Differential negative reinforcement of other behavior to increase wearing of a medical bracelet.

A preschooler with autism refused to wear a medical ID bracelet.

The team used DNRO. When the child kept the bracelet on, they removed a loud white-noise that he hated.

Each week the criterion grew: first 5 seconds, then 30, then 5 minutes, all the way to 7 hours.

Bracelet wearing climbed from 5 seconds to 7 hours a day across several weeks.

The child reached the final goal with no tears or restraint.

Parents later reported he kept the bracelet on during weekend outings without any extra rewards.

Williams et al. (1986) showed that momentary checks can keep DRO effective. Ohan et al. (2015) built on that idea by stretching the time rule inside DNRO.

Hedquist et al. (2020) compared DRA and DRO for stereotypy and found DRA won. The current study picks DNRO, not DRA, because the bracelet could not be put on for the child; the reinforcer had to be removal of noise, not access to toys.

Nishimura et al. (1987) added prompts to DRL when simple timing failed. L et al. did the same: they first modeled and physically guided the bracelet on, then let DNRO finish the job.

If a client fights glasses, hearing aids, or CGM sensors, try DNRO with a hated sound or task as the negative reinforcer. Start tiny, grow slow, and track minutes on a simple graph. You can turn "I won’t wear it" into "I forget it’s there" in about a month.