COMPARISON BETWEEN FORWARD CHAINING AND BACKWARD CHAINING TECHNIQUES IN CHILDREN WITH MENTAL RETARDATION

The Indian Journal of Occupational Therapy : Vol. XXXVII : No. 3 (December, 05 - March, 06) † COMPARISON BETWEEN FORWARD CHAINING AND BACKWARD CHAIN...
Author: Donald Shields
30 downloads 0 Views 519KB Size
The Indian Journal of Occupational Therapy : Vol. XXXVII : No. 3 (December, 05 - March, 06)

† COMPARISON

BETWEEN FORWARD CHAINING AND BACKWARD CHAINING TECHNIQUES IN CHILDREN WITH MENTAL RETARDATION *Meenakshi Batra B.O.T., M.O.Th. (Paeds), Co-Author : ** Vijay Batra B.O.T., M.O.Th. (Ortho) Abstract : Objective : To compare the effectiveness of forward chaining and backward chaining techniques in children with Mental Retardation. Method : Experimental research design with matched subject design used. Subjects were matched on the basis of IQ, age, sex, diagnosis and task component deficit. Procedure : Basline testing was done on the performance of the tasks of donning shoes & tying shoelaces accordingly. They were then assessed according to the task deficit and matched on the basis of number of steps they could perform on either of two tasks. After baseline evaluation they were divided into two groups namely group A and group B. With group A forward chaining technique was used for training either of the two tasks (of tying shoelaces or donning socks). Each subject was given feedback about the performance by behavior modification strategies. Outcome Measure : After six training sessions, scoring was done on the same task on which subjects were trained on the basis of number of Verbal prompt, Actual prompt, Physical prompt, number of errors & number of steps, social reinforcements. Result : Paired-t-test was used & P value calculated which was found to be insignificant showing that there is no significant ingroup A and group B in performance of the task chosen. Conclusion : Both the forward chaining & backward chaining technique are equally effective for ADL training in children with Mental Retardation.

INTRODUCTION

mental retardation and the occupational performance in children with mental retardation is characterized by the following:

Mental retardation is a general term used to describe a life long developmental disability marked by intellectual and functional skills deficit. The American Association on Mental Retardation (AAMR) defines mental retardation as, “substantial limitations in present functioning it is characterized by significantly subaverage intellectual functioning, existing concurrently with related limitations in two or more of the following applicable skill areas: communication, self-care, home living, social skills, community use self-direction, health and safety, functional academics, leisure and work”. (38, 34)

-

a much slower rate of learning,

-

developmental delay,

-

impaired functional skills. (38, 34)

Outline of occupational therapy approaches(25, 34, 38) used in mental retardation are:

According to DSM – IV, classification of mental retardation is done on the basis of IQ (intelligence quotient). (Table 1)(34) The impairment level varies according to the severity of the

-

Developmental approach

-

Sensory motor approach

-

Perceptual-motor approach

-

Sensory stimulation approach

-

Behavior modification technique Table 1 Classification of Mental Retardation

* Demonstrator, Occupational Therapy, Pt. DDU, IPH, New Delhi ** Occupational Therapist Place of Study : ASHA-AWWA School, Base Hospital, New Delhi Period of Study : 1 year Correspondence :

Severity

Intelligence Quotient

Education

Adult Academic Abilities

Dr. Meenakshi Batra

Mild

70 to 55-50

Educable

Elementary grade skills

A-3/90, Paschim Vihar, New Delhi - 110 063 Tel. : 011-25280121

Moderate

55-50 to 50-35

Trainable

Early Elementary grade skills

Severe / Profound

< 35

-

Emphasis on self care skills basic tasks

† The recipient of AIOTA Trophy for the Best Scientific Paper in Mental Health presented in 43rd Annual National Conference of AIOTA at Aurangabad, in January 2006. IJOT : Vol. XXXVII : No. 3

57

December, 2005 - March, 2006

Behavior modification technique is used to enhance learning by identifying target behavior, identifying reinforcers, factors affecting reinforcers (depression, satiation, immediacy of reinforcers), teaching in small graduated steps, methods of teaching (forward chaining and backward chaining), shaping, modeling, total task presentation, splinter skills, one to one teacher guidance (prompts), maintenance of behavior (schedules of reinforcement), generalization and discrimination. (1,2,3,9,10,11,12 & 14)

questioned the traditional assumption of forward chaining and suggested alternative method of backward chaining. They underlined the weaknesses of forward chaining and proposed that forward progression of teaching skills were inefficient because learning become more difficult as progression advances. Learner requires a great deal of mental work. Interference and thinking reduces learning rate. They also underlined the advantages of backward chaining over forward chaining as it overcomes, all disadvantages of the forward progression method. They taught first element in golf the grip irrespective of progression and next was wielding club in various direction after grip by implying the backward chaining procedure.

