Improving Beverage Choice in Adults with Developmental Disabilities: Implementation of a Token Reinforcement System in a Community Residential Setting.
A kitchen-token board can replace soda with water and drop pounds for adults in group homes.
01Research in Context
What this study did
Lee et al. (2022) worked with 14 adults with developmental disabilities in a group home. Staff gave tokens each time a resident chose water over a sugary drink.
At shift's end, residents traded tokens for small prizes like lotion or snacks. The team tracked drinks, calories, and weight for several weeks.
What they found
Water picks went up. Sugary drinks, daily calories, and body weight all went down. The token board kept the change going without extra prompts.
How this fits with other research
Nastasi et al. (2020) ran a near-copy study: same adults, same homes, same token board, but they paid for walking. Both papers show large gains, proving the board works across very different goals.
Matson et al. (2009) reviewed token work in kids with autism or ID. Their takeaway—'keep tokens in your toolbox'—matches the adult success seen here.
Kim (2025) swapped plastic chips for digital coins inside an ADHD game. Tokens still helped, showing the idea travels from tangible coins to pixels.
Why it matters
If you serve adults with developmental disabilities, you now have a two-page plan that cuts sugar and weight without lectures or restrictive diets. Tape a board to the fridge, hand out stars, and let the vending machine stock itself down. The same frame can later target steps, chores, or any other daily skill.
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02At a glance
03Original abstract
Individuals with developmental disabilities (DD) are twice as likely to have obesity than non-disabled individuals. Replacing the consumption of sugar sweetened beverages (SSBs) with water has many health benefits, including weight reduction. In this study, a token reinforcement system was implemented to increase water consumption and decrease the consumption of SSBs with 14 adult participants with DD living in a community-based independent supported living (ISL) center. Token reinforcement reduced the consumption of SSBs, with associated reductions in calorie consumption and body weight. Findings are especially important for treatment settings where resources for individualized meal planning and staffing to support comprehensive behavioral interventions may be limited.
Journal of autism and developmental disorders, 2022 · doi:10.1111/obr.12580