0.63, mean .42, and Form B, range 0.06 to 0.72, mean .46). These l a t t e r r e s u l t s were c o n s i s t e n t with the f i n d i n g s of Furtkamp et a l . , with the same items a c h i e v i n g low p o i n t - b i s e r i a l c o r r e l a t i o n s with t o t a l t e s t . R e s u l t s of the LERTAP a n a l y s i s f o r the f u l l t e s t are presented i n Table 1. R e s u l t s of Furtkamp et a l . (1982) are i n c l u d e d f o r the purpose of comparison. The r e s u l t s summarized i n Table 1 i n d i c a t e an i n t e r n a l c o n s i s t e n c y r e l i a b i l i t y f o r the 16-item v e r s i o n which surpasses that of e i t h e r of the 10-item v e r s i o n s i n the p i l o t study. The obtained standard e r r o r of measurement f o r the two 10-item v e r s i o n s i s not s u b s t a n t i a l l y d i f f e r e n t from that r e p o r t e d by Furtkamp et a l . (1982) although the v a r i a b i l i t y among s u b j e c t s i s much l e s s i n the p i l o t sample. While i t might be expected that a longer v e r s i o n of the t e s t would demonstrate an improved r e l i a b i l i t y , the r e s u l t s o b t ained f o r the two 10-item v e r s i o n s in the p i l o t study are b a r e l y adequate (.42 and .58) i n comparison to that o b tained f o r the 16-item v e r s i o n . A d d i t i o n a l l y , the estimated r e l i a b i l i t i e s f o r each of the 10-item v e r s i o n s i n f l a t e d by the Spearman-Brown formula (10a, r=.54; 10b, r=.69 when 42 TABLE 1 KBPAC PILOT STUDY RESULTS V e r s i o n Number of Mean Standard R e l i a b i l i t y Standard Subjects D e v i a t i o n E r r o r of Measurement P i l o t 1 1 OA 31 5. 87 1 . ,91 0. ,42 1 , .31 1 OB 31 5. 10 2, , 15 0. .58 1 . .32 1 6 33 8. 18 3. ,90 0. ,81 1 . .63 Furtkamp et a l . 2 1 OA 1 1 1 4. 78 2. ,62 0, .74 1 , .35 1 OB 1 1 1 4. 78 2. ,75 0, .77 1 , .33 25 odd 1 64 12. 1 4 4. ,61 0, .77 2, .20 25 even 1 64 13. 1 7 4. .17 0, .74 2, . 1 5 50 1 64 25. 31 8. .26 0, ,86 3, .07 Note. R e l i a b i l i t i e s r e p o r t e d f o r p i l o t study are Hoyt's, those f o r Furtkamp et a l . (1982) are Kuder-Richardson. For dichotomously scored items such as those represented here, these two forms are e q u i v a l e n t . 1 P i l o t s u b j e c t s were student t e a c h e r s . 2Study s u b j e c t s were Mental H e a l t h T e c h n i c i a n t r a i n e e s . i n c r e a s e d i n l e n g t h to 16 items) s t i l l do not reach the d e s i r e d l e v e l of r e l i a b i l i t y , and c e r t a i n l y do not improve upon the r e s u l t obtained using the 16-item v e r s i o n . In comparing the obtained r e s u l t s with those reported by Furtkamp et a l . (1982) the 16-item v e r s i o n most n e a r l y approximates the d e s i r e d l e v e l of i n t e r n a l c o n s i s t e n c y r e l i a b i l i t y . While the r e l i a b i l i t y o btained f o r t h i s form (.81) with a sample of student teachers i s l e s s than that 43 reported f o r the 50-item v e r s i o n (.86) with the Mental Health T e c h n i c i a n t r a i n e e s , use of the 16-item v e r s i o n represented a p o t e n t i a l saving of 20 to 40 minutes of subject time. Since i t was a d e s i r e of the author to obt a i n an accurate measure of s u b j e c t s ' knowledge of b e h a v i o r a l p r i n c i p l e s as a p p l i e d to c h i l d r e n i n the most e f f i c i e n t manner, the 16-item v e r s i o n of the KBPAC was s e l e c t e d as the ap p r o p r i a t e measure f o r i n c l u s i o n i n the study. A copy of the 16-item v e r s i o n of the KBPAC, i n c l u d i n g i n s t r u c t i o n s f o r completion, i s presented i n Appendix B. Sc o r i n g the Knowledge Measure The KBPAC responses f o r both the instrument development and s c r e e n i n g samples were hand scored and t o t a l score f o r each subject c a l c u l a t e d . Item responses r e c e i v e d a value of one for agreement with keyed response and zero f o r any other response. In a d d i t i o n , s u b j e c t item responses were coded and pla c e d on a computer f i l e with 100% v e r i f i c a t i o n . No e r r o r s were found on v e r i f i c a t i o n . T h i s computer f i l e was used f o r v e r i f i c a t i o n of t o t a l score as w e l l as f o r completion of item and t e s t a n a l y s i s using the LERTAP computer program. 3. TREATMENT ACCEPTABILITY MEASURES The treatment a c c e p t a b i l i t y measures c o n s i s t e d of the Treatment E v a l u a t i o n Inventory (TEI) (Kazdin, 1980a) and a three part ( E v a l u a t i v e , Potency, A c t i v i t y ) Semantic D i f f e r e n t i a l (SD) (Osgood, S u c i , & Tannenbaum, 1957). 44 a. Treatment E v a l u a t i o n Inventory The TEI c o n s i s t s of 15 L i k e r t - t y p e items which together r e f l e c t an i n d i v i d u a l ' s o v e r a l l e v a l u a t i o n of the a c c e p t a b i l i t y of a p a r t i c u l a r treatment. Included are such c o n s i d e r a t i o n s as the treatment's o v e r a l l a c c e p t a b i l i t y ; whether i t should be recommended f o r broad a p p l i c a t i o n ; how f a i r , humane or e f f e c t i v e i t might be; whether i t would be a p p r o p r i a t e f o r use with someone not able to g i v e consent and whether i t f i t s with common notio n s of what treatment should be. Regarding development of the TEI, Kazdin (1980a) r e p o r t s that 45 o r i g i n a l items were generated which appeared to r e l a t e t o c l i e n t e v a l u a t i o n of treatment. From t h i s number Kazdin r e p o r t s that 16 were s e l e c t e d which best r e l a t e d to treatment of c h i l d r e n and the use of punishment. Respondents were asked to r a t e a p a r t i c u l a r d e s c r i b e d treatment on each of the 16 items using a seven p o i n t L i k e r t - t y p e s c a l e . One item, f o r example, asked respondents to i n d i c a t e the a c c e p t a b i l i t y of treatment on the dimension of ' s u i t a b i l i t y ' of the treatment f o r a p p l i c a t i o n with problems other than those d e s c r i b e d . The anchor p o i n t s , not s u i t a b l e at a l l to very s u i t a b l e , f o r example, represent r a t i n g s of treatment on one aspect of a c c e p t a b i l i t y . Subsequent f a c t o r a n a l y t i c s t u d i e s conducted to assess the e v a l u a t i v e v a l i d i t y of the TEI l e d to d e l e t i o n of one of the 16 items. The 15-item v e r s i o n of the TEI used i n the present study (see Appendix C) was developed and implemented i n 45 s e v e r a l s t u d i e s subsequent to Kazdin's f i r s t (1980a) study. Scoring the TEI A l l 15 items on the TEI are responded to by s u b j e c t s checking one p o s i t i o n on a seven p o i n t s c a l e which most n e a r l y represents the s u b j e c t ' s response to the d e s c r i b e d treatment. For the purpose of s c o r i n g , each response p o s i t i o n was given a numerical v a l u e , where a value of one was a s s i g n e d to the negative anchor p o i n t (e.g., not at a l l s u i t a b l e ) and a value of seven assi g n e d to the p o s i t i v e anchor p o i n t (e.g., very s u i t a b l e ) f o r each of the 15 q u e s t i o n s . A value of four represented a n e u t r a l p o s i t i o n on a p a r t i c u l a r item. Thus a t o t a l a c c e p t a b i l i t y score c o u l d range from a minimum of 15 to a maximum score of 105. I n d i v i d u a l subject responses to each item f o r each treatment were coded and input to a computer f i l e with 100% v e r i f i c a t i o n . Fewer than 5% e r r o r s i n coding and input were found; a l l were c o r r e c t e d p r i o r to a n a l y s i s . The LERTAP computer program was used to c a l c u l a t e i n d i v i d u a l a c c e p t a b i l i t y scores f o r each treatment r a t e d , and to provide item and t e s t a n a l y s i s data. b. Semantic D i f f e r e n t i a l The three part SD used i n the study (see Appendix D) c o n s i s t e d of 15 items, i n c l u d i n g f i v e from each of the e v a l u a t i v e , potency and a c t i v i t y dimensions d e s c r i b e d by Osgood et a l . (1957). The v e r s i o n used i n the study i s one developed by Kazdin (1980a) who gave two reasons f o r 46 i n c l u d i n g t h e SD w i t h t h e TEI as measures of t r e a t m e n t a c c e p t a b i l i t y . The f i r s t was t o i n c r e a s e t h e number and d i v e r s i t y o f v a r i a b l e s f o r t h e s u b s e q u e n t f a c t o r a n a l y s i s , a l l o w i n g f o r a more c a r e f u l d e l i n e a t i o n of a homogeneous f a c t o r . The s e c o n d was t o p r o v i d e a p a r t i a l v a l i d a t i o n of t h e T E I . I t was e x p e c t e d t h a t t h e e v a l u a t i v e d i m e n s i o n would c o r r e l a t e more h i g h l y t h a n t h e p o t e n c y and a c t i v i t y d i m e n s i o n s w i t h t h e T E I . B o t h t h e TEI and t h e e v a l u a t i v e d i m e n s i o n o f t h e SD were t h o u g h t t o r e f l e c t o v e r a l l a c c e p t a b i l i t y w h i l e t h e p o t e n c y and a c t i v i t y d i m e n s i o n s were t h o u g h t t o r e f l e c t i m p o r t a n t d i m e n s i o n s of t r e a t m e n t p e r h a p s n o t d i r e c t l y r e l e v a n t t o t h e e v a l u a t i o n of a c c e p t a b i l i t y . S c o r i n g t h e SD The 15 i t e m s on t h e SD a r e r e s p o n d e d t o by s u b j e c t s p l a c i n g a c h e c k mark i n one of se v e n p o s i t i o n s r e l a t i v e t o e a c h s e t of b i p o l a r a d j e c t i v e s . F o r t h e e v a l u a t i v e d i m e n s i o n a v a l u e of seven was a s s i g n e d t o t h e che c k s p a c e n e a r e s t t o t h e p o s i t i v e p o l e ( e . g . , good) and a v a l u e of one t o t h e n e g a t i v e p o l e ( e . g . , b a d ) . P o s i t i o n s between were a s s i g n e d v a l u e s a c c o r d i n g l y . F o r t h e f i v e i t e m s r e p r e s e n t i n g t h e p o t e n c y d i m e n s i o n , t h e p o l e r e p r e s e n t i n g g r e a t e r p o t e n c y ( e . g . , s t r o n g ) was a s s i g n e d a v a l u e of s e v e n and t h e o p p o s i t e p o l e ( e . g . , weak) a v a l u e of one. F o r t h e a c t i v i t y d i m e n s i o n t h e more a c t i v e p o l e ( e . g . , f a s t ) was a s s i g n e d a v a l u e of se v e n , t h e l e s s a c t i v e ( e . g . , slow) a v a l u e o f one. S c o r e s f o r e a c h d i m e n s i o n were c o n s i d e r e d s e p a r a t e l y so t h a t f o r e a c h s u b j e c t t h r e e d i m e n s i o n t o t a l s were f o u n d f o r 47 each of the treatments r a t e d . T o t a l scores f o r each dimension c o u l d range from a minimum of f i v e to a maximum of 35 f o r each treatment. As with the TEI, item responses f o r each i n d i v i d u a l under each treatment c o n d i t i o n were coded and input to a computer f i l e f o r c a l c u l a t i o n of t o t a l score, item, and t e s t a n a l y s i s s t a t i s t i c s u s i ng the LERTAP computer program. Subject responses were 100% v e r i f i e d , with fewer than 5% e r r o r s i n coding and input to the data f i l e . A l l e r r o r s were c o r r e c t e d p r i o r to a n a l y s i s . c. Psychometric P r o p e r t i e s Kazdin (1980a) p i l o t e d the treatment a c c e p t a b i l i t y measures (the 16-item TEI and the 15 items of the SD) with 60 undergraduate psychology s t u d e n t s . In the p i l o t study s u b j e c t s each heard one of four treatments d e s c r i p t i o n s , each presented as the treatment might be a p p l i e d to a c l i n i c a l case p r e v i o u s l y d e s c r i b e d to the s u b j e c t . Subjects then r a t e d the a c c e p t a b i l i t y of the treatment using the measures d e s c r i b e d above. The scores f o r p i l o t s u b j e c t s were submitted to a p r i n c i p a l components f a c t o r a n a l y s i s which was r o t a t e d to the varimax c r i t e r i o n (Kazdin, 1980a). The r e s u l t s of t h i s a n a l y s i s r e v e a l e d two f a c t o r s . F i f t e e n of the s i x t e e n items of the TEI loaded h i g h l y on the f i r s t f a c t o r ( p a t t e r n c o e f f i c i e n t s ranged from .61 to .95), as d i d the e v a l u a t i v e items from the SD. Loading f o r the potency and a c t i v i t y dimension of the SD were low ( l e s s than .40) f o r the s i n g l e 48 f a c t o r that c h a r a c t e r i z e d items of the TEI. These data confirmed the e x p e c t a t i o n that the TEI assessed o v e r a l l e v a l u a t i o n s of the treatments and suggested that these e v a l u a t i o n s were made independent of both potency and a c t i v i t y r a t i n g s . A d d i t i o n a l support of t h i s a n a l y s i s i s reported i n a second a d m i n i s t r a t i o n to 144 c o l l e g e students e n r o l l e d i n undergraduate psychology courses (Kazdin, 1980a). In t h i s study items from the TEI y i e l d e d high f a c t o r l o a dings on the f i r s t f a c t o r ( p a t t e r n c o e f f i c i e n t s ranged from .56 to .95) and items from the e v a l u a t i v e dimension of the SD loaded h i g h l y ( p a t t e r n c o e f f i c i e n t s ranged from .69 to .89) on t h i s f a c t o r as w e l l . Treatment a c c e p t a b i l i t y measures used i n subsequent s t u d i e s (Kazdin, 1980b, 1981a, i n p r e s s ; Kazdin et a l . , 1981) i n c l u d e d the three part SD and a TEI c o n s i s t i n g of the 15 items which loaded on the f i r s t f a c t o r of the analyses reported above. R e s u l t s of a n a l y s i s of data from these l a t t e r s t u d i e s supported the o r i g i n a l f i n d i n g s . Although no r e l i a b i l i t y data on e i t h e r the TEI or the dimensions of the SD were r e p o r t e d i n these s t u d i e s , a high i n t e r n a l c o n s i s t e n c y may be i n f e r r e d from the r e s u l t s of the f a c t o r a n a l y s i s ( i . e . , items loaded together on a common f a c t o r ) and the range i n t e r - i t e m c o r r e l a t i o n s f o r items of the f i r s t f a c t o r of the TEI (from .35 to .96, median r=.67). V a l i d i t y of the TEI f o r a s s e s s i n g treatment a c c e p t a b i l i t y i s p a r t l y e s t a b l i s h e d above and f u r t h e r supported by subsequent s t u d i e s i n which the TEI was used as 49 a dependent measure (Hobbs, Walle, & C a l d w e l l , 1984; Kazdin, 1980b, 1981a, in p r e s s ; Kazdin et a l . , 1981). R e s u l t s of these s t u d i e s e s t a b l i s h e d the a b i l i t y of the TEI to d i s t i n g u i s h , in the expected d i r e c t i o n , between s e v e r a l separate treatment s t r a t e g i e s a c r o s s a v a r i e t y of p o p u l a t i o n s and s e t t i n g s . 4. CASE AND TREATMENT QUESTIONNAIRE The f i n a l measure used i n the study was a q u e s t i o n n a i r e developed f o r the purpose of the present study. T h i s q u e s t i o n n a i r e (see Appendix E) was intended to s o l i c i t i n f o r m a t i o n from teachers about c e r t a i n f e a t u r e s of the case and of the treatments which had been r a t e d . In t h i s regard four q u e s t i o n s were posed. The f i r s t q u e s t i o n asked s u b j e c t s to r a t e the p e r c e i v e d s e r i o u s n e s s of the case d e s c r i b e d . Kazdin (1980a) found that treatments were g e n e r a l l y r a t e d more p o s i t i v e l y ( i . e . , were ass i g n e d higher a c c e p t a b i l i t y scores) when treatments were presented f o r a p p l i c a t i o n with more severe cases than those f o r l e s s severe cases. The f i r s t q u e s t i o n was intended to p r o v i d e an i n d i c a t i o n of the degree of p e r c e i v e d s e v e r i t y of the case presented and to d e t e c t p o t e n t i a l d i f f e r e n c e s i n s e v e r i t y of cases d e s c r i b e d . Question two r e q u i r e d s u b j e c t s to i n d i c a t e from t h e i r own experience how t y p i c a l the case d e s c r i b e d was of students i n the r e g u l a r classroom. T h i s q u e s t i o n was intended to o b t a i n some i n d i c a t i o n of i n c i d e n c e and p o s s i b l y 50 to lend v a l i d a t i o n to the p l a u s i b i l i t y of teachers having to c o n f r o n t t h i s kind of problem. Since treatment d e s c r i p t i o n s r e l a t e d i r e c t l y to the case d e s c r i p t i o n , i t was important that teachers see the case as a ' t y p i c a l ' d i f f i c u l t c h i l d or at l e a s t a p l a u s i b l e one so that treatment r a t i n g s might b e t t e r r e f l e c t a c c e p t a b i l i t y in a r e l e v a n t and p l a u s i b l e c o ntext. As Maher (1978) suggests, one danger i n using s c r i p t s (here the case d e s c r i p t i o n ) i s t h a t , i n an attempt to represent an i d e a l ' t y p i c a l ' case, a "case i s c r e a t e d that l i k e the manticore, may never have e x i s t e d i n nature" (p. 645). Teacher responses to t h i s q u e s t i o n i n d i c a t e whether i n f a c t the assumed case d e s c r i p t i o n i s r e l e v a n t and r e a l i s t i c enough to allow teachers to r e l a t e to treatment d e s c r i p t i o n s . The t h i r d q uestion r e q u i r e d s u b j e c t s to c o n s i d e r a l l four treatments at one time and to a s s i g n each to r e l a t i v e ranks on the b a s i s of how l i k e l y the s u b j e c t would be to use each i n the classroom. I f the TEI procedure can be p e r c e i v e d to r e v e a l some absolute measure of an i n d i v i d u a l ' s r a t i n g s of the a c c e p t a b i l i t y of a p a r t i c u l a r treatment, then t h i s p a r t i c u l a r q u e s t i o n asks the subject to c o n s i d e r the r e l a t i v e a c c e p t a b i l i t y of the four treatments d e s c r i b e d . Witt and E l l i o t ( i n press) s t a t e d that a "reason f o r a s s e s s i n g a c c e p t a b i l i t y i s to i n c r e a s e the l i k e l i h o o d that a treatment w i l l be used and w i l l be