Response-contingent stimulation as a treatment for developmental failure in infancy

An 8-month-old infant with a developmental quotient of $\text{1}\text{1}\text{2}$ months was given response-contingent stimulation using a pressure-sensitive pillow which turned an overhead mobile. The subject learned to control the mobile by kicking the pillow, and concurrently began smiling at both the mobile and her mother for the first time. After mastering three contingencies on arm, head, and leg movement, she displayed what appeared to be a Piagetian coordinated secondary circular reaction, in which one response provided 4 seconds of access to another contingency. Although the subject remains severely retarded, the results suggest that some forms of developmental delay may be treated at least in part as a failure to develop contingency awareness.