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Name: Anthony Folino
Degree & Year: PhD, Second Year
Program: School and Clinical Child Psychology
Department: Human Development and Applied Psychology
Supervisor: Dr. Joseph Ducharme

Why OISE?: I was most attracted to the School and Child Clinical Psychology program at OISE. The combined focus on both school and child clinical psychology was a perfect match for both my professional and research interests. In addition, the "scientist-practioner" model strongly embraced by the program was extremely appealing and ensured that I would receive comprehensive training in clinical psychology and applied clinical research. Lastly, after reading some of the research conducted by faculty within the department of Human Development and Applied Psychology and other departments at OISE , I realized that this institute would enable me to be educated by leading researchers in the areas of developmental, educational, and clinical psychology.

Name of award: Canada Graduate Scholarship (CGS) Doctoral Scholarship (SSHRC)

Thesis/research project: The errorless classroom: A success-focused, non-intrusive approach to intervention for severe behaviour.

The idea: My Master’s thesis evaluated the effectiveness of a unique social skills training program designed for children with severe antisocial behavioral difficulties. The study focused on 8 children enrolled in a clinical classroom due to their antisocial behaviours (e.g., extreme aggression, low levels of peer cooperation, poor compliance, etc). Our review of the literature suggested that there were several limitations and drawbacks with many of the programs being used to improve the social skills of children with antisocial behaviors. Two drawbacks in particular led to the conceptualization and development of my Master’s thesis.

First, our review of the literature indicated that most social skills training regimens used time-out as a consequence for inappropriate behaviors. While time-out is effective in reducing undesirable behaviors, several concerns have been raised with this method. For instance, studies suggest that children who are extremely oppositional tend to be resistant to time-out and often engage in escape behaviours when placed in time-out (making this procedure difficult to implement in a proper and successful manner). Secondly, findings suggest that time-out may have unintended emotional side-effects for young children. To preclude the need for time-out, we designed a social skills training program that included the principles of Errorless Remediation. This approach was developed by Dr. Joseph Ducharme, a faculty member in HDAP, and has demonstrated great success in treating children with a variety of behavioral difficulties without the use of punishment procedures. The initial stage of errorless interventions involves the removal of conditions commonly associated with problem behaviour and the introduction of conditions which typically elicit prosocial responding. The initial modification of contextual variables ensures that at the start of treatment, the child will experience a high degree of success managing the simplified conditions in their environment. Consistent with all errorless paradigms, our SST program ensured that key intervention components that moderated problem behavior during peer interactions (i.e., instructions, prompts, reinforcements) were faded slowly enough during treatment to ensure successful interactions among peers.

Secondly, children who display antisocial behaviors have wide-ranging skill deficits. As a result, traditional social skills training packages include training in a wide-range of skills which makes training clinically burdensome. A potential strategy for narrowing the focus and duration of training without compromising treatment effects involves the concept of ‘keystone’ behavior (e.g., a behavior or skill that when modified through treatment causes desirable changes in a broad set of other responses not targeted for improvement). Our informal observations of children enrolled in treatment programs for severe conduct difficulties and antisocial behaviours revealed that many of the social skills difficulties that characterized these children involved an inability to give in to the needs or will of peers. In addition, a review of social skills checklists revealed that the ability to give in to the will of others was the underpinning for a large proportion of skills taught in social skills training programs. This analysis led to consideration of acquiescence, ‘the ability to give in to the needs and will of others’, as a potential keystone for social skills. We hypothesized that a social skills training program using acquiescence as the foundation for the training of social skills would produce broad-ranging social skill improvements in children with antisocial behavioral difficulties.

Findings revealed that throughout and following treatment, children demonstrated increases in acquiescent and prosocial responding as well as reduced antisocial behaviors. Due to the errorless nature of the intervention, behavioral changes were attained with greatly reduced use of time-out for child problem behavior. Also, our focus on acquiescence enabled us to substantially reduce the length of training time.

The issues: Early onset antisocial behavior is among the most prevalent of developmental concerns, accounting for a large proportion of child clinic referrals and making it one of the most costly child mental health issues. Approximately 5-10% of children demonstrate persistent antisocial behaviors and are thus at risk for school failure, juvenile offending, substance abuse, adult crime, and mental health difficulties. Deficient social skills consistently differentiate children who exhibit antisocial behavior from those who do not. Accordingly, social skills training has become a common form of intervention for childhood antisocial behaviors. However, findings indicate that social skills training provides only minimal effects for children with behavioral disorders. Moreover, social skills training is more effective for withdrawn than aggressive children and better at enhancing prosocial behaviors than reducing antisocial behavior, leading some to conclude that those who require social skills training the most, end up benefiting the least.

Importance/application: There is an increasing number of children entering school who are lacking in social skills and thus display severe antisocial behaviors. Unfortunately, as evidenced by recent tragedies in both Canadian and American schools, we are learning the immense risk that such children may pose. The sad reality of the situation is that most teachers are unable to effectively improve these child adjustment difficulties. Even when referred to special education on the basis of a behavioral designation, very few empirically based interventions are used to guide intervention efforts. As a result, it is imperative that researchers continue to develop and empirically evaluate teacher-friendly interventions that enhance the social skills of at risk children early in their development. For this reason, my PhD dissertation will continue to focus on non-intrusive treatments for children experiencing externalizing difficulties. This research will further explore the concept of keystone behaviors in an attempt to devise clinically effective and practical interventions.

Background: I obtained my Honors B.A. from Brock University. While at Brock I was employed in the Neuropsychology/Electrophysiology laboratory, under the supervision of Dr. Sidney Segalowitz and Dr. Jane Dywan. This opportunity along with several courses in neurophysiology made me appreciate the sensitivity and vulnerability of the human nervous system, particularly among children. While at Brock, I also volunteered with several organizations that enabled me to work with children experiencing a variety of emotional and behavioral disorders. I quickly recognized that pharmacological treatments were often the primary and sole treatment approach for children experiencing behavioral difficulties associated with childhood psychopathologies. Given the numerous side-effects that young children may experience when exposed to psychotropic drugs at an early age, I became interested in seeking alternative treatment approaches for children with behavioral difficulties. Dr. Ducharme’s research focus on non-intrusive and developmentally sensitive treatment approaches for child psychopathologies was very consistent with my research and clinical endeavors and ultimately initiated my interest in OISE.

Your work: I am currently employed at two Psychology clinics where I provide psychoeducational and psychological services to individuals with social-emotional and educational difficulties. In addition, I am currently employed by the University of Toronto as a sole-responsibility instructor in the Initial Teacher Education program at OISE/UT. I teach a course entitled Emotional and Behavioral Problems in the Classroom. This course explores innovative, practical, and proactive strategies teachers can employ to manage child behaviour in the classroom. My previous employment endeavors have included working as a Psychoeducational Consultant for the Toronto Catholic District School board and serving as a Research Analyst at the Center for Addiction and Mental Health (CAMH). I am currently fulfilling a practicum component at Surrey Place Center where I provide therapy to children and adolescents with Developmental Disabilities.