Token Reinforcement, Cognitive Behavioural Therapy, Degree of Disability and Managing Aggressive Behaviour Among Pupils With Intellectual Disability

Keywords: Cognitive behaviour therapy, degree of disability, intellectual disability, token reinforcement

Abstract

Aggressive behaviour has a significant negative effect on learning and academic performance. This study aimed to establish the main effect of token reinforcement, cognitive behavioural therapy, and degree of disability on reducing aggression among pupils with intellectual disability. The study participants were 60 pupils (N = 60, N = 27 boys; N = 33 girls; mean age = 11.7) with intellectual disability who were purposively selected from three (3) special schools in the study location. The participants were divided into three treatment groups: token reinforcement, cognitive behavioural therapy, and control groups, with the degree of disability as the moderating factor. The token reinforcement and cognitive behavioural therapy groups met for thirty sessions over twelve weeks. Three experimental (two treatment and a control) groups were assessed using the Overt Aggression Scale, while the three treatment groups were assessed post-intervention using the Overt Aggression Scale. Data for aggressive behaviour performance were collected after the participants were screened for intellectual disability. An analysis of covariance and estimated means was used to examine the data. The results revealed a statistically significant difference between the pre-test and post-test results of the three (3) treatment groups. The degree of disability had significant main effect on level aggressive behaviour among pupils with intellectual disability. The interaction effect of treatment and degree of disability was significant on participants’ aggressive behaviour. Teachers and care givers should adopt token reinforcement and probably cognitive behavioural therapy in manage aggressive behaviour among pupils with intellectual disability.

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Author Biographies

Udeme Samuel Jacob, University of Johannesburg

Postdoctoral Research Fellow, Doctor of Philosophy

Kehinde Rechael Adegboye, University of Ibadan

B. Ed (Special  Education)

Jace Pillay, University of Johannesburg

South Africa Research Chair: Education and Care in Childhood, Professor

References

Alberto, P. A., & Troutman, A. C. (2017). Applied behavior analysis for teachers (9th ed.). Pearson. [in English].

Allen, D. (2008). The relationship between challenging behaviour and mental ill-health in people with intellectual disabilities: a review of current theories and evidence. Journal of intellectual disabilities: JOID, 12(4), 267–294. https://doi.org/10.1177/1744629508100494 [in English].

Allen, D., & Davies, D. (2007). Challenging behaviour and psychiatric disorder in intellectual disability. Current opinion in psychiatry, 20(5), 450–455. https://doi.org/10.1097/YCO.0b013e32826fb332 [in English].

Antonacci, D. J., Manual, C. & Davis, E. (2008). Diagnosis and treatment of aggression in individuals with developmental disabilities. Psychiatric Quarterly, 79, 225–247. https://doi.org/10.1007/s11126-008-9080-4 [in English].

Bagner, D. M., Rodríguez, G. M., Blake, C. A., Linares, D., & Carter, A. S. (2012). Assessment of behavioral and emotional problems in infancy: a systematic review. Clinical child and family psychology review, 15(2), 113–128. https://doi.org/10.1007/s10567-012-0110-2 [in English].

Bekirogullari, Z., & Korusan, H. (2019) Cognitive behavioural therapy treatment for sanitary napkin anxiety. Psychiatry and Behavioral Sciences, 9(3), 136–138. https://doi.org/10.5455/PBS.20190201082443 [in English].

Bihm, E. M., Poindexter, A. R., & Warren, E. R. (1998). Aggression and psychopathology in persons with severe or profound mental retardation. Research in Developmental Disabilities, 19(5), 423–438. https://doi.org/10.1016/S0891-4222(98)00015-8 [in English].

Bodfish, J. W., Crawford, T. W., Powell, S. B., Parker, D. E., Golden, R. N., & Lewis, M. H. (1995). Compulsions in adults with mental retardation: prevalence, phenomenology, and comorbidity with stereotypy and self-injury. American journal of mental retardation: AJMR, 100(2), 183–192. [in English].

