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Behavior Change and Perceptions of Change: Evaluating the Effectivenessof a Token EconomyDavid Reitman a; Molly A. Murphy b; Stephen D. A. Hupp c;Patrick M. O'Callaghan b

a Center for Psychological Studies, Nova Southeastern University, b Department of Psychology,Louisiana State University, c Department of Psychology, Southern Illinois University-Edwardsville,

To cite this Article Reitman, David , Murphy, Molly A. , Hupp, Stephen D. A. andO'Callaghan, Patrick M.(2004) 'BehaviorChange and Perceptions of Change: Evaluating the Effectiveness of a Token Economy', Child & Family BehaviorTherapy, 26: 2, 17 — 36To link to this Article: DOI: 10.1300/J019v26n02_02URL: http://dx.doi.org/10.1300/J019v26n02_02

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Behavior Changeand Perceptions of Change:Evaluating the Effectiveness

of a Token Economy

David ReitmanMolly A. Murphy

Stephen D. A. HuppPatrick M. O’Callaghan

ABSTRACT. Token economies often reduce problematic classroom be-havior in preschool settings. In the present study, direct observation andteacher ratings of child behavior and treatment acceptability were uti-lized to evaluate the effectiveness of a token economy in a Head Startclassroom. Because many teachers express concerns about the effort re-quired to implement and maintain token systems, this study comparedthe relative efficacies of group and individualized contingency manage-ment programs. Direct observation data for three children revealed that boththe individual and group contingency were superior to a baseline condi-tion in which no systematic behavior management program was utilized.In addition, the whole group contingency was generally as effective asthe individual contingency. However, despite reductions in classroom

David Reitman, PhD, is Associate Professor, Center for Psychological Studies, NovaSoutheastern University.

Molly A. Murphy, MA, and Patrick M. O’Callaghan, MA, are affiliated with the De-partment of Psychology, Louisiana State University.

Stephen D. A. Hupp, PhD, is affiliated with the Department of Psychology, SouthernIllinois University-Edwardsville.

Address correspondence to: David Reitman, PhD, Associate Professor, Center forPsychological Studies, Nova Southeastern University, 3301 College Avenue, FortLauderdale, FL 33314.

Child & Family Behavior Therapy, Vol. 26(2) 2004http://www.haworthpress.com/web/CFBT

2004 by The Haworth Press, Inc. All rights reserved.Digital Object Identifier: 10.1300/J019v26n02_02 17

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rule violations for the three target children, the acceptability of the token pro-gram was variable and little change was observed in the teacher’s ratingsof their behavior. The results suggest the ongoing need for multiple mea-sures of treatment outcome (e.g., teacher and student ratings of accept-ability and effectiveness, direct observation) even for empirically sup-ported school-based interventions. [Article copies available for a fee fromThe Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address:<docdelivery@haworthpress.com> Website: <http://www.HaworthPress.com> © 2004by The Haworth Press, Inc. All rights reserved.]

KEYWORDS. Whole classroom token economy, treatment acceptability,teacher ratings, direct observation, behavior modification, Head Start,children

Not all children respond to classroom-based incentives for good be-havior and academic achievement such as grades or teacher attention(O’Leary, Becker, Evans, & Saudergas, 1969; McKee & Witt, 1990).For children that do not respond favorably in typical classroom environ-ments, token economies appear highly effective for improving socialbehavior and academic achievement (Gable & Strain, 1981). Tokeneconomies appear to facilitate positive outcomes by increasing appro-priate behaviors, thus enabling students to participate more fully in theeducational environment (Miltenberger, 1997).

The efficacy of classroom-based token economies is well established(see Pelham, Wheeler, & Chronis, 1998). Numerous studies specificallysupport the use of token economies with young children in Head Start andpreschool settings (Barrish, Saunders, & Wolf, 1969; Brown, Reschly, &Sabers, 1974; Herman & Tramontana, 1971; Swiezy, Matson, & Box,1992). Though many empirically-based studies of token systems havebeen conducted with preschoolers (Sato, Sato, Takayama, & Aikawa,1993; Stollar, Collins, & Barnett, 1994; Wolfe, Boyd, & Wolfe, 1983),good results have also been achieved in more recent studies involvingadolescent (Hicks & Munger, 1990; Moore, Tingstrom, Doggett, & Carl-yon, 2001; Swain & McLaughlin, 1998) and elementary school-aged(DeMartini-Scully, Bray, & Kehle, 2000; Musser, Bray, Kelhle, & Jen-son, 2001) children. In an illustrative study using a multiple baseline de-sign, Reynolds and Kelley (1997) investigated the effect of a token systemon aggression among 4 preschool-aged children. Children lost “smiley faces”contingent on hitting, scratching, or biting. If the child retained at leastone “smiley face” at the end of a 40-minute period, the child could select

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from a list of rewards. Behavioral observations indicated reductions inaggressive behavior and high treatment acceptability.

