ABA Fundamentals

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

Wheatley et al. (2020) · Journal of Applied Behavior Analysis 2020
★ The Verdict

Teacher-run DNRO can turn suit refusal into all-day wearing and the gain lasts a year.

✓ Read this if BCBAs in special-ed classrooms with students who resist medical or safety gear.
✗ Skip if Clinicians working on skill acquisition without avoidance behavior.

01Research in Context

01

What this study did

A middle-school boy with autism kept yanking off his anti-strip suit. The school team used DNRO. If he kept the suit on for a set time, they removed a hated task for a few minutes.

Staff ran the plan in the special-ed room. They slowly raised the suit-wearing goal each week. The design is called changing-criterion: the bar moves up only after the child hits it.

02

What they found

Suit time climbed from 5 minutes to the full 6-hour day in eight weeks. The boy still wore the suit in a brand-new school one year later.

No extra rewards were needed. Escape from work was enough to keep the suit on.

03

How this fits with other research

Mace et al. (1990) first showed parents can run differential reinforcement at home with big drops in problem behavior. Wheatley moves the same idea into school and uses it for medical-device compliance.

Waldron et al. (2023) used high-probability requests to get younger autistic kids to start hard tasks. Both studies hit the same goal—compliance—but DNRO works when the task itself is aversable, like wearing a suit.

Berler et al. (1982) proved mom-led treatment can keep kids compliant for years. Wheatley matches that durability with teacher-led DNRO and adds generalization to a new school.

04

Why it matters

You can train teachers to run DNRO in one afternoon. Pick a task the student hates, set a short initial goal, and remove that task when the goal is met. Raise the goal only after two straight wins. The suit data show the process works for medical wearables, but you can swap in glasses, hearing aids, or even seat belts. One year later the kid still keeps it on—no extra booster sessions needed.

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→ Action — try this Monday

Pick one hated task, set a 2-minute gear-wearing goal, and remove that task the moment the timer dings.

02At a glance

Intervention
differential reinforcement
Design
changing criterion
Sample size
1
Population
autism spectrum disorder
Finding
positive
Magnitude
large

03Original 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.

Journal of Applied Behavior Analysis, 2020 · doi:10.1002/jaba.632