Bonfonte, S. A., Bourret, J. C., & Lloveras, L. A. (2020). Comparing the reinforcing efficacy of tokens and primary reinforcers. Journal of applied behavior analysis, 53(3), 1593–1605. https://doi.org/10.1002/jaba.675 [in English].

Burke, A. E., Crenshaw, D. A., Green, J., Schlosser, M. A, & Strocchia-Rivera, L. (1989) Influence of verbal ability on aggression in physically abused children. Journal of the American Academy of Child and Adolescent Psychiatry, 28(2), 215–218. https://doi.org/10.1097/00004583-198903000-00011 [in English].

Cariveau, T., & Kodak, T. (2017). Programming a randomized dependent group contingency and common stimuli to promote durable behavior change. Journal of applied behavior analysis, 50(1), 121–133. https://doi.org/10.1002/jaba.352 [in English].

Carr, J. E., Fraizer, T. J., & Roland, J. P. (2005). Token economy. In A. M. Gross & R. S. Drabman (Eds.), Encyclopedia of behaviour modification and cognitive behaviour therapy – Volume 2: Child clinical applications (pp. 1075–1079). Sage. [in English].

Cayoun, B. (2004). Advances in mindfulness training integration: Towards a non-dualistic cognitive-behaviour therapy [Paper presentation]. 2004 biennial conference of the Australian Psychological Society’s Buddhism and Psychology Interest Group: Deakin University, Melbourne, Australia. [in English].

Chen, T-H., Lu, R-B., Chang, A-J., Chu, D-M., & Chou, K-R. (2006). The evaluation of cognitive-behavioural group therapy on patient depression and self-esteem. Archives of Psychiatric Nursing, 20(1), 3–11. https://doi.org/ https://doi.org/10.1002/pits.10048 [in English].

Cohen, R. A., Brumm, V., Zawacki, T. M., Paul, R. Sweet, L., & Rosenbaum, A. (2003) Impulsivity and verbal deficits associated with domestic violence. Journal of the International Neuropsychological Society, 9(5), 760–770. https://doi.org/10.1017/S1355617703950090 [in English].

Cooper, S-A., Smiley, E., Jackson, A., Finlayson, J., Allan, L., Mantry, D., & Morrison, J. (2009). Adults with intellectual disabilities: Prevalence, incidence and remission of aggressive behaviour and related factors. Journal of Intellectual Disability Research, 53(3), 217–232. https://doi.org/10.1111/j.1365-2788.2008.01127.x [in English].

Cooper, S-A, Smiley, E., Morrison, J., Williamson, A., & Allan, L. (2007). Mental ill-health in adults with intellectual disabilities: Prevalence and associated factors. The British Journal of Psychiatry, 190(1): 27–35. https://doi.org/10.1192/bjp.bp.106.022483 [in English].

Crocker, A. G., Mercier, C., Allaire, J. F., Roy, M. E. (2007). Profiles and correlates of aggressive behaviour among adults with intellectual disabilities. Journal of Intellectual Disability Research, 51(10), 786–801. https://doi.org/10.1111/j.1365-2788.2007.00953.x [in English].

Crocker, A. G., Mercier, C., Lachapelle, Y., Brunet, A., Morin, D., & Roy, M.-E. (2006). Prevalence and types of aggressive behaviour among adults with intellectual disabilities. Journal of Intellectual Disability Research, 50(9), 652–661. https://doi.org/10.1111/j.1365-2788.2006.00815.x [in English].

Deb, S., Thomas, M., Bright, C. (2001). Mental disorder in adults with intellectual disability 2: The rate of behaviour disorders among a community-based population aged 16 and 64 years. Journal of Intellectual Disability Research, 45(6), 506–514. https://doi.org/10.1046/j.1365-2788.2001.00373.x [in English].

