the desired behavior. Training was accomplished in two 45-minute sessions.
These results are encouraging, although the study does not constitute a true test
of in-operatory management, as the operant procedures were performed between
dental visits, rather than during actual treatment. Nevertheless, this procedure
appears to have promise for the treatment of children whose behavior is so
disruptive as to preclude less intensive forms of treatment.

A contingency reinforcement procedure to decrease disruptive behavior was
employed in the operatory during dental treatment by Stokes and Kennedy
( 1980). Reinforcers employed were a "magic jumping bean" and the opportu-
nity to operate the pneumatic dental chair. Substantial reductions in disruptive
behavior were obtained in eight children previously rated as uncooperative (rates
of disruptive behavior in excess of 20%). Unfortunately, as several intervention
procedures (including in vivo modeling) were employed in this study, the effects
of contingent reinforcement procedures cannot be isolated and assessed.

Melamed's group ( Melamed et al., 1979) initially reported no beneficial
effects of praise for cooperative behavior during dental treatment. However,
Melamed ( 1980) subsequently reported that inexperienced children and girls--
experienced or inexperienced--did better with praise, while boys seemed to do
better when criticism was contingent upon inappropriate behavior.

The use of other types of reinforcers also merits investigation. Difficulties
inherent in the delivery of material and activity reinforcers might be overcome
through the use of tokens, or audiotaped or videotaped material. These stimuli
could be delivered contingent upon the occurrence of cooperative behavior and in
close temporal proximity to that behavior. Further, a differential reinforcement
procedure could be implemented simply by removal of these stimuli following
disruptive behavior. Empirical investigation of these procedures is currently
underway in our laboratory.

Adelson R., & Goldfried M. Modeling and the fearful patient. Journal of Dentistry for Children,
1970, 37, 476-489.

Arata C., Klorman R., Chandler M., & Sveen O. Reducing pedodontic patients' uncooperative-
ness with coping and mastery models. Journal of Dental Research, 1977, 56, 433.

The Association of Pedodontic Diplomates. Technique for behavior management--A survey. Jour-
nal of Dentistry for Children, 1972, 39, 368-372.

Ayer W. Use of visual imagery in needle phobic children. Journal of Dentistry for Children, 1973,
40, 125.

Azrin N., Holtz W., & Goldiamond I. Response bias in questionnaire reports. Journal of Consult-
ing Psychology, 1961, 25, 324-326.

Bailey P., Talbot A., & Taylor P. A comparison of maternal anxiety levels with anxiety levels
manifested in the child dental patient. Journal of Dentistry for Children, 1973, 40, 277-284.

Bandura A. Principles of behavior modification. New York: Holt, Rinehart and Winston, 1969.

Beers T., & Karoly P. Cognitive strategies, expectancy, and coping style in the control of pain.
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