Despite the efficacy of token economies, teachers are sometimes hes-itant to use them (Witt & Elliot, 1982). Some teachers complain thatclassroom management systems developed by researchers are too com-plicated, cumbersome, and time-consuming to be used effectively (Coo-per, Heron, & Heward, 1987). For example, younger children may requireexplicit instruction in the use of the contingency management systemand frequent opportunities to earn reinforcers. For other children, dis-ruptive behavior may necessitate the addition of response cost proceduresto the token system (Kazdin, 1977). These issues are sometimes discussedunder the umbrella of “treatment acceptability,” an aspect of social vali-dation that relates to the extent to which caretakers (e.g., teachers orparents) support the use of specific treatment procedures (see Wolf,1978). For example, behavioral interventions that rely on existing, natu-rally occurring, or readily available reinforcers reduce the need for thepurchase of costly incentives and may enhance acceptability (Ferster,1967; Reitman, 1998). Because token systems require the teacher tomonitor carefully child behavior, deliver consistent consequences, andfrequently modify contingencies (Kazdin, 2001), researchers have beenstriving to streamline token procedures to enhance treatment accept-ability (e.g., Anhalt, McNeil, & Bahl, 1998; Kehle, Bray, Theodore, Jen-sen, & Clark, 2000; Reynolds & Kelley, 1997; Witt & Elliot, 1982).

Based on concerns about the effort required to maintain multiple in-dividualized token programs in the classroom, it has been suggestedthat group contingency approaches might enhance treatment acceptabil-ity (Anhalt et al., 1998; Brown et al., 1974; Hamblin, Hathaway, & Wodar-ski, 1974; Long & Williams, 1973). Collectively, the few existing stud-ies indicate little difference in the effectiveness of individual and groupcontingencies. In a group contingency, the performance of the individ-ual(s) determines consequences for the entire class (Kazdin, 1977). Anumber of variations have been explored, including dividing the classinto teams (see Anhalt et al., 1998) or selecting certain individuals to rep-resent the behavior of the class. For example, in a study by Drabman,Spitalnik, and Spitalnik (1974), individual and three different types ofgroup contingencies were investigated in a first grade class (socioeco-nomic background was not specified). The three group contingenciesvaried depending upon the individual in the class to whom the contin-gency was applied: the most well-behaved child, the least well-behavedchild, or a child chosen at random. All variations worked equally well inimproving classroom behavior but the teacher reported that the group

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contingency (particularly the randomly chosen child) was easier to man-age and monitor. Most authors seem to agree that ease-of-use is a criti-cal factor in the long-term success of token systems, and behavioral inter-ventions more generally (Axelrod, 1973; Drabman et al., 1974; Herman &Tramontana, 1971; Kehle et al., 2000).

Multi-method assessment has become almost axiomatic in clinical childpsychology (see Reitman, Franz, Himmel, & Gross, 1998; Mash & Wolfe,2002), however multi-method outcome assessment appears to have lagged(see Patterson, Reid, & Dishion, 1992 for a discussion of the problem).Most studies of token economies have employed direct observation inthe evaluation of behavior change, but very few studies have obtainedconcurrent teacher ratings of change and/or treatment acceptabilitydata. Unfortunately, the failure to obtain data from all of these sourcesmay lead to erroneous conclusions regarding the success or failure of anintervention in school-based, community, or private-practice settings.For example, both Drabman et al. (1974) and Stollar et al. (1994) ob-tained data via direct observation, but neither study obtained systematicdata on either treatment acceptability or the teacher’s perception of be-havior change (i.e., standardized ratings of child behavior from the teacher).After reviewing over 30 articles involving token systems, we found scantevidence that multiple indicators of treatment outcome were sought.One exception was a study conducted by Anhalt et al. (1998). In this study,a whole classroom token program (e.g., the ADHD Classroom Kit) wasemployed to decrease the disruptive behaviors of a 6-year-old Cauca-sian girl. Both direct observation of the child’s behavior and teacher rat-ings of the child’s behavior suggested improvement and treatment ac-ceptability appeared high. Unfortunately, the study employed only a sin-gle subject, an idiosyncratic treatment acceptability (satisfaction) mea-sure, and an incomplete reversal design (ABA) that did not permit unam-biguous conclusions to be drawn about the effectiveness of the program.Additional investigations of multiple treatment outcomes, especiallydiscrepancies between teacher ratings of behavior change, treatment ac-ceptability, and direct observation data, may inform discussions aboutgeneralization and maintenance. These data are also relevant to ongoingdebates about the nature of the “treatment-to-practice” gap and movingpsychosocial interventions from efficacy to effectiveness (Weisz & Jen-sen, 2001).

In the present study, direct observations of disruptive behavior wereconducted during baseline, individual, and group token economy condi-tions. Based on existing research (e.g., Anhalt et al., 1998; Drabman etal., 1974), it was predicted that the group contingency would reduce dis-

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ruptive behavior to the same degree as the individualized contingencyand that both of these conditions would be superior to baseline condi-tions where no systematic behavior management plan was in effect. Sinceteachers may be hesitant to implement these interventions, the social va-lidity and treatment acceptability of the intervention was evaluated for eachchild using standardized measures. Data from existing studies of agree-ment between teacher ratings and direct observation of child behaviorwould suggest a rather poor likelihood of agreement (Cosper & Erickson,1984). On the other hand, the logic of underlying treatment outcome re-search appears to require convergence of direct observation, teacher rat-ings, and treatment acceptability data (see Patterson et al., 1992). Sinceexisting data on the effectiveness of token systems derives primarilyfrom direct observations of classroom behavior and our experimentaldesign constrained our inferences to data obtained via direct observa-tion, we make no specific prediction about teacher ratings or treatmentacceptability. However, the limited data available suggest (see Anhaltet al., 1998; Reynolds & Kelley, 1997) that teacher ratings would revealfewer post-intervention problems and treatment acceptability data wouldbe supportive of the token program.

