Teaching developmentally disabled students drug-refusal skills (initial study)
Funded by the National Institute on Drug Abuse
Scientist(s):
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Mentally retarded/developmentally disabled (MRDD) students are not immune to peer pressure. Recent research indicates that MRDD is actually a risk factor for substance abuse precisely because the desire to be accepted is even more powerful for intellectually disabled teens. For instance, teens with MRDD are more likely than their nondisabled peers to report that they drink alcohol because their friends drink, because they wish to avoid being laughed at, and because they want to be part of the "in" crowd. Just as nondisabled teens find it difficult to refuse drug or alcohol offers, MRDD students lack the insight and social skills needed to handle such sensitive situations.
The Oregon Center for Applied Science, Inc., conducted interviews with teachers, school administrators, and focus groups with 32 MRDD high school students to learn more about drug use and peer pressure among the intellectually disabled. Focus groups were given examples of student interactions and asked to identify them as "social pressure" or "social encouragement." Interestingly, as long as the dynamic was pleasant and no force was involved, the students labeled the interchange "social encouragement" even if the peer suggestion was for something they knew to be negative (e.g., the use of drugs). As a result of these findings, it was determined that MRDD students needed to distinguish between pressure and encouragement based on the activity being proposed, not the manner of presentation.
But how can MRDD students learn to evaluate the wisdom of engaging in an activity? Because most students (intellectually disabled and nondisabled) indicate they would probably talk to a parent if they were experiencing problems, the advice of a parental figure appeared to be a useful barometer. Unfortunately, not every MRDD student has a parent or a parent who would offer sound advice, thus a useful rule for determining whether an activity is positive or not would be to ask, "Would my school principal think this is a good idea?" The principal is a parental figure known to all high school students, therefore this "rule" could be universally applied.
Preventing Substance Abuse in Special Education Students is an interactive video-based CD-ROM that helps protect MRDD students from substance abuse by teaching them to distinguish between social pressure and social encouragement and then giving them skills to cope with social pressure. The program defines social encouragement as a suggestion by friends that you do something positive, something the principal would think is a good idea. Social pressure, on the other hand, is a suggestion to do something the principal would probably consider a bad idea.
Although the program is delivered via computer, no reading or keyboarding is required. The program relies entirely upon the ability to point and click with the mouse. Before students get to the substance abuse content, "J.T.," the cartoon guide of the program, asks them to click on a picture on the screen. Those who can do so within eight seconds advance to the next part of the program. Those who cannot receive an animated onscreen tutorial that teaches point-and-click skills and offers remediation until the viewer can pass the test for mastery. All viewers receive an onscreen tutorial describing the feedback buttons on the screen, specifically a "thumbs up" button to indicate a "yes" answer and a "thumbs down" button to indicate a "no" answer.
Focus group research revealed that many MRDD students are familiar with video games and enjoy the fast pace and stimulation. NASCAR drivers are well respected by these students, thus J.T., the cartoon guide of the program, is a race car driver. He talks frequently about the joys of driving his car but the need to listen to his pit crew and make safe driving decisions. The analogy is that we are all drivers of our own lives and must make safe decisions for ourselves and know who to rely upon in our own pit crew. The concept of social pressure is introduced, and viewers learn that social pressure occurs when people ask you to do something the principal would think is a bad idea. J.T. then invites the viewers to watch some videos—for instance, high school friends suggesting to an MRDD student that they cut in front of others in line—and asks the viewer to answer with the thumbs up or thumbs down whether this was social pressure.
Once the social pressure unit has been mastered, J.T. has students view video stories about social encouragement (suggestions the principal would think are a good idea) and go through a similar set of exercises and remediation. Once the viewer has mastered social encouragement, J.T. presents another unit that mixes the two types of stories—pressure and encouragement—and offers remediation until the viewer can successfully distinguish between the two. J.T. also teaches the skill of leaving a situation when you feel social pressure to do something you think the principal would consider a bad idea.
Twenty-seven MRDD high school students with moderate to mild mental retardation evaluated Preventing Substance Abuse. Eighty-one percent of the participants (22 of 27) could use a mouse without need for instruction. The remaining five participants were routed to the onscreen mouse tutorial and learned to successfully master the ability to point and click. All participants went through the interface module that described the thumbs up and thumbs down buttons and were able to go through the program independently.
Before watching the substance abuse content, each participant was shown four videos of quick social interchanges between students and was asked to identify whether the story reflected social encouragement or not. They also answered a series of questions about social encouragement, social pressure, and the ability to distinguish between the two. After viewing the CD-ROM, evaluation participants watched the same four video stories and answered the same questions. Participants showed significant improvement in not only their knowledge about pressure and encouragement, but also their ability to identify and distinguish between them when they witnessed such interactions in the form of video stories.
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