Translational Research to Inform Interventions for Challenging Behavior

Vanderbilt University

Status: Completed

Conditions: Behavior and Behavior Mechanisms

Treatments: Behavioral: Demand Informed Moderator Analysis

Study type: Interventional

Funder types: Other

Identifiers

NCT04842500

IRB #202204

Details and patient eligibility

About

This project is meant to identify relations between the reinforcement histories of 80 adults with intellectual and developmental disabilities (IDD) and the prevalence of extinction bursts. Extinction bursts, or temporary increases in rates and intensities of behavior during extinction, often preclude the inclusion of extinction in intervention packages meant to suppress severe challenging behavior, despite the fact that extinction is often necessary to generate therapeutic outcomes. Study results will provide insight into how researchers can enhance interventions for the severe challenging behavior of individuals with IDD while mitigating the undesirable collateral effects (i.e., extinction bursts) of therapeutic action (i.e., extinction). Expanded access to study results will be made available to those who inquire after all data have been obtained and analyzed.

Full description

The Goal of this project is to identify mechanisms responsible for bursts, and to facilitate strategic extensions toward discovery for treatments of challenging behavior. AIM 1: In the service of this goal, the investigators aim to evaluate the accuracy of an efficient alternative to demand-curve analysis (i.e., progressive ratio reinforcer analysis) in quantifying reinforcer value (i.e., Pmax). AIM 2: Investigators also aim to evaluate the utility of manipulating baseline reinforcement parameters for controlling bursts when those manipulations are informed by the results of demand-curve analysis.

Enrollment: 86 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Participants must be older than 18.
• Participants must have a developmental disability (unconstrained to specific diagnoses).
• Participants must be able to correctly manipulate all items used in the study.
• Participants must consent (or assent, when relevant) to procedures prior to and throughout the study.

Exclusion criteria

• Participants younger than 18.
• Participants without disabilities.
• Participants who cannot correctly manipulate items used in the study.
• Participants who do not consent (or assent, when relevant) to participation.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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86 participants in 4 patient groups

"Cheap" Unit Price, Establishing Operation

Experimental group

Description:

Pre-extinction baseline unit price for the programmed reinforcer will be its Pmax, minus one half of the distance between its Pmax and its breakpoint. Extinction will be introduced at the beginning of the relevant appointment, before within-appointment reinforcer consumption has had an opportunity to approximate demand.

Treatment:

Behavioral: Demand Informed Moderator Analysis

"Cheap" Unit Price, Abolishing Operation

Experimental group

Description:

Pre-extinction baseline unit price for the programmed reinforcer will be its Pmax, minus one half of the distance between its Pmax and its breakpoint. Extinction will be introduced at the end of the relevant appointment, after within-appointment reinforcer consumption has approximated demand.

Treatment:

Behavioral: Demand Informed Moderator Analysis

"Expensive" Unit Price, Establishing Operation

Experimental group

Description:

Pre-extinction baseline unit price for the programmed reinforcer will be its Pmax, plus one half of the distance between its Pmax and its breakpoint. Extinction will be introduced at the beginning of the relevant appointment, before within-appointment reinforcer consumption has had an opportunity to approximate demand.

Treatment:

Behavioral: Demand Informed Moderator Analysis

"Expensive" Unit Price, Abolishing Operation

Experimental group

Description:

Pre-extinction baseline unit price for the programmed reinforcer will be its Pmax, plus one half of the distance between its Pmax and its breakpoint. Extinction will be introduced at the end of the relevant appointment, after within-appointment reinforcer consumption has approximated demand.

Treatment:

Behavioral: Demand Informed Moderator Analysis