The reduction of seizure-like behaviors through contingency management

A 22-year-old mildly retarded male, diagnosed as epileptic and paranoid schizophrenic, was admitted to an inpatient behavior unit for a medication assessment and possible behavioral treatment of uncontrolled seizure-like behavior. Since the patient had rarely been allowed out of his living unit in the past year, treatment consisted of a half-hour walk with a preferred staff member made contingent upon a 24-hr period of time free of any occurrence of seizure-like behaviors. An ABAB reversal design was used to assess experimental control. Data indicated that seizures decreased from a mean of 0.70 per day during the initial baseline phase to 0.36 per day during the final treatment phase. Additionally, the duration of seizures decreased from a mean of 50 min per seizure during the initial baseline phase to 17 min per seizure during the final treatment phase, although the contingency was applied irrespective of duration of seizure-like activity. The patient was discharged to a transitional setting until a community placement could be located.