Successful behavioral intervention to treat children who are reluctant to ambulate.

The authors report two patients with marginal ambulation skills whose severe behavioral problems prevented participation in physical therapy. The problem behavior also limited the patients' participation in activities of daily living and social interaction. Because of the risks of loss of ambulation to overall health, an aggressive behavioral intervention was implemented to decrease problem behavior and to increase participation in physical therapy. With the use of the behavioral interventions, the authors demonstrated concomitant increases in compliance to requests to ambulate, distances ambulated, and decreases in the rates of self-injury and aggression.