Teaching an Adolescent With Autism and Intellectual Disability to Tolerate Routine Medical Examination: Effects of a Behavioral Compliance Training Package

The present study evaluated graduated exposure and positive reinforcement in a compliance training intervention package with an adolescent female who had autistic disorder, intellectual disability, and long-standing avoidance of routine medical examination. Intervention consisted of slowly introducing her to a 12-step examination hierarchy and reinforcing compliant responding within a changing criterion experimental design. Reinforcement for appropriate alternative behavior and modeling were also components of intervention. A behavioral clinician first implemented procedures that were subsequently generalized to nurses. The participant learned to comfortably tolerate a medical examination that she had resisted for nearly 2 years. We discuss clinical and research implications of the case.