implemented with i n t e g r i t y " (p. 2). They suggest the need f o r research to l i n k a c c e p t a b i l i t y and use, but a l s o s t r e s s the need to 51 e s t a b l i s h procedures f o r a s s e s s i n g a c c e p t a b i l i t y which are r e l e v a n t to the s e l e c t i o n and use of treatments in the school (and other c l i n i c a l ) s e t t i n g ( s ) . I t i s important to develop a procedure which as n e a r l y as p o s s i b l e approximates the c l i n i c a l decision-making process, whereby the 'most a p p r o p r i a t e ' or 'best a v a i l a b l e ' of s e v e r a l known opt i o n s i s s e l e c t e d f o r use i n the p a r t i c u l a r s i t u a t i o n . T h i s i s p a r t i c u l a r l y important in l i g h t of r e s e a r c h which suggests that some teachers f i n d no i n t e r v e n t i o n which i s t o t a l l y a c c e p t a b l e (Witt & E l l i o t , i n p r e s s ) . T h i s q u e s t i o n i s one attempt at e s t a b l i s h i n g a methodology f o r s o l i c i t i n g such informat i o n . The f i n a l q u e s t i o n r e q u i r e d teacher s u b j e c t s to d e s c r i b e the approach they would most l i k e l y use i f the c h i l d d e s c r i b e d were i n t h e i r c l a s s . In t h i s q u e s t i o n teachers were not r e s t r i c t e d by the treatments which had been presented although a l l had been exposed to the d e s c r i p t i o n s p r i o r to answering t h i s q u e s t i o n . A major i n t e n t of t h i s q u e s t i o n was to provide some data f o r f u t u r e treatment a c c e p t a b i l i t y r e s e a r c h . Teacher responses to t h i s q u e s t i o n may r e v e a l approaches to classroom i n t e r v e n t i o n upon which a c c e p t a b i l i t y i n f o r m a t i o n ought to be accumulated. Witt and E l l i o t ( i n press) and Lambert (1976) suggest that teachers are t y p i c a l l y aware of only one or two treatments. I t i s important then to c o n s i d e r the dimension of a c c e p t a b i l i t y of those known treatments r e l a t i v e to other p o s s i b l e treatments. T h i s q u e s t i o n may r e v e a l a l s o the 52 breadth of approaches seen by teacher s u b j e c t s as a p p r o p r i a t e for use in the classroom s e t t i n g . S c oring the Case and Treatment Q u e s t i o n n a i r e In response to the f i r s t q u e s t i o n , teachers i n d i c a t e d which s c a l e p o i n t most n e a r l y represented t h e i r estimate of the s e r i o u s n e s s of the problems d e s c r i b e d . The p o s i t i o n s on the f i v e p o i n t s c a l e ranged from one (not very s e r i o u s at a l l ) to f i v e (extremely s e r i o u s ) . The second q u e s t i o n , which asked teachers to d e s c r i b e how t y p i c a l was t h i s c h i l d , d i d not produce responses which were r e a d i l y q u a n t i f i a b l e as no met r i c was pro v i d e d . Therefore responses were coded dichotomously. Responses which i n d i c a t e d that the c h i l d was somewhat t y p i c a l (e.g., "one every year", "two l i k e him i n my c l a s s r i g h t now", "one out of f i f t y " , and "I've seen four or f i v e i n 10 years of teaching") were scored as one. Responses which i n d i c a t e d that the case d e s c r i b e d was not at a l l t y p i c a l were coded as zero. Responses to q u e s t i o n three on the q u e s t i o n n a i r e represented s u b j e c t s ranking of the r e l a t i v e l i k e l i h o o d of t h e i r using each of the d e s c r i b e d treatments. S u b j e c t s i n d i c a t e d t h e i r ranking by a r r a n g i n g treatment code l e t t e r s i n order from 'most l i k e l y to use t h i s one' to ' l e a s t l i k e l y to use t h i s one'. For the purpose of s c o r i n g these responses, p o s i t i o n s i n the arrangement were assig n e d a value ranging from, one f o r ' l e a s t l i k e l y ' to four f o r 'most l i k e l y ' . 53 Question four was not scored f o r d i r e c t a n a l y s i s in the study as i t d i d not y i e l d data that was r e a d i l y coded. Moreover, these responses were not of d i r e c t i n t e r e s t to the purpose of the study. Coded responses were added with 1 0 0 % v e r i f i c a t i o n to the computer f i l e c o n t a i n i n g the coded responses to the treatment a c c e p t a b i l i t y measures. As d e s c r i b e d above for s c o r i n g of treatment a c c e p t a b i l i t y measures these data were scored using the LERTAP computer program. The Case and Treatment Q u e s t i o n n a i r e data were t r e a t e d as precoded s u b t e s t s with zero weighting f o r t h i s a n a l y s i s , a l l o w i n g f o r t a b u l a t i o n of responses without a f f e c t i n g the a n a l y s i s of the treatment a c c e p t a b i l i t y measures. C. DESIGN OF THE STUDY 1. DEPENDENT VARIABLES The dependent v a r i a b l e s i n the present study represent subject scores on the TEI and the three dimensions of the SD f o r each of the treatments. The treatments i n c l u d e d : Medication (M), Time Out (TO), Reinforcement (R), and P o s i t i v e P r a c t i c e (PP). The dependent v a r i a b l e s were measured as the t o t a l score a t t r i b u t e d to each treatment on each of the treatment a c c e p t a b i l i t y measures. With regard to the ranking procedure i n the Case and Treatment Q u e s t i o n n a i r e , the dependent v a r i a b l e was the r e l a t i v e rank ass i g n e d to each treatment. A more d e t a i l e d d e s c r i p t i o n of 54 procedures f o r s c o r i n g and a s s i g n i n g values i s presented i n the d e s c r i p t i o n of data p r e p a r a t i o n . 2. INDEPENDENT VARIABLES T h i s study i n c l u d e d three independent v a r i a b l e s which are represented as f a c t o r s in the experimental design. These were knowledge group, type of case, and type of treatment. S u b j e c t s ' scores on the knowledge measure were used as an i n i t i a l b l o c k i n g f a c t o r i n the study. D e t a i l s regarding s c o r i n g of the knowledge measure are i n c l u d e d i n the d e s c r i p t i o n of data p r e p a r a t i o n . On the b a s i s o f . t o t a l score on the knowledge measure s u b j e c t s were separated i n t o two groups using the median scores as the ' c u t p o i n t ' . Subjects who scored at the median were not c o n s i d e r e d f u r t h e r . A more d e t a i l e d d e s c r i p t i o n of t h i s procedure i s presented in the s e c t i o n on assignment of s u b j e c t s . The second independent v a r i a b l e , type of case, had two l e v e l s c orresponding to the h i s t o r y of s p e c i a l c l a s s treatment a t t r i b u t e d to the case (see Appendix F ) . Both d e s c r i p t i o n s are of the same c h i l d and are presented i n the same way. Mike R. i s d e s c r i b e d as a young boy who i s e x h i b i t i n g severe b e h a v i o r a l problems in school and i n a v a r i e t y of other s e t t i n g s . The d e s c r i p t i o n of Mike S., the second case, i s the same as that of Mike R. except f o r the a d d i t i o n of an i n t r o d u c t o r y paragraph which presents Mike S. as coming i n t o the present teacher's c l a s s as a r e s u l t of school and d i s t r i c t e f f o r t s toward mainstreaming. His 55 h i s t o r y s t a t e s that he has been in a s p e c i a l c l a s s s e t t i n g where he has been used to i n d i v i d u a l a t t e n t i o n and s p e c i a l programming. Other than the a d d i t i o n . o f t h i s paragraph on the h i s t o r y of treatment the d e s c r i p t i o n s of the two cases are i d e n t i c a l and are a d a p t a t i o n s of d e s c r i p t i o n s used by Kazdin (1981a). The t h i r d independent v a r i a b l e i s treatment type. Four treatments, M e d i c a t i o n , Time Out, P o s i t i v e P r a c t i c e , and Reinforcement (Kazdin, 1981a) were c o n s i d e r e d . The treatment d e s c r i p t i o n s , presented i n Appendix G, are r e p r e s e n t a t i v e of r e p o r t e d v e r s i o n s of i n t e r v e n t i o n s a p p l i e d to the type of t a r g e t behaviors presented in the case d e s c r i p t i o n (Kazdin, 1981a, p. 497). The design of the study n e c e s s i t a t e d c o n s i d e r a t i o n of the e f f e c t of two a d d i t i o n a l independent v a r i a b l e s . These were the v a r i a b l e s r e l a t e d to sequence i n which the treatments appeared (row e f f e c t ) and the order, or r e l a t i v e p o s i t i o n i n which a treatment appeared (column e f f e c t ) . These might be d i s t i n g u i s h e d from the f o r e g o i n g independent v a r i a b l e s as nuisance or design v a r i a b l e s . 3. EXPERIMENTAL DESIGN The design used i n the present study was an extension of the 4 x 4 L a t i n - s q u a r e design (Myers, 1979) and i s s i m i l a r to that used by Kazdin (1981a) of which t h i s study i s , i n p a r t , a s y s t e m a t i c r e p l i c a t i o n . Since four treatments were to be presented and repeated measures taken on the 56 dependent v a r i a b l e s , treatment p r e s e n t a t i o n was randomized in the square f o l l o w i n g the procedure f o r randomization of L a t i n - s q u a r e s d e s c r i b e d by K i r k (1968) and by Cochran and Cox (1950). One of four standard squares was s e l e c t e d at random. Rows and columns were then randomized independently y i e l d i n g the p a r t i c u l a r square used in the present study. Within t h i s square each of the four treatments occurs once in each order or column ( i . e . , f i r s t , second, t h i r d , or fourth) and once in each sequence or row. The L a t i n - s q u a r e then r e p r e s e n t s a random s e l e c t i o n of four of the 24 p o s s i b l e sequences in which the four treatments c o u l d be presented. In a d d i t i o n to the treatment v a r i a b l e , the f a c t o r s of knowledge l e v e l and type of case were i n c l u d e d i n the design as between-subjects f a c t o r s , hence the L a t i n - s q u a r e was r e p l i c a t e d once at each l e v e l of each of these f a c t o r s y i e l d i n g a 2 x 2 x (4 x 4) (knowledge l e v e l x case l e v e l x (sequence x o r d e r ) ) r e p l i c a t e d L a t i n - s q u a r e d e s i g n . The layout of the o v e r a l l design i s presented i n F i g u r e 1. Myers (1979) has suggested that L a t i n - s q u a r e designs have s e v e r a l p o t e n t i a l advantages over other d e s i g n s . F i r s t , the L a t i n - s q u a r e design allows f o r the i n v e s t i g a t i o n of s e v e r a l v a r i a b l e s with l e s s expenditure of time and fewer s u b j e c t s than a comparable f a c t o r i a l d e s i g n . A d d i t i o n a l l y , Myers suggests than an even more important advantage i s the e f f i c i e n c y of the L a t i n - s q u a r e design r e l a t i v e to other d e s i g n s . In using the L a t i n - s q u a r e i n a repeated measures FIGURE 1 LAYOUT OF THE EXPERIMENTAL DESIGN Knowledge Case Sequence Order Group 1 st 2nd 3rd 4th 1 M TO R PP 2 TO PP M R 3 PP R TO M 4 R M PP TO Hi£h 1 M TO R PP 2 TO PP M R 3 PP R TO M 4 R M PP TO 1 M TO R PP 2 TO PP M R 3 PP R TO M 4 R M PP TO Low 1 M TO R PP 2 TO PP M R 3 PP R TO M 4 R M PP TO 58 design, the researcher i s able to remove e r r o r v a r i a n c e due not only to i n d i v i d u a l d i f f e r e n c e , as in a r e g u l a r repeated measures design, but a l s o sequence and order or temporal e f f e c t s . T h i s advantage i s p a r t i c u l a r l y important when repeated measures on the dependant v a r i a b l e are l i k e l y to be a f f e c t e d by c a r r y o v e r e f f e c t s of potent treatments. D. PROCEDURE 1. SUBJECTS The s u b j e c t s of t h i s study were 107 v o l u n t e e r p r a c t i c i n g elementary school t e a c h e r s , s o l i c i t e d from nine schools in the Burnaby School D i s t r i c t . Burnaby i s a major suburban center w i t h i n the Greater Vancouver area. I t i s r e p r e s e n t a t i v e along most r e l e v a n t dimensions of the surrounding urban and suburban area which comprises a l a r g e p r o p o r t i o n of the t e a c h i n g and student p o p u l a t i o n of the p r o v i n c e . Since a major focus of the study was r a t i n g s p r o v i d e d by r e g u l a r classroom t e a c h e r s , the f i n a l s u b j e c t sample was r e s t r i c t e d to teachers who had a r e g u l a r c l a s s e n r o l l e d and had no more than three hours each week as a s s i g n e d s p e c i a l education or a d m i n i s t r a t i o n time. Subjects were s o l i c i t e d through an o r a l p r e s e n t a t i o n to school s t a f f meetings by the r e s e a r c h e r and f a c i l i t a t e d through the c o o p e r a t i o n of the school d i s t r i c t r e s e a r c h committee and the l o c a l school a d m i n i s t r a t i o n . The i n t r o d u c t o r y p r e s e n t a t i o n and subsequent procedures r e q u i r e d 5 9 approximately 10-15 minutes of s u b j e c t time. Teachers were presented with a w r i t t e n i n t r o d u c t i o n and statement of purpose and procedures f o r the study. A l l s t a f f i n d i c a t i n g i n t e r e s t i n p a r t i c i p a t i o n completed the demographic q u e s t i o n n a i r e and the r e q u i r e d consent form. F o l l o w i n g t h i s , t eachers responded to the 16-item knowledge measure. One hundred and seven teachers agreed to p a r t i c i p a t e i n the study and completed the knowledge measure and demographic q u e s t i o n n a i r e . The mean score on the knowledge measure f o r the i n i t i a l or s c r e e n i n g sample of 107 teachers was 7.03 (S.D.=3.68) with a maximum score of 16 p o s s i b l e . T h i s sample of 30 male and 77 female teachers had a mean age of 39 years and a mean of 14 years of teaching experience. The c h a r a c t e r i s t i c s of the teachers i n the s c r e e n i n g sample are summarized in Table 2. A l l teachers i n d i c a t i n g i n t e r e s t in p a r t i c i p a t i o n i n the study had the o p p o r t u n i t y to complete a l l experimental procedures. S i x t y - f o u r of those who met study requirements and i n d i c a t e d w i l l i n g n e s s to p a r t i c i p a t e were designated w i t h i n the study as s u b j e c t s and had t h e i r data t r e a t e d a c c o r d i n g l y . Data p r o v i d e d by other p a r t i c i p a n t s were r e t a i n e d and used i n analyses o u t s i d e the d i r e c t purpose of the study. T h i s i n c l u d e d a n a l y s i s of v a r i o u s p r o p e r t i e s of the measurement instruments used i n the study. 60 TABLE 2 CHARACTERISTICS OF SCREENING SAMPLE Age (years) Experience (years) Knowledge Le v e l Mean 39.29 14.16 7.03 S.D. 8.74 7.52 3.68 Range 32-60 0-35 0-16 (max. 16) Sex E d u c a t i o n a l L e v e l s L e v e l s of C l a s s E n r o l l e d Male=30 Female=77 Teach. Cert.=10 Deg. + Cert.=83 Grad. Deg. + Cert.=14 Primary=42 Intermediate=45 Spec i a l = 20 Schools Represented T o t a l S u b j e c t s S p e c i a l T r a i n i n g n=9 n=1 07 Yes=56; No=5! 2. ASSIGNMENT OF SUBJECTS Those teachers who scored at the median l e v e l (mdn=7) on the knowledge measure (n=l3), or who d i d not meet the s t a t e d c r i t e r i o n ( i . e . , r e g u l a r classroom teacher) (n=12) or who d i d not wish to p a r t i c i p a t e f u r t h e r i n the study (n=9) were not c o n s i d e r e d f o r the purpose of s e l e c t i o n of 61 s u b j e c t s . Of those remaining, 32 s u b j e c t s from each of the knowledge groups (high, low) were randomly s e l e c t e d f o r assignment to treatment c o n d i t i o n s . Within each knowledge group four teachers were randomly s e l e c t e d and assigned to each of e i g h t experimental c o n d i t i o n s (two c h i l d case d e s c r i p t i o n s x four treatment sequences). Thus, a t o t a l of 32 teachers were randomly s e l e c t e d from the remaining pool of s u b j e c t s at each knowledge l e v e l for p a r t i c i p a t i o n and data c o l l e c t i o n , and i d e n t i f i e d w i t h i n the study as the subj e c t sample. 3. DATA COLLECTION Experimental procedures f o r t h i s second meeting proceeded, as the f i r s t , with group a d m i n i s t r a t i o n . However, fo r t h i s s e s s i o n teachers r e c e i v e d i n d i v i d u a l packages of m a t e r i a l s a p p r o p r i a t e to the prea s s i g n e d experimental c o n d i t i o n . D i f f e r e n c e s i n packages represent the two d i f f e r e n t case d e s c r i p t i o n s and four d i f f e r e n t sequences i n which treatment were presented. Each su b j e c t was pro v i d e d with an e v a l u a t i o n package c o n t a i n i n g the a p p r o p r i a t e case d e s c r i p t i o n , four treatment d e s c r i p t i o n s , four copies of the treatment a c c e p t a b i l i t y measures and a s i n g l e copy of the case and treatment q u e s t i o n n a i r e . The case d e s c r i p t i o n i n c l u d e d and the sequence i n which treatments were arranged was determined p r i o r to s u b j e c t s viewing m a t e r i a l s , in the manner d e s c r i b e d e a r l i e r . 6 2 A f t e r reading t h e i r a s s i g n e d case d e s c r i p t i o n teachers were asked to c o n s i d e r the f i r s t treatment i n t h e i r package, and then to complete the treatment a c c e p t a b i l i t y measures with r e f e r e n c e to t h e i r case. These m a t e r i a l s were then put asi d e and the procedure repeated f o r the remaining three treatment d e s c r i p t i o n s . Subjects were asked t o c o n s i d e r each treatment s e p a r a t e l y , but to remember that each treatment r e l a t e d to the p a r t i c u l a r case d e s c r i p t i o n p r e s ented. F o l l o w i n g completion of the four separate treatment r a t i n g s s u b j e c t s were asked to complete the case and treatment q u e s t i o n n a i r e . The second s e s s i o n , i n c l u d i n g g i v i n g of i n s t r u c t i o n s , treatment e v a l u a t i o n s , and f i n a l q u e s t i o n n a i r e r e q u i r e d approximately 30 minutes of su b j e c t time. The experimenter was present d u r i n g both t h i s and the f i r s t s e s s i o n , to answer q u e s t i o n s and to ensure compliance to experimental procedures. E. DATA PREPARATION AND ANALYSIS 1. DATA PREPARATION Sc o r i n g procedures f o r subject data f o l l o w those d e s c r i b e d e a r l i e r under Instrumentation. A l l data were coded and entered onto computer f i l e s with 100% v e r i f i c a t i o n . A l l e r r o r s were c o r r e c t e d p r i o r to a n a l y s i s . 