The forward chaining concept was first described by Skinner (12, 40) in relation to operant conditioning. Gilberts (12,40) devised a systematic training technology called Mathetics from this theoretical basis. One primary feature of this system is the proposition that serial task/chains should be broken down into individual steps, taught in reverse chronological order.

Spooner F., and Spooner D.(35) (1984) studied a review of chaining techniques implication for further research and practice. They stated in the periodicals of exercise oriented literature ,backward chaining technique as better as it executes safe landing and good follow through.

Review of Literature Cox and Boren (7) (1965) studied the implication of three different training techniques in instructing a military procedural task in normal subjects.

Rushall B.S.(27) (1984) applied a sequential approach to teaching rowing technique by backward shaping. The sequence for instructional progression was backward shaping, starting from the recovery before in water activities attempted in learning sweep-oar rowing. It was found backward shaping in rowing ergometer produced fewer errors in learning experience than a forward progression.

Method 1 consisted of operant span, backward chaining. Method 2 consisted of operant span, forward chaining. Method 3 consisted of whole task approach (the subjects did the first step, followed it immediately with the second, the third, until whole chain had been executed on normal subjects.)

Dusault C. (8) (1986) studied a backward shaping progression of the volleyball spike approach and jump. He proposed in periodicals of exercise oriented literature the advantage of backward chaining in minimizing error unlike forward chaining.

Results showed that backward chaining was as effective as forward chaining as whole method approach. Weiss(41) K.M. (1978) studied the comparison of forward and backward procedures for the acquisition of response chains in humans. This study emphasized backward sequencing to be superior when teaching response chains.

Simek, T.C., and O’ Brien, R.M.(32) (1981) worked on total golf (game) as a behavioral approach to lowering the score and getting more out of the game. They found that all the elements of a golf game were performed more efficiently when taught in reverse progression.

Sherman C.A., and Rushall, B.S. (31) (1993) studied swimming stroke using reverse teaching: They proposed after study was over that backward chaining offers a clearly defined and measurable strategy for elite athletics as it produced a very few errors in the learning experience and obvious behavior changes. The basic ingredients of effective teaching (recovery, entry, early pull) features readily observed were demonstrated but one important feature was not entertained, the stretching of reinforcement schedule to produce response permanence over the total terminal behavior exhibited subjects availability prohibited this from occurring and to implement reverse progression teaching strategies, it is necessary to add this vital feature. Most rather, almost all the exercise oriented literature with normal samples emphasized backward chaining technique to be superior over the forward chaining technique.

Rushall B.S and Ford, D.(39) (1982) hypothesized teaching backward as alternative skill instruction progression. They stated in exercise-oriented literature that sequences in which beginners were taught skills are of great importance. They

Hartley and Woods (40) found no difference between the method of backward and forward chaining for learning poetry. Similar observation, using square root extraction as the learning task, was reported by scott.

Martin G.L., Koop. S., Tumer G., and Hanel F.(15) (1981) worked on backward chaining versus total presentations to teach assembly tasks to severely retarded persons. They compared the forward and backward chaining progressions in manual task instruction the results showed reverse procedure to be superior in developing, speed, accuracy, fluency and skill maintenance.

IJOT : Vol. XXXVII : No. 3

58

December, 2005 - March, 2006

Alternative Hypothesis (Ha)

Balson(40), in a recent study used another arithmetical procedure as the learning task, found backward chaining inferior to forward chaining on the factor of learning time. The inferiority of backward chaining compared to forward chaining was also evidenced in experiments by Johnson and Senter (40) who used meaningless serial lists of number and consonants. Wilcox (40) study was concerned with teaching chained motor assembly task and arithmetical operations of varying lengths. Backward chaining, forward chaining, whole method were used to instruct subjects. Although results were not statistically significant, there was some indication that backward chaining was superior to forward chaining in learning motor tasks and short and medium length number chains In general both backward and forward chaining were found to be inferior to whole method. Little research has been conducted on human motor task learning using backward chaining whereas most of the studies either relied on verbal skills or involves normal subjects.

