Relationship quality (rapport) between people with developmental disabilities and their caregivers has long been suggested as an important variable influencing the likelihood of problem behavior. However, to date, the association between rapport and problem behavior has not been systematically investigated. The authors evaluated a multimethod strategy for assessing rapport and then used the assessment information to develop a multicomponent intervention for problem behavior. In Study 1, a descriptive assessment was carried out in which rapport was operationally defined, and good and poor rapport dyads consisting of staff members and participants were identified. Then, a functional analysis of each participant's problem behavior was conducted with respect to the interaction of two factors: quality of rapport and task demands. The results of the assessment study indicated that when rapport was poor, levels of problem behavior were high; when rapport was good, levels of problem behavior were low. In Study 2, the authors evaluated the effectiveness of a multicomponent intervention package designed to improve rapport between the person with disabilities and his or her caregiver. When rapport improved, participants showed a decrease in problem behavior and an increase in task completion in the presence of staff members who had previously been identified as having poor rapport with participants. The multidimensional nature of rapport assessment, as well as the unique contribution that rapport-building can make to multicomponent intervention, are discussed.
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References
1.
Altman, I. (1990). Conceptualizing “rapport.” Psychological Inquiry, 1(4), 294—323.
2.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
3.
Aronson, E. (1984). The social animal. New York : W.H. Freeman.
Carr, E.G., & Carlson, J.I. (1993). Reduction of severe behavior problems in the community using a multicomponent treatment approach. Journal of Applied Behavior Analysis, 26, 157—172.
6.
Carr, E.G., Levin, L., McConnachie, G., Carlson, J.I., Kemp, D.C., & Smith, C.E. (1994). Communication-based intervention for problem behavior: A user's guide for producing positive change. Baltimore : Brookes.
7.
Carr, E.G., Levin, L., McConnachie, G., Carlson, J.I., Kemp, D.C., Smith, C.E., et al. (1999). Comprehensive multisituational intervention for problem behavior in the community: Long-term maintenance and social validation . Journal of Positive Behavior Interventions, 1(1), 5—25.
8.
Carr, E.G., Magito-McLaughlin, D., Giacobbe-Grieco, & Smith, C.E. (2003). Using mood ratings and mood induction in assessment and intervention for severe problem behavior. American Journal on Mental Retardation, 108, 32—55.
9.
Carr, E.G., McConnachie, G., Levin, L., & Kemp, D.C. (1993). Communication-based treatment of severe behavior problems. In R. Van Houten & S. Axelrod (Eds.), Effective behavioral treatment: Issues and implementation (pp. 231—268). New York: Plenum Press.
10.
Carr, E.G., Newsom, C.D., & Binkoff, J.A. (1980). Escape as a factor in the aggressive behavior of two retarded children. Journal of Applied Behavior Analysis , 13, 101—117.
11.
Carr, E.G., Smith, C.E., Giacin, T.A., Whelan, B.M., & Pancari, J. (2003). Menstrual discomfort as a biological setting event for severe problem behavior: Assessment and intervention. American Journal on Mental Retardation, 108, 117—133.
12.
Cornier, L.S., & Hackney, H. (1987). The professional counselor: A process guide to helping. Englewood Cliffs, NJ: Prentice Hall.
13.
Demchak, M., & Bossert, K.W. (1996). Assessing problem behaviors. In D. Browder (Ed.), Innovations: Research to practice series, 4. Washington, DC: American Association on Mental Retardation.
14.
Dunlap, G., Eno-Hieneman, M., Clarke, S., & Childs, A. (1995). A preliminary exploration of rapport development. Unpublished manuscript, University of South Florida, Tampa.
15.
Dunlap, G., Kern-Dunlap, L.Clarke, S., & Robbins, F.R. (1991). Functional assessment, curricular revision, and severe behavior problems. Journal of Applied Behavior Analysis , 24, 387—397.
16.
Dunlap, G., & Koegel, R.L. (1980). Motivating autistic children through stimulus variation. Journal of Applied Behavior Analysis, 13, 619—627.
17.
Dunst, C.J., Cushing, P.J., & Vance, S.D. (1985). Response-contingent learning in profoundly handicapped infants: A social systems perspective. Analysis and Intervention in Developmental Disabilities, 5, 33—47.
18.
Durand, V.M., & Crimmins, D.B. (1988). Identifying the variables maintaining self injurious behavior. Journal of Autism and Developmental Disorders, 18, 99—117.
19.
Dyer, K. (1987). The competition of autistic stereotyped behavior with usual and specially assessed reinforcers. Research in Developmental Disabilities, 8, 607—626.
20.
Dyer, K., Dunlap, G., & Winterling, V. (1990). Effects of choice-making on the serious problem behaviors of students with severe handicaps. Journal of Applied Behavior Analysis, 23, 515—524.
21.
Egan, G. (1975). The skilled helper. Monterey, CA: Brooks/Cole.
22.
Evans, I.M., & Scotti, J.R. (1989). Defining meaningful outcomes for persons with profound disabilities. In F. Brown & D. Lehr (Eds.), Persons with profound disabilities: Issues and practices. Baltimore : Brookes.
23.