63 2. ANALYSIS OF DEMOGRAPHIC QUESTIONNAIRE The responses of teachers to the demographic q u e s t i o n n a i r e provided data to d e s c r i b e the f i n a l sample of 64 t e a c h e r s . D e s c r i p t i v e s t a t i s t i c s are p r o v i d e d f o r the f i n a l sample of 64 t e a c h e r s , separated i n t o the two knowledge groups. The SPSS:X computer program CROSSTABS (SPSS Inc., 1983) was used to p r o v i d e summary d e s c r i p t i v e s t a t i s t i c s of these two groups. 3. PSYCHOMETRIC ANALYSIS a. Knowledge Measure The psychometric a n a l y s i s of subject responses to the KBPAC was accomplished using the LERTAP computer program. T h i s program prov i d e s s u b j e c t s scores, mean, standard d e v i a t i o n , estimate of i n t e r n a l c o n s i s t e n c y r e l i a b i l i t y (Hoyt, 1941), and standard e r r o r of measurement, as w e l l as s t a t i s t i c s f o r item d i f f i c u l t i e s and p o i n t - b i s e r i a l c o r r e l a t i o n c o e f f i c i e n t s . F o l l o w i n g s a t i s f a c t o r y r e s u l t s of the psychometric a n a l y s i s and f o r the purpose of i d e n t i f y i n g h i g h and low s c o r i n g s u b j e c t p o o l s , the median of the d i s t r i b u t i o n of s u b j e c t s scores was c a l c u l a t e d . T h i s score then provided the 'cut p o i n t ' f o r d i v i d i n g the two groups, with those s u b j e c t s s c o r i n g at the median e l i m i n a t e d from assignment to subject p o o l s . 64 b . T r e a t m e n t A c c e p t a b i l i t y M e a s u r e s The f i r s t a n a l y s i s o f s u b j e c t r e s p o n s e s on e a c h o f t h e d e p e n d e n t m e a s u r e s was an i t e m a n d t e s t l e v e l a n a l y s i s . Once a g a i n t h e L E R T A P p r o g r a m was u s e d t o o b t a i n m e a n s , s t a n d a r d d e v i a t i o n s , s t a n d a r d e r r o r s o f m e a s u r e m e n t , a s w e l l a s i t e m - t e s t c o r r e l a t i o n s and H o y t e s t i m a t e s o f t h e i n t e r n a l c o n s i s t e n c y r e l i a b i l i t y o f t h e t e s t s . In t h e p r e s e n t s t u d y r a t i n g s f o r e a c h t r e a t m e n t on e a c h o f t h e d e p e n d e n t m e a s u r e s were t r e a t e d a s s e p a r a t e s u b t e s t s i n t h e L E R T A P a n a l y s i s . The a p p r o p r i a t e n e s s o f summing i t e m r e s p o n s e s w i t h i n e a c h d e p e n d e n t m e a s u r e was d e t e r m i n e d by an i n s p e c t i o n o f i t e m a n d t e s t s t a t i s t i c s p r o v i d e d i n t h e a n a l y s i s . The t o t a l s c o r e o b t a i n e d f o r e a c h s u b j e c t on e a c h o f t h e d e p e n d e n t v a r i a b l e s was u s e d i n t h e s e c o n d a n a l y s i s o f t r e a t m e n t r a t i n g s . 4 . A N A L Y S I S OF TREATMENT A C C E P T A B I L I T Y RATINGS The a n a l y s i s o f t r e a t m e n t a c c e p t a b i l i t y r a t i n g s was f o r s i g n i f i c a n t e f f e c t s o f t h e i n d e p e n d e n t v a r i a b l e s o f k n o w l e d g e l e v e l , c h i l d c a s e , a n d t r e a t m e n t t y p e , b a s e d on t e a c h e r r e s p o n s e s on t h e d e p e n d e n t m e a s u r e s . A d d i t i o n a l l y , t h e a n a l y s i s c o n s i d e r e d t h e e f f e c t s o f s e v e r a l o t h e r v a r i a b l e s w h i c h a r e f u n c t i o n s o f t h e e x p e r i m e n t a l d e s i g n ( s u b j e c t s , s e q u e n c e , and o r d e r ) . A l l o f t h e s e e f f e c t s were i n v e s t i g a t e d by u t i l i z i n g a r e p l i c a t e d L a t i n - s q u a r e a n a l y s i s o f v a r i a n c e w i t h r e p e a t e d m e a s u r e s . 65 Although L a t i n - s q u a r e designs have c e r t a i n b e n e f i t s and advantages which were d e s c r i b e d e a r l i e r ( c . f . , experimental design) such designs a l s o have attendant c o s t s i n terms of the amount of i n f o r m a t i o n a v a i l a b l e from the a n a l y s i s . The major s a c r i f i c e i n the a n a l y s i s of such designs stems from the f a c t that i n f o r m a t i o n about i n t e r a c t i o n s between treatment v a r i a b l e s and row and/or column v a r i a b l e s are impossible to e x t r a c t . I t i s p o s s i b l e , f o r example, for treatments to be a f f e c t e d d i f f e r e n t i a l l y by e i t h e r row or column placement or a combination of both. Such i n t e r a c t i o n s , i f they do e x i s t may obscure the main e f f e c t s of i n t e r e s t . Within t h i s type of design treatments are s a i d to be a l i a s e d w i t h i n s p e c i f i c higher order i n t e r a c t i o n e f f e c t s that are themselves assumed to be zero ( K i r k , 1968; Rosenthal & Rosnow, 1984; Winer, 1962). In the present a n a l y s i s treatment e f f e c t s are a l i a s e d w i t h i n the sequence x order (row x column) i n t e r a c t i o n term. While sequence, order, and sequence x order i n t e r a c t i o n e f f e c t s may be of some i n t e r e s t i n themselves, the primary focus of the res e a r c h i s the a l i a s e d treatment e f f e c t . I t i s p o s s i b l e , i n experimental designs such as the present one, to e x t r a c t treatment e f f e c t s (and i n t e r a c t i o n e f f e c t s of treatment with independent v a r i a b l e s other than sequence and column) from the s p e c i f i c higher order i n t e r a c t i o n s . These i n t e r a c t i o n s may, however, c o n t a i n i n a d d i t i o n to the treatment e f f e c t , v a r i a n c e a t t r i b u t a b l e to sources other than treatment. In 66 the present a n a l y s i s the sequence x order i n t e r a c t i o n term (which i s the treatment a l i a s ) may c o n t a i n treatment e f f e c t p l u s a ' L a t i n Square R e s i d u a l ' (LSR) (G. J . Johnson, p e r s o n a l communication, August, 1984). The LSR may be both i s o l a t e d and t e s t e d f o r s i g n i f i c a n c e , but where s i g n i f i c a n t w i l l i n most cases be u n i n t e r p r e t a b l e . Myers (1979) suggests that a s i g n i f i c a n t LSR can be i n t e r p r e t e d to be an e f f e c t of a treatment x order i n t e r a c t i o n (or a treatment x order x other independent v a r i a b l e i n t e r a c t i o n , depending on the LSR under c o n s i d e r a t i o n ) i f there i s strong a p r i o r i evidence fo r assuming that no sequence i n t e r a c t i o n s are p r e s e n t . Myers f u r t h e r s t a t e s , however, t h a t , "there i s no t e s t that permits determining which i n t e r a c t i o n component i s present [when the LSR i s s i g n i f i c a n t , and concludes t h a t ] . . . such a r e s u l t only r e v e a l s that some i n t e r a c t i o n component i s p r e s e n t " (p. 282). In s e v e r a l s t u d i e s u s i n g a s i m i l a r experimental design (Kazdin, 1980a, 1980b, 1981a, i n p r e s s ; Kazdin et a l . , 1981), the exact model of a n a l y s i s i s not s t a t e d and complete source t a b l e s f o r the a n a l y s i s of v a r i a n c e are not presented. Kazdin ( i n press) suggests a two stage a n a l y s i s ; the f i r s t of these being a 3 x 3 (sequence x order) L a t i n - s q u a r e a n a l y s i s of v a r i a n c e f o r repeated measures. Kazdin s t a t e s that t h i s stage of a n a l y s i s i s used to e v a l u a t e the impact of the way i n which treatments were presented. The second stage of a n a l y s i s focuses on the remaining v a r i a b l e s of i n t e r e s t , i g n o r i n g sequence and order 67 f a c t o r s . In e a r l i e r work, Kazdin (1980a) appears to f o l l o w the approach suggested by Myers (1979) of t e s t i n g e f f e c t s of the LSR. In the f i r s t study by Kazdin using t h i s design (1980a), t e s t s of treatment e f f e c t s on the potency and a c t i v i t y dimensions of the SD were made ag a i n s t the usual w i t h i n s u b j e c t s e r r o r terms, but the t e s t s of treatment e f f e c t s f o r the TEI and the e v a l u a t i v e dimension of the SD were made aga i n s t the LSR as an e r r o r term, l e a d i n g to a n e g a t i v e l y b i a s e d and hence h i g h l y c o n s e r v a t i v e F t e s t (Kazdin, 1980a, p. 265; see a l s o Myers, 1979, p. 276). Kazdin r e p o r t e d using that approach because the LSR obtained was l a r g e r than the w i t h i n s u b j e c t s e r r o r term. Kazdin does not re p o r t t e s t i n g the LSR f o r s i g n i f i c a n c e i n t h i s a n a l y s i s , but a s i g n i f i c a n t r e s u l t may be i n f e r r e d . In experiment two of the Kazdin (1980a) study the i n i t i a l a n a l y s i s f o r sequence and order e f f e c t s a l s o r e q u i r e d use of the c o n s e r v a t i v e F t e s t s ( l a r g e r mean square and fewer degrees of freedom i n design) i n d i c a t i n g the l i k e l y presence of a s i g n i f i c a n t LSR i n t h i s a n a l y s i s as w e l l . Other s t u d i e s using the same b a s i c experimental design, r e p o r t e d by Kazdin and h i s c o l l e a g u e s (Kazdin, 1980a, 1980b, 1981a, i n p r e s s ; Kazdin et a l . , 1981), however do not report r e s u l t s of a n a l y s i s r e q u i r i n g such t e s t s . A f u r t h e r methodological i s s u e i s r a i s e d i n reviewing the two stage a n a l y s i s r e p o r t e d i n the Kazdin s t u d i e s . While Kazdin s t a t e s , f o r example, that there i s "no d i r e c t 68 i n t e r e s t i n e v a l u a t i n g c h a r a c t e r i s t i c s of the case and i t s i n t e r a c t i o n s with other v a r i a b l e s " (1981a, p. 496), i t i s apparent that n e i t h e r Case D e s c r i p t i o n nor Treatment E f f i c a c y (the other between-subjects v a r i a b l e s in t h i s study) were c o n s i d e r e d i n the f i r s t stage of a n a l y s i s . A n a l y s i s at t h i s f i r s t l e v e l then does not account f o r any v a r i a n c e due to d i f f e r e n c e between l e v e l s of these f a c t o r s or i n t e r a c t i o n s i n v o l v i n g e i t h e r or both. In the second stage of a n a l y s i s the e f f e c t s of the between-subjects v a r i a b l e s and treatments are i n v e s t i g a t e d but the e f f e c t s of sequence and order are not. The experimental design used i n both the present study and those r e p o r t e d by Kazdin and h i s c o l l e a g u e s has the p o t e n t i a l f o r i d e n t i f y i n g s e v e r a l sources of v a r i a n c e not i n v e s t i g a t e d i n the two stage a n a l y s i s . The a n a l y s i s s e l e c t e d f o r the present study was a s i n g l e stage a n a l y s i s which accounts f o r a l l i d e n t i f i a b l e sources of v a r i a n c e i n the experimental d e s i g n . Computational formulae used i n the a n a l y s i s are a t t r i b u t a b l e to Johnson (G. J . Johnson, p e r s o n a l communication, August, 1984) and are e x a c t l y e q u i v a l e n t to Myers (1979). Employing the approach d e s c r i b e d by Myers (1979, p. 279-285) f o r i n v e s t i g a t i n g a d d i t i o n a l independent v a r i a b l e s by ' L a t i n squaring treatment combinations', the computer program BMDP:8V (Dixon, 1983) was used to p r o v i d e four separate analyses of data corresponding to the r a t i n g s from each of the four treatment a c c e p t a b i l i t y measures. The 69 a n a l y s i s approach was the same f o r each and proceeded as f o l l o w s . Since the design of the present study r e q u i r e d a n a l y s i s of a L a t i n - s q u a r e with repeated measures, two analyses of va r i a n c e were performed and then combined to y i e l d the sources of v a r i a n c e corresponding to the a n a l y s i s proposed by Johnson (G. J . Johnson, personal communication, August, 1984) and Myers (1979). The f i r s t repeated measures a n a l y s i s of v a r i a n c e was performed using subject data presented i n column order. The second repeated measures a n a l y s i s of va r i a n c e was performed with the same data r e o r d e r e d i n treatment l e v e l o r d e r i n g . The second a n a l y s i s (treatment l e v e l ordering) p r o v i d e d the sums of squares f o r treatment, treatment x knowledge i n t e r a c t i o n , treatment x case i n t e r a c t i o n , and treatment x knowledge x case i n t e r a c t i o n necessary to decompose a l l l e v e l s of the sequence x order a l i a s . These r e s u l t s were then combined with the r e s u l t s of the f i r s t a n a l y s i s to produce the ANOVA t a b l e d e s c r i b e d by Johnson (G. J . Johnson, p e r s o n a l communication, August, 1984) and Myers (1979). In t h i s a n a l y s i s the LSR i s t e s t e d for s i g n i f i c a n c e . Given a s i g n i f i c a n t LSR the t e s t s of r e l e v a n t main e f f e c t s are made a g a i n s t the LSR r a t h e r than the usual ( w i t h i n s u b j e c t s ) e r r o r term. Given s i g n i f i c a n t F r a t i o s i n these a n a l y s e s , the means were compared using Tukey's Honestly S i g n i f i c a n t D i f f e r e n c e (HSD) t e s t (Bruning & K i n t z , 1977). 70 5. ANALYSIS OF CASE AND TREATMENT QUESTIONNAIRE RESPONSES Only one the four q u e s t i o n s posed i n the q u e s t i o n n a i r e y i e l d e d r e s u l t s which c o u l d be analys e d . T h i s a n a l y s i s was for the e f f e c t of d i f f e r e n c e s i n ranking of treatments provided i n qu e s t i o n t h r e e . T h i s a n a l y s i s u t i l i z e d both Friedman's Two-Way A n a l y s i s of Va r i a n c e by Ranks and Ke n d a l l ' s C o e f f i c i e n t of Concordance. T h i s a n a l y s i s was performed by the computer program BMDP:3S (Dixon, 1983). In t h i s a n a l y s i s ranks given to each treatment were entered as the dependent v a r i a b l e . Given a s i g n i f i c a n t Friedman t e s t s t a t i s t i c , Nemenyi's (1963) procedure was used to compare means. F. CHAPTER SUMMARY The primary purpose of t h i s chapter was to d e s c r i b e the method fo l l o w e d i n the study. The method was f i r s t d e s c r i b e d i n g eneral terms as the nature of the study, then more s p e c i f i c a l l y . The development, s e l e c t i o n , and implementation of four measurement instruments was d e s c r i b e d . The p r e s e n t a t i o n of the design of the study i n c l u d e d both a d e s c r i p t i o n of the v a r i a b l e s of i n t e r e s t and the p a r t i c u l a r experimental design s e l e c t e d . The procedure s e c t i o n d e s c r i b e d the s u b j e c t s of the study and the procedures whereby s u b j e c t s were assigned to c o n d i t i o n s and data gathered. The f i n a l s e c t i o n of the chapter presented the methods of data p r e p a r a t i o n and a n a l y s i s . The methods 7 1 f o l l o w e d i n both the a n a l y s i s of the psychometric p r o p e r t i e s of the measurement instruments and analyses of the demographic, and case and treatment q u e s t i o n n a i r e s were presented. The development and s e l e c t i o n of a p p r o p r i a t e procedures f o r the a n a l y s i s of the treatment a c c e p t a b i l i t y r a t i n g s were d e s c r i b e d i n some d e t a i l . I l l . RESULTS The i n t e n t of t h i s chapter i s to present the r e s u l t s of the a n a l y s i s as d e s c r i b e d in Chapter Two. The chapter begins with a d e s c r i p t i o n of the s u b j e c t s who c o n t r i b u t e d responses i n the study, followed by the r e s u l t s of the psychometric a n a l y s i s . The next and major p o r t i o n of the chapter i s devoted to the p r e s e n t a t i o n of r e s u l t s of the a n a l y s i s of treatment a c c e p t a b i l i t y r a t i n g s . The r e s u l t s of the a n a l y s i s of responses to the case and treatment q u e s t i o n n a i r e are presented l a s t . The chapter concludes with a summary of the r e s u l t s focused on r e s u l t s r e l a t e d to the primary hypotheses. A. SUBJECTS Subjects f o r the study were v o l u n t e e r r e g u l a r c l a s s elementary school t e a c h e r s who were s e l e c t e d and a s s i g n e d w i t h i n the study f o l l o w i n g the procedures o u t l i n e d i n Chapter Two. B r i e f l y , 32 t e a c h e r s were s e l e c t e d f o r each of the (high and low) knowledge groups w i t h i n the study. The study sample of 64 s u b j e c t s d i d not appear to d i f f e r from the s c r e e n i n g sample on the c h a r a c t e r i s t i c s r e p o r t e d on the demographic q u e s t i o n n a i r e . Table 3 p r e s e n t s a summary of the c h a r a c t e r i s t i c s of the groups of high and low knowledge teachers (as measured by the KBPAC). S i g n i f i c a n c e t e s t s between the two knowledge groups f o r each of the r e p o r t e d c h a r a c t e r i s t i c s i n d i c a t e d no s i g n i f i c a n t d i f f e r e n c e s between 72 73 TABLE 3 SUBJECT DEMOGRAPHIC CHARACTERISTICS C h a r a c t e r i s t i c Screen ing Sample Subject Sample Low Knowledge High Knowledge Subjects T o t a l 1 07 64 32 32 Sex Male Female 30(28%) 77(72%) 12(19%) 52(81%) 9(28%) 23(72%) 3(9%) 29(91%) Age Mean S.D. 39.29 8.74 39. 1 7 8.82 39.81 9.59 38.53 8.09 Experience (years) Mean S.D. 14.16 7.52 13.73 6.77 15.06 8.40 1 1 .78 4.51 E d u c a t i o n a l L e v e l Teach. C e r t . Deg. + C e r t . Grad. Deg. + C e r t . 