THE EFFECT OF A TOKEN ECONOMY ON DIETARY COMPLIANCE FOR CHILDREN ON HEMODIALYSIS

• Published in: Journal of applied behavior analysis Vol. 10; no. 4; pp. 573 - 578
• Main Authors: Magrab, Phyllis R., Papadopoulou, Zoe L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 1977; Society for the Experimental Analysis of Behavior
• Subjects: Adolescent; adolescents; Behavior Therapy; Blood Urea Nitrogen; Body Weight; Child; compliance; Diet Therapy; dietary management; Female; Humans; Kidney Failure, Chronic - diet therapy; Kidney Failure, Chronic - therapy; Male; Patient Compliance; Potassium - blood; renal dialysis; Renal Dialysis - psychology; Reward; Token Economy; weight control
• ISSN: 0021-8855; 1938-3703
• DOI: 10.1901/jaba.1977.10-573

Adherence to dietary restrictions is a recurring problem for children on hemodialysis. The effect of behavior modification in maintaining dietary control is reported for four patients aged 11 to 18 years. Weight gain, potassium level, and blood urea nitrogen were utilized as criteria measures. A token reinforcement program implemented by the hemodialysis team resulted in significant changes in the dietary pattern of the children. The average weight gain between dialysis sessions for the four subjects during treatment was reduced by 45% and the degree of weight fluctuation was lessened. Potassium levels and BUN were controlled to their appropriate level for subjects who initially exceeded the criterion level. With the withdrawal of weight gain from the contingency system, increase of weight gain between dialysis sessions was noted for all subjects.