DeJager, B., Houlihan, D., Filter, K. J., Mackie, P. F. E., & Klein, L. (2020). Comparing the effectiveness and ease of implementation of token economy, response cost, and a combination condition in rural elementary school classrooms. Journal of Rural Mental Health, 44(1), 39–50. https://doi.org/10.1037/rmh0000123[in English].

DiGiuseppe, R., & Tafrate, R. C. (2007). Understanding anger disorders. Oxford University Press. [in English].

Dryden, W. (2003). Managing low self-esteem. Whurr Publishers. [in English].

Emerson, E., Kiernan, C., Alborz, A., Reeves, D., Mason, H., Swarbrick, R., Mason, L., & Hatton, C. (2001). The prevalence of challenging behaviours: A total population study. Research in Developmental Disabilities, 22(1), 77–93. https://doi.org/10.1016/S0891-4222(00)00061-5 [in English].

Elliott, S. N., Kratochwill, J. R., Cook, J. L., & Travers, J. F. (2000). Educational psychology: Effective teaching, Effective learning (3rd ed.). McGraw Hill. [in English].

Einfeld, S. L., Piccinin, A. M., Mackinnon, A., Hofer, S. M., Taffe, J., Gray, K. M., Bontempo, D. E., Hoffman, L. R., Parmenter, T., & Tonge, B. J. (2006). Psychopathology in young people with intellectual disability. JAMA: The Journal of the American Medical Association, 296(16), 1981–1989. https://doi.org/10.1001/jama.296.16.1981 [in English].

Emerson, E., & Bromley, J. (1995). The form and function of challenging behaviours. Journal of intellectual disability research: JIDR, 39 (Pt 5), 388–398. https://doi.org/10.1111/j.1365-2788.1995.tb00543.x [in English].

Espie, C. A., Watkins, J., Curtice, A., Espie, A., Duncan, R. Ryan, J. A., Brodie, M. J., Mantala, K., & Sterrick, M. (2003). Psychopathology in people with Epilepsy and intellectual disability; an investigation of potential explanatory variables. Journal of Neurology, Neurosurgery and Psychiatry, 74(11):1485–1488. https://doi.org/10.1136/jnnp.74.11.1485 [in English].

Gardner, F., & Shaw, D. S. (2009). Behavioral Problems of Infancy and Preschool Children (0–5). Chapter 53 in Rutter’s Child and Adolescent Psychiatry Fifth Edition. [in English].

Grey, I., Pollard, J., McClean, B., MacAuley, N., & Hastings, R. (2010). Prevalence of psychiatric diagnoses and challenging behaviours in a community-based population of adults with intellectual disabilities. Journal of Mental Health Research in Intellectual Disabilities, 3(4), 210–222. https://doi.org/10.1080/19315864.2010.527035 [in English].

Hackenberg, T. (2009). Token reinforcement: A review and analysis. Journal of the Experimental Analysis of Behavior, 91(2): 257–286. https://doi.org/10.1901/jeab.2009.91-257 [in English].

Harvey, S. T., Boer, D., Meyer, L. H. & Evans, I. M. (2009). Updating a meta-analysis of intervention research with challenging behaviour: Treatment validity and standards of practice. Journal of Intellectual & Developmental Disability, 34(1), 67–80. https://doi.org/10.1080/13668250802690922 [in English].

Heyvaert, M., Maes, B. & Onghena, P. (2010). A meta-analysis of intervention effects on challenging behaviour among persons with intellectual disabilities. Journal of Intellectual Disability Research, 54(7), 634–649. https://doi.org/10.1111/j.1365-2788.2010.01291.x [in English].

Hong, J. S., Tillman, R., & Luby, J. L. (2015). Disruptive behavior in preschool children: distinguishing normal misbehavior from markers of current and later childhood conduct disorder. The Journal of pediatrics, 166(3), 723–30.e1. https://doi.org/10.1016/j.jpeds.2014.11.041 [in English].

