Training children with autism spectrum disorders to be compliant with a physical exam

The purpose of this study was to train children with autism spectrum disorders to be compliant with a 10-component physical examination. After a physician assistant administered an exam pretest, noncompliance on steps of the exam were considered with respect to a skill deficit and escape from aversive stimuli. A package of training procedures was implemented, including preference assessment, priming DVD, various prompts, contact desensitization (i.e., fading in aversive stimuli), shaping, escape extinction, and differential reinforcement of other behavior. Results showed the efficacy of the intervention procedures, maintenance of responding, and stimulus generalization of responses. The study provides a model for the assessment and intervention of noncompliance to health care procedures by children with autism spectrum disorders.