Differential negative reinforcement of other behavior to increase compliance with wearing an anti‐strip suit

Abstract

Using a changing-criterion design, we replicated and extended a study (Cook, Rapp, & Schulze, 2015) on differential negative reinforcement of other behavior (DNRO). More specifically, educational assistants implemented DNRO to teach a 12-year-old boy with autism spectrum disorder to comply with wearing an anti-strip suit to prevent inappropriate fecal behavior in a school setting. The duration for which the participant wore the suit systematically increased from 2 s at the start of treatment to the entire duration of the school day at the termination of the study. Moreover, these effects were generalized to a new school with novel staff and persisted for more than a year. These findings replicate prior research on DNRO and further support the use of the intervention to increase compliance with wearing protective items, or medical devices, in practical settings.

Increasing passive compliance to wearing a facemask in children with autism spectrum disorder

“…Future research may consider including a behavioral skills training (BST) component to directly teach the skills for independently donning a facemask (e.g., Neef et al, 1989). Further, for individuals with advanced verbal repertoires and/or rule-governed behavior, it may be beneficial to introduce a rule, such as, "If you wear the mask, you will get to play," as part of the treatment package, as a contingencyspecifying stimulus may result in decreased training times or fading steps for all participants (e.g., Falcomata et al, 2008;Wheatley et al, 2020). Researchers should also consider the utility of discrimination training to help individuals discriminate when they should or should not be wearing a facemask (e.g., "If other people are around you, you need to wear the mask.").…”

“…Previous research has evaluated the effectiveness of a variety of procedures to increase both active and passive compliance with medical procedures. Interventions often make use of differential reinforcement procedures with or without escape extinction, including differential reinforcement of other behavior in which the absence of the target behavior is reinforced (DRO; Carton & Schweitzer, 1996;Cook et al, 2015;Cox et al, 2017;Cuvo, Godard et al, 2010;Cuvo, Reagan et al, 2010;Dufour & Lanovaz, 2020;Hagopian & Thompson, 1999;Iwata et al, 1990;Shabani & Fisher, 2006;Slifer et al, 1993;Wheatley et al, 2020) or differential reinforcement of alternative behavior procedures in which a specific target behavior is reinforced (DRA; Slifer et al, 2008;Slifer et al, 2002;Stuesser & Roscoe, 2020). Recently, Dufour and Lanovaz (2020) used a DRO procedure without escape extinction to increase passive compliance to wearing a heart rate monitor in two participants with ASD.…”

“…The DNRO intervals were faded from 5 s to 7 hr. Similarly, Wheatley et al (2020) used a DNRO procedure to increase compliance with wearing an antistrip suit for one participant diagnosed with ASD. The participant was required to tolerate the suit for increasing amounts of time without challenging behavior.…”

Mask Compliance Training for Individuals With Intellectual and Developmental Disabilities

“…Fortunately, previous research has shown that behavioral interventions can be very successful in building tolerance across a variety of issues, including spending time away from caregivers, consuming lesser preferred foods, wearing eyeglasses, and wearing clothing to help prevent inappropriate behavior (e.g., DeLeon et al, 2008 ; Flood & Wilder, 2004 ; Kahng et al, 2003 ; Wheatley et al, 2019 ). Notably, many (but not all) of these referenced studies used a changing-criterion design (CCD), suggesting that it can be particularly effective when teaching individuals to tolerate potentially aversive situations (see McDougall et al, 2006 , for a review).…”

“…Notably, many (but not all) of these referenced studies used a changing-criterion design (CCD), suggesting that it can be particularly effective when teaching individuals to tolerate potentially aversive situations (see McDougall et al, 2006 , for a review). For example, Wheatley et al ( 2019 ) used a CCD to increase the duration of wearing a leotard to help prevent access to fecal play. These studies also highlight various treatment components that may be effective in increasing compliance with health care activities.…”