Token‐economy‐based contingency management increases daily steps in adults with developmental disabilities

Four adults with developmental disabilities lived in a group home. Staff gave each person a Fitbit and set a daily step goal.

Every time a resident hit the goal, they earned a token. Tokens bought snacks, drinks, or extra TV time. The study lasted eight weeks and used a changing-criterion design.

Three of the four adults tripled their daily steps. The fourth walked more, but not as much. Staff said the system was easy to run.

Lee et al. (2022) ran almost the same setup in a sister home. They swapped steps for healthy drinks and also saw big gains. The pair shows one token board can steer two very different habits.

Regnier et al. (2022) warn that gains fade once tokens stop. They found the fix: thin the schedule and lean on praise or self-tracking. Nastasi et al. (2020) did not build this fade, so their walkers may slip back without a plan.

Gutierrez et al. (2020) give the how-to. They proved a short manual is enough to train staff to run a token system with near-perfect accuracy. Group-home managers can copy that manual and plug in any target they choose.

You can start a walking program tomorrow. Tape a token board to the wall, set a step goal on a cheap tracker, and let residents shop with tokens. Add the Regnier fade later: give tokens every other day, then praise only. This keeps legs moving long after the plastic chips are gone.