A function-based treatment for school refusal behavior using shaping and fading.

A function-based behavioral treatment package was developed for an 18-year-old male with mild mental retardation admitted to a specialized inpatient unit for treatment of severe destructive behaviors associated with school refusal behavior. Teacher and school attendance reports, parent interview, and unstructured observations led to the hypothesis that the subject's school refusal behavior was maintained by positive reinforcement. The treatment goals included increasing the subject's compliance with a morning hygiene routine and attending school (shaping), increasing the involvement of the subject's parents in managing the subject's problem behaviors (fading), and generalizing treatment from the hospital to the home. All three treatment goals were achieved in a relatively brief period of time and follow-up data indicated that the treatment effects were durable. The authors concluded that function-based assessment and treatment can be successfully utilized to treat school refusal behavior in children with developmental disabilities.