Journal of Positive Behavior Interventions http://pbi.sagepub.com/
Turkish Special Education Teachers' Reported Use of Positive and Reductive Interventions for Problem Behaviors: An Examination of the Variables Associated With Use Yasemin Turan, Dilek Erbas, Serife Yucesoy Ozkan and Burcu Ulke Kurkuoglu Journal of Positive Behavior Interventions 2010 12: 211 originally published online 20 October 2009 DOI: 10.1177/1098300709340700 The online version of this article can be found at: http://pbi.sagepub.com/content/12/4/211
Published by: Hammill Institute on Disabilities
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Turkish Special Education Teachers’ Reported Use of Positive and Reductive Interventions for Problem Behaviors: An Examination of the Variables Associated With Use
Journal of Positive Behavior Interventions 12(4) 211–221 © Hammill Institute on Disabilities 2010 Reprints and permission: http://www. sagepub.com/journalsPermissions.nav DOI: 10.1177/1098300709340700 http://jpbi.sagepub.com
Yasemin Turan1, Dilek Erbas2, Serife Yucesoy Ozkan3, and Burcu Ulke Kurkuoglu3 Abstract The purpose of this survey study was to determine the following: (a) What strategies do Turkish special education teachers use to address problem behaviors in their classroom? (b) What are teachers’ views with regard to the effectiveness and acceptability of these strategies? (c) Is there a relationship between the use of strategies and teachers’ perceived effectiveness and acceptability? and (d) Are differences among teacher ratings of strategy use, effectiveness, and acceptability associated with teacher characteristics (e.g., area of specialization, years of experience)? Results revealed that Turkish teachers’ views of acceptability and effectiveness of strategies varied; however, in general, their ratings of positive strategies were higher than their ratings of reductive strategies. Results are discussed in the context of current literature, and directions for further research are suggested. Keywords elementary and middle school, challenging behaviors, disabilities, antecedent and consequence intervention
Presence of problem behaviors in school settings is often associated with negative outcomes for students (e.g., segregation, punitive discipline, poor academic outcomes; e.g., Carr et al., 1999; Sprague & Walker, 2000; Sugai et al., 2000). Research also shows that the problem behaviors are more likely to worsen in the absence of intervention (Horner, Carr, Strain, Todd, & Reed, 2002; Oliver, Murphy, & Corbett, 1987). Applied behavior analysis greatly contributed to the development of interventions for problem behaviors. Horner et al. (2002) provided a synthesis of research on behavioral interventions for young children with autism published between 1996 and 2000 and reported that behavioral interventions have been effective in reducing a variety of problem behaviors performed by individuals with autism. These researchers reviewed the published work by integrating intervention approaches into several categories that provided guidance for this study: (a) stimulus-based procedures involving alteration of antecedent events, (b) instruction-based procedures involving direct instruction on appropriate behaviors, (c) reinforcement-based procedures involving contingent delivery of reinforcers to increase appropriate behaviors, (d) extinction-based procedures
involving interventions withdrawing or minimizing delivery of presumed reinforcers, (e) punishment-based procedures involving delivery of aversive stimuli or removal of positive stimuli contingent on inappropriate behavior to decrease problem behaviors, (f) pharmacological-based procedures including the use of medications to decrease problem behaviors, and (g) other including descriptions of interventions that did not fit one of the categories described above. For the purpose of this study, the term positive is used to refer to the interventions that are preventive and/or designed to increase appropriate behaviors (stimulus based, instruction based, reinforcement based) and reductive for the interventions designed to decrease problem behavior 1
San Diego State University, California, USA Erciyes University, Kayseri, Turkey 3 Anadolu University, Eskisehir, Turkey 2
Corresponding Author: Yasemin Turan, San Diego State University, College of Education, Department of Special Education, 5500 Campanile Drive, San Diego, CA 92182, USA Email:
[email protected]
212 (punishment based, pharmacological based, and other) (e.g., Elliott, 1988; Kazdin, 1980a; Witt, Elliott, & Martens, 1984). Empirical support for the effectivenes of positive intervention strategies has been well documented (e.g., Carr et al., 1999; Koegel, Koegel, & Steibel, 1998; Lucyshyn et al., 2007; Vaughn, Dunlap, Fox, Clarke, & Bucy, 1997). However, effectivenes is not the only reason that teachers choose to implement an intervention approach (Kazdin, 1980a). In fact, research shows that a gap exists between what is considered recommended practice and what strategies are actually implemented by teachers (Harris, 1995; Vaughn, Klingner, & Hughes, 2000). Some discuss that blame for the “research-topractice gap” primarily is related to the researcher (e.g., Abbott, Walton, Tapia, & Greenwood, 1999), whereas others agree that the problem lies with the teacher (e.g., Stuart & Thurlow, 2000). However, others believe that it is a complex issue and the blame rests with a number of factors that are related to both teacher and researcher (e.g., Vaughn et al., 2000). Therefore, it is important to identify practices that teachers typically use and why they select these strategies. Such information can assist higher education faculty in strengthening preservice and in-service programs.
