Review is positive on effectiveness of differential reinforcement but warns more robust studies are needed.


Differential reinforcement (DR) is a non-aversive, reinforcement based behavioural intervention; which works by singling out a desired behaviour and reinforcing it, whilst ignoring other non desired behaviours.

This literature review looked to summarize and provide a methodological analysis of studies, conducted between 1980 and 2009, using differential reinforcement to reduce problem behaviours in adults with learning disabilities.

The authors found a total of 31 studies that met inclusion criteria:

  • 15 studies reported DR to be an effective intervention when used independently.
  • 10 studies found DR to be useful as part of a treatment package.
  • 6 studies found a DR contingency used independently to be ineffective, with treatment effects only observed when adding an aversive component.

Several studies did not report on key methodological variables and the authors suggest that despite the encouraging positive findings about effectiveness of DR more methodologically robust studies are needed.

Use of differential reinforcement to reduce behavior problems in adults with intellectual disabilities: A methodological review, Choudhury M & Benson B, in Research in Developmental Disabilities 32, 2, 383-394

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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