Compliance training decreases maladaptive behaviors in two people with developmental disabilities: report of five years' treatment

Abstract

Compliance training was implemented to decrease non-compliance and avoidance behaviors in two women with severe mental retardation and psychiatric disorders over a five year period. In addition to compliance training, reinforcement schedules and behavioral momentum procedures were also included at various times. The program included training staff at home and at work to ensure generalization across settings and times, direct contact staff were used to assist in implementing compliance procedures at home and vocational trainers were used in the work setting. During baseline, Vanessa had pervasive non-compliant behaviors. Five years later, her non-compliance episodes had decreased by 89%. There were also significant decreases in aggression, self-abusive behaviors, and duration of non-compliance episodes. There were increases in interaction, productivity work, and reduced use of restraint. Annette was a woman with Generalized Anxiety Disorder with panic attacks. She had not left the home for several years. Once anxiety and panic attacks were under control maladaptive behaviors, which formerly functioned to avoid anxiety provoking situations, took on a different function, namely avoidance of work demands. Compliance training resulted in a reduction in non-compliance of 40–80% over a five year period. As a result psychoactive medication and restraint have been reduced and staff interaction and participation in campus and community activities have increased. © 1997 John Wiley & Sons, Ltd.