Behavioral case consultation with parents and teachers: An example using differential reinforcement to treat psychogenic cough

This study presents a demonstration of successful behavioral case consultation combined with case study methodology in the treatment of a 13-year-old female who presented with a brief history of psychogenic cough. Psychogenic cough is diagnosed when there is no organic or physiologic basis for the repeated, harsh coughing. We first present a brief review of treatments for psychogenic cough and then describe how we used differential reinforcement of low rate responding (DRL) and differential reinforcement of zero responding (DRO) within an A-B-C design. The DRL schedule produced significant decreases in coughing but plateaued at about one-third the baseline rate. Thereafter, a DRO schedule was employed which resulted in complete and lasting elimination of coughing. Discussion focuses on the limitations of case study methodology as well as its usefulness for conducting service related research in the schools, implications of some of the findings for practitioners, and other issues related to treatment.