An assessment of antecedent events influencing noncompliance in an outpatient clinic.

The team watched six preschool kids in a hospital outpatient clinic.

They switched between three quick conditions: normal instruction, instruction plus a minute of friendly adult chat first, and instruction with an easier task.

Each child rotated through the conditions several times in one visit.

Five of the six kids followed directions more often when they got a little attention first or when the task was simpler.

Noncompliance dropped right away in the same session.

The sixth child did not change; antecedent tweaks were not enough for him.

Rasing et al. (1992) and Rojahn et al. (1994) ran similar brief tests in the same clinic years earlier. Their early work showed that looking at antecedents works; this study narrowed it to two easy moves you can do on the spot.

Majdalany et al. (2017) later added a first step: check if the child simply lacks the skill. When they did that, some kids needed teaching, not antecedents. The two papers seem to clash, but the difference is whether skill deficit has been ruled out. Do the quick skill probe first; if the child can already do the task, then use the 2004 attention-or-easier-task trick.

Mueller et al. (2000) moved the same idea into classrooms. They gave peer attention instead of adult attention and still saw less disruption, showing the principle travels across settings and people.

You can cut noncompliance in the first minute of a session without any extra tools. Give a brief greeting, comment on the child’s shirt, or break the direction into smaller steps. It takes seconds, not minutes, and it often works. If it does not work, that signals you may need a deeper assessment like Majdalany’s skill check or a full functional analysis. Try the simple move first; your session flow stays smooth and you gather immediate data on what that child needs.