Which intervention uses a written contract outlining consequences of meeting or not meeting expectations?

• A. Shaping & Chaining
• B. Exposure & Ritual Prevention
• C. Relaxation training
• D. Behavior contracts (Bruce & Borg, 2002)

Answer: (D)

Using a written contract to specify expectations and consequences is a behavior modification strategy. A behavior contract is a written agreement between the child and caregiver or therapist that clearly states the target behavior, the criteria for meeting it, and the consequences or rewards tied to meeting or not meeting those criteria. This creates clear accountability, consistency, and measurable goals, helping motivate and guide behavior change in pediatric occupational therapy settings.

Shaping and chaining focus on teaching new skills through reinforcement of successive steps and sequences, not on formal written agreements about consequences. Exposure and ritual prevention target anxiety and OCD symptoms by exposing the child to feared stimuli while preventing rituals, rather than outlining contractual consequences. Relaxation training teaches techniques to reduce arousal, which likewise does not use a contract-based approach.