Noncontingent attention for the treatment of excessive medical complaints in a medically fragile man with mental retardation.
Providing medical care to individuals with developmental disabilities who have medical problems may pose several challenges with regard to accurate and reliable report of symptoms. In addition, medical complaints may take on operant functions such as an attention function or an escape function as a result of the natural consequences in the environment. It may be difficult to withhold reinforcers for medical complaints such as attention or escape, making a standard analog functional analysis or extinction-based intervention less appropriate. Recent studies have shown that noncontingent reinforcement without extinction and noncontingent reinforcement using alternative reinforcers can be effective in reducing problem behavior. One practical implication of these findings is that noncontingent reinforcement may be an appropriate treatment in cases where the reinforcer responsible for behavioral maintenance cannot be identified or withheld. In the current study, attention served as a reinforcer for a young man with medical complaints and noncontingent attention without ignoring effectively reduced the participant's excessive medical complaints.
The Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA.
L P
LP
Hagopian
L A
LA
LeBlanc
K A
KA
Maglieri
D000328:Adult; D001288:Attention; D006304:Health Status; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000523:psychology*; D008297:Male; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012054:Reinforcement, Psychology; D013001:Somatoform Disorders / Q000523:psychology