Skip to main content

Behavioral/Environmental Considerations in Pediatric Inpatient Care

  • Chapter
Behavioral Pediatrics

Abstract

Behavioral pediatrics has typically emphasized two areas of interface between the behavioral sciences and pediatric medicine. One is the identification, treatment, and prevention of childhood behavior problems through routine clinic and well-child visits (Christophersen & Rapoff, 1979). The second is the use of behavioral procedures to correct primary medical problems and those secondary to particular medical conditions. For example, behavioral procedures have been demonstrated to be effective in reducing seizures (Cataldo, Russo, & Freeman, 1979; Zlutnick, Mayville, & Moffat, 1975), in the treatment of neuromuscular disorders (Cataldo & Bird, in press; Cataldo, Bird, & Cunningham, 1978), in treating fecal incontinence secondary to myelomeningocele (Whitehead, Parker, Masek, Cataldo, & Freeman, 1981) and in dealing with pediatric chronic pain (Varni, Bessman, Russo, & Cataldo, 1980).

Preparation of this paper and conduct of the work on which it is based were supported in part by Grant 917 from Maternal and Child Health and Grant 9 MPH 1077 JHH from the Morris Goldseker Foundation. This work has been a joint effort of the Kennedy Institute and the Behavioral Medicine Program of the Johns Hopkins University School of Medicine.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Abbott, N. C., Hansen, P., and Lewis, K. Dress rehearsal for the hospital. American Journal of Nursin,c,, 1970, 70, 2360–2362.

    CAS  Google Scholar 

  • Anderson, D. E., and Brady, J. V. Pre-avoidance blood pressure elevations accompanied by heart rate decreases in the dog. Science, 1971, 172, 595–597.

    Article  PubMed  CAS  Google Scholar 

  • Anderson, D. E., and Tosheff, J. Cardiac output and total peripheral resistance changes during pre-avoidance periods in the dog. Journal of Applied Psychology, 1973, 34, 650–654.

    CAS  Google Scholar 

  • Azrin, N. H. Some effects of two intermittent schedules of immediate and non-immediate punishment. Journal of Psychology, 1956, 42, 3–21.

    Article  Google Scholar 

  • Baue, A. E. The energy crisis in surgical patients. Archives of Surgery, 1974, 109, 349–357.

    Article  Google Scholar 

  • Behrend, E. R., and Bitterman, M. E. Sidman avoidance in the fish. Journal of the Experimental Analysis of Behavior, 1963, 6, 47–52.

    Article  PubMed  CAS  Google Scholar 

  • Blachly, P. H., and Starr, A. Post-cardiotomy delirium. American Journal of Psychiatry, 1964, 121, 371–375.

    Google Scholar 

  • Blackman, D. Conditioned suppression and the effects of classical conditioning on operant behavior. In W. K. Honig and J. E. R. Staddon (Eds.), Handbook of operant behavior. Englewood Cliffs, N.J.: Prentice-Hall, 1977.

    Google Scholar 

  • Blumgart, E., and Korsch, B. M. Pediatric recreation: An approach to meeting the emotional needs of hospitalized children. Pediatrics, 1964, 34, 133–136.

    PubMed  CAS  Google Scholar 

  • Bowden, P. The psychiatric aspects of cardiac intensive care therapy: A review. European Journal of Intensive Care Medicine, 1975, 1 (2), 89–91.

    Article  Google Scholar 

  • Brady, J. V. Extinction of a conditioned “fear” response as a function of reinforcement schedules for competing behavior. Journal of Psychology, 1955, 40, 25–34.

    Article  Google Scholar 

  • Brady, J. V. Experimental studies of psychophysiological responses to stressful situations. In Symposium on Medical Aspects in the Military Climate, Walter Reed Army Institute of Research. Washington, D.C.: United States Government Printing Office, 1965.

    Google Scholar 

  • Brady, J. V. Operant methodology and the production of altered physiological states. In W. Honig (Ed.), Operant behavior: Areas of research and application. New York: Appleton-Century Crofts, 1966.

    Google Scholar 

  • Brady, J. V. Learning and conditioning. In O. F. Pomerleau and J. P. Brady (Eds.), Behavioral medicine: Theory and practice. Baltimore: Williams and Wilkins, 1979.

    Google Scholar 

  • Brimer, C. J., and Kamin, L. J. Disinhibition, habituation, sensitization and the conditioned emotional response. Journal of Comparative and Psychological Psychology, 1963, 56, 508–516.