Treatment Acceptability The conceptual foundation for treatment acceptability research originated from Wolf’s early efforts related to social validity (Elliott, 1988). “The use of evaluative feedback from consumers to guide program planning and evaluation is often referred to as assessment of social validity” (Schwartz & Baer, 1991). Wolf (1978) suggested that programs need to be socially validated on three levels: the social significance of goals, the social appropriateness of procedures, and the social importance of outcomes. Treatment acceptability, the second level, refers to “the judgments by lay persons, clients and others of whether treatment procedures are appropriate, fair, and reasonable for the problem or client” (Kazdin, 1981, p. 493). In general, research on treatment acceptability has shown that reinforcement-based procedures are more acceptable than punishment-based procedures with undergraduate students (Kazdin, 1980a, 1980b), preservice student teachers (Witt et al., 1984), and regular and special education teachers (Elliott, Witt, Galvin, & Peterson, 1984). Furthermore, rese archers found that acceptability of interventions varies as a function of the severity of a problem behavior (Kazdin, 1980a), the treatment effectiveness (Reimers & Wacker, 1988), and the time involvement for implementation (Elliott et al., 1984). Very few studies, however, have examined treatment acceptability with ethnic minority groups such as African American (Heffer & Kelley, 1987; Tarnowski, Simonian, Park, & Bekeny, 1992) and Mexican American parents (Borrego, Ibanez, Spendlove, & Pemberton, 2007), and the results of these studies have been mixed. For example, Heffer and Kelley found that regardless of race and income, mothers favored positive reinforcement and
Journal of Positive Behavior Interventions 12(4) response cost over other treatments including timeout, medication, and spanking. On the other hand, fewer low-income African American mothers than middle-upper income Cau casian and African American parents viewed timeout as an acceptable intervention. Furthermore, spanking was rated as acceptable by fewer upper-middle-income Caucasian mothers than low-income Caucasian and low-income and upper-middle–income African American mothers. Unlike Heffer and Kelley, Tarnowski et al. (1992) found that mothers’ ratings of interventions did not vary as a function of race and income. More recent, Borrego et al. (2007) found that punishment-based procedures were rated as the most acceptable by Mexican American parents. This finding seems to contradict some of the acceptability research involving Caucasian participants in which reinforcement-based procedures have been found to be more acceptable than punishment-based procedures. Taken together, only a few studies have focused on different racial and cultural groups, and of the few studies, focus has been on African and Mexican Americans. Another concern in this literature is that treatment acceptability was evaluated primarily for procedures that are reinforcement based, punishment based, and pharmacological based, yet evaluation of strategies that are stimulus based, instruction based, and culture based generally were not included. No studies have examined treatment acceptability with Turkish populations.
Turkish Culture and Teacher Education Researchers agree that educators enter the teaching profession with a set of beliefs and behaviors, which are often very difficult to change (e.g., Stuart & Thurlow, 2000). Teachers’ practices and acceptability might be influenced by their culture, experience, and educational background. Turkish culture is diverse, derived from various elements of the Ottoman Empire, Europe, and Islamic values. Unlike mainstream American values of individual achievement and independence (Hanson, 2004), the collective achievement of the family often is indicated as a source of pride and identity in Turkish culture (Kagıtcıbası, 1990). Even though modern treatment options are used and valued (e.g., biomedical practices; Diken, 2006), fate and God are believed to be responsible for most events (Lamorey, 2002; Masood, Turner, & Boxter, 2007). On the other hand, people of Western European heritage commonly believe that most events have a known physical cause (Althen, 1988; Condon & Yousef, 1975). These differences in culture might influence teachers’ selection and use of interventions for problem behaviors. In addition to culture, educational background is an important variable to consider in understanding teachers’ views of interventions for problem behaviors. The Turkish education system is secular and teachers are trained based on modern educational approaches (Akyüz, 1994; Tasdemirci, 2002).
