Stimulus control refinements of FCT interventions for destructive behavior in ID

针对智力障碍破坏性行为的 FCT 干预措施的刺激控制改进

基本信息

批准号：
9093820
负责人：
WAYNE WILLIAM FISHER
金额：
$ 43.02万
依托单位：
UNIVERSITY OF NEBRASKA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-07-11 至 2019-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9093820
关键词：
Address Aggressive behavior Behavior Behavior Therapy Caregivers Child Communication Community Integration Development Disease Economics Educational Intervention Educational process of instructing Effectiveness Emotional Ensure Epidemiologic Studies Exposure to Extinction (Psychology)Health Intellectual functioning disability Intervention Link Literature Meta-Analysis National Institute of Child Health and Human Development Parents Pilot Projects Problem behavior Procedures Psychological reinforcement Public Health Punishment Reporting Research Research Personnel Resistance Risk Schedule Self-Injurious Behavior Signal Transduction Staging Stimulus Techniques Touch sensation Training Treatment Effectiveness Treatment Efficacy Work alternative communication base behavioral momentum operation prevent reinforcer response social theories therapeutic development treatment effect

项目摘要

DESCRIPTION (provided by applicant): Children with intellectual disability often display severe destructive behaviors (e.g., aggression, self- injurious behavior) that pose significant risks 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 treatment that is inexorably linked to FA 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 an 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 effectiveness has not been established under more routine conditions. In addition, when attempts have been made to increase the practicality and ease of implementation of FCT for use by parents and other caregivers, treatment efficacy was markedly reduced in about 1/2 of cases and led to more intrusive procedures, such as punishment.1 The current project aims to address these limitations of FCT by (a) demonstrating the effectiveness of a simple and efficient empirical assessment for selecting the most appropriate FCT response; and (b) showing that by bringing the FCT response under the control of discriminative stimuli that are separate and distinct from those controlling destructive behavio using multiple schedules will (1) facilitate tranfer of treatment effects to routine caregivers and settings, (2) prevent resurgence of destructive behavior during periods when the FCT response does not produce reinforcement, and (3) prevent the need to add a punishment component to the FCT treatment package in order to sustain maximum treatment efficacy under routine conditions.

描述（由申请人提供）：智障儿童经常表现出严重的破坏性行为（例如侵略，自我伤害行为），对自我或他人构成了重大风险，并代表了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。一种与FA无关的治疗方法称为功能通信培训（FCT），涉及破坏性行为的灭绝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干预措施通常是由训练有素的严格控制研究环境中的训练有素的专家开发和评估的，并且在更常规的条件下尚未建立治疗效果。此外，当试图提高FCT的实用性和易于实施以供父母和其他护理人员使用时，在大约1/2案件中明显降低了治疗效果，并导致更具侵入性的程序，例如惩罚，例如惩罚。（b）表明，通过将FCT响应放在判别性刺激的控制下，这些刺激与使用多个计划的破坏性行为分开且不同设置，（2）防止在FCT响应不会产生强化的时期内破坏性行为的复兴；（3）阻止需要在FCT治疗方案中增加惩罚成分，以便在常规条件下维持最大的治疗效果。