Behavioral Medicine and Developmental Disabilities

249 Pages·1989·3.678 MB·English

by  James K. Luiselli (auth.), James K. Luiselli (eds.)

Disorders of Human Learning,
Behavior, and Communication
Ronald L. Taylor and Les Sternberg
Series Editors
James K. Luiselli
Editor
Behavioral Medicine and
Developmental Disabilities
Springer-Verlag
New York Berlin Heidelberg
London Paris Tokyo
James K. Luiselli, Behavioral and Educational Resource Associates, Concord,
Massachusetts 01742, USA
Series Editors: Ronald L. Taylor and Les Sternberg, Exceptional Student Education,
Florida Atlantic University, Boca Raton, Florida 33431-0991, USA
Library of Congress Cataloging-in-Publication Data
Behavioral medicine and developmental disabilities.
(Disorders of human learning, behavior, and
communication)
Includes bibliographies.
1. Medicine and psychology. I. Luiselli, James K.
II. Series. [DNLM: 1. Behavior Therapy. 2. Child
Development Disorders. WS 350.6 B4184]
R726.5.B4252 1989 616.89'142 88-29475
ISBN-13:978-1-4613-8846-3 (alk. paper)
Printed on acid-free paper
© 1989 by Springer-Verlag New York Inc.
Softcover reprint of the hardcover 1st edition 1989
All rights reserved. This work may not be translated or copied in whole or in part without the written
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Typeset by Publishers Service, Bozeman, Montana.
9 8 7 6 5 432 1
ISBN-13:978-1-4613-8846-3 e-ISBN -13 :978-1-4613-8844-9
DOl: 10.1007/978-1-4613-8844-9
Preface
As a graduate student a decade ago, I recall vividly reading the inaugural issue of
the Journal of Behavioral Medicine when it appeared in 1978. Its purpose was
described as "a broadly conceived interdisciplinary publication devoted to fur
thering our understanding of physical health and illness through knowledge and
techniques of behavioral science:' The articles in that first issue addressed such
topics as the biofeedback treatment of neuromuscular disorders, anxiety manage
ment of Type A behavior, and premorbid psychological factors related to cancer
incidence. At that time, coursework in behavioral medicine was in its infancy at
my university, and I, along with many classmates, was eager to learn more of this
"new and emerging field:'
Thinking back to those times, it is astonishing for one to reflect on the rapid
evolution of behavioral medicine and its current status as a clinical and scientific
discipline. Organizations such as the Society of Behavioral Medicine now include
a broad-based membership that is convened yeady at a major convention. In
addition to the Journal of Behavioral Medicine, professionals can avail them
selves of several other specialty journals (Annals of Behavioral Medicine,
Behavioral Medicine Abstracts, Journal of Developmental and Behavioral Pedi
atrics) as well as the numerous articles on behavioral medicine that appear regu
larly in the clinical psychology, psychiatry, rehabilitation, and behavior therapy
literature. And behavioral medicine services and training programs are encoun
tered with increasing frequency within clinic, hospital, and academic settings.
Keeping pace with the latest developments in behavioral medicine can be an
arduous task for even the most fastidious reader. For this reason, edited volumes
provide a useful function by presenting timely reviews of topical areas, syn
thesizing research findings, and critically evaluating our current knowledge base.
In recent years, several such volumes have been prepared on both general issues
in behavioral medicine and more narrowly defined clinical categories (e.g.,
behavioral pediatrics). This book also represents an attempt to consolidate our
recent clinical and research advances, but differs from previous volumes in two
primary ways. First, whereas the majority of prior books have concentrated on
the popUlation of nonhandicapped persons, the present edition addresses the
topic of behavioral medicine treatment and research with developmentally dis-
vi Preface
abled individuals. The involvement of behavioral medicine specialists with
handicapped persons has been expanding over the years, given advances in bio
medical research, refinements in treatment technology, and the growing alliance
among psychologists and physicians. Second, this book focuses on the contribu
tions of applied behavior analysis to assessment, intervention, and evaluation.
Behavior analysts have been instrumental in the design of habilitation programs
for developmentally disabled persons and, from the beginning, have helped shape
and define the field of behavioral medicine as a whole. Although several journal
articles and book chapters have described behavioral medicine applications with
handicapped persons, this book is one of the first efforts to present this informa
tion in the context of a single edited volume.
The book is geared toward clinicians, physicians, practitioners, researchers,
and advanced graduate students in the areas of psychology, rehabilitation, special
education, and medicine. Psychologists and physicians should find the book
useful in identifying effective therapeutic strategies and methods to design
comprehensive therapy programs. Because of the integrated review of experi
mental findings contained in the book, academic and applied researchers will be
able to locate timely data from varied perspectives. The critical appraisal of
research provided by the authors should also aid in the design and implementa
tion of future studies. The student population can utilize the book as a reference
source that provides an overview of specialized areas of treatment and research.
As always, it will be left to the reader to decide whether these objectives have
been fulfilled.
I am indebted to the people at Springer-Verlag for their support and assistance
throughout the conception and completion of this work. Special thanks are also
extended to Dr. Ronald L. Taylor and Dr. Les Sternberg for providing much help