10(9%) 83(78%) 14(13%) 7(11%) 54(84%) 3(5%) 5(16%) 27(84%) 0 2(6%) 27(84%) 3(9%) Knowledge L e v e l Mean S.D. 7.03 3.68 7.00 3.80 3.84 1 .92 10.16* 2.27 C h i l d Management T r a i n i n g Yes No 56(52%) 51(48%) 33(52%) 31(48%) 12(38%) 20(63%) 21(66%)** 11(34%) *0 = .82, 2<-°5 **X 2 = 4.00, 2 < - 0 5 knowledge groups f o r sex, age, number of years of t e a c h i n g experience, and l e v e l of e d u c a t i o n a l t r a i n i n g . As would be expected, the two knowledge groups do d i f f e r s i g n i f i c a n t l y (# = .82, p_<.05) with regard to score on the knowledge measure. A d d i t i o n a l y , s i g n i f i c a n t d i f f e r e n c e s were found 74 between knowledge groups with regard to t r a i n i n g i n c h i l d management ( x 2 = 4.00, p_<.05), with the high knowledge group having a g r e a t e r p r o p o r t i o n of s u b j e c t s with t r a i n i n g . t h a n not, and the low knowledge group having a g r e a t e r p r o p o r t i o n of s u b j e c t s without t r a i n i n g than with. Included i n Table 3 as w e l l are summaries of the c h a r a c t e r i s t i c s of both the s c r e e n i n g and t o t a l s u b j e c t samples, a f f o r d i n g comparison and c o n t r a s t between groups along each of the r e p o r t e d dimensions. B. PSYCHOMETRIC ANALYSIS 1. KNOWLEDGE MEASURE The summary of r e s u l t s from the item a n a l y s i s of the KBPAC administered to the s c r e e n i n g sample are presented in Table 4. Examination of the i n d i v i d u a l items r e v e a l e d that the d i f f i c u l t y i n d i c i e s ranged from .16 to .70, and the i t e m - t e s t p o i n t - b i s e r i a l c o r r e l a t i o n s ranged from .35 to .62. The corresponding Hoyt estimate of r e l i a b i l i t y , r e p o r t e d i n Table 5, was .78. R e s u l t s of the t o t a l t e s t a n a l y s i s f o r the s c r e e n i n g sample are summarized i n Table 5. 2. TREATMENT ACCEPTABILITY MEASURES a. Treatment E v a l u a t i o n Inventory Since each subject used the TEI to respond to each of the four treatments and responses to each were c o n s i d e r e d to represent separate t e s t s , i t e m - t e s t c o r r e l a t i o n s were 75 TABLE 4 KBPAC ITEM ANALYSIS I tern D i f f i c u l t y Index Point B i s e r i a l C o r r e l a t i o n with T o t a l Test Score 1 .28 .39 2 .51 .35 3 .16 .55 4 .22 .49 5 .54 .45 6 .60 .58 7 .70 .41 8 .33 .62 9 .50 .57 10 .24 .52 1 1 .64 .56 1 2 .43 .43 1 3 .44 .43 1 4 .48 .40 1 5 .38 . 57 16 .58 .50 c a l c u l a t e d s e p a r a t e l y f o r each treatment. Examination of the p o i n t - b i s e i a l c o r r e l a t i o n s r e v e a l e d that f o r the most p a r t , items were p o s i t i v e l y r e l a t e d to t e s t score. F i f t y of the items exceeded .50, of the remaining only one was negative (-.07). These r e s u l t s compare f a v o r a b l y with those presented and d i s c u s s e d i n Chapter Two. The r e s u l t s of the t e s t a n a l y s i s f o r each a p p l i c a t i o n of the TEI appear i n Table 6. As shown by the value of the Hoyt's estimate of i n t e r n a l c o n s i s t e n c y , r e l i a b i l i t y of measurement was high. 76 TABLE 5 KBPAC TEST ANALYSIS Number of I n d i v i d u a l s = 107 Number of Items = 16.00 Mean = 7.03 Highest Score = 16.00 S.D. = 3.68 Lowest Score 0.00 Hoyt Estimate of R e l i a b i l i t y 0.78 Standard E r r o r of Measurement 1 .66 b. Semantic D i f f e r e n t i a l Item and t e s t l e v e l analyses were performed on responses to each of the subt e s t s r e p r e s e n t i n g the three dimensions of the SD f o r each treatment. R e s u l t s of t h i s a n a l y s i s i n d i c a t e that of the 60 items c o n s i d e r e d only one d i d not a t t a i n a p o i n t - b i s e r i a l c o r r e l a t i o n g r e a t e r than .20. T h i s was item number 5 on the a c t i v i t y dimension w i t h i n the Reinforcement c o n d i t i o n , r e p r e s e n t i n g the a d j e c t i v e p a i r f e r o c i o u s / p e a c e f u l . In t h i s case the subtest c o r r e l a t i o n a t t a i n e d was .178, lower than the other three c o n d i t i o n s (Medication=.66, Time Out=.55, and P o s i t i v e P r a c t i c e = . 4 7 ) . Since v a l u e s a t t a i n e d i n the other c o n d i t i o n s were acc e p t a b l e the r e s u l t i n the Reinforcement c o n d i t i o n was c o n s i d e r e d i n s u f f i c i e n t evidence to r e j e c t t h i s item. R e s u l t s of the item l e v e l a n a l y s i s i n general supported use of a l l items i n c a l c u l a t i o n of t o t a l score f o r each 77 TABLE 6 TEI TEST ANALYSIS Treatment Mean S.D. High Low Hoyt Standard Scoret Scored Estimate of E r r o r of R e l i a b i l i t y Measurement M 50.97 18.01 93 18 0.94 4.35 TO 69.97 20.00 96 16 0.95 4.24 R 79.03 14.22 1 03 52 0.89 4.64 PP 66.45 1 9.48 1 03 18 0.94 4.68 n = 64 Note. M = M e d i c a t i o n ; TO = Time Out; R = Reinforcement; PP = P o s t i v e P r a c t i c e fMaximum highest score = 105 ^Minimum lowest score = 7 dimension of the SD. The r e s u l t s of the t e s t l e v e l a n a l y s es p r o v i d e d through the LERTAP program are summarized i n Table 7. In a l l cases the data represent scores from 64 s u b j e c t s on f i v e q u e s t i o n s f o r each s u b t e s t . The maximum r a t i n g t h e r e f o r e would be 35 and a minimum r a t i n g would be f i v e . As summarized in Table 7, Hoyt's estimates of r e l i a b i l i t y were high f o r each dimension of the SD over each treatment c o n d i t i o n . The r e s u l t s r e p o r t e d i n Tables 6 and 7 supported the use of the measurments employed. Given these f i n d i n g s , s u b j e c t s ' t o t a l 78 TABLE 7 SEMANTIC DIFFERENTIAL TEST ANALYSIS Treatment Mean S.D. Hoyt Estimate of R e l i a b i l i t y Standard E r r o r of Measurement EVALUATIVE DIMENSION M 17.50 7.46 0.96 1 .38 TO 23.48 6.83 0.90 1 .97 R 27.05 6.05 0.91 1 .59 PP 21 .94 6.61 0.91 1 .80 POTENCY DIMENSION M . 23.38 6.79 0.93 1 .62 TO 23.03 5.68 0.90 1 .64 R 19.25 5.39 0.86 1 .79 PP 20.63 6.43 0.95 1 .32 ACTIVITY DIMENSION M 19.95 7.44 0.88 2.34 TO 21 .83 6.48 0.88 1 .99 R 20.42 4.49 0.75 1 .99 PP 22.30 5.83 0.85 2.03 Note. M=Medication; TO=Time Out; R=Reinforcement; PP=Positive P r a c t i c e score on each of the dependent measures f o r each treatment were c o n s i d e r e d i n subsequent a n a l y s e s . 79 C. ANALYSIS OF TREATMENT ACCEPTABILITY RATINGS 1. TREATMENT EVALUATION INVENTORY The r e s u l t s of the a n a l y s i s of v a r i a n c e of the TEI r a t i n g s are presented i n Table 8. Tables 9, 10, and 11 present comparisons between means for the a p o s t e r i o r i a n a l y s i s , f o l l o w i n g s i g n i f i c a n t F t e s t s of o v e r a l l d i f f e r e n c e s r e p o r t e d i n Table 8. As shown in Table 8 there were f i v e s i g n i f i c a n t sources of v a r i a n c e in t h i s a n a l y s i s . Two of these, L S R C F B and L SR^ D B correspond to d i f f e r e n t i a l c a r r y o v e r or environmental e f f e c t s on treatment r a t i n g s and are not i n t e r p r e t e d d i r e c t l y . Given s i g n i f i c a n t L a t i n square r e s i d u a l s , however, corresponding i n t e r a c t i o n e f f e c t s ( i . e . , AF, AD) were t e s t e d a g a i n s t the LSR rather than the usual w i t h i n s u b j e c t s e r r o r term.(C s u b j e c t s w i t h i n FDB) (Myers, 1979). D i s c u s s i o n of the remaining sources, knowledge, treatment and order f o l l o w , beginning with the knowledge f a c t o r . The s i g n i f i c a n t F r a t i o f o r the knowledge group f a c t o r [ F (1 , 48) =6 . 33 , p_<.02] i n d i c a t e d that knowledge group membership had a s i g n i f i c a n t e f f e c t on r a t i n g s of treatment a c c e p t a b i l i t y on the TEI. In g e n e r a l , s u b j e c t s i n the high knowledge group gave higher r a t i n g s (M=69.38) acr o s s treatments than d i d the low knowledge group (M=63.88). The f a c t o r of knowledge group i s not present i n any s i g n i f i c a n t i n t e r a c t i o n e f f e c t s (with the exception of the r e s i d u a l i n t e r a c t i o n term L S R ^ ™ ) . 80 TABLE 8 ANOVA FOR TEI Source df MS F Knowledge (F) 1 1897.74 6.33* Case (D) 1 3.33 0.01 Sequence (B) 3 376.16 1 .26 FD 1 73.27 0.24 FB 3 321.26 1 .07 DB 3 75.79 0.25 FDB 3 330. 10 1.10 Subject s w i t h i n FDB 48 299.81 Order (C) 3 1101.35 3.68* CF 3 51 .50 0.17 CD 3 131.51 0.44 Treatments (A) 3 8751.84 29.27* CB L a t i n Square R e s i d u a l ( L S R C B ) 6 299.83 1 .00 CFD 3 193.66 0.65 AF 3 574.43 0.82 L S R C F B 6 697.84 2.33* AD 3 422.00 0.64 L S R C D B 6 658.31 2.20* AFD 3 185.58 0.62 L S R C F D B 6 268.88 0.90 C Subjec t s w i t h i n FDB 1 44 298.98 *2<-05 81 The s i g n i f i c a n t F r a t i o f o r treatment [F(3,144)=29.27, P_<.001] i n d i c a t e s a s i g n i f i c a n t d i f f e r e n c e between l e v e l s of the f a c t o r a t t r i b u t e d to d i f f e r e n c e s i n treatment r a t i n g s . The treatment f a c t o r does not p a r t i c i p a t e in any s i g n i f i c a n t i n t e r a c t i o n e f f e c t s t e s t e d . R e s u l t s of comparisons between treatment r a t i n g means on the TEI using the Tukey Honestly S i g n i f i c a n t D i f f e r e n c e (HSD) procedure are summarized i n Table 9. The summary in Table 9 shows that the Reinforcement i n t e r v e n t i o n was r a t e d as s i g n i f i c a n t l y more ac c e p t a b l e than the other i n t e r v e n t i o n s u s i n g the TEI. Although the P o s i t i v e P r a c t i c e and Time Out procedures were not r a t e d s i g n i f i c a n t l y d i f f e r e n t from each other on the TEI both were l e s s a c c e p t a b l e than Reinforcement and more ac c e p t a b l e than the M e d i c a t i o n i n t e r v e n t i o n . The M e d i c a t i o n i n t e r v e n t i o n was r a t e d s i g n i f i c a n t l y l e s s a c c e p t a b l e than a l l other treatment i n t e r v e n t i o n s . The s i g n i f i c a n t F r a t i o f o r order of p r e s e n t a t i o n i n d i c a t e s that TEI treatment r a t i n g s d i f f e r e d as a r e s u l t of the order i n which treatments were r a t e d . T h i s r e s u l t must be i n t e r p r e t e d with some c a u t i o n i n l i g h t of the two s i g n i f i c a n t r e s i d u a l terms ( L S R C F B and L S R C D B ) i n v o l v i n g the order f a c t o r . Table 10 p r e s e n t s a summary of comparisons between order means on the TEI r a t i n g s . The r e s u l t s presented i n Table 10 i n d i c a t e t h a t , i n g e n e r a l , treatment r a t i n g s were not s i g n i f i c a n t l y d i f f e r e n t i n f i r s t and second p o s i t i o n s . However, r a t i n g s i n second p o s i t i o n were higher than those i n t h i r d and f o u r t h p o s i t i o n . S i m i l a r l y r a t i n g s 82 TABLE 9 TUKEY (HSD) COMPARISONS BETWEEN TREATMENT MEANS ON THE TEI Treatment Mean Di f ference R TO PP M Reinforcement (R) 79.03 9.06* 12.58 * 28.06* Time Out (TO) 69.97 3.52 19.00* P o s i t i v e P r a c t i c e (PP) 66.45 — 15.48* Medica t i o n (M) 50.97 — *2<.05 in the f i r s t p o s i t i o n were, i n g e n e r a l , higher than those i n the f o u r t h p o s i t i o n . I t must be noted that perhaps these are general trends and that the presence of s i g n i f i c a n t LSR e f f e c t s suggests that i n d i v i d u a l knowledge groups ( i n the case of the term LSR^ Bp) and i n d i v i d u a l case groups (LSR^gp) d i d not n e c e s s a r i l y f o l l o w t h i s s p e c i f i c t r e n d . I t may be that the presence of the LSR e f f e c t s suggests a s i g n i f i c a n t treatment x order i n t e r a c t i o n with knowledge group, and with case (Myers, 1979). There i s no t e s t to s u b s t a n t i a t e d i r e c t l y such an i n t e r p r e t a t i o n . However, LSR e f f e c t s can be d i s p l a y e d i n order to a i d i n the i n t e r p r e t a t i o n of the main e f f e c t f o r the order f a c t o r . Two graphs are presented to i l l u s t r a t e the complexity of the order e f f e c t and to r e i n f o r c e the c a u t i o n i n i t s i n t e r p r e t a t i o n . F i g u r e 2 presen t s LSR e f f e c t s f o r the Reinforcement and P o s i t i v e 83 TABLE 10 TUKEY (HSD) COMPARISONS BETWEEN ORDER MEANS ON THE TEI Order Mean D i f f e r e n c e 2 1 3 4 Second (2) 72. ,05 4.72 7.41* 9. ,64* F i r s t (1) 67. .33 — 2.69 4. .92* T h i r d (3) 64. .64 -- 2, .23 Fourth (4) 62, .41 -— *p_<. 05 P r a c t i c e i n t e r v e n t i o n s at each of the four orders f o r the two knowledge groups. As can be seen i n F i g u r e 2, the r a t i n g s f o r the Reinforcement i n t e r v e n t i o n are f a i r l y s t a b l e a c r o s s orders f o r the low knowledge group, and only s l i g h t l y l e s s so f o r the high knowledge group. The shaded area h i g h l i g h t s the r e s i d u a l e f f e c t s f o r the two knowledge groups on the Reinforcement i n t e r v e n t i o n . In st a r k c o n t r a s t the two broken l i n e s represent the LSR e f f e c t s f o r the P o s t i v e P r a c t i v e i n t e r v e n t i o n , and appear to r e f l e c t a d i f f e r e n t p a t t e r n of e f f e c t s . The major d i f f e r e n c e between the two treatments i s that the P o s i t i v e P r a c t i c e i n t e r v e n t i o n r a t i n g s appear to be a f f e c t e d by the order f a c t o r i n a d i f f e r e n t way than the Reinforcement i n t e r v e n t i o n r a t i n g s . Secondly, with respect to the P o s i t i v e P r a c t i c e i n t e r v e n t i o n r a t i n g s , the two knowledge groups appear to be a f f e c t e d Figure 2 LSR EFFECTS-CxFxB RESIDUALS Reinforcement and Positive Practice for High and Low Knowledge 15-i 10-< Q to UJ 5 -9-\ -a -5-\ -10-- 1 5 --20-First 77/77^77////////////^. x ' y Second Third ORDER \ \ \ \ \ a — i Fourth Legend • R for HIGH KNOWLEDGE o R for LOW KNOWLEDGE • PP for HjGHJKNOWLEDGE D PP for LOW KNOWLEDGE CO 8 5 q u i t e d i f f e r e n t l y by the order f a c t o r . A s i m i l a r c o n t r a s t can be drawn in a comparison of the LSR e f f e c t s of two treatments f o r each of the two cases. F i g u r e 3 presents the LSR e f f e c t s f o r the Medication and Reinforcement i n t e r v e n t i o n s f o r the cases of Mike S. and Mike R. Here again the Reinforcement i n t e r v e n t i o n appears to be more s t a b l e a c r o s s orders f o r s u b j e c t s a s s i g n e d to the case of Mike R. than f o r those assigned to Mike S. As w e l l the two case groups appear to be a f f e c t e d somewhat d i f f e r e n t l y by the order f a c t o r . For the Mike R. group r a t i n g s are higher i n the f i r s t than i n f o u r t h p o s i t i o n . For the Mike S. group the opposite i s t r u e . The r a t i n g s of the two case groups on the M e d i c a t i o n i n t e r v e n t i o n appear to be a f f e c t e d s i m i l a r l y i n f i r s t , second, and t h i r d order but d i f f e r i n degree when i n f o u r t h . A d d i t i o n a l l y the M e d i c a t i o n i n t e r v e n t i o n r a t i n g s appear to be a f f e c t e d by the order f a c t o r i n a d i f f e r e n t way than are the Reinforcement i n t e r v e n t i o n r a t i n g s . Since the order x treatment i n t e r a c t i o n i n each of the LSR e f f e c t s i s p e r f e c t l y confounded with the sequence x treatment i n t e r a c t i o n f u r t h e r i n t e r p r e t a t i o n of the e f f e c t of order of p r e s e n t a t i o n and of the r e s i d u a l e f f e c t s i s unwarranted. Thus the s i g n i f i c a n t , and i n t e r p r e t a b l e , e f f e c t s i n the a n a l y s i s of TEI a c c e p t a b i l i t y r a t i n g s were f o r knowledge l e v e l and treatment type. The high knowledge group teachers r a t e d treatments g e n e r a l l y more p o s i t i v e l y than d i d those in i — o UJ < z> Q UJ Figure 3 LSR EFFECTS-CxDxB RESIDUALS Reinforcement and Medication for Two Cases '//////////. O'//, '///A. V////'/ \ ///// y-- \ \ :>• \ \ \ \ -10-1 - 1 5 + -First S e c o n d Third Fourth ORDER Legend • R f o r M i k e s-o R f o r M i k e R . • M J o r J r f i k e S . • M f o r M i k e R . CO 87 teachers i n the low knowledge group. T h i s f i n d i n g was not a f f e c t e d by the case which the teachers c o n s i d e r e d . The second major f i n d i n g was that teachers d i d d i f f e r e n t i a t e treatments i n terms of a c c e p t a b i l i t y r a t i n g s on the TEI. In t h i s c ontext, the Medication i n t e r v e n t i o n was r a t e d lowest in o v e r a l l a c c e p t a b i l i t y , while the Reinforcement i n t e r v e n t i o n r e c e i v e d the h i g h e s t r a t i n g s of the four treatments presented. The P o s i t i v e P r a c t i c e and Time Out i n t e r v e n t i o n s d i d not d i f f e r i n t h e i r a c c e p t a b i l i t y , but both were r a t e d higher than M e d i c a t i o n although lower than Reinforcement. 2. SEMANTIC DIFFERENTIAL As d e s c r i b e d i n Chapter Two, teachers' responses f o r each dimension of the SD were c o n s i d e r e d s e p a r a t e l y in the a n a l y s i s . The r e s u l t s of a n alyses f o r each dimension of the SD are presented i n the same way as the TEI r e s u l t s . a. SD E v a l u a t i v e Dimension The r e s u l t s of the a n a l y s i s of v a r i a n c e f o r the E v a l u a t i v e dimension are presented i n Table 1 1 . As shown i n Table 11 there were three s i g n i f i c a n t sources of v a r i a t i o n in treatment a c c e p t a b i l i t y r a t i n g s on the E v a l u a t i v e dimension of the SD: treatment, sequence and order. The r e s u l t of primary i n t e r e s t to the study i s the s i g n i f i c a n t e f f e c t f o r treatment; t h e r e f o r e , t h i s r e s u l t and comparisons of treatment means are presented f i r s t . The p r e s e n t a t i o n of s i g n i f i c a n t sequence and order e f f e c t s f o l l o w s . 