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Behavioral training for increasing preschool children's adherence with positive airway pressure: a preliminary study
Keith J Slifer1, Deborah Kruglak, Ethan Benore
1Department of Behavioral Psychology, Kennedy Krieger Institute and Departments of Psychiatry and Pediatrics, Johns Hopkins University School of Medicine. Slifer@Kennedykrieger.org
Abstract:
Behavioral training was implemented to increase adherence with positive airway pressure (PAP) in 4 preschool children. The training employed distraction, counterconditioning, graduated exposure, differential reinforcement, and escape extinction. A non-concurrent multiple baseline experimental design was used to demonstrate program effects. Initially, the children displayed distress and escape-avoidance behavior when PAP was attempted. With training, all 4 children tolerated PAP while sleeping for age appropriate durations. For the 3 children with home follow-up data, the parents maintained benefits. The results are discussed in relation to behavior principles, child health, and common barriers to PAP adherence.
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