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Turan et al. Special education teachers are trained in undergraduate programs offered by the special education departments within nine public universities (Kırcaali-Iftar, 2006). These undergraduate programs are field based and designed to prepare teacher candidates to work with individuals with intellectual disabilities from preschool through age 21. Teacher training is based on a behavioral perspective (e.g., antecedent and consequence procedures), and each prospective teacher takes three courses focusing on challenging behavior (Cavkaytar, 2006). Some universities also offer graduate programs in special education. The number of courses and content for graduate programs, however, varies from one program to another. Due to teacher shortages, in addition to graduates of special education programs, graduates of other professions such as psychology, social work, early childhood education, and elementary education are able to work as special education teachers in public schools and agencies upon completion of short-term certification programs (Kırcaali-Iftar, 2006). These professionals typically hold an undergraduate degree and add the “special education certificate” in their current area of specialty. However, the qualifications of individuals who complete these programs have been questioned due to the design of these programs (Kırcaali-Iftar, 2006). Thus, these professionals’ views of interventions for problem behaviors might differ from those of special education teachers who have completed typical preservice training programs. In summary, it is unknown what approaches are used by teachers when intervening with problem behaviors and how positive and reductive strategies are perceived by educators in Turkey. Researchers often emphasize the importance of culturally sensitive practices when working with children with diabilities and their families (e.g., Chen, Downing, & Peckham-Hardin, 2002; Lynch & Hanson, 2004). Also, behavioral interventions are not free from cultural assumptions and beliefs. By nature, these interventions attempt to reduce problem behavior and increase appropriate behavior. It is very important to realize that “appropriate behavior” can only be defined within the cultural contexts where the behavior occurs. Each culture has its own beliefs as to what constitutes appropriate behavior and problem behavior depen ding on how the culture defines a successful or unsuccessful member of that society (Park, 2004). Therefore, investigations of the applicability of interventions across cultures and countries are critical. The purpose of this survey study was to explore Turkish teachers’ views of intervention strategies to address the problem behaviors of individuals with disabilities. We were particularly interested in exploring whether Turkish special education teachers use and favorably view currently recommended practices to address problem behaviors (e.g., positive strategies), which evolved in the United States and reflect Western cultural values (Wang, McCart, & Turnbull, 2007). The study is an initial, exploratory effort to address this question in Turkey. Unlike previous acceptability studies, we also
will explore teachers’ views of interventions not only for reinforcement-based and punishment-based strategies but also for stimulus-based, instruction-based, and culture-based strategies. The study was guided by the following research questions: (a) What strategies do Turkish special education teachers use to address problem behaviors in their classroom? (b) What are teachers’ views with regard to the effectiveness and acceptability of these strategies? (c) Is there a relationship between the use of strategies and teachers’ perceived effectiveness and acceptability? and (d) Are differences among teacher ratings of strategy use, effectiveness, and acceptability associated with teacher characteristics (e.g., area of specia lization, years of experience)?
Method Participants Participants were teachers from special education schools in Turkey that serve 3- to 21-year-old individuals with disabilities. These schools were selected purposefully from three different cities across Turkey to represent different regions of the country (e.g., rural, urban, and suburban; see Table 1). All special education schools from the cities of Eskisehir (suburban) and Kayseri (rural) were included in the sample. Because Istanbul (urban) is a city with a large population, it was not feasible to collect data from all of the schools. Therefore, data in Istanbul were collected only from those schools serving more than 100 students. Thus, the sample included a total of 337 special education schools. Given that the majority of individuals with disabilities receive services in separate educational settings in Turkey (i.e., 28% in inclusive classrooms, 5% in self-contained classrooms, and 67% in segregated special education schools; Turkish Ministry of Education, 2007), teachers were recruited from segregated special education schools. These schools serve individuals with mild to severe intellectual disabilities and/or autism. Although all of the students had intellectual disabilities, some had additional challenges such as physical disabilities and/or sensory impairments. Selection criteria for teachers included (a) a willingness to participate, (b) being employed as a special education teacher in a classroom serving individuals with disabilities, and (c) being a lead teacher for at least 1 year at the time of the study. Six hundred nineteen surveys were distributed and 418 were returned. Ten of the 418 surveys were excluded due to missing data; thus, the adjusted return rate was 66%. As Table 1 shows, the majority of participants were female (63%) and slightly more than half were between 20 and 30 years of age (57.6%). The numbers of students in each classroom ranged from 4 to 10. The type of teaching credentials held by the participants included elementary education with special education certificate (30.1%), special education (27.5%), early childhood with special education certificate (9.3%), and other subjects (33.1%). The “other” group
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Table 1. Participants’ Demographic Information Demographic Gender Female Male Age 20–30 31–40 41–50 51 and older Degree (level of education) High school Associate’s degree Bachelor’s degree Master’s degree Teaching credentials (area of specialization) Other with special education certificate Elementary with special education certificate Special education credential Early childhood with special education certificate Type of disability served by teachersa Intellectual disabilities Learning disabilities Autism Attention deficit/hyperactivity disorder Severe/multiple impairments Behavioral/emotional disorder Physical or health impairments No response Training in behavior management Yes No Training in behavior management by area of specialization Special education Other Elementary Early childhood
Survey Instrument n 257 151 235 76 70 27 14 79 284 31 135 123 112 38 354 150 140 101 88 86 61 13 208 200 112 45 30 21
% 63 37 57.6 18.6 17.2 6.6 3.4 19.4 69.6 7.6 33.1 30.1 27.5 9.3 87 37 34 25 22 21 15 3 51 49 53.8 21.6 14.4 10.2
Note: N = 408. a. Participants could select all disability categories describing the students they currently support. As a consequence, there is overlap among the disability categories, explaining why the total is greater than 100%.
included teachers having credentials in the area of psychology, social work, math, music, and art with a certificate in special education. The type of students with disabilities served by teachers included students with intellectual disabilities (87% of teachers), learning disabilities (37% of teachers), autism (34% of teachers), attention deficit/hyperactivity (25% of teachers), severe/multiple impairments (25% of teachers), behavioral/emotional disorder (21% of teachers), or physical and health impairments (15% of teachers). Because participants could select all disability categories describing the students in their current classroom, there is overlap among disability categories explaining why the total is greater than 100%. Fifty-one percent of the participants indicated that they received training in behavior management with the majority of them being special education teachers (53.8%).