METHOD

Participants and Setting

Children and teachers were recruited from classrooms participatingin an early intervention program providing mental health services to theteachers, parents, and children at four Head Start Centers located in thesouth central United States. Fourteen classrooms were sampled to iden-tify at-risk children and teachers that might benefit from consultation.Target children were selected according to the following criteria:(a) teacher referral for disruptive behavior problems, and (b) a score of65 or above on the Oppositional or Hyperactivity subscales of the ConnersTeacher Rating Scale-Revised: Short Form (CTRS-R: S; Conners, 1997).As a practical matter, it was important to select a classroom in which morethan one child had behavioral problems, so that the influence of group andindividualized contingencies could be contrasted and replicated withmultiple children. One class of 17 students contained 3 children (allboys) that met the above criteria and served as the participants in thisstudy.

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Materials

The experimental materials consisted of a token chart, a Rewards Tar-get Game (RTG) and a digital kitchen timer (buzzer) (all adapted fromAnhalt et al., 1998). The token chart served as a visual performance re-cord made of a soft green felt material (24" � 18"). A velcro ball was at-tached to the token chart enabling the teacher to move the ball up ordown to signal the delivery of a consequence. The chart contained 7 lev-els. The top 3 levels, 1 through 3 (represented by smiley faces of pro-gressively greater intensity and size) indicate good (3) to excellent (1)behavior. Performances at any one of these levels resulted in an oppor-tunity to play the RTG. Levels 4 through 7 represent the middle to lowerlevels on the token chart, did not result in an opportunity to play theRTG. Levels 5 through 7 (represented by sad faces of progressivelygreater intensity), and indicating poor classroom behavior.

The RTG consisted of a felt board, covered with randomly arranged,pool ball-like numbers from 1-10 and a “cue ball” covered with velcro.Based upon performance on the token chart described above, childrenthrew the cue ball at one of three RTGs. For example, at the lowest re-ward level, RTG level 3, a throw connecting with “level 8” permittedthe children to select inexpensive items from a “grab bag.” A throw con-necting with level 4 on RTG level 2 resulted in a 5-minute “dance party.”At the highest level, a throw at level 2 on RTG level 1 resulted in 10 min-utes of “Freeze Frame.” A conventional kitchen timer (buzzer), sounding ev-ery 10 minutes, prompted teachers to praise appropriate behavior.

Measures

Behavioral Observations and Coding (adapted from The RevisedEdition of the School Observation Coding System: REDSOCS (Jacobset al., 2000) is an interval coding system designed to measure disruptivebehavior problems of children in preschool and elementary school set-tings. The present study adapted the behavioral observation codes fromthe REDSOCS to conform to teacher-selected classroom rules. The op-erationally defined problem behaviors included: noncompliant, disrup-tive, negative with the teacher, and negative peer interaction. Althougheach of these behaviors could have been impacted differently by the in-tervention, data analyses suggested that this was not the case. Conse-quently, data for all categories were combined to yield a single measureof problem behavior. Behaviors were coded as occurring if they wereobserved for better than 5 seconds (50%) of any 10-second interval. Re-

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liability was calculated for 25% of all observations during each phase.Interobserver agreement was calculated by dividing the number of in-terval agreements by the sum of the number of interval agreements andinterval disagreements (Kazdin, 1982). Reliability estimates were verygood to high, averaging 91.6 agreement across all phases (range = 85-96%).

The Conners Teacher Rating Scale-Revised: Short Form (CTRS-R:S; Conners, 1997). The CTRS-R:S (Conners, 1997) is a 28-item scaledesigned to measure oppositional behavior, cognitive problems or inat-tention, hyperactivity, and an ADHD Index. Designed for the assess-ment of children between the ages of 3 and 17, test-retest reliability, con-struct and concurrent validity for the CTRS-R:S appear good. Barkley(1990) recommends using the scale for treatment monitoring.

The Intervention Rating Profile-15, (IRP-15; Martens, Witt, Elliot, &Darveaux, 1985). The IRP-15 is a 15-item, 6-point Likert-type ques-tionnaire (1 = strongly disagree to 6 = strongly agree) designed to assessthe acceptability of classroom-based interventions. Scores range from15 to 90 (high acceptability). Excellent internal consistency (Cronbach’salpha = .98) has been reported (Tarnowski & Simonian, 1992) and Elliot(1988) noted that the IRP-15 has been useful for identifying interven-tions that teachers considered too complex.

Procedures

Baseline Condition. During the baseline condition, the teacher was in-structed to conduct her class as usual. No intervention was in effect andthe behavior of the three participants was recorded by a graduate stu-dent observer.

Pre-Intervention Training. The teacher was asked to identify the three mostappropriate and inappropriate behaviors in her classroom. Target behav-iors were translated into positively worded classroom rules and defined.Definitions were refined during baseline observations of the target chil-dren and incorporated into the observational coding system.

Once a stable baseline was established, the teacher was trained to im-plement the token program and handouts were provided. The handoutsincluded: (1) an explanation of the token chart, (2) when and how topraise appropriate behaviors, (3) when and how to deliver back-up rein-forcers, and (4) which behaviors earned or lost levels. The teacher alsoparticipated in a one-hour role-play and discussion about the token pro-gram with the experimenter. At the end of the training, she scored 100%on a paper and pencil quiz covering the material contained in the hand-

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out. An observer was in the classroom for more than 75% of sessions inevery phase. During the first week of implementation, observers promptedthe teacher regarding correct implementation of the procedures (Anhaltet al., 1998). Following the first week, the teacher was instructed to referto her handouts or to a daily checklist. Observers were available if fur-ther clarification was necessary.