88 T A B L E 11 ANOVA FOR SD E V A L U A T I V E D I M E N S I O N S o u r c e d f MS F K n o w l e d g e ( F ) 1 8 7 . 8 9 2.10 C a s e ( D ) 1 4.00 0.10 S e q u e n c e ( B ) 3 1 2 4 . 2 8 2 . 9 8 * FD 1 5. 0 6 0.12 F B 3 6 7 . 4 2 1.61 DB 3 1 8 . 0 3 0.43 FDB 3 5. 4 9 0.13 S u b j e c t s w i t h i n FDB 48 41 .77 O r d e r ( C ) 3 1 6 1 . 3 2 3 . 7 0 * CF 3 2 3 . 4 0 0. 54 CD 3 2 . 8 9 0.07 T r e a t m e n t s ( A ) 3 1 0 0 1 . 8 0 2 2 . 9 5 * CB L a t i n S q u a r e R e s i d u a l ( L S R ^ g ) 6 3 9 . 2 2 0.90 CFD 3 9.45 0.22 A F 3 6 2 . 9 0 1 .44 L S R C F B 6 6 2 . 8 7 1 . 44 AD 3 19.51 0.45 L S R C D B 6 9 2 . 1 2 2.11 AFD 3 2 7 . 0 1 0.62 L S R C F D B 6 6 5 . 6 4 1 .50 C S u b j e c t s w i t h i n FDB 1 44 4 3 . 6 4 *p_<.05 89 The s i g n i f i c a n t F r a t i o f o r treatment [F(3,144)=22.95, p_<.00l] i n d i c a t e s a s i g n i f i c a n t d i f f e r e n c e between r a t i n g s given p a r t i c u l a r treatments. The absence of i n t e r a c t i o n s i n v o l v i n g treatments suggests that the d i f f e r e n c e s in r a t i n g s were c o n s i s t e n t a c r o s s l e v e l s of knowledge group f a c t o r as w e l l as with d i f f e r e n t cases. R e s u l t s of the post hoc comparisons between treatment means using Tukey's HSD procedure are summarized i n Table 12. The r e s u l t s summarized i n Table 12 show that the Reinforcement i n t e r v e n t i o n was given r a t i n g s s i g n i f i c a n t l y higher than the other three i n t e r v e n t i o n s . The r a t i n g s given the Time Out and the P o s i t i v e P r a c t i c e i n t e r v e n t i o n s d i d not d i f f e r s i g n i f i c a n t l y ; however, both were r a t e d s i g n i f i c a n t l y higher than the Me d i c a t i o n i n t e r v e n t i o n . The Medication i n t e r v e n t i o n was r a t e d s i g n i f i c a n t l y lower than a l l other treatment i n t e r v e n t i o n s . Tables 13 and 14 present comparisons of sequence and order means r e s p e c t i v e l y . The r e s u l t s of the comparisons between means f o r the order of p r e s e n t a t i o n summarized i n Table 13 i n d i c a t e that r a t i n g s given i n the t h i r d p o s i t i o n were g e n e r a l l y lower than those given to treatments i n the second or f i r s t p o s i t i o n but not s i g n i f i c a n t l y d i f f e r e n t from those given i n the f i n a l p o s i t i o n . Ratings given i n the second p o s i t i o n were a l s o higher than those i n the f o u r t h p o s i t i o n . The summary of r e s u l t s of comparisons between sequence means i n Table 14 r e v e a l s that the treatments i n sequence four were r a t e d higher than those i n e i t h e r 90 TABLE 12 TUKEY (HSD) COMPARISONS BETWEEN TREATMENT MEANS ON THE SD EVALUATIVE DIMENSION Treatment Mean D i f f e r e n c e R TO PP M Reinforcement (R) 27 .05 3.57* 5.11* 9. 55* Time Out (TO) 23 .48 -- 1 .54 5. 99* P o s i t i v e P r a c t i c e (PP) 21 .94 -- 4. 44* Medication (M) 1 7 .50 — * 2 < - 0 5 sequence two or t h r e e . No other d i f f e r e n c e s were found between sequence means. The presence or order and sequence e f f e c t s in t h i s a n a l y s i s while not of primary i n t e r e s t , suggests that c a r r y o v e r e f f e c t s may be present i n the a n a l y s i s . The major concern of such a r e s u l t i s that these e f f e c t s may obscure some other e f f e c t s of i n t e r e s t ( i . e . , knowledge, case, and treatment d i f f e r e n c e s ) . To summarize the r e s u l t s of the a n a l y s i s of the SD E v a l u a t i v e dimension, the s i n g l e i n t e r p r e t a b l e e f f e c t of i n t e r e s t was that of treatment type. T h i s f i n d i n g r e f l e c t e d the r e s u l t of the TEI a n a l y s i s . S u b j e c t s i n the two d i f f e r e n t knowledge groups and r e a d i n g d i f f e r e n t case d e s c r i p t i o n s d i d not r a t e treatments d i f f e r e n t l y . 91 TABLE 13 TUKEY (HSD) COMPARISONS BETWEEN ORDER MEANS ON THE SD EVALUATIVE DIMENSION Order Mean Di f ference 1 4 Second (2) F i r s t (1) Fourth (4) Third (3) 24.52 23.00 21 .28 21.17 1 .52 3.24* 1 .72 3.35* 1 .83* 0.11 t 2 < . 0 5 TABLE 14 TUKEY (HSD) COMPARISONS BETWEEN SEQUENCE MEANS ON THE SD EVALUATIVE DIMENSION Sequence Mean Di f ference 1 2 Four (4) One (1) Two (2) Three (3) 24.30 22.72 21 .95 21 .00 1 .58 2.35* 0.77 3.30* 1 .72 0.95 *p<.05 92 b. SD Potency Dimension The r e s u l t s of the a n a l y s i s of vari a n c e f o r the potency dimension are presented i n Table 15. The r e s u l t s summarized in Table 15 show treatment to be the only s i g n i f i c a n t source of v a r i a t i o n i n treatment r a t i n g s on the potency dimension of the SD. A summary of comparisons between treatment means f o r t h i s measure i s presented in Table 16. As shown, the Reinforcement i n t e r v e n t i o n r e c e i v e d s i g n i f i c a n t l y lower potency r a t i n g s than any of the other i n t e r v e n t i o n s . M e d i c a t i o n , which r e c e i v e d the highest potency r a t i n g was s i g n i f i c a n t l y higher than e i t h e r the Reinforcement or P o s i t i v e P r a c t i c e i n t e r v e n t i o n s but not s i g n i f i c a n t l y d i f f e r e n t from the Time Out i n t e r v e n t i o n . The Time Out i n t e r v e n t i o n was r a t e d higher on the potency dimension than both the P o s i t i v e P r a c t i c e and Reinforcement i n t e r v e n t i o n s . c. SD A c t i v i t y Dimension The r e s u l t s of the analyses of v a r i a n c e f o r the a c t i v i t y dimension of the SD are presented i n Table 17. The r e s u l t s of the analyses of v a r i a n c e f o r the a c t i v i t y dimension of the SD show that order of p r e s e n t a t i o n was the s i n g l e s i g n i f i c a n t e f f e c t . Comparisons between ordered p r e s e n t a t i o n means on the a c t i v i t y dimension are summarized i n Table 18. The r e s u l t s of comparisons between means f o r order of p r e s e n t a t i o n on the a c t i v i t y dimension show that treatments when presented i n the t h i r d p o s i t i o n are given higher a c t i v i t y r a t i n g s than i n any of the other p o s i t i o n s . No other d i f f e r e n c e s were found. 93 TABLE 15 ANOVA FOR SD POTENCY DIMENSION Source df MS F Knowledge (F) 1 13.14 0.28 Case (D) 1 45.56 0.98 Sequence (B) 3 109.09 2.34 FD 1 9.00 0.19 FB 3 3.55 0.08 DB 3 56.03 1 .20 FDB 3 36.01 0.77 Subjects w i t h i n FDB 48 46.66 Order (C) 3 26.48 0.74 CF 3 45.92 1 .28 CD 3 6.76 0.19 Treatments (A) 3 248.93 6.93* CB L a t i n Square R e s i d u a l (LSR^g) 6 8.56 0.24 CFD 3 55.80 1 .55 AF 3 51.14 1 .42 L S R C F B 6 32.28 0.90 AD 3 44. 60 1 .24 L S R C D B 6 47.69 1 .33 AFD 3 0.75 0.02 L S R C F D B 6 7.70 0.21 C Subjects w i t h i n FDB 1 44 35.94 *p_<.05 94 TABLE 16 TUKEY (HSD) COMPARISONS BETWEEN TREATMENT MEANS ON THE SD POTENCY DIMENSION Treatment Mean D i f f e r e n c e M TO PP R Medication (M) 23. 38 0.35 2.75* 4 . 1 3* Time Out (TO) 23. 03 — 2.40* 3 .78* P o s i t i v e P r a c t i c e (PP) 20. 63 — 1 .38* Reinforcement (R) 19. 25 — *p<.05 3. SUMMARY OF TREATMENT ACCEPTABILITY RESULTS The r e s u l t s of the an a l y s e s of v a r i a n c e f o r the treatment a c c e p t a b i l i t y measure r e v e a l e d s e v e r a l s i g n i f i c a n t f i n d i n g s . The e f f e c t of knowledge group was s i g n i f i c a n t f o r a c c e p t a b i l i t y r a t i n g s on the TEI [F(1,48)=6.33, p<.05] on l y . The e f f e c t of treatments was, however, s t a t i s t i c a l l y s i g n i f i c a n t f o r a c c e p t a b i l i t y r a t i n g s on the TEI [F(3, 144)=29.27, p_<.05] and f o r the E v a l u a t i v e [F(3,144)=22.95, p_<•01] a n d Potency [F(3,144)=6.93, 2<- 0 5^ dimensions of the Semantic D i f f e r e n t i a l . The r e s u l t s of the comparison t e s t s among treatment means are summarized i n Table 19. 95 TABLE 17 ANOVA FOR SD ACTIVITY DIMENSION Source df MS F Knowledge (F) 1 6.89 0.16 Case (D) 1 50.77 1.14 Sequence (B) 3 59.84 1 .35 FD 1 1 .56 0.04 FB 3 38.32 0.86 DB 3 46.59 1 .05 FDB 3 13.72 0.31 Subjects w i t h i n FDB 48 44.42 Order (C) 3 102.45 2.83* CF 3 33.63 0.93 CD 3 0.32 0.01 Treatments (A) 3 79.69 2.20 CB L a t i n Square R e s i d u a l (LSR,,,-) 6 29.30 0.81 CFD 3 13.53 0.37 AF 3 20.64 0.57 L S R C F B 6 50.60 1 .40 AD 3 11.14 0.31 L S R C D B 6 37.23 1 .03 AFD 3 69. 13 1 .91 L S R C F D B 6 32.59 0.90 C Subjec t s w i t h i n FDB 1 44 36.26 *p_<. 05 96 TABLE 18 TUKEY (HSD) COMPARISONS BETWEEN ORDER MEANS ON THE SD ACTIVITY DIMENSION Order Mean D i f f e r e n c e 3 1 4 2 T h i r d (3) 22. ,91 1 .99* 2. 16* 2, .99* F i r s t (1) 20. .92 — 0. 17 1 , .00 Fourth (4) 20. ,75 - - 0, .83 Second (2) 19. .92 — * 2 < - 0 5 On both the TEI and SD E v a l u a t i v e , the Reinforcement i n t e r v e n t i o n r e c e i v e d the highest a c c e p t a b i l i t y r a t i n g s , while the lowest a c c e p t a b l e r a t i n g s were as s i g n e d to the Med i c a t i o n i n t e r v e n t i o n . In terms of potency these r e s u l t s are r e v e r s e d . Order was s i g n i f i c a n t f o r the TEI [F(3, 144) = 3.68, p_<.05] and f o r the E v a l u a t i v e [F(3,144)=3.70, p<.05] and A c t i v i t y [F(3,144)=2,83, 2<- 0 5] dimensions of the Semantic D i f f e r e n t i a l . These r e s u l t s are summarized i n Table 20. The order e f f e c t was not c o n s i s t e n t i n f a v o r i n g one p o s i t i o n over the three measures. A d d i t i o n a l l y , lack of c l e a r d i f f e r e n c e s across dependent measures does not allow any c o n c l u s i o n regarding t h i s e f f e c t . 97 TABLE 19 SUMMARY OF TUKEY (HSD) COMPARISONS BETWEEN TREATMENT CONDITIONS Dependent Measure C o n d i t i o n t Treatment E v a l u a t i o n Inventory R TO PP M SD E v a l u a t i v e Dimension R TO PP M SD Potency Dimension M TO PP R Note. Any two means u n d e r l i n e d by the same l i n e are not s i g n i f i c a n t l y d i f f e r e n t , whereas any two means not un d e r l i n e d by the same l i n e are s i g n i f i c a n t l y d i f f e r e n t . A l l d i f f e r e n c e s are at the p_<.05 l e v e l . Means are arranged in descending order from l e f t to r i g h t . t R = Reinforcement; PP = P o s i t i v e P r a c t i c e ; TO = Time Out; M = M e d i c a t i o n . TABLE 20 SUMMARY OF TUKEY (HSD) COMPARISONS AMONG ORDERS OF PRESENTATION Dependent Measure Treatment E v a l u a t i o n Inventory SD E v a l u a t i v e Dimension SD A c t i v i t y Dimension Orders Fourth T h i r d F i r s t Second T h i r d F ourth F i r s t Second Second Fourth F i r s t T h i r d Note. Any two means u n d e r l i n e d by the same l i n e are not s i g n i f i c a n t l y d i f f e r e n t , whereas any two means not u n d e r l i n e d by the same l i n e are s i g n i f i c a n t l y d i f f e r e n t . Means are arranged i n descending s i z e from l e f t to r i g h t . A l l d i f f e r e n c e s are at the p<.05 l e v e l . 98 Three f u r t h e r s i g n i f i c a n t sources of v a r i a n c e were i d e n t i f i e d . Sequence was s i g n i f i c a n t f o r the E v a l u a t i v e dimension of the Semantic D i f f e r e n t i a l [F(3,48)=2.98, p_<.05] but d i d not a t t a i n s i g n i f i c a n c e over any of the other dependent measures. Two L a t i n Square R e s i d u a l s reached s i g n i f i c a n c e f o r the TEI suggesting d i f f e r e n t i a l c a r r y o v e r e f f e c t s over knowledge groups and case l e v e l s . With the exception of the p o s s i b l e i n t e r a c t i o n of the LSR^ B D, there were no main or i n t e r a c t i o n e f f e c t s f o r case d e s c r i p t i o n . D. CASE AND TREATMENT QUESTIONNAIRE ANALYSIS The r e s u l t s of the Friedman A n a l y s i s of Variance by Ranks fo r the responses to q u e s t i o n three of the q u e s t i o n n a i r e are summarized in Table 21. The r e s u l t s summarized i n Table 21 show th a t , i n f a c t , the mean ranks given the treatments d i f f e r ( x 2 r a n k s = ^ " ^ ^ " I n s p e c t i o n of the means show that Reinforcement and Time Out have the l a r g e r mean ranks, M e d i c a t i o n , the s m a l l e s t , with the P o s t i v e P r a c t i c e mean rank f a l l i n g above that f o r M e d i c a t i o n . In a d d i t i o n , the s i g n i f i c a n t C o e f f i c i e n t of Concordance (a)=.2435) i n d i c a t e s that teachers agree i n t h e i r ranking of p r e f e r e n c e s . The average i n t e r c o r r e l a t i o n between teachers i s s i g n i f i c a n t (jr=.23), again suggesting that there i s some agreement i n the r e l a t i v e ranking of treatments. The r e s u l t s of p a i r w i s e comparisons between treatment rank means using Nemenyi's (1963) procedure are summarized 99 TABLE 21 RESULTS OF FRIEDMAN TWO-WAY ANALYSIS OF VARIANCE ON RANKING OF TREATMENTS Treatment Rank Sum Mean Rank S.D. Reinforcement 193.5 3.02 0.90 Time Out 191.5 3.00 0.94 P o s i t i v e P r a c t i c e 147.0 2.28 1.09 Med i c a t i o n 108.0 1.69 0.97 Friedman Test S t a t i s t i c X 2 r a n j c s = 46.76 * 2(.05,3) = 7 ' 8 2 K e n d a l l C o e f f i c i e n t of Concordance u> = 0.24 I n t e r c o r r e l a t i o n between Ranks r = .23 in Table 22. The r e s u l t s summarized i n Table 22 show that while Reinforcement was ranked h i g h e s t , i t was not ranked s i g n i f i c a n t l y higher than Time Out. Both of these treatments, however, r e c e i v e d higher rankings than the P o s i t i v e P r a c t i c e i n t e r v e n t i o n . The M e d i c a t i o n i n t e r v e n t i o n was ranked lowest, s i g n i f i c a n t l y lower than any of the other three treatments. The r e s u l t s of the Case and Treatment Q u e s t i o n n a i r e ranking of treatments i n d i c a t e d that treatments were ranked d i f f e r e n t i a l l y . Comparisons of treatment means i n d i c a t e d g e n e r a l l y s i m i l a r r e s u l t s to those found on both the TEI and E v a l u a t i v e dimension of the SD. TABLE 22 NEMENYI PAIRWISE COMPARISONS BETWEEN MEAN TREATMENT RANKS Treatment Mean D i f f e r e n c e R TO PP M Reinforcement (R) 3.02 0.02 0.74* 1.33* Time Out (TO) 3.00 — 0.72* 1.31* P o s i t i v e P r a c t i c e (PP) 2.28 0.59* Medica t i o n (M) 1 .69 — *2<-05 The r e s u l t s of the analyses presented i n t h i s chapter and p o s s i b l e i m p l i c a t i o n s are d i s c u s s e d i n Chapter Four. IV. SUMMARY AND CONCLUSIONS The purpose of t h i s chapter i s to summarize the methods used and r e s u l t s obtained i n the present study. These r e s u l t s are d i s c u s s e d i n l i g h t of re s e a r c h f i n d i n g s i n other i n v e s t i g a t i o n s . The i m p l i c a t i o n s f o r f u r t h e r research and fo r education are a l s o c o n s i d e r e d . A. SUMMARY OF METHODS AND RESULTS In t h i s r esearch, r e g u l a r classroom teachers' r a t i n g s of the a c c e p t a b i l i t y of four classroom treatment i n t e r v e n t i o n s were examined. Teachers were assig n e d to treatment c o n d i t i o n s based on the score which they r e c e i v e d on a measure of knowledge of b e h a v i o r a l p r i n c i p l e s as a p p l i e d to c h i l d r e n and randomly assigned w i t h i n knowledge groups to one of two case d e s c r i p t i o n s . The f i r s t case d e s c r i b e d a student who i s ex p e r i e n c i n g extreme emotional and b e h a v i o r a l problems i n the classroom s e t t i n g s . The second case d e s c r i b e d the same c h i l d but with the i n s e r t i o n of a d d i t i o n a l background i n f o r m a t i o n suggesting a h i s t o r y of. s p e c i a l c l a s s treatment. A major purpose of t h i s r e s e a r c h was to determine i f , as hypothesized, teacher's l e v e l of knowledge of b e h a v i o r a l p r i n c i p l e s would s i g n i f i c a n t l y a f f e c t r a t i n g s of treatment a c c e p t a b i l i t y . A second purpose of the study was to i n v e s t i g a t e whether t e a c h e r s ' r a t i n g s of treatment would r e f l e c t the d i f f e r e n t cases d e s c r i b e d . Related to these q u e s t i o n s was the qu e s t i o n of whether teachers would d i f f e r e n t i a t e treatments i n terms of a c c e p t a b i l i t y . I t was 1 0 1 1 02 hypothesized that teachers would p r o v i d e s i g n i f i c a n t l y d i f f e r e n t r a t i n g s on the treatment a c c e p t a b i l i t y measures fo r the four treatments presented and f u r t h e r that the degree of knowledge expressed on the knowledge measure would have a s i g n i f i c a n t e f f e c t on the r a t i n g s teachers p r o v i d e . Past research evidence supported these r e s e a r c h q u e s t i o n s , although research f i n d i n g s had not d i r e c t l y s u b s t a n t i a t e d these s p e c i f i c hypotheses. The q u e s t i o n of case d i f f e r e n c e s i s l e s s c l e a r . Research to date has been e q u i v o c a l . Despite mixed evidence supporting such a h y p o t h e s i s i t was t h e o r i z e d that the background a t t r i b u t e d to the two cases would would have a s i g n i f i c a n t e f f e c t on teacher r a t i n g s of treatment a c c e p t a b i l i t y . Another q u e s t i o n addressed by the r e s e a r c h was r e l a t e d to the method of measurement of a c c e p t a b i l i t y r a t i n g s . The method d e s c r i b e d in the study as Treatment A c c e p t a b i l i t y Measures r e f l e c t an e s t a b l i s h e d methodology using four measures of treatment a c c e p t a b i l i t y (Kazdin, 1980a). The present study employed, in a d d i t i o n to these, a q u e s t i o n n a i r e which i n p a r t asked s u b j e c t s to rank the four d e s c r i b e d treatments i n terms of a c c e p t a b i l i t y and use. I t was suggested that t h i s type of procedure might simulate more c l o s e l y the c l i n i c a l decision-making p r o c e s s , and hypothesized that such a procedure would p r o v i d e r e s u l t s comparable to those of the TEI treatment a c c e p t a b i l i t y measure. 