Dr. Pamela Neidert is an associate professor of Applied Behavioral Science at the University of Kansas and directs three early childhood clinical programs. She has a master’s degree (Special Education, Johns Hopkins) and a PhD (Psychology, University of FL). She teaches various undergraduate and graduate courses in ABA. Her research interests involve skill acquisition and intervention/prevention of challenging behavior in both typically developing children and those with IDD. Dr. Neidert has published numerous empirical articles; conducted presentations at local, state, and national conferences; and served on several editorial and advisory boards.

Abstract: Child noncompliance during healthcare routines (e.g., dental exams) can be a serious problem, particularly when a routine involves the use of sharp objects (e.g., scissors, dental scrapper). After finding a high prevalence of the problem in our early intervention program, we evaluated a reinforcement-based training procedure (with and without extinction) for compliance with several healthcare routines. Training occurred in a simulated context, and probes were conducted periodically to evaluate compliance in the absence of treatment and generalization to novel therapists. Additionally, compliance was assessed periodically in the actual relevant environments to assess the extent to which training effects generalized. Several children required only exposure to the training environment, but training was required for the majority of children. Complete generalization to the actual environment was observed for a limited number of children. However, dramatic decreases in screaming and the use of restraint were observed for most children. Results will be discussed in terms of treatment effectiveness, advantages and disadvantages of extinction, and programming for generalization to actual healthcare settings.

Objectives:

1. The learner will be able to explain several reasons why noncompliance with healthcare routines is problematic, especially for children diagnosed with intellectual and developmental disabilities.
2. The learner will be able to explain why it might be helpful to develop a training procedure to teach young children to comply with healthcare routines that can be used in preschool/classroom settings.
3. The learner will be able to describe at least three treatment components (e.g., task analysis, demand fading, differential reinforcement, extinction) that may be required to achieve successful increases in compliance with essential healthcare routines.
4. The learner will be able to describe what is meant by the term generalization and the extent to which the current project achieves this desirable outcome.