Treatment and management of chronic disease processes on children occurs across multiple settings, placing demands for consultation and expertise on school personnel, including school psychologists. One such chronic condition in children is type I diabetes. Children with type I insulin dependent diabetes mellitus exhibit high rates of noncompliance to treatment, which can lead to a variety of medical problems. This study examined the effectiveness of a specific behavioral intervention using behavioral consultation (BC) and conjoint behavioral consultation (CBC) to reduce uncontrolled blood glucose levels in medically at-risk children. An intermittent reward procedure was utilized to reinforce individualized target behaviors associated with treatment noncompliance. Specific target behaviors were individually established for six patients ages 8-12 through behavioral consultation interviews. Each child was randomly assigned to a reward ϩ BC or reward ϩ CBC condition. Results of the study showed that all participants improved; with slightly greater gains shown in the CBC condition. Follow-up data for 3 of the 4 participants completing the study showed improved compliance and mental health status. Treatment acceptability date indicate the intervention was viewed positively by parents and school based nurses.