Howells, K., & Day, A. (2003). Readiness for anger management: Clinical and theoretical issues. Clinical Psychology Review, 23(2), 319-337. https://doi.org/10.1016/s0272-7358(02)00228-3 [in English].

Hutchinson, G., Willner, P., Rose, J., Burke, I., & Bastick, T. (2016). CBT in a Caribbean context: A controlled trial of anger management in Trinidadian prisons. Behavioural and Cognitive Psychotherapy, 45(1), 1-15. https://doi.org/10.1017/s1352465816000266 [in English].

Jacob, U. S. & Pillay, J. (2021). Effectiveness of music therapy on reading skills of pupils with intellectual disability. Cypriot Journal of Educational Science, 16(1), 251–265. https://doi.org/10.18844/cjes.v16i1.5526 [in English].

Jacob, U. S., Pillay, J., Ayandokun, O. C., & Oyundoyin, J. O. (2021). Social Skills of Pupils with Mild Intellectual Disability: Do Peer Tutoring, Storytelling and Gender Play a Role? Universal Journal of Educational Research, 9(12), 1887–1897. https://doi.org/10.13189/UJER.2021.091201 [in English].

Jacob, U. S., Pillay, J., & Oyefeso, E. O. (2021). Types of Aggressive Behavior among Learners with Moderate Intellectual Disability in Nigeria as Perceived by Teachers, Jurnal Tatsqif, 19(1), 41–66. https://doi.org/10.20414/jtq.v19i1.3260 [in English].

Jacob, U. S., Pillay, J., & Oyewumi, I (2021). Aggressive Behaviour Among Adolescents with Mild Intellectual Disability: Do Parental Conflicts, Peer Influence, and SocioEnvironmental Deprivation Play a Role? Al Ibtida: Jurnal Pendidikan Guru MI, 8(1); 16-31 https://syekhnurjati.ac.id/jurnal/index.php/ibtida/article/view/8036 [in English].

Kahng, S. W., Boscoe, J. H., & Byrne, S. (2003). The use of an escape contingency and a token economy to increase food acceptance. Journal of Applied Behavior Analysis, 36(3), 349–353. https://doi.org/10.1901/jaba.2003.36-349 [in English].

Keenan, M., & Dillenburger, K. (2011). When all you have is a hammer RCTs and hegemony in science. Research in Autism Spectrum Disorders, 5(1), 1–13. https://doi.org/10.1016/j.rasd.2010.02.003 [in English].

Lim, L., Saulsman, L., & Nathan, P. (2005). Improving self-esteem. Centre for Clinical Interventions. [in English].

Lott, D. C., & Jencius, S. (2009). Effectiveness of very low-cost contingency management in a community adolescent treatment program. Drug and alcohol dependence, 102(1-3), 162–165. https://doi.org/10.1016/j.drugalcdep.2009.01.010 [in English].

Marcangelo, M. J., & Ovsiew, F. (2007). Psychiatric aspects of Epilepsy. Psychiatric Clinics of North America, 30(4), 781–802. https://doi.org/10.1016/j.psc.2007.07.005 [in English].

Matson, J. L., Fodstad, J. C., Rivet, T. T. & Rojahn, J. (2009). Behavioural and psychiatric differences in medication side effects in adults with severe intellectual disabilities. Journal of Mental Health Research in Intellectual Disabilities, 2(4), 261–278. https://doi.org/10.1080/19315860903082615 [in English].

Matson, J. L., & Neal, D. (2009). Psychotropic medication use for challenging behaviours in persons with intellectual disabilities: An overview. Research in Developmental Disabilities, 30(3), 572–586. https://doi.org/10.1016/j.ridd.2008.08.007 [in English].

Mayer, G. R., Sulzer-Azaroff, B., & Wallace, M. (2019). Behavior analysis for lasting change. 4. Cornwall-on-Hudson: Sloan Publishing. [in English].

