Synchronous reinforcement schedules promote tolerance of health‐related routines for adults with disabilities

Failure to engage in or tolerate health-related routines is a major barrier to good health for individuals with intellectual and developmental disabilities (IDD). In the current study, we evaluated the effects of a synchronous schedule of reinforcement (SSR) for five adults with IDD across eight health-related routines (e.g., toothbrushing, handwashing, tolerating wearing health-related devices). The results showed that SSR alone effectively increased tolerance for five of eight health-related routines. Additional modifications were necessary for two other routines, and no effects were observed for one participant. We successfully trained direct-care staff to implement the effective treatment. Social validity outcomes showed higher levels of positive affect and lower levels of negative affect during treatment relative to baseline for all participants as well as staff acceptance of the procedures and training. The current study adds to the literature supporting SSR as an alternative to graduated exposure; however, further research on the efficacy of SSR alone is needed.