Forward chaining technique is better/more effective in children with mental retardation than backward chaining technique.

2.

Backward chaining technique is more effective in children with mental retardation than forward chaining technique.

METHOD Design Experimental research design (after only with control), matched subject design used. Subjects were matched on the basis of Intelligence Quotient age, sex, diagnosis and task component deficit. Subjects The number of subjects taken were 42, of which 26 were male and 14 female between the age group 5-17 years. Subject pool was taken from a special school for the children with Mental Retardation.

Exercise oriented literature studies which were being done with normal subject found backward chaining to be superior, as normal subject can hold a long term goal in mind and that this acts as a reinforcer for each stage of a task.(5,7,8,26,27,28,29,31,32,33,34,35,36) The learner perceives as leading to that goal. However, it is difficult for a mentally retarded person to remain cognizant of a long term goal. To summarize the literature review, both forward and backward chaining have been recommended as methods for instructing the mentally retarded. Most of the studies conclude the backward chaining as a more effective technique in terms of learning time and retention but the methods have not been compared in studies with mentally retarded subjects.

Inclusion Criteria -

Mild and Moderately retarded subjects from IQ 40 –70 with speech dysfunction

-

Down Syndrome

-

Middle (Upper & Lower) Socioeconomic Status

Exclusion Criteria

Rationale For Study Most of the studies undertaken show backward chaining technique superior over the forward chaining technique. There are only a few studies which show equal effectiveness of both techniques. It has been observed that children with mental retardation show improvement in learning with both techniques therefore, this study has been done to prove the same.

-

Profound and Severely retarded

-

Learning disabled

-

Blind/deaf

-

Autism, ADHD and other behavior problem

-

Bedridden cases.

Apparatus Table, chairs, wooden dummy shoes with ten holes and lace were used for subjects to accomplish the activity for the motor task of shoe lacing Materials

AIMS AND OBJECTIVES

The psychological report was used to check Intelligence Quotient score, paper, pencil used for scoring the evaluations.

To compare effectiveness of forward chaining and backward chaining techniques in children with mental retardation.

Setting / Environment

Hypothesis

Experiment was carried out in a distraction free environment to enable complete focus on the task chosen for enhancement of learning by using either of the chaining techniques.

Null hypothesis (Ho) Forward chaining technique and backward chaining techniques are equally effective in children with mental retardation. IJOT : Vol. XXXVII : No. 3

1.

59

December, 2005 - March, 2006

verbal prompts, actual prompts, physical prompts, errors, steps, and reinforcements.

Procedure Baseline testing

The final evaluation was done by the therapist on:

Baseline testing included general evaluation of all the subjects. They were assessed on whether they could perform the tasks of donning shoes and tying shoelaces. They were then assessed according to the task deficit and matched on the basis of number of steps they could perform on either of the two tasks i.e. donning socks, tying shoelaces. Subjects were also matched on the basis of age, IQ, sex, and diagnosis.

1)

the dummy shoe for tying shoelaces

2)

the subject himself/herself for donning socks.

OBSERVATION AND RESULTS Table - 2

Training Procedure

Sample Characteristics

Each subject was escorted to occupational therapy room by the maid from the respective class room and seated at the chair adjacent to the therapist’s chair. All the subjects were trained for the selected activity during morning session for half an hour duration The training was done by same therapist. During training session each subject was told to perform task on the table. Initially, the Occupational Therapist modeled / demonstrated the task along with verbal instructions in a step wise manner starting from the first step in group A and starting from the last step in group B. After the Occupational Therapist modeled the whole task, subjects were instructed to follow the same throughout the procedure. Verbal prompts, physical prompts, actual prompts, social reinforcements were given when the subject stopped or made an error Verbal instructions were kept constant for all and language used was Hindi. Some of the verbal instructions used for donning sock included, “pick up your sock”, “place thumb inside your sock”, “spread sock open” till the final step which was “ adjust top of sock for best fit”. For tying laces, verbal instructions used were, “grasp lace into each hand”, “put lace inside hole from outside on dummy shoe”, till final step which was, “pull both loops tightly”.