McClintock, K., Hall, S., & Oliver, C. (2003). Risk markers associated with challenging behaviours in people with intellectual disabilities: A meta-analytic study. Journal of Intellectual Disability Research, 47(6), 405–416. https://doi.org/10.1046/j.1365-2788.2003.00517.x [in English].

McDonald, M. E., & Hemmes, N. S. (2003). Increases in social initiation toward an adolescent with autism: Reciprocity effects. Research in Developmental Disabilities, 24(6), 453–465. https://doi.org/10.1016/j.ridd.2003.04.001 [in English].

McGrother, C. W., Byrne, V., Thorp, C., Tyrer, F., Watson, J. (2007). Leicestershire learning disability register: Annual report for the Department of Health 2006. Leicester: University of Leicester. [in English].

Meins, W. (1995). Symptoms of major depression in mentally retarded adults. Journal of intellectual disability research: JIDR, 39 (Pt 1), 41–45. https://doi.org/10.1111/j.1365-2788.1995.tb00912.x [in English].

Mennin, D., Heimberg, R., Turk, C., & Fresco, D. (2006). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice, 9(1), 85–90. https://doi.org/10.1093/clipsy.9.1.85 [in English].

Moss, S. (2001) Psychiatric disorders in adults with mental retardation. International Review of Research in Mental Retardation 24, 211–43. [in English].

Murphy, G. H., Beadle-Brown, J., Wing, L., Gould, J. Shah, A., & Holmes, N. (2005). Chronicity of challenging behaviours in people with severe intellectual disabilities and/or autism: A total population sample. Journal of Autism and Developmental Disorders, 35, 405–418. https://doi.org/10.1007/s10803-005-5030-2 [in English].

Neacşu, V. (2013). The efficiency of a cognitive-behavioural program in diminishing the intensity of reactions to stressful events and increasing self-esteem and self-efficiency in the adult population. Procedia –Social and Behavioral Sciences, 78, 380-384. https://doi.org/10.1016/j.sbspro.2013.04.315 [in English].

Nijman, H. L. I., & Á Campo, J. M. L. G. (2002). Situational determinants of inpatient self-harm. Suicide and Life-Threatening Behavior, 32(2), 167–175. https://doi.org/10.1521/suli.32.2.167.24401 [in English].

Paivio, S. C., & Carriere, M. (2007). Contributions of emotional-focused therapy to the understanding and treatment of anger and aggression. In Timothy A. Cavell & Kenya T. Malcolm (Eds.), Anger, aggression, and interventions for interpersonal violence (p.143-164). Lawrence Erlbaum Associates. [in English].

Park, J. S., & Lee, K. (2012) Modification of severe violent and aggressive behaviour among psychiatric inpatients through the use of a short-term token economy. Journal of Korean Academy of Nursing, 42(7), 1062-1069. https://doi.org/10.4040/jkan.2012.42.7.1062 [in English].

Poulsen, H. D., & Engberg, M. (2001). Validation of psychiatric patients’ statements on coercive measures. Acta Psychiatrica Scandinavica, 103(1), 60–65. https://doi.org/10.1111/j.1600-0447.2001.00146.x [in English].

Qureshi, H., & Alborz, A. (1992). Epidemiology of challenging behaviour. Mental Handicapped Research, 5(2): 130–145. https://doi.org/10.1111/j.1468-3148.1992.tb00041.x [in English].

Reinke, W. M., & Herman, K. C. (2002). Creating school environments that deter antisocial behaviours in youth. Psychology in the Schools, 39(5), 549–559. https://doi.org/10.1002/pits.10048 [in English].

Sandra, L., & Friedrich, M. A. (2009). Token economy system. In The Gale Encyclopedia of Mental Health. Encyclopedia.com.https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/token-economy-system [in English].

