Monetary Reinforcement for Increasing Walking in Adults with Intellectual Disabilities

Physical inactivity is a widespread problem associated with numerous health problems. Individuals with intellectual disabilities are at a high risk of living a sedentary lifestyle. Although a few studies have examined interventions consisting of goal-setting and reinforcement for increasing PA, no studies have evaluated the use of monetary reinforcement. Interventions using monetary reinforcement have been shown to be effective for increasing PA with typically developing adults. The present studies evaluated monetary reinforcement for increasing PA in adults with intellectual disabilities. Study 1 evaluate a session-based intervention where participants earned monetary rewards for attaining step count goals as recorded by pedometers. The intervention increased the rate of walking for all five participants, demonstrating experimental control with four participants. The study also found that a staff member implemented the intervention with fidelity and rated it as highly acceptable. Study 2 evaluated a whole-day intervention where participants earned monetary rewards for attaining daily step goals as measured by wrist-worn Fitbit Alta™ accelerometers. The whole-day intervention resulted in noticeable increases in daily steps for only two participants, with experimental control demonstrated for one participant. Discussion includes the advantages and limitations of the approaches in each study and recommendations for future studies