Motivational Refinements for Facilitating Reinforcement Schedule Thinning

促进强化计划细化的激励细化

• 批准号: 10729562
• 负责人: Brian D. Greer
• 金额: $ 38.08万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-06 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10729562
• 关键词: Acceleration; Affect; Aggressive behavior; Animals; Attention; Behavior; Behavior Disorders; Caregivers; Caring; Child; Clinical; Clinical Research; Clinical Services; Communication; Communities; Dangerousness; Developmental Disabilities; Educational process of instructing; Equation; Exhibits; Extinction; Family; Future; Home; Institutionalization; Intellectual functioning disability; Intervention; Laboratory Research; Methods; Motivation; Outcome; Patients; Pharmaceutical Preparations; Physical Restraint; Play; Process; Psychological reinforcement; Quality of life; Randomized, Controlled Trials; Reinforcement Schedule; Relapse; Research; Resources; Risk; Role; Schedule; Self-Injurious Behavior; Services; Severities; Signal Transduction; Social isolation; Source; Stimulus; Testing; Thinness; Time; Training; Work; autism spectrum disorder; comorbidity; developmental disease; effective therapy; improved; novel; prevent; process improvement; reinforcer; response; service delivery; social integration; theories

Project Summary Severe destructive behavior represents a comorbid condition of developmental disability for which risk increases with intellectual disability severity, communication deficits, and co-occurring autism spectrum disorder.1,2 Destructive behavior, such as self-injurious behavior and aggression, causes harm to the child and others and increases the risk for institutionalization, social isolation, physical restraint, medication overuse, service denial, and abuse.3 Clinicians have used functional analyses to identify the variables that reinforce destructive behavior and to develop effective, function-based treatments.4-7 Functional communication training (FCT) is an empirically supported, function-based treatment that decreases destructive behavior.8,9 Using FCT, the clinician teaches the child to use a functional communication response (FCR) to request the reinforcer maintaining destructive behavior, while placing destructive behavior on extinction.10-12 For example, if functional-analysis results showed that attention reinforced destructive behavior, the clinician would provide attention when the child used the FCR (“Play with me, please”) and would not provide attention for destructive behavior. Two important limitations of FCT are that (a) schedules of reinforcement maintaining the FCR must often be thinned gradually to levels that are practical for caregivers to implement consistently in the home and in the community,13-15 and (b) this necessary process of reinforcement schedule thinning regularly causes destructive behavior to increase following initially effective treatment, a form of treatment relapse called resurgence.16-19 The current project aims to improve these limitations of FCT by (a) hastening the process of reinforcement schedule thinning by removing unnecessary schedule-thinning steps using the results of a progressive interval assessment20-23 and (b) mitigating the resurgence of destructive behavior by providing stimuli that highly compete with the reinforcer maintaining destructive behavior.23-27 We will conduct a randomized controlled trial to evaluate the extent to which these two promising refinements to FCT improve the process of reinforcement schedule thinning, and an exploratory study will examine the interactive effects of these two approaches. This novel project has the potential to substantially improve standards of care guiding the treatment of severe destructive behavior and to improve the long-term outcomes for children and families afflicted by these debilitating behavior disorders.

项目摘要 严重的破坏性行为代表了发育残疾的合并状况，风险 随着智力残疾的严重程度，沟通缺陷和同时发生的自闭症谱系的增加而增加 障碍。1,2破坏性行为，例如自我伤害行为和侵略性，对孩子造成伤害 他人并增加了制度化，社会隔离，身体约束，药物过度使用的风险， 3临床医生使用功能分析来确定加强的变量 破坏性行为并开发有效的，基于功能的治疗。4-7功能通信培训 （FCT）是一种经验支持的基于功能的治疗，可降低破坏性行为。8,9使用FCT， 孩子使用功能通信响应（FCR）的临床教义要求增强器 维持破坏性行为，同时将破坏性行为放在扩展上。10-12，例如，如果 功能分析结果表明，注意力增强了破坏性行为，临床医生将提供 当孩子使用FCR时（“请和我一起玩”），并且不会引起破坏性的关注 行为。 FCT的两个重要局限性是（a）维护FCR的加固时间表 通常会逐渐变细到照顾者在家庭中始终实施的实际水平 在社区中，13-15和（b）这种必要的加固时间表定期稀疏的过程 最初有效治疗后，破坏性行为增加了一种称为治疗的形式 16-19目前的项目旨在通过（a）加速该过程来改善FCT的这些局限性 强化时间表通过使用A 进行性间隔评估20-23和（b）通过提供来缓解破坏行为的复兴 与维持破坏性行为的强化竞争的刺激。23-27我们将进行一次 随机对照试验，以评估这两种有前途的FCT改进的程度 加固时间表的过程细化，探索性研究将检查 这两种方法。这个新颖的项目有可能大大提高护理标准指导的标准 治疗严重的破坏性行为并改善儿童和家庭的长期结局 受到这些使人衰弱的行为障碍的困扰。