Before implementing treatment, the children were systematicallytaught to discriminate appropriate from inappropriate behavior and toreport the consequences of rule violations. Four teacher-selected class-room rules were taught: (a) “Use your inside voice,” (b) “Use yourwalking feet,” (c) “Keep your hands and feet to yourself,” and (d) “Lis-ten to the teacher.” For the purposes of the study, “inside voice” was de-fined as a voice that could not be heard at a distance of 15 feet.“Walking feet” was defined as moving at a pace consistent with otherchildren (i.e., not moving ahead of others in line or the absence of run-ning). Keeping “hands and feet to yourself” was defined as holdingone’s hands at one’s sides, or placing them on the desk, rather than incontact with other children. Violations of the “hands and feet” rule werenot recorded during play unless the behavior was defined as hitting thatproduced protest behavior from another child (i.e., attempts to escape,counterattack, telling the teacher, or crying). “Listening to the teacher”was defined as complying, or beginning to comply, with a direct requestwithin 5 seconds.

Classroom rules were posted at eye level as a prompt for the students.Using a 30-minute explanation and role-play, each child was instructedto act appropriately (practice following the rules) and received conse-quences. Specifically, when the children performed appropriate behav-iors the cue ball moved from neutral level 4 to level 3; a buzzer wassounded; and the child was directed to play the RTG. The RTG consistedof throwing a velcro ball at a felt board. Throws were followed immedi-ately by selection and delivery of the backup reinforcers including a va-riety of inexpensive tangible items (e.g., stickers) and activity rewards(e.g., a brief game of “Simon Says”). When children performed inap-propriate behaviors the target moved down a level (from 4 to 5) and theRTG was not available. The children were also instructed to remindother children to act appropriately.

Star Intervention. Fundamental to the procedure was the identifica-tion of some children as “Stars” during each session. During these ses-sions, the behavior of the Stars determined whether the group gained orlost points on the token chart. Before each session, 3 Stars were chosenrandomly by drawing names from a hat. Every child in the class served

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as a Star at least twice.1 After selection, the children were ineligible toserve again until every child received a turn.

During the token program, incentives were delivered twice a day atthe end of each of two sessions: 10:30 a.m. and 1:00 p.m. The first ses-sion began at approximately 8:30 a.m. Before each session, the teacherinstructed one of the Stars to announce the class rules, and to explainhow the children’s behavior would affect the cue ball’s movement. Thecue ball was placed at the neutral level of the token chart (level 4). Whena Star engaged in appropriate behavior (e.g., a child was observed fol-lowing a classroom rule), the teacher delivered descriptive praise, suchas, “Good job standing quietly in line and keeping your hands to your-self” and moved the ball towards the smiley face (RTG level 1). As aprompt, a timer was set for 10-minute intervals starting at 8:30 a.m. untilthe end of the session. When prompted by the timer, she delivered praiseand moved the cue ball up one level. She then reset the buzzer for an-other 10 minutes until the session was over and consequences were de-livered contingent on the level attained. The buzzer served as a prompt to theteacher to deliver points and to cue the Stars and other children to behaveappropriately during the session. Stars were given the opportunity to “re-cover” levels lost due to inappropriate behavior.

If Stars engaged in disruptive behavior, the child received a quick,descriptive reprimand for the behavior, such as “Simon, you have lost alevel for not listening.” A level was lost immediately after the reprimandand the child was told to watch, as the ball was moved towards the sadface (Reynolds & Kelley, 1997). If the cue ball resided in any of the up-per three levels of the token chart at the conclusion of the session, chil-dren were allowed to play the RTG. The value of the activities or incen-tives was determined by the placement of the ball on the token chart atthe time the buzzer sounded. For example, if the children earned pointsto level 3, they could play RTG level 3. To play the game, Stars tookturns throwing the velcro ball. Incentives were delivered based on thenumber closest to the ball. Because there were 3 Stars, if an RTG wereearned, each child had the opportunity to throw. Thus, the teacher was freeto choose any one of the three rewards to distribute to the class. If the cueball resided at levels 5, 6, or 7 when the buzzer sounded, the class lostthe opportunity to play the RTG. The next session began at 11:00 a.m. andended at 1:00 p.m. Three new Stars were chosen for the 11:00 a.m. session andthe procedures were repeated.

Group Intervention. During sessions where a target child was not se-lected as a Star, the behavior of other randomly selected children from theclassroom determined whether opportunities to play the RTG were earned.

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Otherwise, this condition was identical to the Star phase described above.During this condition, observers continued to monitor the behavior ofthe target children to contrast the effects of the individualized and groupcontingencies. It is important to note that while target child “A” was partof the “group,” target child “B” could have been chosen as a Star for thatsession. Thus, the individual contingency was in effect for child “B.”

Experimental Design

An alternating treatments design with reversal across three participants wasemployed to evaluate the effect of the individualized and group contin-gencies. Observations rotated between three study participants for 30 min-utes each session, yielding a 10-minute observation of each target child,twice per day. Each session consisted of children participating in child-directed learning centers, teacher instruction group (e.g., arts and crafts),and healthcare activities (e.g., brushing teeth, using the bathroom). Thetoken program was not in effect during recess and no observations oc-curred in that setting. During each session, target children were ran-domly selected for observation to control for the influence that differ-ences in classroom activities might have on classroom behavior. Duringthe initial and reintroduced baseline sessions no token system was in ef-fect, although the teacher continued to use other standard disciplinarytechniques at her discretion (e.g., praise of appropriate behavior, repri-mand, redirection, time out). During the Star and Group contingencysessions the token system was active. As noted above, during the Starsessions, the behavior of a target child dictated reward delivery. DuringGroup sessions, the behavior of other randomly selected children deter-mined whether the class earned the opportunity to play the RTG. Everychild in the classroom received the opportunity to be a Star, but only thebehavior of the three target children was monitored.

