Behavior Modification, Ahead of Print.
Many people with serious mental illness (SMI) experience cognitive disabilities and poor independent living skills which limit their ability to live independently in the community. This study examined the feasibility and initial effectiveness of integrating a new cognitive remediation program, Thinking Skills for Life (TSL), into independent living skills training programs in four secure residential treatment facilities (SRTFs) to facilitate discharge to more independent living situations. Participants were 30 individuals in the SRTF, of whom 11 were forensically committed to the SRTF. Results showed the intervention was feasible to implement, with 97% of participants exposed to TSL and 67% completing the program. Initial promise of the TSL program at improving independent living was suggested by post cognitive program discharge to less restrictive living situations of 63% of participants not on forensic commitment, and 55% of those on forensic commitment. These promising findings set the stage for more rigorous evaluation of the efficacy of the TSL program.

Behavior Modification, Ahead of Print.
The identification of behavioral markers that predict the trajectory of behavior could guide the allocation of limited clinical resources to improve efficacy, efficiency, and safety. As a preliminary exploration of this possibility, we conducted a retrospective records review of incident reports for aggression displayed by residents at a secure juvenile detention center. Our purpose was to evaluate latency to first aggression as a candidate behavioral marker for predicting subsequent high-rate aggression. Our results indicate that latency to first aggression may be a high-quality predictor of subsequent high-rate aggression, and we identified specific cutoff scores that added high levels of predictive value. We use these data to demonstrate a process by which clinicians and researchers can identify predictor variables and use them to guide subsequent allocation of clinical resources. Practical, conceptual, and ethical considerations related to applications of this process as well as potential directions for future research in this area are discussed.

Behavior Modification, Ahead of Print.
Persistent inappropriate self-feeding (e.g., finger-feeding food typically consumed using a utensil after 14–24 months of age) is common for children with neurodevelopmental disorders and other delays and can result in energy and nutrient deficiencies. Although interventions for problematic feeding behavior are common, there is limited information for children without a pediatric feeding disorder who self-feed but exclusively do so inappropriately. We used a proactive approach, with a foundation in the skill-acquisition literature, to address the inappropriate self-feeding of seven children with neurodevelopmental disorders or other delays but without a feeding-related diagnosis. We first evaluated response blocking as an assessment to identify motivation and skill deficits. The assessment identified a skill deficit, a motivation deficit, and a combined deficit for four, two, and one participant, respectively. These results informed treatment for six of the seven participants. Treatment for a motivation deficit included response blocking with and without programmed differential reinforcement. Treatment for a skill deficit included backward chaining with response blocking and programmed differential reinforcement. Treatments were generally successful for all six participants. We discuss the usefulness and implications of response blocking as a brief assessment for inappropriate self-feeding.