Increasing Exercise Intensity: Teaching High-Intensity Interval Training to Individuals with Developmental Disabilities Using a Lottery Reinforcement System


Rates of overweight and obesity are above 70% in typically developing adults in the United States, with higher rates observed in individuals diagnosed with developmental disability (DD). Lottery reinforcement systems have been validated as effective exercise interventions for individuals with DD. Although high-intensity interval training (HIIT) has demonstrated health benefits, it has not been studied using individuals within this population. The purpose of this study was to implement a lottery reinforcement system to systematically increase heart rate (HR) during 30-min HIIT sessions with 3 adults with DD. Results demonstrated increases in HR from below to within the prescribed range in all 3 participants. For 1 participant, weight decreased by 10.8 pounds during the 9-week program. Implications include that lottery systems increase exercise intensity with adults with DD, that HR during exercise can be reliably controlled using a lottery system, and that similar programs may result in health benefits.

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The authors would like to thank Heather Lewis for her thoughtful comments on an earlier version of this manuscript.

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Correspondence to Brandon K. May.

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Procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Research Highlights

• Of adults over the age of 20 in the United States, 71.6% are overweight or obese, with individuals diagnosed with developmental disability (DD) at increased risk.

• Lottery reinforcement systems have been effective in promoting physical fitness in typically developing populations and participants with DD.

• High-intensity interval training (HIIT) is an exercise procedure with strong empirical support, but it has not been studied with individuals with DD.

• A lottery system was implemented with 3 adults with DD to systematically shape heart rate during exercise from below to within the prescribed range for HIIT.

• Participants increased their heart rate during HIIT by 37%, 38%, and 52% during a 9-week implementation of the lottery reinforcement system.

• Weight was tracked throughout the experiment in 1 participant, resulting in a 10.8-pound reduction



Baseline Script

“I would like you to use the treadmill for 10 minutes at whatever speed you choose. I will be watching and occasionally writing things down. If you use the treadmill for the entire 10-minute period, you will receive a token, which can be used to purchase one of the lottery tickets in our prize box. Please begin whenever you are ready.”

Treatment Script

“Today, your target heart rate is [target]. For the first 6 minutes, you can walk at whatever speed you choose. I will then ask you to raise your heart rate to [target]. You will have 2 minutes to get your heart rate to [target]. Once you reach your target, you must keep your heart rate at [target] for the next 2 minutes in order to earn a token. This token can be used to purchase one of the lottery tickets from our prize box. Please begin whenever you are ready.”

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May, B.K., Treadwell, R.E. Increasing Exercise Intensity: Teaching High-Intensity Interval Training to Individuals with Developmental Disabilities Using a Lottery Reinforcement System. Behav Analysis Practice (2020).

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  • Exercise
  • Physical activity
  • High-intensity interval training
  • Lottery system
  • Developmental disabilities