Comparing self-monitoring and differential reinforcement of an alternative behavior to promote on-task behavior by three children with cerebral palsy: A pilot study

We compared two behavioral strategies (i.e., self-monitoring [SM] and differential reinforcement of an alternative behavior [DRA]) to promote on-task behavior by three children with cerebral palsy and developmental disabilities during classroom activities. The first objective of the study was to evaluate the effectiveness and the suitability of each strategy individually within a school setting, and make their systematic comparison. A second aim of the study was to assess the effects of the intervention on participants' mood as an outcome measure concerning the quality of life. The third objective was to assess the preference checks for each participant. Finally, a social validation procedure, involving 24 teachers as raters, was conducted for corroborating the clinical validity and providing the study with a formal endorsement by sensitive and expert professionals. The study was carried out according to an alternating treatment embedded in a non-concurrent multiple baseline reversal design across participants. Furthermore, a maintenance phase, three months after the end of the intervention, was realized. Results showed that both interventions were successful, increasing on-task behavior for all participants involved, as well as improving their mood. All participants preferred self-monitoring during preference checks. Raters involved in the social validation assessment considered SM as more positive than DRA. Clinical, educational, psychological and rehabilitative implications of the findings were discussed.