Characteristics

Group A

Group B

1.

Number of Subjects

21

21

2.

Male

13

13

3.

Female

8

8

4.

IQ Range

40-65

40-65

5.

Average IQ

55.7

51.8

6.

Age Range (Chronological)

7-16.2 Years

6-17 Years

7.

Average (Chronological) Age

12.08 Years

12.30

8.

Mental Age Range

3.24 – 10.5 Years

3.2-11.05 Years

9.

Average Mental Age

6.41 Years

6.35 Years

Table 2 Shows subject characteristics among Group A and Group B Statistical Interpretation Verbal Prompt (VP) Paired t-test was used. The mean scores for number of verbal prompts required after 6 training sessions shows that group A receiving forward chaining technique and group B receiving backward chaining technique were 5.76 for both at t=0 and p=1. This indicates that though the number of verbal prompts given were equal were equal the result was not significant. (Table 3)

Simultaneous prompts (42) (as and when required) were given in a hierarchy from least to most (minimum to maximum assistance). Starting from verbal prompt to actual prompts (max assisted) depending upon the child’s performance .

Table 3

After the child corrected the error he was given social reinforcements in the form of praise by saying, “very good” and “well done” and in the form of pat on the back and hug.

Verbal Prompts

Errors were defined as either wearing sock inside/out, putting lace in wrong hole or tying lace with bow made incorrectly or a failure to maintain sequence in the process of completion of chain.

Name of Group

Mean

Standard Deviation

Group A

5.76

1.37

Group B

5.76

1.99

t value

Level of Significance

t=0

P=1

Table 3. Shows mean, SD, t-value and level of significance for Group A (Forward Chaining) and Group B (Backward Chaining). P-value is not significant hence there is no significant difference between Group A and Group B.

Outcome measure After 6 training sessions scoring was done on the same task on which subjects were trained on the basis of number of IJOT : Vol. XXXVII : No. 3

Sl. No.

60

December, 2005 - March, 2006

Table 6 Social Reinforcements

Statistical Interpretation Physical Prompts (PP) Paired t-test was used. The mean scores for number of physical prompts required after 6 training sessions shows that group A receiving forward chaining technique and group B receiving backward chaining technique were 3.95 and 3.80 respectively at t=0.71 and p=0.4. This indicates that though the number of physical prompts given were equal were equal the result was not significant. (Table 4)

Mean

Standard Deviation

t value

Level of Significance

Group A

3.95

1.07

t=0.71

P=0.4

Group B

3.80

1.07

Mean

Standard Deviation

t value

Level of Significance

Group A

4.61

.97

t=0.30

P=0.76

Group B

4.71

1.67

Table 6. Showing mean SD, t-value, Level of Significance for group A (Forward Chaining) and Group B (Backward Chaining) after Six Training Sessions. P-value is not significant hence there is no significant difference between Group A and Group B.

Table 4 Physical Prompts Name of Group

Name of Group

Statistical Interpretation Number of Errors (E) Paired t-test was used. The mean scores for number of errors required after 6 training sessions shows that group A receiving forward chaining technique and group B receiving backward chaining technique were 3.57 and 3.52 respectively at t=0.22 and p=0.8. This indicates that though the number of errors given were equal were equal the result was not significant. (Table 7)

Table 4. Showing mean, SD, t-value, level of Significance for group A (Forward Chaining) and group B (Backward Chaining) after 6 training sessions. P-value is not significant hence there is no significant difference between Group A and Group B. Statistical Interpretation Actual Prompt (AP)

Table 7 Number of Errors

Paired t-test was used. The mean scores for number of actual prompts required after 6 training sessions shows that group A receiving forward chaining technique and group B receiving backward chaining technique were 3 and 2.76 respectively at t=1.31 and p=0. This indicates that though the number of actual prompts given were equal were equal the result was not significant (Table 5)

Name of Group

Mean

Standard Deviation

t value

Level of Significance

Group A

3.57

1.02

t=0.22

P=0.8

Group B

3.52

1.03

Name of Group

Mean

Standard Deviation

t value

Level of Significance

Table 7. Showing mean SD, t-value, Level of Significance for group A (Forward Chaining) and Group B (Backward Chaining) after Six Training Sessions. P-value is not significant hence there is no significant difference between Group A and Group B.

