THE EFFICACY OF NONCONTINGENT ESCAPE FOR DECREASING CHILDREN'S DISRUPTIVE BEHAVIOR DURING RESTORATIVE DENTAL TREATMENT

• Published in: Journal of applied behavior analysis Vol. 39; no. 2; pp. 161 - 171
• Main Authors: O'Callaghan, Patrick M., Allen, Keith D., Powell, Shawn, Salama, Fouad
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 2006; Society for the Experimental Analysis of Behavior
• Subjects: Attention Deficit and Disruptive Behavior Disorders - prevention & control; Attention Deficit and Disruptive Behavior Disorders - psychology; Behavior; Behavior Modification; Behavior Patterns; Behavior Problems; Biological and medical sciences; Child; Child discipline; Child, Preschool; Children; Children & youth; Clinical medicine; Contingencies; Cooperative Behavior; Dental Health; Dental Restoration, Permanent; dental visits; Dentistry; Dentists; disruptive behavior; escape; Escape Reaction; Extinction, Psychological; Female; Fundamental and applied biological sciences. Psychology; Health Behavior; Humans; Intervals; Intervention; Investigations; Male; Miscellaneous; noncontingent reinforcement; Office Visits; Pediatric Dentistry; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Reinforcement; Studies; Time Factors; Human; Escape behavior; noncontingent reinforcement; Disruptive behavior; Reinforcement; dental visits; Dentistry; Operation; Child; escape
• ISSN: 0021-8855; 1938-3703
• DOI: 10.1901/jaba.2006.79-05

We evaluated the effectiveness of a dentist‐implemented behavioral intervention in which brief escape from dental treatment was provided on a regular basis, independent of the child's behavior. Within a multiple baseline design across subjects, 5 children, ages 4 to 7 years, were provided with temporary escape from dental treatment on a fixed‐time schedule. The intervals were signaled by an electronic timer worn by the dentist. Clinically significant reductions were observed in physically disruptive behavior across all 5 children with the introduction of noncontingent escape, and verbally disruptive behavior was markedly reduced in 4 of the 5 children. In addition, the dental staff's use of physical restraint was reduced to near zero across all 5 children. The research extends the literature in both clinical dentistry and in applied behavior analysis by demonstrating that a dentist can easily and effectively implement noncontingent reinforcement to produce clinically significant and socially important changes in children's health behavior.