persons with complex partial seizures have difficulty in the
neural inhibition of irrelevant stimuli.
It would seem then that
one would need to make use of highly discriminable and highly
organized stimuli in an intervention environment.
Provided that
the stimuli
programmed during
intervention
have
sufficient
saliency from environment to environment it should be possible to
satisfy two major technical "givens" of punishment procedures and
generalization, that is, the known specificity of punishment
effects and the efficacy of programming common stimuli to obtain generalization. This could be done by making some of the programmed common stimuli the discriminative stimuli for the occurrence of punishment.
Obtaining compatibility with complex partial seizures
This approach is compatible with the neuropsychological requirements of epileptics with complex partial seizures (i.e., temporal lobe dysfunction) in that it seems logical to present highly discriminable and organized stimuli to persons who may be experiencing difficulty in processing and integrating information. In addition, when dealing with a subject who is severely or profoundly intellectually disabled it may be of assistance to consider the literature pertaining to transfer and generalization in relation to task-specific cognitive strategy training in the intellectually disabled.
Some important points emerge from a review of generalization training in the educable intellectually disabled by Blackman and Lin (1984). Essentially those that seem most relevant to the task at hand are that (1) failure to generalize strategy on serial recall tasks may have been due to " ... inability to organize stimulus input spontaneously"; and (2) in comparing training packages “The superiority of the explicit over the general
instruction group again demonstrated the importance of task analysis as the basis for specific strategy selection" (Blackman & Lin, 1984, pp. 243-244).
It may be that presenting cues which virtually task analyse a situation (i.e., a setting where the desired behavior is to occur) will sufficiently structure and organize the client's perception of the environment to allow the subject to respond appropriately
( i . e . , t o adopt t he c o r r e c t s t r a t e g y ) . In such a s i t u a t i o n t h e a d d i t i o n of an o p e r a n t consequence ( e . g . , puni shme nt ) would f u n c t i o n t o enhance t he s a l i e n c y of t he s t i m u l i , and t o e n s u r e s e l e c t i v e a t t e n t i o n t o t h a t s t i m u l i .
Again t h i s approach i s c o n s i s t e n t w i t h bot h t h e n e u r o p s y c h o l o g i c a l d a t a in r e l a t i o n t o temporal lobe d y s f u n c t i o n and t he EEG d a t a . In p a r t i c u l a r s i n c e t h e EEG d a t a s u g g e s t s t h a t p e r s o n s w it h e p i l e p t o g e n i c f o c i of t h e temporal l o b e s may have an i n c r e a s e d i n a b i l i t y t o deal with s t i m u l i ( e s p e c i a l l y i n h i b i t i o n of i r r e l e v a n t s t i m u l i ) i t seems l o g i c a l t o t r a i n a t t e n t i o n t o c e r t a i n w e l l - d e f i n e d s t i m u l i by add ing an o p e r a n t consequence f o r f a i l u r e
t o r es pond t o t h a t s t i m u l i .
However t h e n e u r o p s y c h o l o g i c a l d a t a in r e l a t i o n t o p e r s o n s w it h temporal lobe d y s f u n c t i o n s p r e s e n t s a n o t h e r problem in t h a t i t p r o v i d e s e vi de nc e t h a t such p e r s o n s have d i f f i c u l t y in p r o c e s s i n g a u d i t o r y i n f o r m a t i o n . I t i s o b v i o u s l y d e s i r a b l e f o r problem b e h a v i o r s i f not t o t a l l y e l i m i n a t e d from a s u b j e c t ' s r e p e r t o i r e t o be under ve rba l c o n t r o l . S t o k e s and Baer (1977) in d i s c u s s i n g me d ia t ed g e n e r a l i z a t i o n s t a t e t h a t " . . . t h e most commonly us ed m e d i a t o r i s language" and t h a t " . . . i t ( l a n g u a g e ) meets p e r f e c t l y t he l o g i c of a s a l i e n t common s t i m u l u s , t o be c a r r i e d from any t r a i n i n g s e t t i n g t o any g e n e r a l i z a t i o n s e t t i n g " ( p. 361).
