The Modification of a Child's Enuresis: Some Response‐response Relationships

Abstract

The present study attempted to evaluate experimentally the relationship between two response classes, enuresis and oppositional behavior. One child who had a long history of bed-wetting was observed in his home setting. Parents' reports and initial observations confirmed that the child was oppositional much of the time. When a timeout operation and differential attention were presented, removed, and presented again, the frequency of oppositional behavior decreased, increased, and decreased accordingly. Fluctuations in enuretic activity also correlated with the presence and absence of the timeout and differential attention operations. The suppression of oppositional behavior and enuretic activity persisted over an 18-month treatment period. It was suggested that the parental operations performed on oppositional behavior may have led to an increase in the parents' social reward value. Cessation of enuretic activity was explained in terms of a shift in parental reinforcer effectiveness.Yates (1969) indicated that the conditioning method for treating childhood enuresis may not be as effective as was once thought. He recently compiled results from every study that selected an initial arrest criterion of six dry nights per week and provided follow-up data over a minimum period of six months. Taking these studies as a whole, Yates reports that only 53% of the cases were successfully treated by the conditioning method. Although he suggests that this figure might be somewhat higher if experimenters had more closely supervised parents in administration of the method, even the most careful instructions are no guarantee that mistakes will not be made in the home (Bostock and Shackelton, 1957).When initial symptom arrest has been achieved, it is not clear that the treatment effect will be sustained once the conditioning apparatus is removed. Lovibond (1964) reported that the relapse rate may be as high as 35 to 40% when follow-up extends to 2 yr or more. Turner and Young (1966) reported a similar relapse figure over a 3 to 5 yr follow-up period.

ANALYSIS OF THE EFFECTS OF SEQUENTIAL REINFORCEMENT CONTINGENCIES ON ASPECTS OF COMPOSITION1

“…However, there is a growing body of literature indicating consistent correlated changes in behaviors classified as attitudes with changes in other directly manipulated behaviors. (Nordquist, 1971;Bandura, 1971). …”

The Positive Side Effects of Reinforcement: A Commentary on Balsam and Bondy (1983)

“…The physical appearance, mannerisms, and verbal and nonverbal behavior of the therapist undoubtedly affect patients in ways that are more complex than our concepts can now capture. For example, it seems safe to say that one cannot affect any single response dass without affecting others; response classes seem to interact in orderly ways (Dunham & Grantmyre, 1982;Epstein, 1983, in press;Herbert et al, 1973;Kazdin, 1982;Nordquist, 1971;Sajwaj, Twardosz, & Burke, 1972). A stimulus that serves as a reinforcer for one organism on one occasion may not do so on another.…”

Experimental Analysis of Response Covariation Among Compliant and Inappropriate Behaviors

“…Inverse relationships between appropriate and inappropriate behaviors have been noted across multiple target/nontarget behaviors and across age groups from infancy to adolescence, using a wide range of interventions (e.g., Ayllon & Roberts, 1974;Bucher & Lovaas, 1968;Buell et al, 1968;Epstein et al, 1974;Koegel, Firestone, Kramme, & Dunlap, 1974;Nordquist, 1971). Such inverse relationships have been described as collateral or side effects (either beneficial or detrimental) of procedures aimed at changing other behaviors.…”