A Modification of the Token Economy for Nonresponsive Youth in Family-Style Residential Care

Abstract

Out-of-home treatment for youth with conduct problems is increasing rapidly in this country. Most programs for these youth deliver treatment in a group format and commonly employ some version of a token economy. Despite widespread evidence of effectiveness, a substantial minority of treated youth fail to respond. Participants for this study were 3 youth who were nonresponsive to treatment provided in a family-style residential care program with a comprehensive token economy. Our approach to the "nonresponse" of these youth involved modifications of the frequency and immediacy of their access to the backup rewards earned with tokens. We evaluated the effects of the modifications with a treatment-withdrawal experimental design. Dependent measures included two indices of youth response to treatment: intense behavioral episodes and backup rewards earned. Results showed substantial improvement among these indices during treatment conditions.

Impulsive and premeditated subtypes of aggression in conduct disorder: differences in time estimation

“…Previous research and theory have shown that performance feedback can result in improved accuracy of time estimation [Ryan and Robey, 2002]. The use of feedback mechanisms for treatment intervention is supported by other studies that have demonstrated the effectiveness of reward-contingent behavioral feedback therapies in youth with aggressive symptoms who were otherwise treatment resistant [Field et al, 2004].…”

Use of Cognitive Behavioral Therapy and Token Economy to Alleviate Dysfunctional Behavior in Children with Attention-Deficit Hyperactivity Disorder

“…Fabiano et al reported that the economy token “assigns points for targeted behaviors within the program setting,” and the technique is widely used in programs treating dysfunctional behaviors of various disorders (21, 22, 31, 33). However, most studies specifically comparing token economy technique effects have used counts of behaviors emitted as outcome measures, then comparing average frequencies at baseline date and post-intervention (21, 22, 31, 33).…”

“…However, most studies specifically comparing token economy technique effects have used counts of behaviors emitted as outcome measures, then comparing average frequencies at baseline date and post-intervention (21, 22, 31, 33). Other studies comparing effects of behavioral intervention have used standardized measures from cognitive tasks or behavioral inventories (14–16, 23, 24, 27, 28, 30).…”

The Effects of a Classroom-based Intervention on Aggression-related Injuries

“…Teaching-Family research on aggression suggests that Teaching-Family procedures effectively reduced the aggression displayed by group home youth (Field et al 2004b;Phillips 1968), parent/caregiver perceptions of aggressive behaviors displayed by group home youth (Larzelere et al 2001) and the frequency of crisis teaching episodes in reaction to severe behaviors such as aggression (Field et al 2004a). Teaching-Family procedures reduced staff use of restraint (Jones and Timbers 2003), the number of days spent in inpatient care by youth for whom aggression was a referring factor (Fabry et al 2002) and disruptive behaviors, including aggression, displayed by an adult with intellectual disabilities living in a group-home (Reese et al 1998).…”