Basic and Clinical Studies in Reinforcing Positive Behaviors in Intellectual and Developmental Disabilities

加强智力和发育障碍积极行为的基础和临床研究

• 批准号: 10583211
• 负责人: Timothy A Shahan
• 金额: $ 63.21万
• 依托单位: UTAH STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-02-09 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10583211
• 关键词: Affect; Aggressive behavior; Animal Testing; Basic Science; Behavior; Behavior Therapy; Caregivers; Child; Child Behavior; Clinic; Clinical; Clinical Research; Collaborations; Complex; Dangerousness; Data; Discrimination; Discrimination Learning; Educational process of instructing; Empirical Research; Exposure to; Extinction; Family; Future; Individual; Infant; Intellectual functioning disability; Laboratory Animals; Laboratory Study; Laws; Learning; Length; Methods; National Institute of Child Health and Human Development; Participant; Patients; Phase; Problem behavior; Procedures; Psychological reinforcement; Quality of life; Randomized, Controlled Trials; Rattus; Relapse; Research Personnel; Scientist; Self-Injurious Behavior; Series; Siblings; Stimulus; Testing; Thinness; Time; Training; Variant; behavioral momentum; clinical application; clinical practice; comorbidity; developmental disease; experience; experimental study; improved; innovation; reinforcer; relapse prevention; response; severe behavior problem; social integration; theories; treatment as usual; treatment duration

Project Summary Understanding complex, comorbid conditions of intellectual developmental disorder (IDD) is an NICHD priority. Severe problem behavior (e.g., self-injurious behavior, aggression) of children with IDD is prevalent, potentially dangerous, and negatively impacts social integration and quality of life. Function-based differential- reinforcement-of-alternative-behavior interventions reduce such behavior effectively, but treatment relapse is common when a caregiver cannot deliver reinforcement for the alternative behavior. Such relapse is known as resurgence. Previously, we developed a quantitative theory of resurgence based on two well-established principles: (1) individuals allocate proportionally more responding to options that produce proportionally more reinforcement, and (2) the value of past reinforcement decays hyperbolically as time passes. The theory provides a quantitative account of behavior in dynamically changing reinforcement conditions, including when all reinforcement ceases (i.e., extinction)—the conditions giving rise to resurgence. In Period 1 of this project, we showed the quantitative accuracy of many of the theory’s predictions with laboratory animals and we have shown similar relations in resurgence of severe problem behavior of children with IDD in the clinic. However, the most important and promising finding from Period 1 was one the theory failed to predict. We found that exposure to a treatment (i.e., contingency discrimination training, CDT) involving alternating sessions in which alternative reinforcement was and then was not available during continued extinction of a target response substantially mitigated resurgence. To account for these effects, we have developed a refined version of the quantitative theory suggesting that individuals exposed to CDT rapidly learn to discriminate the continued unavailability of reinforcement for the target behavior, even when reinforcement is not available for the alternative response, thus serving to inoculating them against later resurgence. These findings and the refined quantitative theory from Period 1 suggest promising, innovative, and unexplored procedures for treating severe problem behavior that are likely to produce better resurgence mitigation than existing approaches, while also avoiding some downsides of the current methods to mitigate resurgence of problem behavior (i.e., arbitrary stimuli that caregivers may lose or use incorrectly). Period 2 of this project will focus on this highly innovative approach identified in Period 1 in two aims by conducting: (1) the first randomized controlled trial evaluating the resurgence-mitigating effects of CDT on severe problem behavior of children with IDD and (2) a series of experiments with laboratory animals testing the refined theory under a range of conditions predicted to improve the efficacy, efficiency, and practicality of CDT in future clinical applications. This project represents a close collaboration between basic and clinical scientists with a demonstrated ability to use basic quantitative theoretical and empirical research to improve clinical practice to prevent relapse of severe problem behavior, and thus, to reduce its devastating impact on children and their families.

项目摘要 了解智力发展障碍（IDD）的复杂，合并状况是NICHD 优先事项。患有IDD儿童的严重问题行为（例如，自我伤害行为，侵略性）是普遍的， 潜在的危险，并对社会融合和生活质量产生负面影响。基于功能的差异 - 强化北方行为干预措施有效地减少了这种行为，但治疗继电器是 当护理人员无法为替代行为提供加固时，很常见。这种浮雕被称为 再起。以前，我们基于两个公认 原则：（1）个人分配比例分配更多的响应，以应比例产生更多 加固，以及（2）过去加固的价值随着时间的流逝而倍增。理论 在动态变化的强化条件下，包括 所有强化停止（即扩展） - 导致复兴的条件。在该项目的第1期中， 我们展示了该理论对实验动物的许多预测的定量准确性，我们已经 显示出诊所患有IDD的儿童严重问题行为的重新出现相似的关系。然而， 从时期1中最重要，最重要的发现是理论未能预测的理论。我们发现 接触治疗（即应急歧视培训，CDT），其中涉及替代性会话 替代加固是，然后在持续扩展目标响应期间没有可用 大大减轻了恢复。为了解释这些效果，我们开发了 定量理论表明，暴露于CDT的个体迅速学会区分持续 即使没有加固，也无法加强目标行为 替代反应，从而使他们反对以后的复兴。这些发现和精致 第1期的定量理论提出了有希望的，创新和意外的程序来治疗严重的 问题行为可能会产生比现有方法更好的缓解复苏的行为 避免当前方法的某些缺点，以减轻问题行为的复兴（即任意 护理人员可能会失去或使用错误）。该项目的第2期将重点放在这一高度创新性上 通过进行两个目标，在第1期中确定的方法：（1）第一个随机对照试验评估 CDT对IDD儿童严重问题行为的复兴降低作用和（2）一系列 实验动物的实验在预测改善的一系列条件下测试精制理论 CDT在将来的临床应用中的效率，效率和实用性。这个项目代表一个接近 基本科学家和临床科学家之间的合作，具有使用基本定量的能力 理论和实证研究以改善临床实践以防止严重的问题行为缓解， 因此，减少对儿童及其家人的破坏性影响。