1 03 1 . KNOWLEDGE GROUP In general the hypothesis of knowledge group d i f f e r e n c e was supported. The high knowledge group teachers g e n e r a l l y p r o v i d e d higher a c c e p t a b i l i t y r a t i n g s f o r a l l treatments. T h i s r e s u l t was evident from the r a t i n g s on the TEI only. Ratings on the three dimensions of the Semantic D i f f e r e n t i a l showed no s i g n i f i c a n t d i f f e r e n c e f o r t h i s f a c t o r . The f i n d i n g of g e n e r a l l y higher a c c e p t a b i l i t y r a t i n g s (on the TEI) f o r the high knowledge group lends suppport to the major f i n d i n g s reviewed i n Chapter One. The m a j o r i t y of e a r l i e r s t u d i e s had found g e n e r a l l y more p o s i t i v e a t t i t u d e s toward b e h a v i o r a l approaches to treatment with i n c r e a s e d knowledge of b e h a v i o r a l techniques and u n d e r l y i n g p r i n c i p l e s . T h i s i s a p a r t i c u l a r l y i n t e r e s t i n g f i n d i n g which would suggest that improved a c c e p t a b i l i t y , and p o t e n t i a l i n c r e a s e i n use of b e h a v i o r a l treatments, may be f a c i l i t a t e d through i n c r e a s e d f a m i l i a r i t y with the techniques and u n d e r l y i n g p r i n c i p l e s of b e h a v i o r a l i n t e r v e n t i o n s . Presumably, the same might be s a i d f o r the a c c e p t a b i l i t y and knowledge of the Medica t i o n i n t e r v e n t i o n . T h i s remains an e m p i r i c a l q u e s t i o n , although i t may be assumed that the two knowledge groups were s i m i l a r l y informed r e g a r d i n g the use of M e d i c a t i o n i n the treatment of b e h a v i o r a l d i s o r d e r s . In a very broad sense, these f i n d i n g s would suggest that with i n c r e a s e d knowledge of a v a r i e t y of t h e r a p u t i c approaches teach e r s would l i k e l y become more a c c e p t i n g of a l t e r n a t i v e approaches to classroom treatment. Perhaps i d e a l , i n 1 04 s e t t i n g s where a v a r i e t y of student needs are expressed, i s a teacher w i l l i n g and able to draw upon a s i m i l a r l y l a r g e v a r i e t y of treatment approaches to meet those needs. The f i n d i n g of no s i g n i f i c a n t d i f f e r e n c e s between knowledge groups on the three dimensions of the Semantic D i f f e r e n t i a l i s i n t e r e s t i n g i n l i g h t of s i m i l a r f i n d i n g s of no d i f f e r e n c e by Burkhart, Behles, and Stumphauzer (1976). Burkhart et a l . (1976) employed a semantic d i f f e r e n t i a l measure of a t t i t u d e toward behavior m o d i f i c a t i o n and found no d i f f e r e n c e s i n a t t i t u d e s f o r t r a i n e d and c o n t r o l groups. Kazdin (1980a, 1980b, 1981a, i n press) and Kazdin, French and Sherick (1981) have a l s o found few s i g n i f i c a n t e f f e c t s on the SD other than d i f f e r e n c e s i n treatment type. T h i s would suggest that while the SD p r o v i d e s an accurate r e f l e c t i o n of d i f f e r e n c e s between treatments, i t does not appear to be a s u f f i c i e n t l y s e n s i t i v e r a t i n g procedure to c o n s i s t e n t l y r e f l e c t other more s u b t l e between groups d i f f e r e n c e s . Another comparison of i n t e r e s t i s that of the present study with that of Kazdin, French, and Sherick (1981) which used the same measures of treatment a c c e p t a b i l i t y and s i m i l a r treatment d e s c r i p t i o n s . Three groups of s u b j e c t s p a r t i c i p a t e d in the Kazdin et a l . (1981) study: c h i l d i n p a t i e n t s , parents, and treatment s t a f f . The authors r e p o r t f i n d i n g s i g n i f i c a n t d i f f e r e n c e s between parent and c h i l d o v e r a l l r a t i n g s of treatment a c c e p t a b i l i t y ( i . e . , TEI r a t i n g s ) , with parents g i v i n g higher mean r a t i n g s to 1 0 5 treatments than c h i l d r e n . Treatment s t a f f , who presumably are expert in the use of the d e s c r i b e d techniques, provided r a t i n g s which were not s i g n i f i c a n t l y d i f f e r e n t from e i t h e r the parent or c h i l d r a t i n g s . In the present study, however, the high knowledge group r a t e d treatments g e n e r a l l y more p o s i t i v e l y than the low knowledge group. While the subject samples i n the two s t u d i e s are d i f f e r e n t , i t i s reasonable to suggest that the s u b j e c t s i n the present study are most s i m i l a r to the treatment s t a f f s u b j e c t s i n the Kazdin study. However, Kazdin et a l . d i d not i n v e s t i g a t e the s t a t u s of p a r t i c i p a n t s ' knowledge of b e h a v i o r a l p r i n c i p l e s and d i d not i n v e s t i g a t e the d i f f e r e n c e s between [parent, s t a f f , c h i l d ] groups i n the r a t i n g s of b e h a v i o r a l treatments or medication making more d i r e c t comparisons of r e s u l t s between these two s t u d i e s i m p o s s i b l e . 2. CHILD CASE The r e s u l t s of the a n a l y s i s of treatment measure r a t i n g s d i d not r e v e a l s i g n i f i c a n t d i f f e r e n c e s i n the a c c e p t a b i l i t y of treatments f o r the two cases d e s c r i b e d . There are s e v e r a l p l a u s i b l e e x p l a n a t i o n s which might account f o r such a r e s u l t . The most obvious of these i s t h a t , i n f a c t , the cases were not d i f f e r e n t and that the a d d i t i o n a l i n f o r m a t i o n regarding p r e v i o u s s p e c i a l c l a s s placement provided i n the case of Mike S. added no i n f o r m a t i o n r e l e v a n t to treatment e v a l u a t i o n . In e i g h t r e p o r t e d experiments using t h i s methodology, Kazdin and h i s 1 06 c o l l e a g u e s (Kazdin 1980a, 1980b, 1981a, in p r e s s , Kazdin, French, & S h e r r i c k 1981 ) have found a c c e p t a b i l i t y r a t i n g d i f f e r e n c e s between case d e s c r i p t i o n s in only one study and with manipulation of case f e a t u r e s , such as s e v e r i t y of problem, found d i f f e r e n c e s r e f l e c t e d only s p o r a d i c a l l y . In one study (1980a, Experiment 2) the TEI and E v a l u a t i v e dimension of the SD showed s i g n i f i c a n t e f f e c t s f o r case d e s c r i p t i o n although expected d i f f e r e n c e s i n r a t i n g s f o r more and l e s s severe cases were noted only with the TEI. S e v e r i t y of case was s i g n i f i c a n t on the TEI and SD E v a l u a t i v e i n a more recent study as w e l l (Kazdin, i n p r e s s ) . A major d i f f e r e n c e between the present study and e a r l i e r work by Kazdin i s that the cases used i n the Kazdin s t u d i e s are purposely v a r i e d on a number of t r a d i t i o n a l l y r e l e v a n t dimensions, f o r example, age, sex, type of problem i n order to render the r e s u l t s more g e n e r a l i z a b l e . In c o n t r a s t , the present study sought to vary only one dimension ( i . e . , background of c l a s s placement of the case d e s c r i p t i o n ) in order to t e s t the e f f e c t of p r i o r placement i n f o r m a t i o n on treatment a c c e p t a b i l i t y r a t i n g s i n a manner more r e l e v a n t to the r e g u l a r classroom s e t t i n g . D espite the d i f f e r e n c e s i n purpose, the f i n d i n g s of the Kazdin s t u d i e s f o r i n c r e a s e d a c c e p t a b i l i t y i n more severe cases may be q u i t e r e l e v a n t here. In the present study, i n a d d i t i o n to the treatment a c c e p t a b i l i t y procedures, teachers were asked to r a t e the s e r i o u s n e s s of the problems Mike i s e x h i b i t i n g as p a r t of the Case and Treatment Q u e s t i o n n a i r e . Without 1 07 e x c e p t i o n , teachers r a t e d these problems more than moderately s e r i o u s and almost always as extremely s e r i o u s , although they d i d i n d i c a t e that t h i s c h i l d ' s behavior was t y p i c a l of the kinds of problems e x h i b i t e d by some c h i l d r e n in the r e g u l a r classroom s e t t i n g . Teachers d i d not d i f f e r e n t i a t e the s e v e r i t y of the problems e x h i b i t e d between case d e s c r i p t i o n s . A l s o r e l e v a n t here are the f i n d i n g s of S a f r a n , Safran, and Orlansky (1982). In t h i s study v a r i a t i o n s i n w r i t t e n background i n f o r m a t i o n had s i g n i f i c a n t e f f e c t s upon s u b j e c t s ' p e r c e p t i o n s of the c h i l d ' s behavior, and upon the degree to which c h i l d r e n were regarded as a b l e to f u n c t i o n s u c c e s s f u l l y i n the r e g u l a r classroom. T h i s f i n d i n g was true f o r d e s c r i p t i o n s of both hearing impaired and normal c h i l d r e n . However t h i s f i n d i n g d i d not extend to the case of an a c t i n g - o u t c h i l d . The authors suggest that the extreme nature of the behavior r e l e g a t e d the w r i t t e n background i n f o r m a t i o n to a l e s s i n f l u e n t i a l p o s i t i o n . I t i s reasonable to s p e c u l a t e that such a r e s u l t may have occ u r r e d i n the present study and that any relevance t h a t placement h i s t o r y may have had was masked by the p e r c e i v e d extreme nature of the problems the c h i l d was d e s c r i b e d as e x h i b i t i n g . T h i s e x p l a n a t i o n c e r t a i n l y i s c o n s i s t e n t with the f i n d i n g s of Keogh and L e v i t t (1976, c i t e d i n Safran, S a f r a n , & Orlansky, 1982) who suggest that the s a l i e n t i s s u e s are both the r e g u l a r t e a c h e r s knowledge of the c h a r a c t e r i s t i c s and needs of e x c e p t i o n a l c h i l d r e n and 108 descr i p t ive i n f o r m a t i o n r e l e v a n t to the c h i l d ' s performance. A f u r t h e r p o s s i b l e , although l e s s l i k e l y , e x p l a n a t i o n may be that teachers in the present study d i d not r e l a t e a c c e p t a b i l i t y r a t i n g s to the presented case d e s c r i p t i o n . 3. TREATMENT TYPE R e s u l t s of the a n a l y s i s presented i n the p r e v i o u s chapter suggested that the r e g u l a r classroom teachers sampled i n the present study d i d d i f f e r e n t i a t e treatments i n terms of a c c e p t a b i l i t y . Two measures of a c c e p t a b i l i t y (TEI and E v a l u a t i v e SD) showed that the Reinforcement i n t e r v e n t i o n , a p o s i t i v e approach to classroom i n t e r v e n t i o n f o r the problem behavior d e s c r i b e d , was the most a c c e p t a b l e . The M e d i c a t i o n i n t e r v e n t i o n was r a t e d as the l e a s t a c c e p t a b l e of the four a l t e r n a t i v e s , although i t was c l e a r l y seen as the most potent or powerful. That Reinforcement was seen as the l e a s t powerful i s a l s o worthy of note. In terms of the TEI and SD E v a l u a t i v e r e s u l t s i t seems reasonable to group the i n t e r v e n t i o n s i n v a r i o u s ways f o r the purpose of d i s c u s s i o n . The r e s u l t s of a n a l y s i s on these two measures c l e a r l y i n d i c a t e d that teachers p r e f e r b e h a v i o r a l to medical i n t e r v e n t i o n s , p a r t i c u l a r l y f o r the type of problems d e s c r i b e d . What i s a l s o c l e a r , however, i s that the Reinforcement i n t e r v e n t i o n i s seen as more ac c e p t a b l e than e i t h e r of the two more p u n i t i v e b e h a v i o r a l i n t e r v e n t i o n s , P o s i t i v e P r a c t i c e and Time Out. In turn both of the p u n i t i v e i n t e r v e n t i o n s were seen as more ac c e p t a b l e 1 09 than use of M e d i c a t i o n . In g e n e r a l t h i s f o l l o w s the r e s u l t s of Kazdin (1980a, 1981, i n press), and Kazdin, French, and Sherick (1981). The r e s u l t s of the ranking procedure rep o r t e d in the a n a l y s i s of the Case and Treatment Q u e s t i o n n a i r e suggest that Medication i s lowest i n a c c e p t a b i l i t y and p o t e n t i a l f o r use. P o s i t i v e P r a c t i c e i s seen as an improvement on t h i s . The d i s t i n c t i o n evident i n r a t i n g s of Reinforcement r e l a t i v e to other i n t e r v e n t i o n s on the TEI and E v a l u a t i v e SD are not so evident i n the ranking procedure. Perhaps the r e s u l t s of the ranking procedure r e f l e c t both the a c c e p t a b i l i t y as measured by the TEI and E v a l u a t i v e SD as w e l l as some c o n t r i b u t i o n of the s t r e n g t h of the i n t e r v e n t i o n or i t s e f f e c t i v e n e s s as r e f l e c t e d i n the potency r a t i n g s . Kazdin, French, and Sherick (1981), i n d i s c u s s i o n of a s i m i l a r f i n d i n g of high a c c e p t a b i l i t y and low potency f o r Reinforcement concluded that parents and others need to be convinced t h a t , i n f a c t , Reinforcement can be very e f f e c t i v e ( i . e . , p o t e n t ) . The present f i n d i n g s a l s o suggest that when asked about a c c e p t a b i l i t y and p o t e n t i a l use teachers consi d e r not only f e a t u r e s of a c c e p t a b i l i t y but a l s o the p o t e n t i a l f o r the treatments under c o n s i d e r a t i o n to be e f f e c t i v e i n d e a l i n g with the p a r t i c u l a r problem i n the d e s c r i b e d s e t t i n g . R e s u l t s on the a c t i v i t y dimension of the SD d i d not r e v e a l any s i g n i f i c a n t d i f f e r e n c e s between treatments i n the present study. Again t h i s f i n d i n g i s s i m i l a r to that of 1 10 previous r e s e a r c h . T h i s dimension appears, i n t h i s study and to some extent i n those p r e v i o u s , to be of l i m i t e d u t i l i t y i n r e f l e c t i n g d i f f e r e n c e s between treatments. Two a d d i t i o n a l comments should be made with regard to the treatment a c c e p t a b i l i t y f i n d i n g s . The f i r s t of these i s that while M e d i c a t i o n was given the lowest mean r a t i n g on the TEI (50.97) and the SD E v a l u a t i v e (17.5) these r e s u l t s s t i l l suggest moderate o v e r a l l a c c e p t a b i l i t y , as a score of 52.5 on the TEI and 17.5 on the SD E v a l u a t i v e represent n e u t r a l r a t i n g s . In other words, teachers have not suggested o u t r i g h t that M e d i c a t i o n i s an unacceptable i n t e r v e n t i o n . S i m i l a r l y , the mean r a t i n g s f o r Reinforcement on the TEI (79.03) and SD E v a l u a t i v e (27.05) while q u i t e f a v o r a b l e , do not r e f l e c t o u t r i g h t acceptance as these v a l u e s represent 75% and 77% of the maximum value f o r t h e i r r e s p e c t i v e instrument. A second important o b s e r v a t i o n to be made with regard to the r e l a t i v e a c c e p t a b i l i t y of treatments i s that i t i s l i k e l y that many of the teach e r s sampled i n the present study use, d a i l y , v a r i a t i o n s of s e v e r a l of the d e s c r i b e d treatment i n t e r v e n t i o n s . None of these i n t e r v e n t i o n s represent novel approaches to management of problem classroom behavior. L i k e l y the most u n f a m i l i a r of these i s the Me d i c a t i o n i n t e r v e n t i o n and i n p a r t i c u l a r the s p e c i f i c drug treatment d e s c r i b e d . 