Data Collection

In addition to direct observation of the children’s behavior, the teach-ers completed the CTRS-R:S (Conners, 1997) for the three target childrenat baseline and at the end of the study. Following the last treatment phase,the IRP-15 was given to assess treatment acceptability (Reynolds &Kelley, 1997).

RESULTS

The effect of the token system on violation of classroom rules was eval-uated by visual inspection (Cooper et al., 1987; Kazdin, 1982). Interven-

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tion effects were quantified by calculating the percentage of intervalsthat violations were observed across conditions. As shown in the graphs,both interventions appeared to decrease rule violations. Social validity(i.e., teacher ratings at pre- and post-intervention) and treatment accept-ability data (post-intervention) are also reported.

Direct Observation Data

Figures 1 through 3 show the percentage of intervals in which class-room rule violations were observed for the 3 target children–Simon, Xa-vier, and Tom. During baseline phases, no systematic approach to ruleviolations was employed. In the Group contingency sessions non-targetchildren affected the movement of the cue ball on the token chart. Dur-ing Star sessions movement of the cue ball was dependent on the behav-ior of target children.

Results for Simon are shown in Figure 1. During baseline, Simon en-gaged in disruptive behaviors an average of 13% of the intervals (range =5-28). During the Group phase, Simon’s negative behaviors decreasedto a mean of 3.4% (range = 0-13%). In the Star phase Simon exhibitednegative behaviors 6% of the time (range = 0-37%). It should be notedthat during Simon’s first Star session he was disciplined for a rule viola-tion and engaged in a temper tantrum that resulted in multiple rule vio-lations. During his next Star session he contacted the contingency suc-cessfully and rule violations decreased to less than 5% (range = 0-5%)of the subsequent Star sessions.

In Figure 2, Xavier violated classroom rules during approximately13.1% of the baseline intervals (range = 5-27%). During the Group phase,negative behaviors were observed during 4.6% of the intervals (range =0-18%). During the Star phase, rule violations were observed during1.75% (range = 0-7%) of the intervals.

In Figure 3, Tom violated classroom rules during 13.4% of the base-line intervals (range = 5-30%). During the Group phase, Tom violatedclassroom rules during 1.6% of the intervals (range = 0-15%). Finally,Tom violated rules less than 1% (0.9%) of the Star intervals (range =0-3%).

Social Validity and Treatment Acceptability Data

Few differences in teacher ratings of behavior were noted on pre- andpost-test contrasts using the Hyperactivity and Oppositional subscalesof the CTRS-R: S (Conners, 1997). The teacher rated Simon as oppositional

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at pre-intervention (T = 86) and post-intervention (T = 86). His scoreson the Hyperactivity scale were also similar at pre- and post-interven-tion, T = 81 and T = 79, respectively. Xavier was also rated as highlyoppositional (pre-T = 90; post-T = 90) and hyperactive (pre-T = 81,post-T = 79) before and after the intervention. Tom was rated as slightlyless oppositional than the other boys. However, as for Simon and Xa-vier, no change was observed in teacher ratings of Tom’s Oppositionalbehavior (pre-T = 65, post-T = 68). The teacher rated Tom as slightly lessHyperactive (pre-T = 77, post-T = 73) after the intervention.

The teacher rated treatment acceptability for each participant. Scoreson the IRP-15 were variable across children: Simon (61), Xavier (20),Tom (83). Despite the absence of improvement in teacher ratings andvariable treatment acceptability, when interviewed at the conclusion ofthe study, the teacher stated that she liked the program and would use it inthe future.

DISCUSSION

One purpose of this study was to investigate the effectiveness of a groupor individualized contingency system on classroom rule violation. Di-

28 CHILD & FAMILY BEHAVIOR THERAPY

Simonnegative behavior

40%

30%

20%

10%

0%

%of

inte

rval

s

1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46

sessions

baseline

group

star

FIGURE 1. Problem Behaviors During Baseline, Star, and Group TreatmentConditions for Simon

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rect observation suggested that both individual and group-based contin-gencies had a similar effect on the behavior of the target children. Thetoken system appeared to effectively decrease the children’s disruptivebehaviors in the classroom. Upon return to baseline, problem behaviors(e.g., physical aggression or disruptive behaviors such as yelling, etc.)increased suggesting that the token economy was responsible for theobserved changes in classroom behavior. Although the target childrenresponded to both the Group and Star contingencies, the Star contingencyappeared slightly more effective, especially for Tom and Xavier. Al-though the differences are not large, these data suggest that, at least forsome children, an individualized token system could be superior to agroup contingency. Hughes (1979) found group and individual contin-gencies had similar effects; however, that study employed a between-sub-jects design that could have obscured individual differences (Morgan &Morgan, 2001).