The initial survey was developed in Turkish by the researchers after examining the literature and surveys designed by other researchers (i.e., Hemmeter, Santos, & Ostrosky, 2008; Peckham-Hardin, 2002). The survey included new items and some items that were derived directly from others’ instruments (e.g., Hemmeter et al., 2008; Peckham-Hardin, 2002). The items selected from existing surveys were translated into Turkish and then English and translated back to Turkish to check for accuracy by two special education faculty who are fluent in both English and Turkish. Then, drafts of the instrument were revised based on feedback from special education faculty (two professors from the United States and two professors in Turkey) and one Turkish faculty member in educational psychology with expertise in constructing and developing survey instruments. The experts provided feedback in four major areas: (a) content (e.g., positive and reductive strategies), (b) readability of instructions and items, (c) match between research questions and survey questions, and (d) physical design and order of the questions and sections. Finally, the survey was field tested with 12 teachers from different geographical regions across Turkey (e.g., rural, urban, and suburban). The survey questions were then refined for clarity. The revised survey was 11 pages in length and divided into four major sections. In Part 1, teachers were asked to indicate the extent to which specific challenging behaviors occur with their students and their level of concern with these behaviors. They also were asked to indicate their agreement or disagreement with the underlying reasons that children might engage in challenging behavior. Part 2 includes positive and reductive strategies and requires participants to indicate how often they use these strategies and to rate the effectiveness and acceptability of these strategies. Part 3 includes questions about teachers’ resources and the support needed to deal with their children’s problem behaviors. Part 4 includes demographic information. For the purpose of this article, we will focus only on the first sections of Part 2 and Part 4. The rest of the data are shared in a different article (Erbas, Turan, Arslan, & Dunlap, in press). In the first section of Part 2, there were 17 strategies representing positive (stimulus based—giving choices, varying task difficulty, intercepting easy with difficult tasks; instruction based—self-management, teaching replacement behavior; and reinforcement based—praise, differential reinforcement, token economy) and reductive (extinction based—ignoring; punishment based—verbal reprimand, response cost, complaining to school principal, spanking, timeout; pharmacological based—medication; and culture based—praying, talisman [i.e., an object usually given by a religious person to act as a charm or to protect the person from evil]). However, these interventions were presented to the teachers without categorizing as positive or reductive to reduce
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Turan et al. potential bias. Teachers were given a description along with an example for each intervention strategy and asked to indicate how often they used the 17 strategies using a 4-point scale (1 = never, 2 = monthly, 3 = weekly, 4 = daily). In addition, they were asked to note additional strategies they used that were not listed on the survey. Teachers also were asked to rate each intervention they used in terms of perceived effectiveness and acceptability using a 4-point Likert-type scale (1 = strongly disagree, 2 = disagree, 3 = agree, 4 = strongly agree). Internal consistency. Estimates of internal consistency for positive and reductive interventions also were calculated separately using Cronbach’s alpha. Cronbach’s alpha values for reported usage of positive and reductive strategies were .76 and .70, respectively, and for reported acceptability of positive and reductive strategies were .78 and .53, respectively. Whereas Cronbach’s alpha for the reported effectiveness of positive strategies was .72, it was low for reductive strategies, .35. Therefore, the section related to effectiveness of reductive strategies was not included in the analysis of variance (ANOVA).
Procedures Permission to conduct this study was obtained from both the Turkish Ministry of National Education and the General Directorate of Social Welfare and Child Protection Agency. In addition, the addresses and telephone numbers of schools serving individuals with developmental disabilities were obtained from these agencies. Data collection began simultaneously in three cities in January 2006 and was completed in 3 months. To collect data, project staff contacted school administrators to arrange for the distribution of the surveys. Surveys were hand-delivered to potential participants in each school by project staff during a prearranged time. During this contact with teachers, project staff discussed the importance and purpose of the study, provided information about the confidentiality of the information to be collected, and asked teachers to complete the survey. Depending on the participants’ preference, they completed the 50-minute survey either at this initial contact or at a different time individually. If participants preferred to complete the survey at a different time, they were given 1 week to complete the surveys. The completed surveys were picked up by the project staff at the end of the week from school admin istrators. The surveys were not coded for the purpose of identifying individual participants; however, they were coded by schools and cities.
Data Analysis Data analyses were conducted using descriptive and inferential statistics. To describe teacher demographics and teachers’ ratings for use, effectiveness, and acceptability, percentages and measures of central tendency were calculated. In addition,
correlations, t tests, and a series of one-way ANOVAs for positive and reductive interventions were computed.
