A Study to Assess the Effectiveness of Token Economy for Behavior Problems among Mild and Moderate Mentally Challenged Children in Selected Special Homes

This study was conducted to evaluate the Effectiveness of Token Economy on Behavioural Problem among Mentally Challenged Children in a Selected Special homes, Chennai. In this study Pre Experimental (one group pre test- post test) design was adopted. Setting of the study was Matheraiee, special school, valluvargurukullam campus, Chennai. The sample size was 37 and they were selected through Non Probability Purposive Sampling Technique. Behaviour problem was assessed through Conner’s Abbreviated Rating Scale (CARS). After Token Economy Intervention the collected data were analysed by using both descriptive and inferential statistical methods. Of the study participants, 48.65% showed severe behavioral problem, 32.43% had moderate and 18.92% had mild behavioral problem. There was no significant similarity between the pre test score and behavirol problems but, the study showed significant relationship between the token economy and behavior of the participants. This study concluded that the Token Economy was effective, attractive, easy to carry, dispense and cost effective therapeutic intervention in reducing the Behavioral Problems among Mentally Challenged Children.


INTRODUCTION
Few of the people population show significant retardation or slowness on their mental ability due to much complex reasons spanning from the family to social conditions. They are termed to "Mentally Retarded" or "Mentally Challenged" [1]. Their IQ ratio is quite low (lesser than 99) and those mentally challenged children show behaviors that are considered as problematic because of the harm or inconvenience they cause others, or to the child himself, unknowingly [2]. These problem behaviors could be due to a number of reasons (i.e.) lack of communication skills, may also be due to a wrong handling by people in the environment of the child. The behavior could be Violent and destructive, mischievous with others, self-injurious, repetitive, odd, hyperactivity, rebellious and antisocial in nature. Mentally challenged is not a disease to be cured. It is a condition or handicap that has to be helped by training or rehabilitation. There can be no operations or surgeries to increase memory or intelligence. Mentally challenged children require teaching and training using scientific methods to become self-dependent and useful citizens. Behavior modifications for children's are a method of therapy geared towards turning undesirable behavior into desirable behavior [3][4]. There are different methods that can be used for behavior modifications such as positive reinforcements, direct instructions, punishments, verbal reprimand and token economy for adaptive behavior and time-outs for maladaptive behavior. Based on this concept researcher have adopted the token economy program [5][6][7][8]. The token economy is a behavioral therapy technique in which the desired change is achieved by means of tokens administered for the performance of predefined behaviors according to the programme. The token economy is a treatment intervention based on principles of operant conditioning and social learning [9][10][11][12].

Operational Definition
Effectiveness: It calculated based on the token economy that is achieved by the mentally retarded children using inferential statistical method.
Token Economy: It describes the ratio of star stricker that is given to the mentally retarded children as the rewards of fruits and fruits for their timely actions directed by the tutors. This method comprehensively slow down the risks associated with their thinking ability.
Behavior problem: This refers to the complete set of problems that reasoning behind inability of the mentally retarded children to sit, to listen, to follow the instructions and to get irritate, anger and hurt others easily. It is based on the Conner's Abbreviated Rating Scale. The present study aimed to analyze the impacts of token economy on the behavior of the mentally retarded children. This study was framed based on the conceptual work suggested by modified Roy's adaptation model. It consists of five elements namely, person, Goal of Nursing, Nursing Activities, Health and Environment. One's behavior is the result of cognator and Regulator Coping Mechanisms. It is the outcome of complex and oriented processes like information processing, learning, timely action of the brain activity. The present study analyzed the brain status of the participants in view of token economy.

Research Approach
The research approach adopted for this study was Quantitative Evaluative Research Approach.

Research Design
Pre Experimental Research Design, in which one group pre test-post test design was used in this study to evaluate the Effectiveness of Token Economy on Behavioral Problem among Mentally Challenged Children in a Matheraiee, special school, valluvargurukullam campus, Chennai. O1 = Pre test X = Intervention (Token Economy) O2 = Post test.

Sample Size
The sample size of this study was 37 (determined based on the pilot study and h Non Probability Purposive Sampling Technique).

Sampling Technique
The sampling technique adopted for this study was Non Probability Purposive Sampling.

Inclusion criteria
1. Mentally challenged children with behavioural problem. 2. The age group between 6-15 years. 3. Includes both males and females.

Exclusion criteria
Mentally Challenged Children with,

RESULTS
The Table 1  The Table 3 indicates that, in post-test majority of the samples i.e. 15(40.54%) have moderate behavioral problem, 13(35.14%) have severe behavioral problem and remaining samples 9(24.32%) have mild behavioral problem.

Comparison between the Pre and Post Test Scores of Behavioural Problem among Samples
The above figure shows that, during pretest 18(48.65%) have severe behavioral problem, 12(32.43%) have moderate behavioral problem and remaining 7(18.92%) have mild behavioral problem (Fig. 1).
During posttest the majority of the samples i.e. 15(40.54%) have moderate behavioral problem, 13(35.14%) have severe behavioral problem and remaining 9(24.32%) samples have mild behavioral problem. The mean pre test score is 18.54 ± 5.99 and the mean post test score is 15.49 ± 5.88 with a mean difference is 3.05. This highlights that there is reduction in the behavior problem among samples ( Table 4).
The mean pretest score is 18.54 ± 5.99 and the mean post test score is 15.49 ± 5.88.The paired 't' test value is 2.93 at p ≤0.05 level. This reveals that the token economy is effective in reducing the behavior problem among samples. Hence the hypothesis H1 is retained (Table 5).
There is no significant association found between the pretest scores on behavior problem among samples and their selected baseline variables at p ≤ 0.05 level. Hence hypothesis H2 is rejected (Table 6).

CONCLUSION
A study was conducted to evaluate the Effectiveness of Token Economy on Behavior Problem among Mentally Challenged Children in a Selected Special School, Salem. During the pre test, majority of samples had severe behavioral problem. After the implementation of token economy intervention majority of the samples had moderate behavioral problem .This indicates that the token economy intervention was effective in reducing the behavioral problem of mentally challenged children.

CONSENT
As per international standard or university standard, respondents' written consent has been collected and preserved by the author(s).

ETHICAL APPROVAL
The study was approved by the Institutional Ethics Committee.