    Article  CAS  Google Scholar 

  • Bruhn, J. G., Thurman, E., Jr., Chandler, B. C., and Bruce, T.A. Patients’ reactions to death in a coronary care unit. Journal of Psychosomatic Research, 1970, 14, 65–70.

    Article  PubMed  CAS  Google Scholar 

  • Carlson, N. J., and Black, A. H. Traumatic avoidance learning: The effects of preventing escape responses. Canadian Journal of Psychology, 1960, 14, 21–28.

    Article  PubMed  CAS  Google Scholar 

  • Cataldo, M. F., and Bird, B. L. Behavioral medicine treatment of neuromuscular disorders. In T. J. Coates (Ed.), Behavioral medicine: A practical handbook. New York: Research Press, in press.

    Google Scholar 

  • Cataldo, M. F., and Risley, T. R. Infant day care. In R. Ulrich, T. Stachnik, and J. Mabry (Eds.), Control of human behavior (Vol. III ). Glenview, III.: Scott, Foresman, 1974, pp. 44–50.

    Google Scholar 

  • Cataldo, M. F., Bird, B. L., and Cunningham, C. E. Experimental analysis of EMG feedback in treating cerebral palsy. Journal of Behavioral Medicine, 1978, 1, 311–322.

    Article  PubMed  CAS  Google Scholar 

  • Cataldo, M. F., Bessman, A., Parker, L. H., Pearson, J. E., and Rogers, M. C. Behavioral assessment for pediatric intensive care units. Journal of Applied Behavior Analysis, 1979, 12, 83–97.

    Article  PubMed  CAS  Google Scholar 

  • Cataldo, M. F., Russo, D. C., and Freeman, J. M. A behavioral analysis approach to high-rate myoclonic seizures. Journal of Autism and Developmental Disorders, 1979, 9, 413–427

    Article  PubMed  CAS  Google Scholar 

  • Christophersen, E. R., and Rapoff, M. A. Behavioral pediatrics. In O. F. Pomerleau and J. Brady, Behavioral medicine: Theory and Practice. Baltimore: Williams and Wilkins, 1979.

    Google Scholar 

  • Cuthbertson, D. P. The disturbance of metabolism produced by bony and non-bony injury, with notes of certain abnormal conditions of bone. Biochemical Journal, 1930, 24, 1244–1263.

    PubMed  CAS  Google Scholar 

  • Danilowicz, D. A., and Gabriel, H. P. Post-operative reactions in children: “Normal” and abnormal responses after cardiac surgery. American Journal of Psychiatry, 1971, 128, 185–188.

    PubMed  CAS  Google Scholar 

  • Davenport, H. T., and Werry, J. S. The effect of general anesthesia surgery and hospitalization upon the behavior of children. American Journal of Orthopsychiatry, 1970, 40, 806–824.

    Article  PubMed  CAS  Google Scholar 

  • Dickinson, A., and Pearce, J. M. Preference and response suppression under different correlations between shock and a positive reinforcer in rats. Learning and Motivation, 1976, 7, 66–85.

    Article  Google Scholar 

  • Dickinson, A., and Pearce, J. M. Inhibitory interactions between appetitive and aversive stimuli. Psychological Bulletin, 1977, 84, 690–711.

    Article  Google Scholar 

  • Druss, R. G., and Kornfeld, D. S. The survivors of cardiac arrest: A psychiatric study. Journal of the American Medical Association, 1967, 201, 291–296.

    Article  PubMed  CAS  Google Scholar 

  • Dweck, C. S., and Wagner, A. R. Situational cues and correlation between CS and US as determinants of the conditioned emotional response. Psychonomic Science, 1970, 18, 145–147.

    Google Scholar 

  • Efthymiou, G. Management of attention-seeking patients-2. Nursing Times, 1976, 72, 1490–1491.

    PubMed  CAS  Google Scholar 

  • Egerton, N., and Kay, J. H. Psychological disturbances associated with open heart surgery. British Journal of Psychiatry, 1964, 110, 433–439.

    Article  PubMed  CAS  Google Scholar 

  • Erofeeva, M. N. Contributions a l’étude des réflexes conditionnels destructifs. Compte rendu de la société de biologie, Paris, 1916, 79, 239–240.

    Google Scholar 

  • Erofeeva, M. N. Additional data on nocuous conditioned reflexes. lzvestiya Petrogradskovo Nauchnavo Instituta On P. F. Lesgafta, 1921, 3, 69–73.

    Google Scholar 

  • Estes, W. K., and Skinner, B. F. Some quantitative properties of anxiety. Journal of Experimental Psychology, 1941, 29, 390–400.