Results Reported Use of Positive and Reductive Strategies The first research question focused on determining the type and frequency of strategies used by teachers to address the problem behaviors of their students with developmental disabilities. Table 2 displays the means and standard deviations for each strategy. As shown in Table 2, the three positive strategies used most frequently were praise (tangible and social) (M = 3.69, SD = .597), differential reinforcement (M = 3.22, SD = .983), and token economy (M = 2.84, SD = 1.02). The three positive strategies used least frequently were teaching replacement behavior (M = 2.02, SD = .568), giving choices (M = 2.19, SD = .709), and interspersing easy with difficult tasks (M = 2.26, SD = .743). The three reductive strategies used most frequently included verbal reprimand (M = 2.64, SD = .974), ignoring (M = 2.63, SD = 1.03), and response cost (M = 2.48, SD = 1.02), whereas the three reductive strategies reportedly used the least frequently were talisman (M = 1.02, SD = .230), school complaining to school principal (M = 1.14, SD = .427), and praying (M = 1.20, SD = .596). Even though these means provide information on average use per month, viewing the results in terms of what percentage of teachers reported using the strategies on a daily, weekly, and monthly basis is of value because it provides further insights into teacher behavior. Looking at these results shows that approximately 75% of teachers reported using praise on a daily basis with almost all teachers using praise at least monthly (99%). The rest of the positive strategies, except for teaching replacement behavior and self-management, were reportedly used by more than 50% of teachers at least on a weekly basis. Similarly, several reductive strategies (e.g., verbal reprimand, ignoring, and response cost) were used by approximately 50% of teachers at least weekly. In addition, 37% of teachers reported using timeout, and 8% reported using medication on a daily or weekly basis.
Perceived Effectiveness and Acceptability of Positive and Reductive Strategies The second and third research questions addressed perceived effectiveness and acceptability of positive and reductive strategies. Perceptions of effectiveness and acceptability were rated on a 4-point Likert-type scale with 1 indicating the lowest and 4 indicating the highest ratings. To interpret data, we assigned mean scores of 3.5 or higher as very effective/acceptable, and we designated scores between 2.5 and 3.4 as being within the effective/acceptable range. Finally, scores below 2.5 were classified as ineffective/ unacceptable. As shown in Table 2, all of the positive strategies received mean scores above 2.5 and therefore fell within
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Table 2. Reported Usage and Perceived Effectiveness and Acceptability of Strategies
Usage
Effectiveness
Acceptability
Strategy
M (SD)
M (SD)
M (SD)
Positive strategies Praise 3.69 (0.597) 3.66 (.499) Differential reinforcement 3.22 (0.983) 3.55 (.591) Token economy 2.84 (1.024) 3.47 (.593) Varying task difficulty 2.47 (0.835) 3.26 (.555) Self-management 2.29 (0.835) 3.33 (.590) Interspersing easy with difficult tasks 2.26 (0.743) 3.41 (.542) Giving choices 2.19 (0.709) 3.32 (.594) Teaching replacement behavior 2.02 (0.568) 3.38 (.537) Reductive strategies Verbal reprimand 2.64 (0.974) 2.92 (.622) Ignoring 2.63 (1.03) 3.12 (.657) Response cost 2.48 (1.02) 3.25 (.616) Timeout 2.15 (0.958) 3.13 (.630) Medication 1.68 (1.04) 3.01 (.650) Spanking 1.21 (0.557) 2.62 (.678) Praying 1.20 (0.596) 2.55 (.964) Sending to school principal 1.14 (0.427) 2.69 (.795) Talisman 1.02 (0.230) 2.88 (.333)
the effective/acceptable range. The three strategies perceived as most effective were praise, differential reinforcement, and token economy with all of them falling within the very effective range. Similarly, these three strategies were perceived to be the most acceptable. In contrast, none of the reductive strategies fell within the very effective/acceptable range. However, in general, all nine strategies were viewed as effective. The three reductive strategies rated most effective were response cost, timeout, and ignoring; the three least effective strategies were praying, spanking, and school referral. Of the nine reductive strategies, only five fell within the acceptable range. The three reductive strategies perceived as most acceptable were medication, response cost, and ignoring. The three strategies rated least acceptable were talisman, spanking, and praying. In addition, we were interested in determining whether there was a relationship between (a) usage and perceived effectiveness, (b) usage and perceived acceptability, and (c) perceived effectiveness and acceptability. To assess these relationships, Pearson’s correlation coefficients were calculated using mean scores for reported use, perceptions of acceptability, and perceptions of effectiveness for positive and reductive strategies. As Table 3 reveals, a high positive relationship for usage and perceived acceptability of positive strategies (r = .70, p < .001) and a moderate positive relationship for usage and perceived acceptability of reductive strategies (r = .54, p < .001) emerged. Similarly, significant relationships were found for the use of positive strategies and perceptions of effectiveness (r = .24, p < .001) as well as for use of reductive strategies and perceptions of
3.65 (.506) 3.39 (.780) 3.35 (.640) 3.06 (.631) 3.15 (.647) 3.11 (.844) 2.94 (.957) 3.09 (.632) 2.64 (.785) 2.91 (.878) 2.98 (.832) 2.75 (.903) 3.01 (.431) 1.40 (.711) 1.45 (.759) 1.50 (.820) 1.13 (.436)
effectiveness (r = .18, p < .001). Finally, results yielded significant relationships for effectiveness and acceptability of positive strategies (r = .53, p < .001) and effectiveness and acceptability of reductive strategies (r = .35, p < .001).