Favell, J.E., Realon, R.E., & Sutton, K.A. (1996). Measuring and increasing the happiness of people with profound mental retardation and physical handicaps. Behavioral Interventions, 11(4), 47—58.
24.
Flannery, K.B., Horner, R.H., Albin, R.W., Shukla, S., & Heathfield, L.T. (1993). A descriptive analysis of rapport development and its effects on problem behaviors. Unpublished manuscript , University of Oregon, Eugene .
25.
Forehand, R., & McMahon, R.J. (1981). Helping the noncompliant child: A clinician's guide to parent training. New York: Guilford Press.
26.
Gaylord-Ross, R., & Haring, T. (1987). Social interaction research for adolescents with severe handicaps. Behavioral Disorders, 12, 264—275.
27.
Green, C.W., & Reid, D.H. (1996). Defining, validating, and increasing indices of happiness among people with profound multiple disabilities. Journal of Applied Behavior Analysis, 29, 67—78.
28.
Halle, J.W., Baer, D.M., & Spradlin, J.E. (1981). An analysis of teachers' generalized use of delay in helping children: A stimulus control procedure to increase language use in handicapped children. Journal of Applied Behavior Analysis, 14, 389—409.
29.
Haring, T.G. (1991). Social relationships. In L. H. Meyer, C. A. Peck, & L. Brown (Eds.), Critical issues in the lives of people with disabilities (pp. 195—217). Baltimore : Brookes.
30.
Hembree-Kigin, C., & McNeil, B. (1995). Parent-child interaction therapy. New York: Plenum Press .
31.
Hunt, P., Alwell, N., & Goetz, L. (1988). Acquisition of conversation skills and the reduction of inappropriate social interaction behaviors. Journal of the Association for Persons with Severe Handicaps, 13, 20—27.
32.
James, S.D., & Egel, A.L. (1986). A direct prompting strategy for increasing reciprocal interactions between handicapped and nonhandicapped siblings. Journal of Applied Behavior Analysis, 19, 173—187.
Kemp, D.C., & Carr, E.G. (1995). Reduction of severe problem behavior in community employment using an hypothesis-driven multicomponent intervention approach . Journal of the Association for Persons with Severe Handicaps , 20(4), 229—247.
35.
Koegel, L.K., Koegel, R.L., & Dunlap, G. (1996). Positive behavioral support: Including people with difficult behavior in the community. Baltimore: Brookes.
36.
Koegel, L.K., Koegel, R.L., Hurley, C., & Frea, W.D. (1992). Improving social skills and disruptive behavior in children with autism through self-management. Journal of Applied Behavior Analysis, 25(2), 341—353.
37.
Koegel, R.L., Dyer, K., & Bell, L.K. (1987). The influence of child-preferred activities on autistic children's social behavior. Journal of Applied Behavior Analysis, 20(3), 243—252.
38.
Koegel, R.L., O'Dell, M., & Dunlap, G. (1988). Producing speech use in non-verbal autistic children by reinforcing attempts. Journal of Autism and Developmental Disorders, 18, 525—538.
39.
Lovaas, O.I., Freitag, G., Gold, V.J., & Kassorla, I.C. (1965). Experimental studies in childhood schizophrenia: Analysis of self-destructive behavior. Journal of Experimental Child Psychology, 2, 67—84.
40.
Lucyshyn, J.M., Dunlap, G., & Albin, R.W. (2002). Families and positive behavior support: Addressing problem behavior in family contexts. Baltimore: Brookes.
41.
Meyer, L.H., & Evans, I.M. (1989). Nonaversive intervention for behavior problems: A manual for home and community. Baltimore: Brookes.
42.
Michael, J. (1982). Distinguishing between discriminant and motivational functions of stimuli. Journal of the Experimental Analysis of Behavior, 37, 149—155.
43.
O'Neill, R.E., Horner, R.H., Albin, R.W., Sprague, J.R., Storey, K., & Newton, J.S. (1997). Functional assessment and program development for problem behavior: A practical handbook. Pacific Grove, CA: Brooks/Cole.
44.
Roberts, S.D., & Bouchard, K.R. (1989). Establishing rapport in rehabilitative audiology. Journal of the Academy of Rehabilitative Audiology, 22, 67— 73.
45.
Seifer, R., Clark, G.N., & Sameroff, A.J. (1991). Positive effects of interaction coaching on infants with developmental disabilities and their mothers. American Journal on Mental Retardation, 96(1), 1—11.
46.
Skinner, B.F. (1953). Science and human behavior. New York: Free Press.
47.
Tickle-Degnan, L., & Rosenthal, R. (1990). The nature of rapport and its non-verbal correlates . Psychological Inquiry, 1(4), 285—293.
48.
Touchette, P.E., MacDonald, R.F., & Langer, S.N. (1985). A scatter plot for identifying stimulus control of problem behavior. Journal of Applied Behavior Analysis , 18, 343—351.
49.
Webster-Stratton, C., Reid, J., & Hammond, M. (2001). Preventing conduct problems, promoting social competence: A parent and teacher training partnership in Head Start. Journal of Clinical Child Psychology, 30(3), 283—302.