A second purpose of this study was to examine other indicators oftreatment outcome and their relation to direct observation data. In thepresent study, evidence of changes in standardized teacher ratings con-stituted social validation. Despite the impact of the intervention on di-rect observations of target children’s behavior, little change in the teacher’sratings of child behavior was evident at post-intervention. Previous re-search suggests that teachers often do not recognize changes in student

Reitman et al. 29

Xaviernegative behavior

1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52

sessions

baseline

group

star

40%

30%

20%

10%

0%

%of

iner

vals

FIGURE 2. Problem Behaviors During Baseline, Star, and Group TreatmentConditions for Xavier

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behavior, especially when these changes are gradual or the teacher has aparticularly strong opinion of the child (Drabman & Tucker, 1974; Elliot,1988; Tarnowski & Simonian, 1992). In the absence of specific infor-mation about changes in child behavior teachers may prematurely aban-don effective interventions. To address this problem, teachers might beshown weekly graphs of the target child’s behavior to demonstrate pro-gram effectiveness (Erchul & Martens, 2002; Hawkins, Mathews, &Hamdan, 1999; Reitman & Drabman, 1999). For example, presentingthis teacher with graphs of changes in the children’s behavior might havealtered her perceptions of effectiveness. Additional research on the rela-tionship of teacher perceptions of behavior change and treatment ac-ceptability would be quite valuable.

Treatment acceptability data indicate variable support for the tokensystem, despite consistent reductions in classroom rule violations. Treat-ment acceptability was high for Tom and the teacher reported that he hadresponded very well to the intervention. Prior to the intervention, Tomwas described as very distractible and the token program significantlyreduced the frequency of this behavior. The teacher rated treatment ac-ceptability for Simon as moderate. Specifically, she expressed concernsabout the generalization and maintenance of effects of the intervention,noting that at times of the day when the intervention was not in effect,she perceived that he engaged in more frequent aggressive behavior.

30 CHILD & FAMILY BEHAVIOR THERAPY

Tomnegative behavior

40%

30%

%of

inte

rval

s

20%

10%

0%

sessions

1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46

baseline

group

star

FIGURE 3. Problem Behaviors During Baseline, Star, and Group TreatmentConditions for Tom

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Acceptability was rated as poor for Xavier despite the fact that he hadresponded as positively to the intervention as had the other children.The teacher indicated that Xavier did not appear to respond to the pro-gram incentives or positive attention. However, commenting on theoverall intervention, the teacher reported that she intended to use theprogram in the future. This may have been due to her perception that theimpact of the program was inconsistent for targeted children, but posi-tive for the class as a whole. Anecdotally, the teacher reported that non-target children appeared very responsive to the additional teacher praiseprompted by the intervention.

Indications for Future Research

Perhaps the most important suggestion from this study is that neitherclinicians nor researchers interested in the effectiveness of contingencymanagement systems should assume that positive results found in effi-cacy research will necessarily translate into changes in teacher percep-tions of child behavior. Had this intervention been evaluated in terms ofthe direct observation data only, the results would have been more clearlysupportive. Since few researchers obtain direct observation, social va-lidity, and treatment acceptability data, it is unclear how common dis-crepancies of the sort described in this paper might be. Such discrepan-cies might help to explain why “efficacious” interventions are not al-ways adopted outside of controlled research settings or, when they are,why they cease to be “effective” (Weisz & Jensen, 2001). Also, sincetoken systems are typically employed in settings where multiple inter-ventions might be attempted (e.g., pharmacological, academic assistance)examinations of the acceptability and effectiveness of empirically sup-ported interventions in larger, dynamic systems would also seem valu-able (see Kehle et al., 2000).

On a clinical note, future studies could also evaluate the impact of vary-ing the length of the intervals between timed prompts to praise (Gross &Ekstrand, 1983). At the outset of the study, teachers were instructed topraise every 20 minutes. However, it became apparent that this intervalwas not optimal for preschool children. While we were concerned that ashorter interval would become burdensome to the teacher, she agreed totry 10-minute intervals and found this both appropriate and easy to im-plement. Investigations of the optimal interval lengths for delivering praiseand guidance to students of different ages while preserving the instruc-tional flexibility could be of paramount importance for treatment ac-ceptability (Burnett, McLaughlin, & Hunsacker, 1978).

Reitman et al. 31

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Limitations of the Study

Several limitations of this study are apparent. First, while initial teacherratings indicate significant externalizing behavior problems, the chil-dren in this study were only mildly noncompliant when evaluated usingdirect observation. However, although the mean level of problem be-havior for the three target boys appeared low (approximately 13% of theintervals for all the target children), the combined impact of their misbe-havior could have been significant. For example, during a 30-minuteclass period, as much as 30 to 40% (i.e., 12 minutes) of classroom timecould have been spent responding to problem behavior (assuming four-minutes of independent problem behavior for each of the three children).Consequently, frequent disruptions associated with problem behavior,whether deriving from a single individual or several, could represent animportant classroom management issue. As noted by McKee and Witt(1990), antecedent interventions such as teaching classroom rulesthrough token systems may significantly improve learning outcomes. Inthis study, problem behaviors were reduced by approximately 50-75%for each child. Nevertheless, data supporting the effectiveness of the to-ken program and conclusions regarding the relative merits of group ver-sus individualized contingency management programs might not holdfor children with more severe behavior problems.

Another limitation of the present study is the absence of data on changesin teacher behavior as function of the intervention. As noted above, whileoverall treatment integrity appeared good (i.e., the teacher appeared todeliver the intervention as instructed and utilized a daily interventionchecklist as a prompt), future research should more carefully followpre- and post-intervention changes in the teacher’s behavior. For exam-ple, anecdotal reports indicate that once the intervention was imple-mented, the teacher began to praise the children more frequently than shehad prior to the intervention, but these changes could not be confirmed.Such data would greatly strengthen conclusions about the impact of thisintervention and should be obtained in future studies.