Variables Affecting Use, Effectiveness, and Acceptability of the Strategies Using the mean scores obtained for positive and reductive strategies, a series of one-way ANOVAs and t tests was conducted to determine whether there were statistically significant differences in ratings of positive and negative among teacher groups based on demographics (e.g., area of specialization, training, years of experience). Familywise Type I error inflation generated by multiple comparisons was controlled for using the Bonferroni adjustment, as is standard in the field (Abdi, 2007). Given multiple comparisons, the Bonferroni adjustment alters the alpha level during significance testing to account for the increased probability of rejecting the null hypothesis erroneously. Results showed statistically significant differences across teacher groups based on certain demographic characteristics for use and acceptability ratings only. Reported use. A one-way ANOVA revealed that teachers’ reported use of positive strategies varied as a function of area of specialty (special education, elementary education, early childhood, other subjects), F(3, 404) = 5.2, p = .001. Follow-up Bonferroni analyses revealed that elementary school teachers had significantly lower mean ratings for use of positive strategies (M = 2.60, SD = .544) than did special education teachers (M = 2.88, SD = .431) and early childhood teachers (M = 2.82, SD = .433).
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Turan et al. Table 3. Pearson’s Correlation Coefficients Among Reported Use, Perceived Acceptability, and Effectiveness
Use of PBS
Use of Non-PBS
Acceptability of PBS
Acceptability of Non-PBS
Effectiveness of PBS
1.000 0.10* 0.70** 0.03 0.24** Use of PBS Use of non-PBS 1.000 0.09 0.536** 0.12* Acceptability of PBS 1.000 0.08 0.533** 1.000 0.06 Acceptability of non-PBS Effectiveness of PBS 1.000 Effectiveness of non-PBS
Effectiveness of Non-PBS -0.01 0.18** 0.145** 0.35** 0.27** 1.000
Note: PBS = positive behavior support. *p < .05. **p < .01.
In addition, teachers’ reported use of positive strategies varied as a function of their years of teaching experience (i.e., 1–3 years, 4–6 years, 7–15 years, 16 years or more), F(3, 404) = 3.60, p = .01. Bonferroni analyses revealed that teachers with 16 years or more of teaching experience had significantly lower mean ratings for use of positive strategies (M = 2.56, SD = .608) than did teachers with 1 to 3 years of teaching experience (M = 2.79, SD = .494). Also, use of reductive strategies was influenced by teachers’ years of teaching experience, F(3, 404) = 3.88, p = .001. Teachers with 16 years or more of teaching experience had significantly lower mean ratings for use of reductive strategies (M = 1.70, SD = .315) than did teachers with 4 to 6 years of teaching experience (M = 1.86, SD = .364). In addition to one-way ANOVAs, a nondirectional t test for independent samples was computed to determine whether teachers’ use of positive strategies varied based on their training. Results revealed statistically significant group differences between teachers who had attended or not attended a behavior management course. This result was evident in teachers’ perceived use of positive strategies, t = –2,368, p = .01. Teachers who received training on behavioral strategies had higher mean ratings for use of positive strategies (M = 2.78, SD = .439) than did teachers without training (M = 2.66, SD = .544). Reported acceptability. A one-way ANOVA revealed that teachers’ acceptability of positive strategies varied as a function of their area of specialty (special education, elementary education, early childhood, other subjects), F(3, 404) = 3.76, p = .01. Bonferroni analyses showed that elementary school teachers had significantly lower mean ratings for acceptability of positive strategies (M = 3.16, SD = .379) than did special education teachers (M = 3.36, SD = .365) and early childhood teachers (M = 3.30, SD = .387). Furthermore, a one-way ANOVA revealed significant differences across teacher groups based on years of teaching experience for ratings of acceptability, F(3, 404) = 5.94, p = .001. Bonferroni analyses revealed that teachers with 16 years or more of teaching experience had significantly lower mean ratings for acceptability of positive strategies (M = 3.08, SD = .397) than did teachers with 1 to 3 (M = 3.31,
SD = .396), 7 to 15 (M = 3.26, SD = .363), and 4 to 6 years of experience (M = 3.27, SD = .372).
