Noncontingent attention for the treatment of excessive medical complaints in a medically fragile man with mental retardation.
Give attention on a clock, not for complaints, and fragile clients still calm down.
01Research in Context
What this study did
One adult with intellectual disability lived in a medical unit. He asked for help every few minutes even when staff said he was fine.
Staff could not ignore the calls because he was medically fragile. The team tried giving him planned attention every five minutes no matter what he did.
What they found
Scheduled attention cut his complaints to almost zero. Staff never had to ignore him or say no.
The plan stayed in place for weeks and the low rate held.
How this fits with other research
Mueller et al. (2000) ran the same idea in a classroom. They gave peer attention on a fixed schedule and saw disruptive behavior drop. Both studies show noncontingent attention works even when you do not withhold the reinforcer.
Burack et al. (2004) later tried brief noncontingent praise before tasks. Compliance went up for five of six preschool kids. The tactic now spans medical complaints, disruption, and non-compliance.
Hanley et al. (1997) looked at client choice. When people could pick, they liked functional communication training over noncontingent attention. The 2000 case still helps when clients cannot do FCT or when ignoring is unsafe.
Why it matters
You can use noncontingent attention any time extinction is off the table. Set a timer, deliver brief praise or small talk, and keep the client safe. Start with two to five minute intervals and adjust with data. This one-page plan travels well across hospitals, homes, and classrooms.
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02At a glance
03Original abstract
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.
Research in developmental disabilities, 2000 · doi:10.1016/s0891-4222(00)00035-4