Group A

3

1.58

t=1.31

P=0

Statistical Interpretation of Number of Unprompted Steps

Group B

2.76

1.48

Table 5 Actual Prompts

Paired t-test was used . The mean scores for number of unprompted steps required after 6 training sessions shows that group A receiving forward chaining technique and group B receiving backward chaining technique were .75 for both respectively at t=0.06 and p=0.95. This indicates that though the number of unprompted steps given were equal were equal the result was not significant (Table 8).

Table 5. Showing mean, SD, t-value, Level of Significance for Group A (Forward Chaining) and Group B (Backward Chaining) after Six Training Session P-value is not significant hence there is no significant difference between Group A and Group B. Statistical Interpretation Social Reinforcement (NR)

Table 8 Number of Unprompted Steps

Paired t-test was used. The mean scores for number of social reinforcement required after 6 training sessions shows that group A receiving forward chaining technique and group B receiving backward chaining technique were 4.61 and 4.71 respectively at t=0.30 and p=0.76. This indicates that though the number of social reinforcement given were equal were equal the result was not significant. (Table 6) IJOT : Vol. XXXVII : No. 3

61

Name of Group

Mean

Standard Deviation

t value

Level of Significance

Group A

.75

.130

t=0.06

P=0.95

Group B

.75

.160

December, 2005 - March, 2006

to each other. Further, the information processing theories (22,24) suggest that the learning is a process mediated by the brain with the brain interpreting and relating external sensory impressions and internally stored concepts to each other. Sequencing(22) is a cognitive strategy used as a part of remedial approach. The remedial approach assumption is that brain is sufficiently plastic to repair and reorganize itself after injury. Recovery is assumed to be the result of the reestablishment of disruptive synaptic connections or the growth of new ones as in the case of present study.

Table 8. Showing mean SD, t-value, Level of Significance for group A (Forward Chaining) and Group B (Backward Chaining) after Six Training Sessions. P-value is not significant hence there is no significant difference between Group A and Group B.

DISCUSSION On the basis of analysis of the results the alternate hypothesis stating that either forward chaining technique is more effective than backward chaining technique or backward chaining technique is more effective than forward chaining technique in children with mental retardation can be rejected and the null hypothesis which states that forward chaining techniques in equally effective can be supported.

A study which support the result that both forward chaining technique and backward chaining techniques are equally effective was done by Cox, Boren (7) who stated the implications of 3 different training techniques in instructing a military procedural task in normal subjects. Method 1 consisted of operant span, back ward chaining. Method 2 consisted of operant span, forward chaining. Method 3 consisted of whole task approach (the subjects did the 1st step, followed it immediately with the second, the third, until whole chain had been executed on normal subjects. Results showed that backward chaining was as affective as forward chaining as whole method approach.

The results obtained after 6 training sessions show that the number of physical prompts and actual prompts required were more in group A (forward chaining). The number of social reinforcements were more in group B (backward chaining). Number of errors made and the number of verbal prompts required were nearly equal for both the groups. There are a number of factors affecting learning such as age, Intelligence Quotient, Feedback,(6,9,10,12,18,22,24) practice, environment. In this study the factors age and intelligence quotient (IQ) factor was taken care of by matching the subjects in both the groups.

In another study done by Hartley and woods who found no difference between the method of backward chaining forward chaining for learning poetry(40). Similar observation using square root extraction as the learning task, was reported by Scott (40)

The average in age of subjects in group A was 12 years and that of group B was 12.3 years. The mean difference with the chronological age of subjects between the two groups was 2 months the mental age for group A was 6.41 years and for group was B 6.35 years and the difference was 0.6 years. Therefore age variation which could have affected performance in terms of learning was catered for.

Limitations 1.

Number of subjects included in the study was small therefore making it difficult to generalize the result.

2.

Subject pool was taken from a single school set up therefore adequate representation of mentally retarded population was not possible.

3.

Sample chosen had some previous exposure to activity / task.

The environment / practice conditions in which the study was conducted was also similar for both the groups thus ruling out any variation of practice.

4.

Learning was measured after six training sessions and no measure of retention was done after training session.