111 B. IMPLICATIONS FOR EDUCATION At the present time the t e a c h i n g mandate i n r e g u l a r school classrooms i n c l u d e s an e x p e c t a t i o n that teachers take on the major r e s p o n s i b i l i t y f o r making changes i n student behavior not only with regard to the student's academic performance but a l s o i n myriad other ways. E d u c a t i o n a l and l e g a l p o l i c y , as w e l l as p r o f e s s i o n a l e t h i c s d i c t a t e that e f f o r t s d i r e c t e d toward such change should occur d e s p i t e such adverse c o n d i t i o n s as i n t e l l e c t u a l impairment and emotional and b e h a v i o r a l d i s t u r b a n c e . Given these demands teachers i n c r e a s i n g l y have need of e f f e c t i v e approaches which w i l l a i d i n the c a r r y i n g out of t h i s mandate. De s p i t e the wealth of l i t e r a t u r e which e x i s t s s u b s t a n t i a t i n g the e f f e c t i v e n e s s of p a r t i c u l a r procedures and indeed of s e v e r a l g e n e r a l approaches i n the classroom s e t t i n g such procedures and approaches have not r e c e i v e d anywhere near u n i v e r s a l acceptance and use. The present study suggests that one f a c t o r which may e x p l a i n t h i s s i t u a t i o n i s a lack of knowledge of the procedures and u n d e r l y i n g p r i n c i p l e s . A f u r t h e r i n d i c a t i o n of note here i s the f i n d i n g that those t e a c h e r s who were i n the high knowledge group g e n e r a l l y i n d i c a t e d having s p e c i f i c t r a i n i n g i n c h i l d management, whereas those i n the low knowledge group i n d i c a t e d not having such t r a i n i n g . T y p i c a l l y teacher t r a i n i n g programs s t r e s s c u r r i c u l u m and methodology but do not r o u t i n e l y prepare t e a c h e r s to be e f f e c t i v e managers and behavior.change agents. T h i s becomes p a r t i c u l a r l y c r u c i a l i n 1 1 2 the case of those students who are not capable of s e l f management in the clasroom s e t t i n g . Teachers must be w e l l informed and capable i n both g e n e r a l management and behavior change s k i l l s as w e l l as i n the understanding and a p p l i c a t i o n of the u n d e r l y i n g p r i n c i p l e s of l e a r n i n g and behavior. The obvious i m p l i c a t i o n here i s that both p r e - s e r v i c e and i n s e r v i c e teacher t r a i n i n g must begin to devote a g r e a t e r emphasis to development and a p p l i c a t i o n of r e l e v a n t knowledge and s k i l l s . The work of s e v e r a l authors (Merrett & W h e l d a l l , 1982; Mohlman, C o l a d a r c i & Gage, 1982 Robinson & Swanton, 1980; ) c e r t a i n l y supports such a c o n t e n t i o n . A second i m p l i c a t i o n which f o l l o w s from t h i s r e s e a r c h and from the f i n d i n g s of W itt, Martens, and E l l i o t (1984) i s that teachers o f t e n are working i n l e s s than i d e a l s e t t i n g s and under c o n s t r a i n t s of time and personnel which seem to d i c t a t e use of procedures which may not be the best but which are pragmatic. Ford and K e n d a l l (1979) suggest that even those c l i n i c i a n s committed to a p a r t i c u l a r o r i e n t a t i o n do not n e c e s s a r i l y bypass more pragmatic s o l u t i o n s i n favor of t h e o r e t i c a l l y c o n s i s t e n t procedures. In attempts at short term change and i n t e r v e n t i o n , c o n s u l t a n t s must be aware that treatment recommendations w i l l vary in t h e i r success not only as a r e s u l t of the v e r i f i e d e f f e c t i v e n e s s of the procedure but a l s o of the a c c e p t a b i l i t y f o r use by the p a r t i c u l a r teacher i n the given s e t t i n g s . Kazdin (Kazdin, French, & S h e r i c k , 1981) has suggested that a v a i l a b l e 1 1 3 treatments may be presented and d e l i v e r e d i n ways which make the treatments "more p a l a t a b l e to persons who, f o r whatever reasons, are not l i k e l y to adhere to treatment procedures" (p. 906). Witt and E l l i o t support t h i s p o i n t of view and f u r t h e r suggest that i n t e v e n t i o n s be d e s c r i b e d from the p e r s p e c t i v e of the a t t i t u d e s and values of the teacher r a t h e r than from a p a r t i c u l a r t h e o r e t i c a l p e r s p e c t i v e , a c c e p t i n g the f a c t that i n short c o n s u l t a t i o n s e s s i o n s i t i s probably impossible to a l t e r markedly a te a c h e r ' s b e l i e f s about the causes of behavior. Thus the i m p l i c a t i o n s s t a t e d above are r e l a t e d i n that the a c c e p t a b i l i t y of an i n t e r v e n t i o n i s a l i k e l y p r e q u i s i t e f o r i t s e v e n t u a l use by a classroom teacher. T h i s study would suggest that i n c r e a s e d knowledge of b e h a v i o r a l p r i n c i p l e s f a c i l i t a t e s g r e a t e r a c c e p t a b i l i t y of e f f e c t i v e b e h a v i o r a l techniques. A c c e p t a b i l i t y i s seen as a necessary c o n d i t i o n f o r use--which i s the primary o b j e c t i v e . Given that i n d i v i d u a l s do vary i n t h e i r knowledge and t h e o r e t i c a l o r i e n t a t i o n , a c c e p t a b i l i t y of treatments can be enhanced through a p p r o p r i a t e p r e s e n t a t i o n and a p p l i c a t i o n . An approach which i s both a c c e p t a b l e and e f f e c t i v e i s l i k e l y to be used i n the f u t u r e . S i m i l a r l y , an approach which i s not seen as acc e p t a b l e i s not l i k e l y to be used at a l l . 1 1 4 C. IMPLICATIONS FOR FUTURE RESEARCH A major goal of the study of treatment a c c e p t a b i l i t y i s to b u i l d a body of r e s e a r c h which w i l l f a c i l i t a t e the i d e n t i f i c a t i o n and use of e f f e c t i v e and a c c e p t a b l e treatments. Witt and E l l i o t ( i n press) have suggested that the dimensions of treatment a c c e p t a b i l i t y , i n t e g r i t y , e f f e c t i v e n e s s , and use are r e c i p r o c a l l y and s e q u e n t i a l l y i n t e r r e l a t e d ( c f . Yeaton & Sechrest, 1 9 8 1 ) . The u l t i m a t e t e s t of a treatment i s i t s use. Witt and E l l i o t ( i n press) suggest that the i n i t i a l i s s u e i n treatment s e l e c t i o n i s a c c e p t a b i l i t y , and that use then i s r e l a t e d to how e f f e c t i v e the procedure proves to be. The i n t e g r i t y with which treatment i s a p p l i e d o f t e n determines i t s e f f e c t i v e n e s s . Future r e s e a r c h should focus on b u i l d i n g strong evidence r e l a t i n g each of these dimensions. An obvious and important area f o r immediate i n v e s t i g a t i o n i s that of the l i n k between a c c e p t a b i l i t y and use. The r e s u l t s of the ranking procedure i n the present study may be viewed as encouraging i n terms of f u r t h e r i n g the development of r e l e v a n t procedures f o r the measurement of treatment a c c e p t a b i l i t y . T h i s procedure was proposed as an i n i t i a l attempt at approximating the c l i n i c a l d e c i s i o n making p r o c e s s . Future r e s e a r c h may extend such an approach to sample more of the dimensions of i n t e r e s t . One p o s s i b l e a p p l i c a t i o n c o u l d i n v o l v e ranking of s e v e r a l treatments on each of the areas sampled by q u e s t i o n s on the TEI. For example s u b j e c t s c o u l d be asked to examine s e v e r a l 1 1 5 treatments and to rank each on i t s r e l a t i v e e f f e c t i v e n e s s or how humane each treatment i s l i k e l y to be. In the f i e l d of s p e c i a l education i n p a r t i c u l a r and education i n general i t i s c l e a r that i t i s o f t e n e a s i e r to f i n d 'good assessments and diagnoses' than i t i s to f i n d good treatment. S i m i l a r l y i t i s o f t e n e a s i e r to f i n d good theory than i t i s to f i n d good a p p l i c a t i o n , p a r t i c u l a r l y with respect to d e a l i n g with c h i l d r e n ' s problem behavior i n the r e g u l a r classroom s e t t i n g . There i s a need f o r research which assesses the implementation of a c t u a l treatment recommendations. Related to t h i s are i s s u e s of a c c e p t a b i l i t y but a l s o of ' i n t e g r i t y ' of methods ( i . e . , do people do what they say they do), e f f e c t i v e n e s s , and the a b i l i t y and w i l l i n g n e s s of teachers and other school and treatment personnel to c a r r y out recommended treatments. One example of such r e s e a r c h might i n v o l v e follow-up on implementation of treatment recommendations from a d i a g n o s t i c c e n t e r . There i s the suggestion, from Witt and E l l i o t ( i n p r e s s ) , t h at i n a d d i t i o n to past experience with changing the t a r g e t e d problem, one's p h i l o s o p h i c a l o r i e n t a t i o n or general approach to changing behavior w i l l a f f e c t i n i t i a l judgements about the a c c e p t a b i l i t y of treatments. With regard to the issue of p h i l o s o p h i c a l o r i e n t a t i o n , the work of M i l l e r (1981) and Norcross & Prochaska (1983) represent attempts to c h a r a c t e r i z e i n a r e l i a b l e manner teachers' a f f i l i a t i o n to v a r i o u s o r i e n t a t i o n s and t h e o r i e s . Such approaches may provide important dimensions r e l a t e d to the 1 1 6 a c c e p t a b i l i t y of i n t e r v e n t i o n s from a v a r i e t y of t h e o r e t i c a l o r i e n t a t i o n s . A f u r t h e r i m p l i c a t i o n presented i s in response to the needs i d e n t i f i e d by K i e s l e r (1983). Future r e s e a r c h in the areas of program e f f e c t i v e n e s s and consumer e v a l u a t i o n of treatments w i l l need to e s t a b l i s h what K i e s l e r c a l l s an ' a t t i t u d e p r e t e s t ' i n order to b e t t e r understand the impact of treatments a c c e p t a b i l i t y in such r e s e a r c h s e t t i n g s . The procedures d e s c r i b e d i n t h i s study and p r e v i o u s l y by Kazdin may be most u s e f u l i n p r o v i d i n g such data. 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J o u r n a l of Behavior Therapy and Experimental P s y c h i a t r y , 12(3), 189-196. APPENDIX A I n t r o d u c t i o n , Consent, and Demographic Data Forms PROJECT TITLE: Teacher Ratings of A l t e r n a t i v e Classroom Treatment S t r a t e g i e s . PROJECT RESEARCHER: W i l l i a m T. McKee, under the d i r e c t i o n of Dr. Barry Munro, P r o f e s s o r , Department of E d u c a t i o n a l Psychology and S p e c i a l E d ucation, U n i v e r s i t y of B r i t i s h Columbia. PURPOSE AND PROCEDURES: I n d i v i d u a l s p a r t i c i p a t i n g i n t h i s p r o j e c t w i l l be e v a l u a t i n g s e v e r a l a l t e r n a t i v e classroom treatment s t r a t e g i e s f o r d e a l i n g with c h i l d r e n ' s deviant classroom behavior. P a r t i c i p a n t s w i l l be asked to complete an i n i t i a l s i x t e e n - i t e m m u l t i p l e c h o i c e q u e s t i o n n a i r e on approaches to d e a l i n g with some d i f f i c u l t but t y p i c a l c h i l d behavior. P a r t i c i p a n t s w i l l then be presented with an e v a l u a t i o n package which w i l l be used i n the r a t i n g s procedure. P a r t i c i p a n t s w i l l be asked to complete two r a t i n g s forms f o l l o w i n g each of four p r e s e n t a t i o n s of treatment a l t e r n a t i v e s . The e n t i r e procedure should r e q u i r e no more than 45 minutes. P a r t i c i p a n t s w i l l be asked to provide some minimal p e r s o n a l data (e.g. gender, age, highest l e v e l of education a t t a i n e d ) . In order to maintain complete i n d i v i d u a l 1 33 1 3 4 c o n f i d e n t i a l i t y and to ensure candid responses, the i n f o r m a t i o n , o p i n i o n s , and data presented by a l l s u b j e c t s w i l l be coded and the i d e n t i t y of i n d i v i d u a l s p a r t i c i p a t i n g w i l l remain c o n f i d e n t i a l throughout the study. The researcher w i l l be a v a i l a b l e d u r i n g and f o l l o w i n g the procedures in order to answer any i n q u i r i e s concerning the procedures and to ensure that they are f u l l y understood. F o l l o w i n g completion of the study the r e s e a r c h e r w i l l be a v a i l a b l e f o r d i s c u s s i o n or p r e s e n t a t i o n of r e s u l t s and i m p l i c a t i o n s as w e l l as to p r o v i d e any f u r t h e r d e t a i l s r e g a r d i n g procedures and methodology. 1 35 CONSENT It i s the r i g h t of any subject to refuse to p a r t i c i p a t e or to withdraw from the p r o j e c t at any time. Such a d e c i s i o n w i l l n e i t h e r j e o p a r d i z e nor i n f l u e n c e you in any way. Please i n d i c a t e your w i l l i n g n e s s to p a r t i c i p a t e i n the p r o j e c t by p r o v i d i n g your s i g n a t u r e consenting to your p a r t i c i p a t i o n . I consent to p a r t i c i p a t e i n t h i s p r o j e c t . S ignature Date PERSONAL DATA: Gender M / F Age Highest l e v e l of education a t t a i n e d Teaching experience: practicum years f u l l time Grade l e v e l s taught mainly Have you had s p e c i a l t r a i n i n g i n c h i l d management? If yes, please i n d i c a t e with a check ( ) below. Courses Workshops I n s e r v i c e t r a i n i n g Other (please s p e c i f y ) APPENDIX B Knowledge Measure KBPAC 16E Th i s measure c o n s i s t s of 16 items and w i l l take approximately 8 to 10 minutes to complete. Di r e c t ions 1 . You w i l l be r e q u i r e d to s e l e c t responses to que s t i o n s d e a l i n g with some t y p i c a l c h i l d b e h a v i o r s . 2. Read c a r e f u l l y each q u e s t i o n and each of i t s four p o s s i b l e answers. In some q u e s t i o n s and under c e r t a i n circumstances more than one answer might be c o r r e c t , however, you must s e l e c t the s i n g l e best answer or one which you f e e l i s most g e n e r a l l y t r u e . C i r c l e the l e t t e r beside that answer. Example; Probably the most important i n f l u e n c e i n a young c h i l d ' s l i f e i s h i s . . . a. Toys b. T e l e v i s i o n c. Parents d. F r i e n d s Please do not c o n s u l t others while d e c i d i n g how to answer the q u e s t i o n s . Complete a l l q u e s t i o n s , even i f you must guess. 137 1 38 KBPAC 16E 1. Which of the f o l l o w i n g i s most important f o r parents i n c o n t r o l l i n g t h e i r c h i l d ' s behavior? a. The r u l e s the parents make about behavior. b. The parents' understanding of the c h i l d ' s f e e l i n g s . c. The behaviors to which the parents a t t e n d . d. Being s t r i c t , but a l s o warm and g e n t l e . 2. A boy l o v e s f o o t b a l l . What i s most l i k e l y to happen i f , each time he i s p l a y i n g n i c e l y with h i s s i s t e r , h i s f a t h e r i n v i t e s him to play f o o t b a l l ? a. He w i l l always be asking h i s f a t h e r to p l a y f o o t b a l l . b. He w i l l p l a y n i c e l y with h i s s i s t e r more o f t e n . c. He w i l l be annoyed with h i s f a t h e r f o r i n t e r f e r i n g with h i s a c t i v i t i e s . d. He w i l l be encouraged to teach h i s s i s t e r to p l a y f o o t b a l l . 3. I f you want your c h i l d to develop proper study h a b i t s , you should: a. Encourage him to do h i s homework. b. Help him to see school as p l e a s a n t . c. Reward him whenever he s t u d i e s . d. Give him good reasons why he w i l l need s c h o o l . 139 4. A c h i l d o f t e n c r i e s o v e r any s m a l l m a t t e r t h a t b o t h e r s h e r . How s h o u l d h e r p a r e n t s r e a c t t o b e s t r e d u c e h e r c r y i n g ? a . Reward when s h e r e a c t s w i t h o u t c r y i n g . b . U s e a m i l d p u n i s h m e n t when she c r i e s . c . T r y t o f i n d o u t what i s r e a l l y t r o u b l i n g t h e c h i l d a n d d e a l w i t h t h a t . d . P r o v i d e h e r w i t h s o m e t h i n g i n t e r e s t i n g s o s h e w i l l s t o p c r y i n g . 5. A f a t h e r t e l l s a c h i l d s h e c a n n o t go t o t h e s t o r e w i t h h i m b e c a u s e she d i d n ' t c l e a n h e r room l i k e s h e p r o m i s e d . She r e a c t s by s h o u t i n g , c r y i n g a n d p r o m i s i n g s h e w i l l c l e a n t h e room when s h e g e t s home. What s h o u l d t h e f a t h e r d o ? a . I g n o r e h e r a n d go t o t h e s t o r e . b . T a k e h e r t o t h e s t o r e b u t make h e r c l e a n h e r room when t h e y r e t u r n . c . C a l m h e r down a n d go h e l p h e r c l e a n h e r room t o g e t h e r . d . T a l k t o h e r a n d f i n d o u t why she d o e s n ' t t a k e r e s p o n s i b i l i t y . 6. I f y o u want t o make a b e h a v i o r a l o n g - l a s t i n g h a b i t , y o u s h o u l d : a . R e w a r d i t e v e r y t i m e . b . F i r s t r e w a r d i t e v e r y t i m e a n d t h e n r e w a r d i t o c c a s i o n a l l y . c . P r o m i s e s o m e t h i n g t h e c h i l d w a n t s v e r y m u c h . d . G i v e s e v e r a l r e a s o n s why i t i s i m p o r t a n t a n d r e m i n d t h e c h i l d o f t h e r e a s o n s o f t e n . 1 40 7. A b a b y o f t e n s c r e a m s f o r s e v e r a l m i n u t e s a n d g e t s h i s p a r e n t s ' a t t e n t i o n . W h i c h o f t h e f o l l o w i n g i s p r o b a b l y t h e b e s t w a y f o r h i s p a r e n t s t o r e d u c e h i s s c r e a m i n g ? a . I f t h e r e i s n o t h i n g p h y s i c a l l y w r o n g w i t h t h e c h i l d , i g n o r e h i s s c r e a m i n g e v e n t h o u g h t h e f i r s t f e w t i m e s h e s c r e a m s e v e n l o u d e r . b . D i s t r a c t t h e c h i l d w i t h s o m e t h i n g h e f i n d s i n t e r e s t i n g w h e n e v e r h e s c r e a m s . c . I g n o r e a l l n o i s e s a n d s o u n d s t h e c h i l d m a k e s . d . N o n e o f t h e a b o v e . B a b i e s u s u a l l y h a v e g o o d r e a s o n s f o r s c r e a m i n g . 8. P r o b a b l y t h e m o s t i m p o r t a n t i d e a t o k e e p i n m i n d w h e n f i r s t c h a n g i n g b e h a v i o r i s : a . T o u s e b o t h r e w a r d a n d p u n i s h m e n t . b . T o r e w a r d e v e r y t i m e t h e d e s i r e d b e h a v i o r o c c u r s . c . T o b e f l e x i b l e a b o u t w h e t h e r o r n o t y o u r e w a r d . d . T o b e s u r e t h e c h i l d u n d e r s t a n d s w h y y o u w a n t t h e b e h a v i o r t o c h a n g e . 9. A c h i l d b e g i n s t o w h i n e a n d c r y w h e n h i s p a r e n t e x p l a i n s w h y h e c a n ' t g o o u t s i d e . H o w s h o u l d t h e p a r e n t r e a c t ? a . A s k t h e c h i l d w h y g o i n g o u t s i d e i s s o i m p o r t a n t t o h i m . b . E x p l a i n t h a t i t i s a p a r e n t ' s r i g h t t o m a k e s u c h d e c i s i o n s . c . E x p l a i n a g a i n w h y h e s h o u l d n o t g o o u t s i d e . d . I g n o r e t h e w h i n i n g a n d c r y i n g . 141 10. If punishment i s used f o r a behavior such as p l a y i n g f o o t b a l l i n the house, which type i s probably the best to use? a. Make the c h i l d do e x t r a homework. b. C l e a r l y express your d i s a p p r o v a l . c. Remove the c h i l d to a bori n g s i t u a t i o n each time. d. A reasonable spanking. 11. Which of the f o l l o w i n g i s most e f f e c t i v e i n g e t t i n g a c h i l d to do homework? a. "When you f i n i s h your homework, you can watch T.V." b. "You can watch t h i s show on T.V., i f you promise to do your homework when the show i s over." c. " I f you don't do your homework t o n i g h t , you can't watch T.V. at a l l tomorrow." d. E x p l a i n the importance of school work and the dangers of p u t t i n g t h i n g s o f f . 12. Parents who use l o t s of rewards f o r good behavior and few punishments w i l l probably tend to have c h i l d r e n who: a. Do not understand d i s c i p l i n e . b. W i l l not cooperate unless they are 'pa i d ' . c. Take advantage of t h e i r p a r e n t s . d. Are well-behaved and c o o p e r a t i v e . 