Association for Behavior Analysis International

It is important to establish proper dental hygiene routines in children to prevent cavities and other dental issues. The effects of noncontingent reinforcement (NCR) without extinction was used to increase compliance with tooth brushing for two elementary-aged siblings. Specifically, a podcast called Chompers® produced by Gimlet Media was played during treatment. The results showed that the podcast was ineffective in maintaining increased tooth brushing durations for both participants. The addition of a new instruction was also not effective for one of the participants, and the addition of sibling interaction did not lead to a consistent increase in the toothbrushing duration of both participants.

People with intellectual and developmental disabilities (IDD) and autism spectrum disorders (ASD) often have difficulty in tolerating new or infrequently contacted stimuli (e.g., Fisher et al., 2019; Woodcock & Humphreys, 2009). Limited tolerance for health-related behavior, such as nail cutting, haircuts, and dental cleanings can cause distress for these individuals and their families (e.g., Cavalri et al., 2013). During the Covid 19 pandemic, face masks are a new stimulus that may cause distress for many people, especially those who may not understand the need for a mask. The inability to tolerate face masks could limit safe access to public locations for people with IDD and ASD. Therefore, we evaluated preference for different types of face masks with five adults with IDD and limited verbal communication skills. Using a multielement design, we assessed the duration each participant wore five different face masks and subsequently used reinforcement schedule manipulations to increase mask wearing for all five participants. For all five individuals initial preference assessments proved helpful in determining appropriate, individualized treatment steps for increasing cooperation with wearing a face mask.

The Centers for Disease Control (CDC) provided the public with recommendations to slow the spread of Covid-19 in 2020, which including wearing a mask in the community. In Study 1, experimenters coached direct-care group home staff via telehealth to use synchronous schedules of reinforcement (SSR; Diaz de Villegas, 2020; Rovee-Collier & Gekoski, 1979) to increase mask wearing for 4 adults with intellectual and developmental disabilities. In Study 2, experimenters directly implemented SSR to increase mask wearing for four young children with and without disabilities. Results across both studies showed SSR effectively increased mask wearing (i.e., participants tolerated wearing their mask for increased durations up to 30 min). Additionally, some participants demonstrated generalization to the everyday environment (e.g., in the classroom with their teachers, in community locations). Furthermore, procedural integrity data in Study 1 suggested staff could be coached via telehealth to implement the intervention, and staff surveys suggested the procedures and coaching were socially valid.