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 h ave medical problems may pose several challenges with regard to accurate an d 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 intervent ion less appropriate. Recent studies have shown that noncontingent reinforc ement without extinction and noncontingent reinforcement using alternative reinforcers can be effective in reducing problem behavior, One practical im plication of these findings is that noncontingent reinforcement may be an a ppropriate treatment in cases where the reinforcer responsible for behavior al maintenance cannot be identified or withheld. In the current study, atte ntion served as a reinforcer for a young man with medical complaints and no ncontingent attention without ignoring effectively reduced the participant' s excessive medical complaints. (C) 2000 Elsevier Science Ltd. All rights r eserved.