Stimulus control refinements of FCT interventions for destructive behavior in ID

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，攻击，自残行为），对自己或他人构成重大风险，并对社区融合构成巨大障碍。这些破坏性行为通常通过功能分析（FA）衍生的行为干预来治疗，功能分析用于识别引起并加强目标反应的环境前因和后果。一种与FA不可避免地联系在一起的治疗方法被称为功能性沟通训练（FCT），它包括消除破坏性行为和强化替代沟通反应，其结果是先前的破坏性行为得到加强。流行病学研究和荟萃分析的结果表明，基于FA的干预措施，如FCT，通常可将问题行为减少90%或更多，比其他行为治疗有效得多。尽管有这些令人印象深刻的发现，但文献中报道的FCT干预措施通常是由训练有素的专家在严格控制的研究环境中开发和评估的，治疗效果尚未在更常规的条件下确定。此外，当试图提高家长和其他照顾者使用FCT的实用性和便利性时，治疗效果在大约1/2的病例中显着降低，并导致更具侵入性的程序，例如惩罚目前的项目旨在通过以下方式解决FCT的这些局限性：(a)证明选择最合适的FCT响应的简单而有效的经验评估的有效性；(b)表明，通过将FCT反应置于区别性刺激的控制之下，这些区别性刺激与使用多个时间表控制破坏性行为的刺激是分开和不同的，将(1)促进治疗效果转移到常规照顾者和

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.