The use of language a s a m e d i a t o r may be i mp o r t a n t in t erms of maximizing t h e p o s s i b i l i t y of g e n e r a l i z a t i o n s i n c e language may p r e d i s p o s e towards s e l f - c o n t r o l and a c c o r d i n g t o S t o k e s and Baer (1977) r e s e a r c h on b e h a v i o r a l t e c h n i q u e s i n v o l v i n g s e l f - c o n t r o l or s e i f-management ha s shown p r om i s in g ma i nt en anc e and g e n e r a l i z a t i o n of b e h a v i o r change. I t may be t h a t d i f f i c u l t i e s in p r o c e s s i n g
a u d i t o r y i n f o r m a t i o n c o u l d be o f f s e t by t h e use of h i g h l y emphasized and r e p e t i t i v e language accompanied by g e s t u r e w i t h i n a h i g h l y s t r u c t u r e d e nvironment.
S tok es and Baer (1977) a l s o recommend t h e us e of i n d i s c r i m i n a b l e c o n t i n g e n c i e s . Thi s p r e s e n t s some d i f f i c u l t y i f one i s c o n s i d e r i n g t he use of a punishment t e c h n i q u e s i n c e i t i s well e s t a b l i s h e d t h a t punishment e f f e c t s a r e enhanced i f a c o n t i n u o u s s c h e d u l e i s us ed f o r t he d e l i v e r y of an a v e r s i v e s t i m u l i (Heron, 1987). However i f one were p r e p a r e d t o s a c r i f i c e immediacy and s t r e n g t h of t he e f f e c t f o r a s l o w er r e d u c t i o n in problem b e h a v i o r s but w i t h h o p e f u l l y b e t t e r p r o s p e c t s of long term ma inte nanc e and g e n e r a l i z a t i o n i t may be p o s s i b l e t o combine a form of i n d i s c r i m i n a b l e c o nt inge ncy u s i n g language a s a s t i m u l u s f o r m e d i a t i o n . T h i s c ou ld be done by p r o v i d i n g a v e r ba l cue f o r d e s i r e d b e h a v i o r c o n t i n g e n t on o c c ur r e nc e of a t a r g e t b e h a v i o r . The s u b j e c t ' s r e s p o n s e t o t h a t verbal cue c o u l d th e n be p u n i s h e d
( c o n t i n g e n t upon f a i l u r e t o respond) or p o s i t i v e l y r e i n f o r c e d ( c o n t i n g e n t upon t he o c cu r r e n c e of t he d e s i r e d r e s p o n s e ) . T h i s would seem t o p r o v i d e some o p p o r t u n i t y f o r t he development of s e l f c o n t r o l , a s w e l l , each o c c ur r e nc e of t a r g e t b e h a v i o r i s not on a c o n t i n u o u s , t h e r e f o r e e a s i l y d i s c r i m i n a b l e , s c h e d u l e of p unis hme nt. The s u b j e c t d e te r m i n e s t he c o n t i n ge n cy f o r punishment or p o s i t i v e r e i n f o r c e m e n t by h i s own r e s p o n s e t o t h e v e r b a l s t i m u l i . That t h e r a t e of r e s p o n s e s both p u n i s h a b l e and p o s i t i v e l y r e i n f o r c a b l e i s l i k e l y t o be h i g h l y v a r i a b l e i s f a i r l y p r e d i c t a b l e in a s u b j e c t of low i n t e l l i g e n c e and w i th t h e a d d i t i o n a l c o g n i t i v e p r o c e s s i n g problems a t t r i b u t a b l e t o complex p a r t i a l s e i z u r e s a n d / o r temporal lobe d y s f u n c t i o n .