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 了解智力发育障碍（IDD）的复杂共病条件是一个NICHD 要务严重的问题行为（例如，自我伤害行为，攻击）的儿童与碘缺乏病是普遍的， 潜在危险，并对社会融合和生活质量产生负面影响。基于功能的差分- 替代行为干预措施有效地减少了这种行为，但治疗复发是不可能的。 当看护者不能为替代行为提供强化时，这种情况很常见。这种复发被称为 复苏以前，我们根据两个公认的理论， 原则：（1）个人分配比例更多的选择，按比例产生更多 过去强化的价值随着时间的推移呈双曲线衰减。理论 提供了一个定量的行为在动态变化的加固条件，包括当 所有增强停止（即，灭绝）-引起复苏的条件。在本项目的第一阶段， 我们用实验室动物证明了该理论的许多预测的定量准确性， 与临床上IDD儿童严重问题行为的复发有相似的关系。然而，在这方面， 第一阶段最重要和最有希望的发现是理论未能预测到的。我们发现 暴露于治疗（即，应急歧视培训，CDT）涉及交替会议，其中 在目标反应持续消退期间，替代强化是可用的，然后是不可用的 大大缓解了复苏。为了解释这些影响，我们开发了一个改进版本的 定量理论表明，暴露于CDT的个体迅速学会区分持续的 目标行为的强化不可用，即使强化对目标行为不可用， 替代性的反应，从而有助于防止他们对以后的复苏。这些发现和完善的 第1阶段的定量理论提出了有前途的、创新的和未探索的治疗严重 问题行为，可能会产生更好的复苏缓解比现有的方法，同时也 避免了当前方法的一些缺点以减轻问题行为的重现（即，任意 护理人员可能丢失或不正确使用的刺激）。该项目的第二阶段将重点关注这一高度创新的 在第1阶段确定的方法有两个目标，即：（1）第一项随机对照试验， CDT对IDD儿童严重问题行为的缓解作用;（2）一系列 用实验室动物进行的实验，在一系列条件下测试改进的理论， CDT在未来临床应用中的功效、效率和实用性。这个项目代表了一个结束 基础和临床科学家之间的合作，具有使用基础定量 理论和实证研究，以改善临床实践，以防止复发的严重问题行为， 从而减少其对儿童及其家庭的破坏性影响。