TREATMENT INTEGRITY AND ACCEPTABILITY WITH FAMILIES - A CASE-STUDY OFA CHILD WITH SCHOOL REFUSAL

This article describes a graduated re-entry behavioral intervention im plemented over an eight week period to treat a child with school refus al who would run away from school if taken there against his will. A m ulti-method evaluation procedure was used. Baseline data were collecte d over a five day period documenting school attendance and running awa y behaviors. In addition, a comprehensive psychological test battery w as administered to the child, and clinical interviews conducted with t he child's parents and teacher were used to develop the most appropria te treatment program. Based on these data, an initial graduated exposu re to school combined with positive reinforcement for staying in schoo l was chosen. As the intervention proceeded the greatest concern becam e the need to minimize the reinforcing impact of the child's mother on the child's school refusal. The intervention was eventually changed t o a rapid exposure to school. By the third week of the intervention, t he child was attending school all day for five consecutive days. He ma intained this attendance record for the remainder of the treatment pro gram. Follow-up data collected at bi-weekly intervals for a seven mont h time period until the end of the school year and follow-up for the f irst two months of the next school year showed stable and continued ef ficacy of the intervention, with no reoccurrence of refusal to attend or remain at school once he had arrived. (C) 1996 John Wiley & Sons, I nc.