Assessment and modification of delusional speech in an 11-year-old child: A comparative analysis of behavior therapy and stimulant drug effects

A reversal design was utilized in which differential vs non-differential adult attention was made contingent upon the delusional speech of an 11-yr-old boy. Within this design, effects of verbalizing the contingency and the use of a pharmacological treatment were also studied. The results indicated that differential adult attention only to appropriate task related statements increased such statements while decreasing delusional speech, whereas non-differential attention to any type of statement resulted in a predominance of delusional speech. A trial of methylphenidate showed no difference relative to non-differential attention. Additionally, the results suggest that verbalizing the differential attention contingency may be an effective tactic for rapid behavior change. The results are discussed in relation to the necessity for comparing possible courses of treatment as a strategy for insuring effective treatment.