along the way. I am grateful to many colleagues, too numerous to mention, who
have helped shape my thinking over the years, given encouragement, and lent an
ear. Finally, this book is dedicated to my parents, who have always been my finest
teachers and a constant source of love and inspiration.
James K. Luiselli
Contents
Preface. . . . . . . . .. . . . . . .. . . . . . . . . . .. . . .. . .. . . . . . . . . . . . . . . .. . . v
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Behavioral Medicine, Behavior Therapy, and Developmental
Disabilities: An Overview
James K. Luiselli. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Behavioral Assessment
Thomas R. Linscheid, L. Kaye Rasnake, Kenneth J. Tarnowski,
and James A. Mulick. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3 Feeding Disorders
Lori A. Sisson and Vincent B. Jizn Hasselt 45
4 Bladder and Bowel Incontinence
Louis D. Burgio and Kathryn Larsen Burgio. . . . . . . . . . . . . . . . . . . . . 74
5 Obesity and Weight Regulation
Robert A. Fox, Donald J. Meyer, and Anthony F. Rotatori 92
6 Health-Threatening Behaviors
James K. Luiselli. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 114
7 Behavioral Pharmacology
Nirbhay N. Singh and Alan S. W. Winton 152
8 Professional Training
Carol Lewis and Ronald S. Drabman . . . . . . . . . . . . . . . . . . . . . . . . . .. 180
viii Contents
9 Behavioral Medicine Consultation
Don P. Sugai and James K. Luiselli. . . . . . . . . . . . . . . . . . . . . . . . . . .. 199
Author Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 227
Subject Index ................................................ 247
Contributors
Kathryn Larsen Burgio, PHD, Section on Geriatric Medicine, University of Pitts
burgh School of Medicine, Pittsburgh, PA 15213, USA.
Louis D. Burgio, PHD, University of Pittsburgh School of Medicine, Pittsburgh,
PA 15213, USA.
Ronald S. Drabman, PHD, Department of Psychiatry and Human Behavior,
University of Mississippi Medical Center, Jackson, MS 39216, USA.
Robert A. Fox, PHD, School of Education, Marquette University, Milwaukee,
WI 53233, USA.
Carol Lewis, PHD, Private practice, Gainesville, FL 32601, USA.
Thomas R. Linscheid, PHD, Department of Pediatrics, Children's Hospital,
Columbus, OH 43205, USA.
James K. Luiselli, EoD,. Behavioral and Educational Resource Associates, Con
cord, MA 01742, USA.
Donald J. Meyer, PHD, School of Education, Marquette University, Milwaukee,
WI 53233, USA.
James A. Mulick, PHD, Department of Psychology, Ohio State University,
Columbus, OH 43205, USA.
L. Kaye Rasnake, PHD, Department of Pediatrics, Children's Hospital, Colum
bus, OH 43205, USA.
Anthony F. Rotatori, PHD, School of Education and Allied Professions, Fairfield
University, Fairfield, CT 06430, USA.
Nirbhay N. Singh, PHD, Educational and Research Service Center, Northern
Illinois University, DeKalb, IL 60115, USA.
Lori A. Sisson, PHD, Department of Psychiatry, Western Psychiatric Institute and
Clinic, Pittsburgh, PA 15261, USA.
x Contributors
Don P. Sugai, PHD, Department of Behavioral Medicine and Psychiatry, Lahey
Clinic Medical Center, Burlington, MA 01803, USA.
Kenneth J. Tarnowski, PHD, Department of Pediatrics, Children's Hospital,
Columbus, OH 43205, USA.
Vincent B. Jim Hasselt, PHD, Department of Psychiatry and Human Behavior,
Irvine Medical Center, Orange, CA 92668, USA.
Alan S. W Winton, PHD, Department of Psychology, Massey University, Christ
church, New Zealand.
1
Behavioral Medicine, Behavior Therapy,
and Developmental Disabilities:
An Overview
JAMES K. LUISELLI
In its broadest terms, behavioral medicine represents, "the integration of
behavioral and biomedical expertise in the search for solutions to problems of
health and illness" (Schwartz & Weiss, 1978, p. 4). Although scientific inquiry in
the behavioral sciences and medicine has a long history, the confluence of these
disciplines is a relatively new area of investigation. Some authors have suggested
that the term behavioral medicine first appeared in 1973 with the publication of
Birk's volume, Behavioral Medicine: Biofeedback (Blanchard, 1982; Russo &
Varni, 1982). Beginning in 1977, significant organizing events occurred, such as
the Yale Conference on Behavioral Medicine and the formation of special
interest groups such as the Society of Behavioral Medicine and the Academy of
Behavioral Medicine Research. Another area of development originating in the
late 1970s was the establishment of several university-affiliated centers specializ
ing in behavioral medicine treatment and research. As an outflow of this
increased clinical and experimental activity, scholarly publications in behavioral
medicine proliferated during the decade of 1977 to 1987. These include the
appearance of peer-refereed journals (Journal of Behavioral Medicine, Annals of
Behavioral Medicine) and numerous texts addressing general issues in behavioral
medicine (Ferguson & Taylor, 1980; Pomerleau & Brady, 1979; Williams & Gen
try, 1977), as well as more circumscribed target areas such as cardiology (Surwit,
Williams, & Shapiro, 1982), rehabilitation (Ince, 1976), and pediatrics (Russo &
Varni, 1982; Varni, 1983).
Although behavioral medicine clearly appears to be a discipline "whose time
has come;' there is still no uniformly accepted definition of the field. In fact, as
discussed subsequently, considerable disagreement prevails concerning focus,
scope, and methodology. As with any emerging, investigative area, definitive
boundary conditions have yet to be established. It is, perhaps, more useful to
view behavioral medicine as a general orientation towards the psychological and
environmental treatment of illness and disease rather than a fixed set of princi
ples and procedures.
The intent of this chapter is to provide an overview of behavioral medicine,
its relevance to the treatment of developmentally disabled persons, and the