Differential reinforcement and stimulus fading without escape extinction to teach cooperation with nasal swab tests

Abstract

A nasal swab test is commonly used to detect the presence of respiratory viruses, such as SARS-COV2 or influenza. Some individuals with autism spectrum disorder may display challenging behavior during these types of tests, which may interfere with safe and successful test completion. Research has shown that differential reinforcement without escape extinction combined with stimulus fading can be effective to increase cooperation with other types of medical tasks (e.g., blood draws). The purpose of the current study was to systematically replicate the procedures described in Stuesser and Roscoe (2020) to increase cooperation with nasal swab tests with five participants with autism spectrum disorder in a group-home setting in the context of an urgent global pandemic. Differential reinforcement was effective for one participant, and the addition of stimulus fading was effective for the remaining four participants. All five participants continued to cooperate with the nasal swab test during follow-up probes.