Signalling changes to individuals who show resistance to change can reduce challenging behaviour
Signalling changes to individuals who show resistance to change can reduce challenging behaviour
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DOI：
10.1016/j.jbtep.2016.06.006
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发表时间：
2017-03-01
影响因子：
1.8
通讯作者：
Woodcock, Kate A.
中科院分区：
文献类型：
--
作者：
Bull, Leah E.;Oliver, Chris;Woodcock, Kate A.
背景与目标：几种神经发育障碍与抗拒改变和挑战行为有关-包括在改变常规，计划或期望（在这里统称为：期望）后随之而来的脾气爆发。在这里，一个变化的信号干预测试的概念和潜在的实际effectiveness.Methods的证明：12个人与普拉德-威利综合征参加了研究人员和领导的配对的一个独特的视觉语言信号与随后的变化的期望。在最低限度操纵的自然环境中，系统地观察到对计划的五名参与者的子集的具体期望。九个照顾者完成了一个脾气爆发日记在四周的基线期和两个星期的信号evaluationperiod.Results：参与者表现出一贯较少的脾气爆发行为的系统观察时，施加到预期的变化是有信号的，相比，当变化没有信号。四个参与者的照顾者完成的行为日记表现出可靠的减少基线和信号evaluation.Limitations之间的脾气爆发：积极的控制组，目前初步评估的信号策略，使用证据从照顾者的行为日记是本试点研究的范围之外。因此，研究结果不能支持本信令approach.Conclusions的临床疗效：概念的证据证明，可靠的配对的一个独特的线索与随后的变化，期望可以减少相关的挑战性行为。数据为进一步评价变革信号方法的具体实际步骤的重要性提供了额外的支持。(C)2016爱思唯尔有限公司版权所有。
Background & objectives: Several neurodevelopmental disorders are associated with resistance to change and challenging behaviours - including temper outbursts that ensue following changes to routines, plans or expectations (here, collectively: expectations). Here, a change signalling intervention was tested for proof of concept and potential practical effectiveness.Methods: Twelve individuals with Prader-Willi syndrome participated in researcher- and caregiver-led pairing of a distinctive visual-verbal signal with subsequent changes to expectations. Specific expectations for a planned subset of five participants were systematically observed in minimally manipulated natural environments. Nine caregivers completed a temper outburst diary during a four week baseline period and a two week signalling evaluation period.Results: Participants demonstrated consistently less temper outburst behaviour in the systematic observations when changes imposed to expectations were signalled, compared to when changes were not signalled. Four of the nine participants whose caregivers completed the behaviour diary demonstrated reliable reductions in temper outbursts between baseline and signalling evaluation.Limitations: An active control group for the present initial evaluation of the signalling strategy using evidence from caregiver behaviour diaries was outside the scope of the present pilot study. Thus, findings cannot support the clinical efficacy of the present signalling approach.Conclusions: Proof of concept evidence that reliable pairing of a distinctive cue with a subsequent change to expectation can reduce associated challenging behaviour is provided. Data provide additional support for the importance of specific practical steps in further evaluations of the change signalling approach. (C) 2016 Elsevier Ltd. All rights reserved.