Doctor of Philosophy (PhD)



Document Type



Behavioral interventions have been implemented to increase compliance with medical devices across patient populations and target devices. Intervention to increase medical device compliance (MDC) can involve a variety of components, including different reinforcement, graduated exposure, extinction, and punishment with varying degrees of acceptability and feasibility. In the current study, we compared the effects of noncontingent (NCR) versus synchronous reinforcement schedules on the duration of MDC and latency to device removal with KN95 face masks with 2 patients with Autism Spectrum Disorder. Following an initial baseline phase demonstrating that both participants engaged in compliance for less than 5 min, we used a multielement design to compare NCR and synchronous reinforcement conditions to increase compliance. We then evaluated the effect of the percentile schedule of reinforcement on shaping compliance and parametrically evaluated the m value parameter of the percentile schedule. For one participant, NCR was sufficient to increase compliance to 5 min. For the other, neither NCR nor synchronous reinforcement alone were sufficient to increase MDC. However, both participants’ latency to medical device removal increased substantially under a percentile schedule of reinforcement with an m value of 5. One participant’s responding maintained in the absence of reinforcement contingencies. These findings support the use of NCR as an initial treatment approach to increase MDC and the percentile schedule of reinforcement to increase the duration of MDC.



Committee Chair

Donaldson, Jeanne