    Article  Google Scholar 

  • Forsyth, R. P. Blood pressure responses to long-term avoidance schedules in the restrained rhesus monkey. Psychosomatic Medicine, 1969, 31, 300–309.

    PubMed  CAS  Google Scholar 

  • Gamzu, E., and Williams, D. R. Classical conditioning of a complex skeletal response. Science, 1971, 171, 923–925.

    Article  PubMed  CAS  Google Scholar 

  • Gann, D. S. Endocrine control of plasma protein and volume. Surgical Clinics of North America, 1976, 56, 1135–1145.

    PubMed  CAS  Google Scholar 

  • Glazer, H. I., Weiss, J. M., Pohorecky, L. A., and Miller, N. E. Monoamines as mediators of avoidance-escape behavior. Psychosomatic Medicine, 1975, 37, 535–543.

    PubMed  CAS  Google Scholar 

  • Goffman, E. Asylums. New York: Doubleday, 1961.

    Google Scholar 

  • Griffith, F. R. Fact and theory regarding the calorigenic action of adrenaline. American Journal of Physiology, 1951, 31, 151.

    CAS  Google Scholar 

  • Hackett, T. P., Cassem, N. H., and Wishnie, H. A. The coronary-care unit: An appraisal of its psychologic hazards. The New England Journal of Medicine, 1968, 279 (25), 1365–1370.

    Article  PubMed  CAS  Google Scholar 

  • Hale, M., Koss, N., Kerstein, M., Camp, K., and Barush, P. Psychiatric complications in a surgical ICU. Critical Care Medicine, 1977, 5 (4), 199–203.

    Article  PubMed  CAS  Google Scholar 

  • Haller, J. A., Talbert, J. L., and Dombro, R. H. The hospitalized child and his family. Baltimore: Johns Hopkins, 1967.

    Google Scholar 

  • Harrison, T. S., Seton, J. F., and Feller, I. Relationship of increased oxygen consumption to catecholamine excretion in thermal burns. Annals of Surgery, 1967, 165, 169.

    Article  PubMed  CAS  Google Scholar 

  • Herd, J. A., Morse, W. H., Kelleher, R. T., and Jones, L. G. Arterial hypertension in the squirrel monkey during behavioral experiments. American Journal of Physiology, 1969, 217, 24–29.

    PubMed  CAS  Google Scholar 

  • Holland, J., Sgroi, S. M., Marwit, S. J., and Solkoff, N. The ICU syndrome: Fact or fancy. Psychiatry in Medicine, 1973, 4, 241–249.

    Article  CAS  Google Scholar 

  • Hott, J. Rx: Play PRN in pediatric nursing. Nursing Forum, 1970, 9, 288–309.

    Article  PubMed  CAS  Google Scholar 

  • Jarhult, J. Osmotic fluid transfer from tissue to blood during hemorrhagic hypotension. Acta Physiologica Scandinavica, 1973, 89, 213.

    Article  PubMed  CAS  Google Scholar 

  • Jarhult, J., Lundvall, J., Mellander, S., and Tibblin, S. Osmolar control of plasma volume during hemorrhagic hypotension. Acta Physiologica Scandinavica, 1972, 85, 142.

    Article  PubMed  CAS  Google Scholar 

  • Jolly, R. H. Play and the sick child. Lancet, 1968, 2, 1286–1287.

    Article  PubMed  CAS  Google Scholar 

  • Klein, R. F., Kliner, V. S., Zipes, D. P., Troyer, W. G., Jr., and Wallace, A. G. Transfer from a coronary care unit. Archives of Internal Medicine, 1968, 122, 104–108.

    Article  PubMed  CAS  Google Scholar 

  • Kornfeld, D. S. Psychological problems of intensive care units. Medical Clinics of North America, 1971, 55, 1353–1363.

    PubMed  CAS  Google Scholar 

  • Kornfeld, D. S., Zimberg, S., and Malm, J. R. Psychiatric complications of open-heart surgery. New England Journal of Medicine, 1965, 273, 282–287.

    Article  Google Scholar 

  • Langford, W. S. The child in the pediatric hospital: Adaptation to illness and hospitalization. American Journal of Orthopsychiatry, 1961, 31, 667.

    Article  PubMed  CAS  Google Scholar 

  • Lazarus, H. R., and Hagens, J. H. Prevention of psychosis following open-heart surgery. American Journal of Psychiatry, 1968, 124, 1190–1195.