Discussion Research in the area of behavioral interventions has demonstrated its effectiveness in addressing problem behavior (Carr et al., 1999; Koegel et al., 1998; Vaughn et al., 1997). However, few studies have been conducted to investigate the degree to which these strategies are used by teachers outside the research context (Crone, Hawken, & Bergstrom, 2007; Lucyshyn et al., 2007; Peckham-Hardin, 2002; Todd, Horner, Sugai, & Colvin, 1999) and how these strategies are perceived across different cultural contexts (e.g., Heffer & Kelley, 1987; Wang et al., 2007). This study extends our understanding of the perceptions of intervention strategies to address challenging behavior within the context of a different culture. Specifically, this survey extends our understanding of the strategies used by Turkish special education teachers when addressing problem behavior and teachers’ views of the effectiveness and acceptability of these strategies. In the following sections, the results are linked to the literature, and limitations and implications for research and practice are addressed.
Use of Positive and Reductive Strategies The results of this study showed that at least 50% of the Turkish participants reported using five of the seven positive strategies on a weekly or daily basis. The top three strategies used fell within the “reinforcement-based consequent strategies” category (i.e., praise, differential reinforcement, and token economy), whereas two of the three strategies used least frequently fell within the “stimulus-based” category (i.e., giving choices and interspersing easy with difficult tasks) and one fell within the “instruction-based” category (i.e., teaching replacement behavior). Even though these findings are promising in that they show that Turkish teachers are using positive procedures quite frequently, there are two concerns worthy of further discussion. First, although consequent strategies can be effective in reducing problem behaviors, they are considered a reactive approach, meaning that teachers must wait until a
218 problem (or appropriate) behavior occurs to intervene (Carr et al., 1999). As the focus of intervention has shifted from reactive to preventive approaches, positive behavior support has emerged as an effective intervention approach (Carr et al., 1999). Positive behavior posits that education professionals create opportunities to increase the occurrence of appropriate behavior and find ways to prevent problem behavior. The second concern is related to whether the use of positive stra tegies by Turkish teachers is occurring at levels that are needed to produce positive changes in behavior. For example, praise (social and tangible) was reported to be the most frequently used strategy. Approximately 75% of Turkish teachers reported using praise on a daily, 20% on a weekly, and 4% on a monthly basis. However, if a teacher uses praise only a few times per month or week, the effect of this strategy is most likely minimal. Results also revealed that reductive strategies were used less frequently than positive strategies. Of the nine reductive strategies, verbal reprimand, ignoring, and response cost were used most frequently. These strategies are less aversive than other reductive strategies such as timeout and spanking. The two latter strategies were reported to be used by approximately 15% of the teachers on at least a monthly basis, which raises some ethical concerns given their punitive nature (Budd & Baer, 1976). These strategies make it difficult to include people with challenging behaviors in community settings because they dehumanize individuals and can cause others to look negatively on those who have been placed in timeout or spanked (Singer, Gert, & Koegel, 1999).
Perceived Effectiveness and Acceptability The results revealed that teachers’ views of acceptability and effectiveness of strategies varied; however, in general, their ratings of positive strategies were higher than their ratings of reductive strategies. This finding is consistent with the previous research conducted in the United States (Elliott et al., 1984; Kazdin, 1980a, 1980b). Specifically, all of the positive strategies were rated within the effective and acceptable range with some falling within the very effective range (e.g., praise, differential reinforcement, and token economy). In contrast, the acceptability and effectiveness of reductive strategies varied. In general, all nine strategies were found to be effective, yet only five of them were perceived as acceptable. The most acceptable strategies included less aversive forms of reductive interventions such as response cost, ignoring, and verbal reprimand, whereas the bottom three included either aversive forms of reductive interventions such as spanking or interventions related to religious beliefs (talisman and praying). It is not surprising that teachers rated less aversive interventions as more acceptable considering ethical issues and previous treatment acceptability research (Kazdin, 1980a, 1980b). It was somewhat surprising that interventions related
Journal of Positive Behavior Interventions 12(4) to religious beliefs were rated unacceptable even though they were deemed effective. Considering that 99% of Turkish people are Muslim, we expected that these interventions would be considered acceptable, even if they were not used on a consistent basis by Turkish educators. One explanation for these results is that Turkey has a secular educational system and therefore teachers might be reluctant to share their religious beliefs. A second explanation might be related to the influence of the modern educational theories and practices (e.g., behavioral intervention) in teacher education programs in Turkey (Akyüz, 1994; Tasdemirci, 2002). In this study, we hypothesized that if a strategy is used frequently, it would be well perceived and viewed as effective. Or alternatively, if an intervention is effective and acceptable, it would be used more frequently. The results revealed statis tically positive relationships between usage and perceived acceptability, usage and perceived effectiveness, and perceived effectiveness and acceptability of both positive and reductive strategies. These findings are not sufficient to draw conclusions about a causal relationship among these variables; however, they do suggest that frequently used strategies tend to be more acceptable and effective.