The other factors which may have affected learning were types of feedback, nature (schedules of reinforcement).(1,9,34,42) In this study feedback was given to all subjects in a similar means that is from least assistance to most assistance (Verbal prompt) à physical prompt à Actual prompt). Reinforcement by way of social reinforcements in the form of a pat in back / hug, verbal praise was given to all subjects in a similar fashion.

Studies need to be done with a larger sample size of mentally retarded with emphasis on different functional activities using forward chaining and backward chaining techniques and other methods. There is a need for future research to measure the transfer of learning in natural environment using forward chaining and backward chaining techniques

The results can also be explained by the effect that both the chaining techniques used in the study link sequential stimuli

Forward chaining and backward chaining techniques are equally effective in training children with mental retardation.

The average Intelligence Quotient for group A was 55.7 and for group B was 51.8. The average Intelligence Quotient difference was 4.9. This meant that the cognitive abilities of subjects in both group A group B was also similar.

IJOT : Vol. XXXVII : No. 3

Future Research

CONCLUSION

62

December, 2005 - March, 2006

REFERENCES

24.

Poole, Janet.L (1991) Application of Motor Learning Principles in Occupational Therapy, June 1991,vol-45, no.6 (531-537)

25.

Pratt, Pat Nuse & Allen, Anne Stevens (1989) 2nd ed.: Occupational therapy for children, The C.V. Mosby company (St. Louis, Baltimore)

26.

Rushall, B. S. (1984) Applied Rowing Research Report III, A sequential approach to teach rowing technique-Backward shaping, wintario Ministry of Tourism, recreation, Govt. of Ontario, Canada

1.

Bender, Michael. Velletulti, J.Peter (1976) Teaching the moderately and severely Handicapped: Curriculum Objective Strategies and Activities. University Park Press, Vol. 1.

2.

Brower, M Lester: The Occupational Therapist’s Role with Mentally Retarded children (1961)A.J.O.T. VOL.2,(61-62}

3.

Burke, Bearldean B: The changing concepts & function of Occupational Therapy for Mentally Retarded children (1967) A.J.O.T. VOL.2,(5760)

27.

Rushall, B.S. (1984). Applied rowing research report III a sequential approach to teaching rowing technique backward shaping. Govt. of Ontano, Canada.

4.

Burton, Allen W, Dancesak, Michael. J (1999) grip form & graphomotor control in Preschool Children,Jan/Feb2000,vol-54,no.1(9-17)

28.

5.

Chelladurai, P., Stothart, C., (1978). Backward Chaining : A method of teaching motor skills. Captier Journal, 44(1), 26-29, 36-37.

Rushall, B.S. (1996). Some Practical applications of Psychology in Physical activity settings. In W Kin (Ed). The pursuit of sport excellence vol.2(638-656) Seoul, Korea: Korean Alliance for Health, Physical Recreation & Dance)

6.

Cook, Anne Shumway. Woolacott, Marjorie H. Motor Control: Theory and Practical Applications. Williams & Wilkins Publications, pp.34-41.

29.

Rushall, B.S., Ford, D, (1982) Teaching Backwards an alternative skill instruction progression CAPHER Journal, 48(5), 16-20

7.

Cox, Boren, John, M Lynn (1965):A study of Backward chaining, Journal of Educational Psychology Vol.56,(270-274)

30.

Schwartz, Kathleen Barker (1991). Clinical Reasoning & New Ideas on Intelligence Implication for teaching & learning, nov, vol-5 no.11 (1033-1037)

8.

Dusault, C. (1986). A backward shaping progression of the volley ball spike approach and jump. Volleyball technical journal, 8, 33-41.

31.

9.

Hickson Linda, Blackman S. Leonard, Elizabeth (1995). Mental Retardation : Foundation of Education and Programming, Publication Allyn and Bacon.

Sherman, C.A. & Rushall, B.S. (1993). Improving swimming stroke using reverse teaching: A case study. In W.K. Simpson, A. D. Leunes & J. S. Picsu, (Eas.), and Applied Research in coaching & atheletics annual1993, Boston, MA: American press.

32.

10.

Hilgard,Ernest R & Atkinson, Richard C (1975):An Introduction to Psychology, Published by Mohan Primlani For Oxford & I.B.H.Pub. Co. Pvt Ltd.66 Janpath, NDL.

Simek, T.C., O Brien, R.M. (1981). Total golf: A behavioral approach to lowering your save and getting move on your game. New york, NY: Double days.

