Translational Research to Inform Interventions for Challenging Behavior
- Conditions
- Behavior and Behavior Mechanisms
- Interventions
- Behavioral: Demand Informed Moderator Analysis
- Registration Number
- NCT04842500
- Lead Sponsor
- Vanderbilt University
- Brief Summary
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.
- Detailed 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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 86
- 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.
- 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.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description "Cheap" Unit Price, Establishing Operation Demand Informed Moderator Analysis 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. "Cheap" Unit Price, Abolishing Operation Demand Informed Moderator Analysis 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. "Expensive" Unit Price, Abolishing Operation Demand Informed Moderator Analysis 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. "Expensive" Unit Price, Establishing Operation Demand Informed Moderator Analysis 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.
- Primary Outcome Measures
Name Time Method Peak Response Rate During Extinction This measure was obtained throughout the primary assessment (i.e., the extinction challenge) This term describes the highest rate of responding observed during extinction and will be depicted as a proportion of baseline. For example, assuming the mean rate of responding during the final three sessions of baseline is 3 responses per minute (i.e., \[2.8 rpm + 3.2 rpm + 3 rpm\] / 3 = 3 rpm), and the highest rate of responding during a single session of extinction is 3.4 rpm, then peak response rate for this hypothetical individual would be 1.13 (i.e., 3.4 / 3 = 1.13). This value will serve as the primary dependent variable for each participant in all between-groups comparisons in our data-analysis plan.
Schedule Value at Breakpoint PRA breakpoints were obtained during pre-assessment and were used as a matching variable prior to random assignment. The progressive-ratio reinforcer analysis (PRA) is a game of diminishing returns that is considered an assessment of reinforcer value (e.g., if a participant does not value the reinforcer, they will quit sooner than a participant that does value the reinforcer). During the assessment, we increased the "price" (i.e., the schedule value) of reinforcers each time a participant earns two reinforcers at a currently established price.
The breakpoint describes the "price" (schedule value; e.g., FR1, FR4, FR7) of the last obtained reinforcer prior to response cessation (i.e., the breakpoint is the last schedule value that supported enough responding to produce a reinforcer, before the participant quit playing the game). Higher breakpoints are interpreted as reflecting higher-value reinforcers. Lower breakpoints are interpreted as reflecting lower-value reinforcers.The Schedule Value Designated as Pmax Pmax values were obtained during pre-assessment and were used as a scaling variable to set baseline schedule parameters. The progressive fixed-ratio reinforcer analysis (PFRA) is an assessment of consumer demand that first establishes how much of a reinforcer a participant would consume when consumption is free of constraint (i.e., when participants can have as much of the reinforcer as they want; referred to as "bliss-point consumption").
With bliss-point consumption established, PFRA evaluates how much a participant will "spend" (respond) to maintain bliss-point consumption patterns as price (schedule value) is increased. Unlike PRA, prices in the PFRA are held constant within each session and only increase across sessions. Initially, participants "spend" more. Eventually, they "spend" less. The price that produces maximum "spending" (i.e., higher and lower prices yield lower response outputs) is referred to as Pmax.
Pmax is one way to quantify a reinforcer's value. That is, reinforcers that produce high Pmax have more value than reinforcers that produce low Pmax.Response Latency This measure was obtained throughout the primary assessment (i.e., the extinction challenge) This term describes the latency from session onset to eventual response cessation during the extinction challenge.
- Secondary Outcome Measures
Name Time Method Number of Sessions in Extinction This measure was obtained throughout the primary assessment (i.e., the extinction challenge) In addition to between-groups differences in peak-response rate (primary dependent variable), the investigators will also compare between-groups differences in the number of sessions required to achieve response elimination during extinction.
Overall Session Duration Duration values were obtained during pre-assessment and were used as a scaling variable to set baseline schedule parameters. The investigators will measure the total duration of PFRA sessions (in seconds) at Pmax to establish baseline-session parameters.
Trial Locations
- Locations (5)
Habilitative and Training Services (HATS)
🇺🇸Gallatin, Tennessee, United States
Easterseals Tennessee: Prospect
🇺🇸Lebanon, Tennessee, United States
Possibility Place
🇺🇸Murfreesboro, Tennessee, United States
Chrysalis
🇺🇸Orem, Utah, United States
Next Steps at Vanderbilt
🇺🇸Nashville, Tennessee, United States