Variables Affecting Use, Effectiveness, and Acceptability of the Strategies The results of this study demonstrate that area of specialization, training on interventions for challenging behavior, and years of teaching influenced use and acceptability of positive intervention strategies. Teachers who had special education or early childhood education and/or training in behavioral interventions reported using positive strategies more frequently than did elementary school teachers. Similarly, teachers with special education or early childhood credentials found positive strategies more acceptable than did elementary school teachers. These findings are promising in that they show that training and expertise influence teachers’ use of intervention strategies. Furthermore, teachers with more years of teaching experience used positive strategies less frequently and found these strategies less acceptable than did teachers with fewer years of teaching experience. On the other hand, teachers with only a few years of experience reported using reductive strategies less frequently than did teachers with more years of experience. One explanation for these findings might be related to the teachers’ knowledge and training on strategies to address challenging behavior. Because positive behavior support is a relatively new concept in Turkey, recent graduates are more likely to receive some training or enroll in a university course related to these strategies. However, it is also important to note that although these results were statistically significant, the mean scores clustered close to each other, causing one to question the clinical significance of the findings.
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Limitations Several limitations warrant discussion. The first limitation is related to the methodology of the study. The results rely on self-report by teachers without a measure of fidelity. Whether the participant teachers actually used the strategies in their classrooms as frequently as they reported is unknown. Class room observations would have strengthened the validity of the findings. Another limitation is that the sample was purposefully drawn from three geographical regions in Turkey. Therefore, the results may not be generalizable to all teachers in Turkey. However, the sample was drawn from special education schools, which represent schools serving individuals with disabilities. In other words, because individuals with disabilities are typically served in special education schools or segregated classes within public schools in Turkey, the results of the study might prove valuable to professionals working in such settings.
Implications for Practice and Research This study extends the current literature by increasing our understanding of the perceptions of special educators about behavior support strategies within the context of a different culture. The cross-cultural examination of challenging behaviors and behavior support strategies is critical, thus the findings from this study provide several implications for practice and research. The results suggest that, similar to the United States, positive behavioral strategies are well received by Turkish teachers in general and strategies used least frequently are also the ones deemed less acceptable and effective. However, because these findings are based on teacher report, observational studies should be conducted to validate whether Turkish teachers are using the strategies consistently and with fidelity in their classrooms and whether perceived acceptability and effectiveness influence teachers’ actual classroom use. In other words, future studies should include an objective measure of the teachers’ interpretation, fidelity, and implementation of the techniques. If effectiveness and acceptability do influence use, then we can provide opportunities for educators to observe positive outcomes of interventions and make the necessary modifications to these interventions to increase their acceptability. The survey results also demonstrate that preventive strategies and teaching strategies were used less frequently than consequent strategies. This finding might be the result of some Turkish educators not being exposed to or trained in using these strategies for several reasons. These intervention strategies have only recently been publicized in the Turkish literature, with just a few published research studies focusing on these strategies (Erbas, 2002; Yucesoy, 2007). Furthermore, prospective special education teachers receive only a few courses addressing challenging behavior and the foci of these courses may vary depending on the
instructor’s background. Based on personal communications with several faculty members (Arzu Ozen, Seyhun Topbas), it appears that the content of these courses typically focuses on consequent procedures rather than preventive strategies. Finally, services for individuals with disabilities are provided by not only special education teachers but also other pro fessionals (e.g., psychologists, social workers, early childhood teachers, and elementary school teachers) due to longstanding teacher shortages. Assuming that preservice and inservice training has the potential to influence the strategies that teachers are most comfortable implementing in their classrooms, attention should be given to providing knowledge and skill-based training to current and future special education teachers across disciplines on evidence-based strategies to address challenging behavior. Authors’ Note The opinions and other content contained in this article do not necessarily reflect the opinion of the agency and no official endorsement should be inferred. The authors would like to thank the teachers who participated in this study. Also, the authors would like to express their appreciation to Yesim Gulec Aslan for her role in collecting data and to Evrim Guleryuz for her statistical contribution. Furthermore, they would like to thank Rena Lewis, Glen Dunlap, and Michaelene Ostrosky for their insightful feedback on the manuscript.
Declaration of Conflicting Interests The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
Funding The authors disclosed receipt of the following financial support for the research and/or authorship of this article: Scientific and Technical Research Council of Turkiye Grant number: SBB-104K061
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About the Authors Yasemin Turan, PhD, is an assistant professor of special education at San Diego State University. Her current interests include early intervention, behavior analysis, and assessment of treatment acceptability. Dilek Erbas, PhD, is an associate professor of special education at Erciyes University. Her current interests include applied behavioral analysis, early intensive behavioral intervention, and positive behavioral support. Serife Yucesoy Ozkan, PhD, is an assistant professor of special education at Anadolu University. Her current interests include applied behavior analysis, self-determination, and positive behavioral support. Burcu Ulke Kurkcuoglu, PhD, is an assistant professor of special education at Anadolu University. Her current interest is applied behavioral analysis and early intensive behavioral intervention.
