A Review of Strategies to Increase Comfort and Compliance with Medical/Dental Routines in Persons with Intellectual and Developmental Disabilities

Noncompliance with basic health care can have profound effects on long term health and well-being for everyone, but especially for individuals with intellectual and developmental disabilities (IDD). Perhaps the factor most responsible for noncompliance is the fear associated with medical and dental procedures. We reviewed the research literature to identify the empirical support for interventions designed to address noncompliance with medical routines in the IDD population. Across 32 studies that were reviewed, the most common components used in treatment of fear avoidance and noncompliance with medical/dental routines were graduated exposure and contingent reinforcement. Promising alternative and supplemental treatments are discussed. Step-by-step practice recommendations for preventing the need for treatment, preparing for treatment of noncompliance, and implementing treatment are included.