Extensions of Resurgence as Choice: Basic and Clinical Studies
Rutgers, The State University of New Jersey
Summary
Although behavioral treatments for decreasing destructive behavior, such as differential reinforcement of alternative behavior (DRA), are effective in the clinic, problem behavior often returns when a caregiver does not give the child their way in the natural environment (e.g., caregiver is busy with an infant sibling). This form of treatment relapse is known as resurgence. The goal of the current study is to evaluate whether alternating sessions in which the child can have their way (i.e., "on" sessions) with sessions in which the child can not have their way (i.e., "off" sessions) helps to mitigate resurgence.
Description
Preliminary Procedures Functional Analysis. As part of our standard clinical practice, the investigators will conduct a functional analysis of each participant's problem behavior. Functional analyses identify the consequences (e.g., access to attention) that maintain problem behavior. Prior to conducting a functional analysis, the investigators routinely conduct a risk assessment to ensure that it is safe to conduct a functional analysis with each patient using the procedures developed in our program and described most recently by Saini et al. (2021). The investigators also will conduct prefe…
Eligibility
- Age range
- 3–17 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: 1. boys and girls from ages 3 to 17; 2. problem behavior that occurs at least 10 times a day, despite previous treatment; 3. problem behavior maintained by social positive reinforcement; 4. stable protective supports for self-injurious behavior (e.g., helmet) with no anticipated changes during enrollment; 5. on a stable psychoactive drug regimen for at least 10 half-lives per drug or drug free; 6. stable educational plan and placement with no anticipated changes during the child's treatment. Exclusion Criteria: 1. patients who do not meet the inclusion criteria; 2. patie…
Interventions
- BehavioralCDT
In this condition, the clinician will alternate sessions with reinforcement for the alternative response and sessions without reinforcement for the alternative response during extinction treatment of problem behavior. According to RaC2, alternating periods of reinforcer availability and unavailability for the alternative response will teach the participant that the alternative response alone produces reinforcement but not always. The investigators predict that resurgence of problem behavior will lower, shorter lasting, and with fewer participants experiencing resurgence than those in the control group.
- BehavioralControl
This condition emulates a traditional approach to treatment in which the clinician does not alternate sessions with reinforcement for the alternative response and sessions without reinforcement for the alternative response during extinction treatment of problem behavior. The investigators predict that resurgence of problem behavior will higher, longer lasting, and with more participants experiencing resurgence than those in the CDT group.
Location
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and ServicesSomerset, New Jersey