Finally, the social validity and treatment acceptability data obtainedhere are only suggestive and require more systematic investigation thanwas attempted in the present study. Moreover, the small and unrepre-sentative sample does not permit generalization of the results to otherteachers or classrooms and thus requires replication (Sidman, 1960).

These data are presented to raise awareness concerning the impor-tance of obtaining multiple treatment outcome indicators in clinical set-tings and to illustrate possible avenues for future research and practice.

32 CHILD & FAMILY BEHAVIOR THERAPY

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NOTE

1. Because of the need to obtain a larger number of data points, the hat was “rigged”so that the target children would serve as Stars more frequently than other children inthe classroom.

REFERENCES

Anhalt, K., McNeil, C. B., & Bahl, A. B. (1998). The ADHD classroom kit: A whole-classroom approach for managing disruptive behavior. Psychology in the Schools,35, 67-79.

Axelrod, A. (1973). Comparison of individual and group contingencies in two specialclasses. Behavior Therapy, 4, 83-90.

Barkley, R. A. (1990). Attention-deficit hyperactivity disorder: A handbook for diag-nosis and treatment. New York: Guilford Press.

Barrish, H. H., Saunders, M., & Wolf, M. M. (1969). Good behavior game: Effects ofindividual contingencies for group consequences on disruptive behavior in a class-room. Journal of Applied Behavior Analysis, 2, 119-124.

Brown, D., Reschly, D., & Sabers, D. (1974). Using group contingencies with punish-ment and positive reinforcement to modify aggressive behaviors in a Head Startclassroom. The Psychological Record, 24, 491-496.

Burnett, L., McLaughlin, T. F., & Hunsaker, D. (1978). Instruction-following behaviorof an entire third-grade classroom: Effects of a timing device, public posting andteacher praise. Behavioral Engineering, 5, 37-40.

Conners, C. K. (1997). Manual for the Conners’ Rating Scales-Revised. Toronto: Multi-health Systems.

Cooper, J. O., Heron, T. E., & Heward, W. L. (1987). Applied behavior analysis. NewYork: Macmillan Publishing Company.

Cosper, M. R., & Erickson, M. T. (1984). Relationships among observed classroom be-havior and three types of teacher ratings. Behavioral Disorders, 9, 189-195.

DeMartini-Scully, D., Bray, M. A., & Kehle, T. J. (2000). A packaged intervention toreduce disruptive behaviors in general education students. Psychology in theSchools, 37, 149-156.

Drabman, R. S., Spitalnik, R., & Spitalnik, K. (1974). Sociometric and disruptive be-havior as a function of four types of token reinforcement programs. Journal of Ap-plied Behavior Analysis, 7, 93-101.

Drabman, R. S., & Tucker, R. D. (1974). Why classroom token economies fail. Journalof School Psychology, 12, 178-188.

Elliot, S. N. (1988). Acceptability of behavioral treatments: Review of variables thatinfluence treatment selection. Professional Psychology: Research and Practice, 19,68-80.

Erchul, W. P., & Martens, B. K. (2002). School consultation: Conceptual and empiri-cal bases of practice (2nd ed.). New York: Kluwer.

Ferster, C. B. (1967). Arbitrary and natural reinforcement. The Psychological Record,17, 341-347.

Reitman et al. 33

Downloaded By: [Nova Southeastern University] At: 20:29 23 April 2010

Gable, R. A., & Strain, P. S. (1981). Individualizing a token reinforcement system forthe treatment of children’s behavior disorders. Behavior Disorders, 7, 39-45.

Gross, A. M., & Ekstrand, M. (1983). Increasing and maintaining rates of teacherpraise: A study using public posting and feedback fading. Behavior Modification, 7,126-135.

Hamblin, R. L., Hathaway, C., & Wodarski, J. (1974). Group contingencies, peer tutor-ing, and accelerating academic achievement. In R. Ulrich, T. Stachnik, &, J. Mabry(Eds.), Control of human behavior. (Vol. 3, pp. 421-432). Glenview, IL: Scott-Foresman.

Hawkins, R. P., Mathews, J. R., & Hamdan, L. (1999). Measuring behavioral healthoutcomes: A practical guide. New York: Kluwer Academic/Plenum Publishers.

Herman, S. H., & Tramontana, J. (1971). Instructions and group versus individual rein-forcement in modifying disruptive group behavior. Journal of Applied BehaviorAnalysis, 4, 113-119.

Hicks, T., & Munger, R. (1990). A school day treatment program using an adaptationof the Teaching-Family Model. Education and Treatment of Children, 13, 63-83.

Hughes, H. (1979). Behavior change in children at a therapeutic summer camp as afunction of feedback and individual versus group contingencies. Journal of Abnor-mal Child Psychology, 7, 211-219.

Jacobs, J. R., Boggs, S. R., Eyberg, S. M., Edwards, D., Durning, P., Querido, J. G.,McNeil, C. B., & Funderburk, B. W. (2000). Psychometric properties and referencepoint data for the Revised Edition of the School Observation Coding System. Be-havior Therapy, 31, 695-712.

Kazdin, A. E. (1977). The token economy: A review and evaluation. New York: PlenumPress.

Kazdin, A. E. (1982). Single-case research designs. New York: Oxford University Press.Kazdin, A. E. (2001). Behavior modification in applied settings (6th ed.). Belmont,

CA: Wadsworth.Kehle, T. J., Bray, M., Theodore, L. A., Jensen, W. R., & Clark, E. (2000). A multi-

component intervention designed to reduce disruptive classroom behavior. Psy-chology in the Schools, 37, 475-481.

