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March 1987

Cognitive Training in Treatment of Hyperactivity in Children-Reply

Author Affiliations

Children's Behavior Disorders Clinic Hillside Hospital Long Island Jewish Medical Center New Hyde Park, NY 11042
Department of Psychology Columbia University College of Physicians and Surgeons New York, NY 10032

Arch Gen Psychiatry. 1987;44(3):296-297. doi:10.1001/archpsyc.1987.01800150120015

In Reply.—  Kendall and Reber claim that efficacy could not be expected from our cognitive training program because of a failure to include behavioral contingencies. As noted in our article (page 954), response contingent social reinforcements were employed systematically. Response cost procedures (taking away points for failure to perform), was the only aspect of a complex cognitive-behavioral treatment package that was not included. There is ample evidence that contingent positive social reinforcement increases desired behaviors, and this approach is widely recommended in the management of children with attention deficit disorder with hyperactivity (ADDH).1Kendall and Reber also report that the lack of generalization in socially appropriate behavior illustrated in our "cab driver" anecdote was to be expected, due to an absence of training "that focuses on the child-adult problem-situation." This criticism reflects misreading of the anecdote. As noted in our article (page 959), the conflict was a child-child, not a child-adult,