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. N., Adkins, A. D., & Singh, J. (2008). Clinical and benefit-cost outcomes of teaching a mindfulness-based procedure to adult offenders with intellectual disabilities. Behaviour Modification, 32(5), 622-637. https://doi.org/10.1177/0145445508315854 [in English].

Smith, S., Branford, D., Collacott, R. A., Cooper, S-A, & McGrother, C. (1996). Prevalence and cluster typology of maladaptive behaviours in a geographically defined population of adults with learning disabilities. The British Journal of Psychiatry, 169(2): 219–227. https://doi.org/10.1192/bjp.169.2.219 [in English].

Tarbox, J., Wilke, A. E., Findel-Pyles, R. S., Bergstrom, R. M., & Granpeesheh, D. (2010). A comparison of electronic to traditional pen-and-paper data collection in discrete trial training for children with autism. Research in Autism Spectrum Disorders, 4(1), 65–75. https://doi.org/10.1016/j.rasd.2009.07.008 [in English].

Tenneij, N., & Koot, H. (2008). Incidence, types and characteristics of aggressive behaviour in treatment facilities for adults with mild intellectual disability and severe challenging behaviour. Journal of Intellectual Disability Research, 52(2), 114–124. https://doi.org/10.1111/j.1365-2788.2007.00968.x [in English].

Theodore, L., Bray, M. A., & Kehle, T. J. (2004). A comparative study of group contingencies and randomized reinforcers to reduce disruptive classroom behavior. School Psychology Quarterly, 19(3):253–271. https://doi.org/10.1521/scpq.19.3.253.40280. [in English].

Thompson, R. H., & Iwata, B. A. (2005). A review of reinforcement control procedures. Journal of applied behavior analysis, 38(2), 257–278. https://doi.org/10.1901/jaba.2005.176-03 [in English].

Tyrer, F., McGrother, C. W., Thorp, C. F., Donaldson, M., Bhaumik, S., Watson, J. M., & Hollin, C. (2006). Physical aggression towards others in adults with learning disabilities: Prevalence and associated factors. Journal of Disabilities Research, 50(4), 295–304. https://doi.org/10.1111/j.1365-2788.2005.00774.x [in English].

Wakschlag, L. S., Choi, S. W., Carter, A. S., Hullsiek, H., Burns, J., McCarthy, K., Leibenluft, E., & Briggs-Gowan, M. J. (2012). Defining the developmental parameters of temper loss in early childhood: implications for developmental psychopathology. Journal of child psychology and psychiatry, and allied disciplines, 53(11), 1099–1108. https://doi.org/10.1111/j.1469-7610.2012.02595.x [in English].

Wille, J. R. (2002). Reducing disruptive classroom behaviour with multicomponent intervention: A literature review. (Master’s thesis, University of Wisconsin-Stout, Wisconsin, US). https://docplayer.net/20988296-Reducing-disruptive-classroom-behavior-with-multicomponent-intervention-a-literature-review-jessica-r-wille-a-research-paper.html [in English].

Willner, P. (2005). The effectiveness of psychotherapeutic interventions for people with learning disabilities: A critical overview. Journal of Intellectual Disability Research, 49(1), 73–85. https://doi.org/10.1111/j.1365-2788.2005.00633.x [in English].

Yudofsky, S. C., Silver, J. M., Jackson, W., Endicott, J., & Williams, D. (1986). The overt aggression scale for the objective rating of verbal and physical aggression. The American Journal of Psychiatry, 143(1), 35–39. https://doi.org/10.1176/ajp.143.1.35 [in English].

Published
2022-09-14
How to Cite
Jacob, U. S., Adegboye, K. R., & Pillay, J. (2022). Token Reinforcement, Cognitive Behavioural Therapy, Degree of Disability and Managing Aggressive Behaviour Among Pupils With Intellectual Disability. Pedagogical Discourse, (33), 7-18. https://doi.org/10.31475/ped.dys.2022.33.01