Long, J. D., & Williams, R. L. (1973). The comparative effectiveness of group and in-dividually contingent free-time with inner-city junior high school students. Journalof Applied Behavior Analysis, 6, 465-474.

Martens, B. K., Witt, J. C., Elliot, S. N., & Darveaux, D. (1985). Teacher judgementsconcerning the acceptability of school-based interventions. Professional Psychol-ogy: Research and Practice, 16, 191-198.

Mash, E. J., & Wolfe, D. A. (2002). Abnormal Child Psychology, 2e. Wadsworth Pub-lishing.

McKee, W. T., & Witt, J. C. (1990). Effective teaching: A review of instructional andenvironmental variables. In T. B. Gutkin & C. R. Reynolds (Eds.), The handbook ofschool psychology (2nd ed., pp. 821-846). Oxford, England: Wiley.

Miltenberger, R. (1997). Behavior modification: Principles and procedures. PacificGrove, CA: Brooks/Cole.

Moore, J. W., Tingstrom, D. H., Doggett, R. A., & Carlyon, W. D. (2001). Restruc-turing and existing token economy in a psychiatric facility for children. Child &Family Behavior Therapy, 23, 53-59.

34 CHILD & FAMILY BEHAVIOR THERAPY

Downloaded By: [Nova Southeastern University] At: 20:29 23 April 2010

Morgan, D. L., & Morgan, R. K. (2001). Single-participant research design: Bringingscience to managed care. American Psychologist, 56, 119-127.

Musser, E. H., Bray, M. A., Kehle, T. J., & Jensen, W. R. (2001). Reducing disruptivebehaviors in students with serious emotional disturbance. School Psychology Re-view, 30, 294-304.

O’Leary, K. D., Becker, W. C., Evan, M. B., & Saudergas, R. A. (1969). A token rein-forcement program in a public school: A replication and systematic analysis. Jour-nal of Applied Behavior Analysis, 2, 3-13.

Patterson, G. R., Reid, J. B., & Dishion, T. J. (1992). Antisocial boys. Eugene, OR:Castalia.

Pelham, W. E., Wheeler, T., & Chronis, A. (1998). Empirically supported psycho-social treatments for attention deficit hyperactivity disorder. Journal of ClinicalChild Psychology, 27, 190-205.

Reitman, D. (1998). Punished by misunderstanding: A critical evaluation of Kohn’sPunished by Rewards and its implications for behavioral interventions with chil-dren. The Behavior Analyst, 21, 143-157.

Reitman, D., Hummel, R., Franz, D. Z., & Gross, A. M. (1998). A review of methodsand instruments for assessing externalizing disorders: Theoretical and practicalconsiderations in rendering a diagnosis. Clinical Psychology Review, 18, 555-584.

Reitman, D., & Drabman, R. S. (1999). Multi-faceted uses of a simple time-out recordin the treatment of a noncompliant 8-year-old boy. Education and Treatment ofChildren, 22, 194-203.

Reynolds, L. K., & Kelley, M. L. (1997). The efficacy of a response cost-based treat-ment package for managing aggressive behavior in preschoolers. Behavior Modifi-cation, 21, 216-230.

Sato, S., Sato, Y., Takayama, I., & Aikawa, A. (1993). Social skills training with ag-gressive kindergarten children: Maintenance of social skills by coaching. JapaneseJournal of Behavior Therapy, 19, 20-31.

Sidman, M. (1960). Tactics of scientific research: Evaluating experimental data inpsychology. New York: Basic Books.

Stollar, S. A., Collins, P. A. D., & Barnett, D. W. (1994). Structured free-play to reducedisruptive activity changes in Head Start classroom. School Psychology Review, 23,310-322.

Swain, J. C., & McLaughlin, T. F. (1998). The effects of bonus contingencies in aclasswide token program on math accuracy with middle-school students with be-havioral disorders. Behavioral Interventions, 13, 11-19.

Sweizy, N. B., Matson, J. L., & Box, P. (1992). The Good Behavior Game: A token re-inforcement system for preschoolers. Child & Family Behavior Therapy, 14, 21-32.

Tarnowski, K. J., & Simonian, S. J. (1992). Assessing treatment acceptance: The ab-breviated acceptability rating profile. Journal of Behavior Therapy and Experimen-tal Psychiatry, 23, 101-106.

Weisz, J. R., & Jensen, A. L. (2001). Child and adolescent psychotherapy in researchand practice contexts: Review of the evidence and suggestions for improving thefield. European Child & Adolescent Psychiatry, 10, 12-18.

Witt, J. C., & Elliot, S. E. (1982). The response cost lottery: A time efficient and effec-tive classroom intervention. Journal of School Psychology, 20, 155-161.

Reitman et al. 35

Downloaded By: [Nova Southeastern University] At: 20:29 23 April 2010

Wolfe, V. V., Boyd, L. A., & Wolfe, D. A. (1983). Teaching cooperative play to behav-ior-problem preschool children. Education and Treatment of Children, 6, 1-9.

Wolf, M. M. (1978). Social validity: The case for subjective measurement or how ap-plied behavior analysis is finding its heart. Journal of Applied Behavior Analysis,11, 203-214.

RECEIVED: 8/10/03REVISED: 10/15/03

ACCEPTED: 11/1/03

36 CHILD & FAMILY BEHAVIOR THERAPY

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