Medication and reinforcement within a token programme for disturbed mentally retarded residents

The interaction between psychotrophic medication and a token programme as treatment modalities for mentally retarded individuals with behavioural problems was investigated in two studies. In the first, involving four residents, the dependent variables were credits earned and lost each day for performing specified behaviours within the token programme. Each subject was given a major tranquillizer in alternate months over a four month period. There was a noncontingent token phase prior to, and after completion of, the experimental phases. All subjects showed an immediate increase in the level of appropriate behaviour with the introduction of the token economy, and continuing improvements thereafter. Medication did not have a significant effect on the rate of appropriate or inappropriate behaviour. The second study assessed the relative efficacy of token reinforcement and medication in controlling behaviour symptomatic of psychosis in a resident at school and during meal-times in the ward. Five behaviours recorded were swearing, inappropriate laughter, facial grimaces, fighting, and out-of-seat. Following baseline measures, the absence of facial grimaces was reinforced in the school but not in the word. The contingencies were then reversed. A major tranquillizer was then administered, together with a replication of the first two conditions. The use of tokens to control facial grimaces resulted in the concurrent suppression of the four other symptoms. There weas no remission of any symptom as a consequence of medication alone.