1 42 13. Which reward i s probably best to help a 12-year-old c h i l d improve h i s a r i t h m e t i c s k i l l s ? a. A d o l l a r f o r each evening he s t u d i e s . b. A dime f o r each problem he works c o r r e c t l y . c. Ten d o l l a r s f o r each A he r e c e i v e s on h i s report c a r d i n a r i t h m e t i c . d. A b i c y c l e f o r passing a r i t h m e t i c f o r the r e s t of the year. 14. Johnny has j u s t torn up a new magazine. Of the f o l l o w i n g c h o i c e s , which i s the best way f o r h i s mother to d i s c i p l i n e him? a. T e l l him he w i l l be spanked by h i s f a t h e r when he gets home. b. Punish him then and t h e r e . c. E x p l a i n to Johnny the wrongness of h i s a c t i o n s . d. A n g r i l y s c o l d Johnny so that he w i l l l e a r n that such an a ct i s bad and u p s e t t i n g to h i s mother. 15. Jimmy sometimes says obscene words, but only i n f r o n t of h i s mother. She has been shocked and makes her f e e l i n g s c l e a r to him. How should she re a c t when he uses obscene words? a. Wash h i s mouth out with soap. b. Ignore him when he uses obscene words. c. T e l l him how bad he i s and how she doesn't l i k e him when he uses those words. d. E x p l a i n to him the reason such words are not used. 1 16. Which of the f o l l o w i n g i s probably most important i n h e l p i n g a c h i l d behave i n d e s i r a b l e ways? a. To teach him the importance of s e l f - d i s c i p l i n e . b. To h e l p him understand r i g h t and wrong. c. P r o v i d i n g c o n s i s t e n t consequences f o r h i s behavior d. Understanding h i s moods and f e e l i n g s as a unique person. APPENDIX C Treatment E v a l u a t i o n Inventory (Kazdin, 1980a) Please complete the items l i s t e d below. The items should be completed by p l a c i n g a checkmark on the l i n e under the q u e s t i o n that best i n d i c a t e s how you f e e l about the treatment. Please read the items very c a r e f u l l y because a checkmark a c c i d e n t l y p l a c e d on one space r a t h e r than another may not represent the meaning you intended. Note that throughout the inventory the term treatment i s used, and may be thought of as s i m i l a r to such terms as i n t e r v e n t i o n , method, procedure, or s t r a t e g y . 1. How a c c e p t a b l e do you f i n d t h i s treatment to be f o r the c h i l d ' s problem behavior? not at a l l moderately very a c c e p t a b l e a c c e p t a b l e a c c e p t a b l e 2. How w i l l i n g would you be to c a r r y out t h i s procedure y o u r s e l f i f you had to change the c h i l d ' s problems? not at a l l moderately very w i l l i n g w i l l i n g w i l l i n g 3. How s u i t a b l e i s t h i s procedure f o r c h i l d r e n who might have other b e h a v i o r a l problems than those d e s c r i b e d f o r t h i s c h i l d ? not at a l l moderately very s u i t a b l e s u i t a b l e s u i t a b l e 4. I f c h i l d r e n had to be a s s i g n e d to treatment without t h e i r consent, how bad would i t be to give them t h i s treatment? very bad moderately bad not bad at a l l 1 44 1 4 5 5. How c r u e l or u n f a i r do you f i n d t h i s treatment? very c r u e l moderately c r u e l not c r u e l at a l l 6. Would i t be accep t a b l e to apply t h i s procedure to i n s t i t u t i o n a l i z e d c h i l d r e n , the mentally r e t a r d e d , or other i n d i v i d u a l s who are not given an o p p o r t u n i t y to choose treatment f o r themselves? not at a l l a c c e p t a b l e to apply t h i s procedure moderately a c c e p t a b l e very acceptable to apply t h i s procedure 7. How c o n s i s t e n t i s t h i s treatment with common sense or everyday n o t i o n s about what treatment should be? very d i f f e r e n t or i n c o n s i s t e n t moderately c o n s i s t e n t very c o n s i s t e n t with everyday n o t i o n s 8. To what extent does t h i s procedure t r e a t the c h i l d humanely? does not t r e a t humanely at a l l t r e a t s them moderately humanely t r e a t s them very humanely 9 . To what extent do you think there might be r i s k s in undergoing t h i s kind of treatment? l o t s of r i s k s are l i k e l y some r i s k s are 1 i kely no r i s k s are l i k e l y 1 46 10. How much do you l i k e the procedures used i n t h i s treatment? do not l i k e moderately l i k e l i k e them them at a l l them very much 11. How e f f e c t i v e i s t h i s treatment l i k e l y to be? not at a l l moderately very e f f e c t i v e e f f e c t i v e e f f e c t i v e 12. How l i k e l y i s t h i s treatment to make permanent improvements in the c h i l d ? u n l i k e l y moderately very l i k e l y 1i kely 13. To what extent are u n d e s i r a b l e s i d e e f f e c t s l i k e l y to r e s u l t from t h i s treatment? many some no u n d e s i r a b l e u n d e s i r a b l e u n d e s i r a b l e s i d e e f f e c t s s i d e e f f e c t s s i d e l i k e l y l i k e l y e f f e c t s would occur 14. How much dis c o m f o r t i s the c h i l d l i k e l y to experience d u r i n g the course of treatment? very much moderate no disc o m f o r t d i s c o m f o r t d i s c o m f o r t at a l l 15. O v e r a l l , what i s your g e n e r a l r e a c t i o n to t h i s form of treatment? very negative ambivalent very p o s i t i v e APPENDIX D Semantic D i f f e r e n t i a l (Kazdin, 1980a) Please p l a c e your checkmarks on the l i n e that best c h a r a c t e r i z e s your r e a c t i o n to the treatment. If the s c a l e i s d i f f i c u l t t o r a t e , s t i l l put a checkmark that best r e f l e c t s your ge n e r a l r e a c t i o n to the treatment. There i s no need to spend much time on any one of the items. Your f i r s t impressions and immediate f e e l i n g about the items are what I would l i k e . bad unpleasant c r u e l worthless u n f a i r s t r o n g hard heavy l a r g e t h i c k weak s o f t l i g h t small t h i n act i ve sharp hot f a s t f e r o c ious p a s s i v e d u l l c o l d slow p e a c e f u l 1 47 APPENDIX E Case and Treatment Qu e s t i o n n a i r e Now that you have had a chance to think about Mike's problems and about some p o s s i b l e s t r a t e g i e s f o r d e a l i n g with Mike, I would l i k e you to c o n s i d e r a few a d d i t i o n a l q u e s t i o n s . 1. How s e r i o u s would you rate the problems Mike i s d e s c r i b e d as e x h i b i t i n g ? 5 4 3 2 1 extremely moderately not very s e r i o u s s e r i o u s s e r i o u s at a l l 2. In your own experience, how t y p i c a l i s Mike of the kind of c h i l d being seen in the r e g u l a r classroom? 1 48 1 49 3. C o n s i d e r t h e f o u r i n t e r v e n t i o n s t r a t e g i e s d e s c r i b e d f o r d e a l i n g w i t h M i k e ' s p r o b l e m s . P o s i t i v e P r a c t i c e PP M e d i c a t i o n M R e i n f o r c e m e n t R Time Out TO P l e a s e rank t h e s e f o u r i n t e r v e n t i o n s a c c o r d i n g t o how l i k e l y y o u would be t o use e a c h i n y o u r c l a s s r o o m . Do so by p l a c i n g t h e l e t t e r ( s ) c o r r e s p o n d i n g t o e a c h i n t e r v e n t i o n i n t h e o r d e r w h i c h b e s t r e p r e s e n t s y o u r f e e l i n g s . l e a s t most l i k e l y l i k e l y t o t o use t h i s use t h i s one one 4. A f t e r r e a d i n g t h r o u g h M i k e ' s c a s e d e s c r i p t i o n and t h e i n t e r v e n t i o n s t r a t e g i e s , y ou p r o b a b l y have had some r e a c t i o n s ( e . g . "My God, who would e v e r do t h a t t o a k i d " , o r , " W e l l o f c o u r s e , t h a t ' s what I do a l l t h e t i m e f o r k i d s l i k e h i m ! " ) . T e a c h e r s f a c e t h i s and s i m i l a r k i n d s of p r o b l e m s i n many c l a s s r o o m s . The r e a c t i o n s o f t h o s e t e a c h e r s t o t h e s e k i n d s of s i t u a t i o n s a r e an i m p o r t a n t a r e a o f i n v e s t i g a t i o n . In a few s e n t e n c e s , p l e a s e d e s c r i b e how you might a p p r o a c h t h e s i t u a t i o n i f Mike were i n y c u r c l a s s . APPENDIX F Case D e s c r i p t i o n Case of Mike R. Mike i s a 9-year o l d boy who l i v e s with h i s parents and younger brother, Tom, who i s 6 years o l d . Although Mike i s of normal i n t e l l i g e n c e and has no obvious academic d i f f i c u l t i e s , h i s s o c i a l behavior has been a concern f o r some time. His main problem i s that he i s very a g g r e s s i v e and does not f o l l o w a d u l t i n s t r u c t i o n s . He does many d i f f e r e n t t h i n g s that are dangerous to h i m s e l f or to o t h e r s . O c c a s i o n a l l y , he throws t h i n g s at h i s teache r s and h i s parents when they ask him to do t h i n g s . He has broken many o b j e c t s at s c h o o l , such as books, c h a i r s , t o y s , and a tape r e c o r d e r , e i t h e r by throwing them or knocking them o f f t a b l e s and s h e l v e s . He a l s o has had problems at home. For example, he f i g h t s with h i s brother p h y s i c a l l y and sometimes throws sharp o b j e c t s d i r e c t l y at him. Both Mike's parents and h i s teacher are worried because they have not been ab l e to c o n t r o l h i s a g g r e s s i v e n e s s . He has a l r e a d y i n j u r e d h i s brother and h i s f r i e n d s when he was angry, and most of the c h i l d r e n i n the school w i l l not play with him because they are a f r a i d he w i l l hurt them. He has been i n s e r i o u s t r o u b l e i n the community and at s c h o o l . Mike's teacher i s p a r t i c u l a r l y concerned that t h i n g s w i l l get worse i f something i s not done r i g h t away. 1 5 0 151 Case of Mike S. Mike i s a 9-year o l d boy who l i v e s with h i s parents and h i s younger brother, Tom, who i s 6 years o l d . Although Mike i s of normal i n t e l l i g e n c e and has no obvious academic d i f f i c u l t i e s , h i s s o c i a l behavior has been of concern f o r some time. Mike has been in a s p e c i a l c l a s s managed by a teacher and her a i d e . In t h i s s e t t i n g , the teacher and aide conducted a l l a c t i v i t i e s d u r i n g the day. The goals of t h i s c l a s s were "to develop b a s i c academic and s o c i a l s k i l l s . " With the advent of program cu t s and with a new emphais i n the school d i s t r i c t on mainstreaming, Mike has been p l a c e d i n a r e g u l a r school s e t t i n g . U n f o r t u n a t e l y Mike i s having some t r o u b l e i n the c l a s s . The main problem i s that he i s very a g g r e s s i v e and does not f o l l o w a d u l t i n s t r u c t i o n s . He does many d i f f e r e n t t h i n g s that are dangerous to himself or to o t h e r s . O c c a s i o n a l l y , he throws t h i n g s at h i s teachers and h i s parents when they ask him to do t h i n g s . He has broken many o b j e c t s at s c h o o l , such as books, c h a i r s , toys, and a tape r e c o r d e r , e i t h e r by throwing them or knocking them o f f t a b l e s and s h e l v e s . He a l s o has had problems at home. For example, he f i g h t s with h i s brother p h y s i c a l l y and sometimes throws sharp o b j e c t s d i r e c t l y at him. Both Mike's parents and h i s teacher are worried because they have not been ab l e to c o n t r o l h i s a g g r e s s i v e n e s s s . He has a l r e a d y i n j u r e d h i s brother and h i s f r i e n d s when he was angry, and most of the c h i l d r e n i n the school w i l l not p l a y 152 with him because they are a f r a i d he w i l l hurt them. He has been in s e r i o u s t r o u b l e in the community and at s c h o o l . Mike's teacher i s p a r t i c u l a r l y concerned that things w i l l get worse i f something i s not done r i g h t away. APPENDIX G I n t e r v e n t i o n D e s c r i p t i o n M e d i c a t i o n I n t e r v e n t i o n f o r Mike There i s a drug that can be used to decrease a g g r e s s i v e behavior. The drug i s c a l l e d M e l l a r i l . For a g g r e s s i v e c h i l d r e n , the drug i s used to i n c r e a s e a c h i l d ' s a b i l i t y to t o l e r a t e f r u s t r a t i o n . While on the drug, c h i l d r e n are able to handle events and i n t e r a c t i o n s with others that o r d i n a r i l y might be f r u s t r a t i n g . Because the c h i l d r e n do not become e a s i l y f r u s t r a t e d when on the drug, they are l e s s l i k e l y to react a g g r e s s i v e l y to o t h e r s . The drug seems to make some c h i l d r e n l e s s impulsive i n general so that they are more able to think about the consequences of t h e i r a c t i o n s before behaving i n a p p r o p r i a t e l y . For Mike, the drug i s administered i n t a b l e t form 3 times a day. The d a i l y dosage of the drug i s estimated on the b a s i s of body weight and may be changed s l i g h t l y u n t i l the optimal dose i s found. 153 1 54 Time-Out I n t e r v e n t i o n f o r Mike A procedure that can be used to change Mike's d i s r u p t i v e behavior i s c a l l e d TIME OUT FROM REINFORCEMENT. T h i s procedure i s designed to punish h i s a g g r e s s i v e and noncompliant behaviors so that they are e l i m i n a t e d . Time out means that there i s a p e r i o d of time i n which a person i s removed i n some way from the s i t u a t i o n . The procedure i s c a l l e d "time out from reinforcement" because d u r i n g the time that Mike i s taken away from the s i t u a t i o n , he cannot r e c e i v e reinforcement or rewards such as a t t e n t i o n from o t h e r s . For Mike, the time out procedure c o n s i s t s of t a k i n g him out of the s i t u a t i o n f o r 10 minutes whenever he misbehaves. For example, when Mike throws something or h i t s another p u p i l he i s immediately taken out of the s i t u a t i o n . He would be i s o l a t e d i n a part of the l a r g e classroom that i s p a r t i t i o n e d o f f f o r t h i s purpose. The p a r t i t i o n makes a l i t t l e booth where Mike can be i s o l a t e d . T h i s time out booth c o n s i s t s of a c h a i r i n the booth. No books or toys are given to him so that he i s cut o f f from a l l rewarding a c t i v i t i e s and from other people. 155 He has to s i t i n the booth f o r 10 minutes. He cannot see out nor can others see i n because of the p a r t i t i o n that c l o s e s him o f f from the r e s t of the classroom completely. A f t e r h i s time i s up, the teacher l e t s him out. When Mike comes out, he can resume h i s a c t i v i t i e s . As soon as any ag g r e s s i o n occurs, he i s immediately p l a c e d i n t o the time out booth a g a i n . 1 56 Reinforcement I n t e r v e n t i o n f o r Mike A procedure that can be used to change Mike's a g g r e s s i v e behavior i s c a l l e d REINFORCEMENT OF INCOMPATIBLE BEHAVIOR. T h i s i s a procedure that i s designed to develop compliant and coop e r a t i v e behaviors to re p l a c e the ag g r e s s i v e behaviors. T h i s i s not a punishment procedure. I t works, r a t h e r , by rewarding d e s i r a b l e b e h a v i o r s . As the a p p r o p r i a t e behaviors are developed, the i n a p p r o p r i a t e behaviors drop out and are e l i m i n a t e d . S p e c i f i c a l l y , Mike's teacher w i l l develop compliance to i n s t r u c t i o n s and c o o p e r a t i v e behavior by s y s t e m a t i c a l l y rewarding a p p r o p r i a t e responses. The teacher w i l l e x p l a i n the reward program to Mike. The program c o n s i s t s of l e t t i n g Mike earn p r i v i l e g e s i f he l i s t e n s to the teacher and behaves c o o p e r a t i v e l y . For example, i f Mike f o l l o w s d i r e c t i o n s i n s t a r t i n g and completing h i s work on time, i s c o o p e r a t i v e i n classroom r o u t i n e and looks a f t e r h i s own and school p r o p e r t y , he can earn S t a r s on a s p e c i a l c h a r t . Mike can a l s o earn Stars by p l a y i n g n i c e l y with h i s classmates and, when Mike get mad, he can earn S t a r s i f he does not throw t h i n g s , or does not act a g g r e s s i v e l y . The S t a r s can be traded f o r such p r i v i l e g e s as e x t r a r e c e s s , a s p e c i a l game, f r e e time i n c l a s s , or viewing an e d u c a t i o n a l T.V. show f o r the c l a s s as a whole. When Mike whines or argues the teacher w i l l j u s t ignore t h i s . Mike w i l l not earn S t a r s unless he behaves cooperat i v e l y . 1 57 P o s i t i v e P r a c t i c e I n t e r v e n t i o n f o r Mike A procedure that can be used i s c a l l e d POSITIVE PRACTICE. T h i s procedure i s designed to suppress a g g r e s s i v e and noncompliant behaviors so that they are e l i m i n a t e d . P o s i t i v e p r a c t i c e means that Mike rep e a t e d l y p r a c t i c e s the c o r r e c t behaviors to l e a r n when he i s supposed to do. When Mike misbehaves, he i s immediately made to p r a c t i c e the a p p r o p r i a t e behaviors t h a t should have been done. He goes through the a c t u a l motions of a p p r o p r i a t e behavior and, i f necessary, i s p h y s i c a l l y guided though the a c t i v i t i e s . When Mike performs an a g g r e s s i v e a c t , the teacher comes over to him immediately. The teacher t e l l s Mike he.has to go through the a p p r o p r i a t e b e h a v i o r s . The teacher t e l l s him e x a c t l y what to do and s t a y s there while Mike goes through each of the a p p r o p r i a t e b e h a v i o r s . For example, when Mike throws something at a classmate, he i s t o l d to express h i s anger r i g h t then i n a more a p p r o p r i a t e manner. He must say he i s mad and t e l l the other person why he i s mad. Mike i s t o l d he must go through t h i s sequence 3 times i n a row to p r a c t i c e the c o r r e c t behavior. With p o s i t i v e p r a c t i c e , Mike p r a c t i c e s e x p r e s s i n g h i s anger and behaving a p p r o p r i a t e l y .rather than throwing t h i n g s or h i t t i n g o t h e r s . Repeatedly p r a c t i c i n g the c o r r e c t behaviors i s an important part of the procedure.