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

摘要 了解智力发育障碍（IDD）的复杂共病条件是NICHD的优先事项。 严重的问题行为（例如，自我伤害行为，攻击）的IDD儿童是普遍的，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 替代性行为干预措施有效地减少了这种行为，但治疗复发往往发生在 看护者没有为替代行为提供强化。这种复发被称为复苏。的 长期以来，理论上认为，预防性干预在减少严重问题行为方面的功效与以下因素有关： 控制在同时可用的强化源之间进行选择的基本过程。然而，定量 这种选择行为的理论（例如，匹配定律）以前不适用于以下的复苏 这是因为他们无法解释一种或两种行为不再产生强化的情况。 该项目代表了基础科学家/理论家和临床科学家之间的合作， 治疗，以评估和翻译一种新的选择为基础的理论复苏的预测。这一创新 理论是建立在两个基本的和完善的原则强化：（a）个人分配 成比例地更多地响应于产生成比例地更多强化的响应（即，匹配法）; （B）强化的价值随着进一步向过去后退而呈双曲线下降。通过组合这些 两个原则转化为一个数学模型，该理论占复苏的情况下，唯一存在的 复苏的定量理论（行为动力理论）失败了。基于选择的理论 关于复苏可能发生的确切条件以及如何发生的新预测 可以改变治疗以减少复发（例如，延长治疗时间，动态调整治疗方案 薄化）。该项目实证检验了这些和其他关于高潜力临床变量的新预测。 相关性，但缺乏明确的数据（例如，针对目标和替代品的不同应对努力的影响 反应），并直接将理论和动物基础研究的见解转化为提高 在临床上治疗问题行为，减少治疗复发。我们的首要假设是， 由这一新理论提供信息的干预措施将不太容易受到问题行为死灰复燃的影响：（a）在 当调度器不可用时;（B）当调度器可用性在强化计划期间减少时 变薄;以及（c）当其他响应或增强参数改变时，例如响应努力的增加。 因此，该项目旨在填补有关复兴的基础/理论知识方面的现有空白，并代表了罕见的 基础和临床科学家之间的密切合作，以更好地协调基础研究和临床实践。

Abstract 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 (DRA) interventions reduce such behavior effectively, but treatment relapse often occurs when a caregiver does not deliver reinforcement for the alternative behavior. Such relapse is known as resurgence. The efficacy of DRA interventions in reducing severe problem behavior has long been theorized to be related to the same basic processes that govern choice between concurrently available sources of reinforcement. However, quantitative theories of such choice behavior (e.g., the matching law) have not previously been applicable to resurgence following DRA because they could not account for situations in which one or both behaviors no longer produced reinforcement. This project represents a collaboration between a basic scientist/theorist and clinical scientists with expertise in DRA treatments to evaluate and translate the predictions of a novel choice-based theory of resurgence. This innovative theory is built from two fundamental and well-established principles of reinforcement: (a) individuals allocate proportionally more responding to responses that produce proportionally more reinforcement (i.e., the matching law); and (b) the value of reinforcement decreases hyperbolically as it recedes further into the past. By combining these two principles into a mathematical model, the theory accounts for resurgence in situations in which the only existing quantitative theory of resurgence (behavioral momentum theory) has failed. The choice-based theory generates novel predictions about the precise conditions under which resurgence might be expected to occur and how treatments might be altered to reduce resurgence (e.g., extending treatment duration, dynamically adjusting schedule thinning). This project empirically examines these and other novel predictions about variables of high potential clinical relevance, but for which clear data are lacking (e.g., effects of different response efforts for the target and alternative responses) and directly translates insights from the theory and basic research with animals in order to improve treatment of problem behavior in the clinic and reduce treatment relapse. Our overarching hypothesis is that DRA interventions informed by this novel theory will be less susceptible to resurgence of problem behavior: (a) during periods when reinforcers are unavailable; (b) when reinforcer availability diminishes during reinforcement schedule thinning; and (c) when other response or reinforcement parameters change, such as increases in response effort. Thus, this project seeks to fill existing gaps in basic/theoretical knowledge about resurgence and represents a rare close collaboration between basic and clinical scientists to better align basic research and clinical practice.