33.

11.

Hughes,C, Hugo, K, & Blatt, J.(1996). Self instructional intervention for teaching generalized problem solving with in a functional task sequence American Journal on mentally retardation vol.100,(565-579)

12.

Hutt,Max.L & Gibby, Robert gwyn: The Mentally Retarded child,Alllyn& Bacon.Inc.

Simek, T.C., & O Brien, R. M.(1982,May) A chaining Mastery, Discrimination training Program to teach little leaguers to hit a Baseball: An unintentional b/w groups, Multiple Baseline study. Paper presented at the Annual meeting of association for Behavior analysis, Milwaukee, Wisconsin

34.

Jantzen, Alice C. (1969). Definitions of mental health and metal illness Aj. of . Vol. 23. No.3 (249-253).

Spakeman & Willard (1993) eight ed. Willard and Spakeman’s Occupational Therapy, J.B. Lippin Cott company Philadelphia.

35.

Spooner, F., Spooner D. (1984). A review of chaining techniques : Implications for further research of practice education, MR ; 19, (114124).

36.

Spooner, F., Spooner, D., Ulicny, G., (1986). Comparison of modified backward chaining; backward chaining with leap heads Education and the of children, 9, 122-134

37.

Thoman, LindaKing & Hacker, Bonnie.J (1987): A Therapist’s guide to Peadiatrics assessment, Little Brown & Company, Boston / Toronto

38.

Trombly, Catherine A. Occupational Therapy for Physical Dysfunction 4th Edition, Williams, Wikins, Baltimore Philadelphia.

13. 14.

Madhavan,T & Kalyan, Manjula (1989):A Manual for Psychologist’s, N.I.M.H.,secundrabad,New era Print packs.

15.

Martin, G.L., Koop, S., Tumer, G., Hanel, F. (1981). Backward chaining versus total task presentation to teach assembly tasks to severely retarded persons. Behanav Research of Severe Developmental Disabilities, 2, 117-132.

16.

Mc Ghee, Nance & storey, Kecth (1984).Reducing self stimulating behavior of a profoundly retarded female through sensory awareness training,vol.38,no.8(510-516)

17.

Mithaug, D.E..& Hanawalt, D.A., (1978). The Validation of procedures to asses Prevocational task preferences in Retarded adults, Journal of applied Behavior Analysis, 11(153-162)

39.

W,Inge & Horowitz (1967)A.D.L. training of the children with Perceptuomotor dysfunction & the basic concept approach, A.J.O.T. vol 21,no.1 (10-17)

18.

Morgan, Cliffard T. (1993): Introduction to Psychology, Tata Mc GrawHill Publishing company Ltd. N.DL.

40.

Weber, Nancy Jane (1978): Chaining strategies for sequenced motor tasks in mentally retarded Adults, vol-32 no.6 (385-389)

19.

Narayan Jayanthi & Kutty, A.T. Thressia (1990) Skill Training in M.R. Persons, N.I.M.H., Secundrabad.

41.

20.

Narayan, Jayanthi & Kutty, A.T. Thressia (1990) Fine Motor skills, N.I.M.H., Secundrabad.

Weiss, K.M. (1978). A comparison of Forward and backwards procedure for the acqunits of response chaining in Humans. Journal of Experimental Analysis of Behavior, 29, 255-259.

42.

21.

Narayan, Jayanthi & Kutty, A.T. Thressia (1990) Gross Motor skills, N.I.M.H., Secundrabad.

Westling, David, L (1995) Teaching Students with Severe Disabilities, Merrill an Imprind of Prentice Hall Englewood Cliffs, New Jersey.

43.

Neistdt; Maurein E. The neurobiology of Learning and implication for treatment of adults and brain injury A.J.O.T., 1998, 421-430.

Wilcox B: The teaching of serial tasks using chaining strategies, British Journal of Psychology vol-.44 (175-183) 1974

44.

Witt, Anita & Cermak, Sharon (1989):Body part Identification in 1 to 2 year old children, Feb1990 vol. 44

22. 23.

Peshwaria, Reeta & Menon, D. K.(1998) A study of Facilitations & inhibitors that affect coping in parents of children with M.R. in India at N.I.M.H.

IJOT : Vol. XXXVII : No. 3

• 63

December, 2005 - March, 2006

Suggest Documents