Behavioural treatment of non-compliance in adolescents with newly acquired spinal cord injuries

Jo Anne Gorski, Keith John Slifer, Vanessa Townsend, Jennifer Kelly-Suttka, Adrianna M Amari

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: To demonstrate the efficacy of using differential reinforcement to treat non-compliance in adolescents with spinal cord injury. Method: A case series design was used to examine three adolescents (aged 14-16 years) with tetraplegia who received multi-disciplinary rehabilitation treatment and a behavioural contract programme during an in-patient hospital admission. Assessment included collecting data on each patient's weekly percentage of compliance with all rehabilitation goals, weekly percentage of negative affect observed in therapy sessions and scores on a measure of mobility in physical therapy. Results: Compliance with rehabilitation demands improved from a baseline of 20-65% to 80% or greater after the patients received differential reinforcement for participating in the rehabilitation regimen. Patients exhibited less anger, sadness and frustration during therapy sessions once contracts were started. Conclusions: The adolescents demonstrated greater compliance after the implementation of a behavioural contract. Future studies should identify the specific variables that affect psychological adjustment and predict readiness to participate in rehabilitation.

Original languageEnglish (US)
Pages (from-to)187-198
Number of pages12
JournalDevelopmental Neurorehabilitation
Issue number3
StatePublished - Jul 2005


  • behaviour modification
  • behavioural contract
  • compliance
  • Spinal cord injury

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Rehabilitation
  • Developmental Neuroscience


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