Preventing relapse of destructive behavior using behavioral momentum theory

使用行为动量理论防止破坏性行为复发

• 批准号: 10129514
• 负责人: WAYNE WILLIAM FISHER
• 金额: $ 38.84万
• 依托单位: RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-18 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10129514
• 关键词: Preventing; relapse; destructive; behavior; using

 DESCRIPTION (provided by applicant): Children with intellectual disability often display severe destructive behaviors (e.g., aggression, self-injurious behavior) that pose significant risk to self or others and represent overwhelming barriers to community integration. These destructive behaviors are often treated with behavioral interventions derived from a functional analysis (FA), which is used to identify the environmental antecedents and consequences that occasion and reinforce the target response. One such treatment is called functional communication training (FCT), which involves extinction of destructive behavior and reinforcement of an alternative communication response with the consequence that previously reinforced destructive behavior. Results from epidemiological studies and meta analyses indicate that interventions based on FA, like FCT, typically reduce problem behavior by 90% or more and are much more effective than other behavioral treatments. Despite these impressive findings, FCT interventions reported in the literature have typically been developed and evaluated by highly trained experts in tightly controlled research settings, and treatment relapse (i.e., increased destructive behavior) often occurs in the natural environment when a caregiver is unable reinforce the FCT response due to competing responsibilities (e.g., caring for a sick sibling). Behavioral momentum theory helps to explain why treatment relapse occurs under these circumstances and also provides mathematical equations that can be used to model and predict the variables that increase and decrease the likelihood that treatment relapse will occur. In the current project, we have used these equations to identify several potential refinements to FCT that are likely to markedly decrease the probability that treatment relapse will occur when the FCT response is not reinforced. In some cases, these refinements are at odds with what is recommended in the clinical literature on FCT. Therefore, it is critically important that we compare these refinements that are derived from behavioral momentum theory with current clinical practice in order to determine the best way to implement FCT, so that treatment remains effective when it is implemented with less than perfect precision by caregivers in the natural environment.

 描述（由适用提供）：智障儿童经常表现出严重的破坏性行为（例如，侵略性，自我伤害行为），构成很大的风险 自我或他人，代表社区融合的压倒性障碍。这些破坏性行为通常是通过功能分析（FA）得出的行为干预措施来处理的，该行为干预措施用于识别有这种情况并加强目标响应的环境前因和后果。一种这样的治疗方法称为功能沟通培训（FCT），涉及破坏性行为的扩展和加强替代性交流响应，并以前增强的破坏性行为的结果。流行病学研究和元分析的结果表明，基于FA（例如FCT）的干预措施通常将问题行为降低90％或更多，并且比其他行为治疗更有效。尽管有这些令人印象深刻的发现，但文献中报告的FCT干预措施通常是由受过高度控制的研究环境中训练有素的专家开发和评估的，而治疗继电器（即，破坏性行为的增加）通常在自然环境中发生在自然环境中，而当护理人员无法加强由于竞争责任而引起的FCT响应（例如，承担了竞争责任（例如，携带了患病的人）。行为动量理论有助于解释为什么在这种情况下发生治疗继电器，还提供数学方程，可用于建模和预测增加和减少治疗继电器发生的可能性的变量。当前的项目，我们使用这些方程式确定了对FCT的几种潜在改进，这些细化可能会显着降低当未加强FCT响应时处理中继的可能性。在某些情况下，这些改进与FCT临床文献中建议的内容不符。因此，至关重要的是，我们将这些从行为动量理论与当前的临床实践中得出的改进进行比较，以确定实施FCT的最佳方法，以便在自然环境中照料者的精度实施的情况下，这种治疗仍然有效。