    PubMed  CAS  Google Scholar 

  • Leaf, R. C. Avoidance response evocation as a function of prior discriminative fear conditioning under curare. Journal of Comparative and Physiological Psychology, 1964, 58, 446–449.

    Article  PubMed  CAS  Google Scholar 

  • Lindheim, R., Glazer, H., and Coffin, C. Changing hospital environments for children. Cambridge: Harvard, 1972.

    Google Scholar 

  • Mackintosh, N. J. The psychology of animal learning. New York: Academic Press, 1974.

    Google Scholar 

  • Maier, S. F. Failure to escape traumatic shock: Incompatible skeletal motor responses or learned helplessness? Learning and Motivation, 1970, 1, 157–170.

    Article  Google Scholar 

  • Maier, S. F., Seligman, M. E. P., and Solomon, R. L. Pavlovian fear conditioning and learned helplessness. In B. A. Campbell and R. M. Church (Eds.), Punishment and aversive behavior. New York: Appleton, 1969.

    Google Scholar 

  • Maron, L., Bryan-Brown, C., and Shoemaker, W. C. Toward a unified approach to psychological factors in the ICU. Critical Care Medicine, 1973, 1, 81–84.

    Article  PubMed  CAS  Google Scholar 

  • Marukhanyan, E. V. The effect of the duration and intensity of a conditioned electroshock stimulus upon the magnitude of the conditioned food and acid reflexes. Zhurnal Vysshei Nervio Deyatel’nosti,1954, 4,684–691. (Russian)

    Google Scholar 

  • Mason, J. W., Brady, J. V., and Tolson, W. W. Behavioral adaptations and endocrine activity. In R. Levine (Ed.), Proceedings of the Association for Research in Nervous and Mental Diseases. Baltimore: Williams and Wilkins, 1966.

    Google Scholar 

  • McKegney, F. P. The intensive care syndrome: The definition, treatment, and prevention of new “diseases of medical progress.” Connecticut Medicine, 1966, 30, 633–636.

    PubMed  CAS  Google Scholar 

  • Melamed, B. G., and Siegel, L. J. Behavioral medicine: Practical applications in health care. New York: Springer, 1980.

    Google Scholar 

  • Miller, N. E. Interactions between learned and physical factors in mental illness. Seminars in Psychiatry, 1972, 4, 239.

    PubMed  CAS  Google Scholar 

  • Miller, N. E. Applications of learning and biofeedback to psychiatry and medicine. In H. I. Kaplan, A. M. Freeman, and B. J. Sadock (Eds.), Comprehensive textbook of psychiatry III. Baltimore: Williams and Wilkins, 1980.

    Google Scholar 

  • Moot, S. A., Cebulla, R. P., and Crabtree, J. M. Instrumental control and ulceration in rats. Journal of Comparative Physiological Psychology, 1970, 71, 405–410.

    Article  CAS  Google Scholar 

  • Mullin, A. D., and Mogenson, G. J. Effects of fear conditioning on avoidance learning. Psychological Reports, 1963, 13, 707–710.

    Article  Google Scholar 

  • Overmier, J. B., and Seligman, M. E. P. Effects of inescapable shock upon subsequent escape and avoidance responding. Journal of Comparative and Physiological Psychology, 1967, 63, 28–33.

    Article  PubMed  CAS  Google Scholar 

  • Pavlov, I. P. Conditioned reflexes. New York: Dover, 1927.

    Google Scholar 

  • Pearce, J. M., and Dickinson, A. Pavlovian counterconditioning: Changing the suppressive properties of shock by association with food. Journal of Experimental Psychology: Animal Behavior Processes, 1975, 1, 170–177.

    Article  PubMed  CAS  Google Scholar 

  • Pearson, J. E. R., Cataldo, M. F., Tureman, A., Bessman, C., and Rogers, M. C. Pediatric intensive care unit patients: Effects of play intervention on behavior. Critical Care Medicine, 1980, 8, 64–67.

    Article  PubMed  CAS  Google Scholar 

  • Petrillo, M. Preventing hospital trauma in pediatric patients. American Journal of Nursing, 1968, 68, 1469–1473.

    Article  Google Scholar 

  • Pinckney, G. Avoidance learning in fish as a function of prior fear conditioning. Psychological Reports, 1967, 20, 71–74.

    Article  PubMed  CAS  Google Scholar 

  • Pirkle, J. C., and Gann, D. S. Restitution of blood volume after hemmorrhage: role of the adrenal cortex. American Journal of Physiology, 1976, 230, 1683–1687.

    PubMed  Google Scholar 

  • Rescorla, R. A. Probability of shock in the presence and absence of CS in fear conditioning. Journal of Comparative Physiological Psychology, 1968, 66, 1–5.

    Article  CAS  Google Scholar 

  • Rie, H. E., Boverman, H., Grossman, B., and Ozoa, N. Immediate and long-term effects of intervention early in prolonged hospitalization. Pediatrics, 1968, 41, 755–764.

    PubMed  CAS  Google Scholar 

  • Seligman, M. E. P., and Maier, S. F. Failure to escape traumatic shock. Journal of Experimental Psychology, 1967, 74, 1–9.

    Article  PubMed  CAS  Google Scholar 

  • Seligman, M. E. P., Maier, S. F., and Solomon, R. L. Unpredictable and uncontrollable aversive events. In F. R. Bush (Ed.), Aversive conditioning and learning. New York: Academic Press, 1971.

    Google Scholar 

  • Sveinsson, I. S. Postoperative psychosis after heart surgery. Journal of Thoracic and Cardiovascular Surgery, 1975, 70, 717–726.

    PubMed  CAS  Google Scholar 

  • Tomlin, P. J. Psychological problems in intensive care. British Medical Journal, 1977, 2, 441–443.

    Article  PubMed  CAS  Google Scholar 

  • Varni, J. W., Bessman, C. A., Russo, D. C., and Cataldo, M. F. Behavioral management of chronic pain in children: Case study. Archives of Physical Medicine and Rehabilitation, 1980, 61, 375–379.

    PubMed  CAS  Google Scholar 

  • Vernon, D. T. A., Foley, J. M., Sipowicz, R. R., and Schulman, J. L. The psychological responses of children to hospitalization and illness. Springfield, Ill.: Charles C Thomas, 1965.

    Google Scholar 

  • Weiss, J. M. Somatic effects of predictable and unpredictable shock. Psychosomatic Medicine, 1970, 32, 397–409.

    PubMed  CAS  Google Scholar 

  • Weiss, J. M. Effects of coping behavior in different warning signal conditions on stress pathology in rats. Journal of Comparative Physiological Psychology, 1971, 77, 1–13

    Article  CAS  Google Scholar 

  • Weiss, J. M., Stone, E. A., and Harrell, N. Coping behavior and brain norepinephrine level in rats. Journal of Comparative Physiological Psychology, 1970, 72, 153–160.

    Article  CAS  Google Scholar 

  • Weiss, J. M., Glazer, H. I., Pohorecky, L. A., Brick, J., and Miller, N. E. Effects of chronic exposure to stressors on avoidance—escape behavior and on brain norepinephrine. Psychosomatic Medicine, 1975, 37, 522–534.

    PubMed  CAS  Google Scholar 

  • Weiss, J. M., Glazer, H. I., and Pohorecky, L. A. Coping behavior and neurochemical changes: An alternative explanation for the original “learned helplessness” experiments. In G. Serban and A. Kling (Eds.), Animal models in human psycho-biology. New York: Plenum Press, 1976.

    Google Scholar 

  • Whitehead, W. E., Parker, L. H., Masek, B. J., Cataldo, M. F., and Freeman, J. M. Biofeedback treatment of fecal incontinence in myelomeningocele. Developmental Medicine and Child Neurology, 1981, 23, 313–322.

    PubMed  CAS  Google Scholar 

  • Wilmore, D. W., Long, J. M., Mason, A. D., Skreen, R. W., and Pruitt, B. A. Catecholamines: Mediator of the hypermetabolic response to thermal injury. Annals of Surgery, 1974, 180, 653–669.

    Article  PubMed  CAS  Google Scholar 

  • Zide, B., and Pardoe, R. The use of behavior modification therapy in a recalcitrant burned child: Case report. Plastic and Reconstructive Surgery, 1976, 57, 378–382.

    Article  PubMed  CAS  Google Scholar 

  • Zlutnick, S., Mayville, W. J., and Moffat, S. Modification of seizure disorders: The inter-ruption of behavioral chains. Journal of Applied Behavior Analysis, 1975, 8, 1–12.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1982 Springer Science+Business Media New York

About this chapter

Cite this chapter

Cataldo, M.F., Jacobs, H.E., Rogers, M.C. (1982). Behavioral/Environmental Considerations in Pediatric Inpatient Care. In: Russo, D.C., Varni, J.W. (eds) Behavioral Pediatrics. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-9403-8_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-9403-8_8

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-9405-2

  • Online ISBN: 978-1-4757-9403-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics