Extensions of Resurgence as Choice
Problem Behavior, Aggression, Self-Injury
About this trial
This is an interventional treatment trial for Problem Behavior
Eligibility Criteria
Inclusion Criteria:
- boys and girls from ages 3 to 17;
- problem behavior that occurs at least 10 times a day, despite previous treatment;
- problem behavior maintained by social positive reinforcement;
- stable protective supports for self-injurious behavior (e.g., helmet) with no anticipated changes during enrollment;
- on a stable psychoactive drug regimen for at least 10 half-lives per drug or drug free;
- stable educational plan and placement with no anticipated changes during the child's treatment.
Exclusion Criteria:
- patients who do not meet the inclusion criteria;
- patients currently receiving 15 or more hours per week of treatment for their problem behavior;
- DSM-5 diagnosis of Rett syndrome or other degenerative conditions (e.g., inborn error of metabolism);
- a comorbid health condition or major mental disorder that would interfere with study participation;
- occurrence of self-injury during study assessments that presents a risk of serious or permanent harm (e.g., detached retinas) based on our routine clinical-risk assessment;
- patients requiring changes to protective supports for self-injury or drug treatment, but we will invite these patients to participate when protective supports and drug regimen are stable.
Sites / Locations
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and ServicesRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Contingency-Discrimintation Training (CDT)
Control
In this condition, the clinician will alternate sessions with reinforcement for the alternative response and sessions without reinforcement for the alternative response during extinction treatment of problem behavior. According to RaC2, alternating periods of reinforcer availability and unavailability for the alternative response will teach the participant that the alternative response alone produces reinforcement but not always. The investigators predict that resurgence of problem behavior will lower, shorter lasting, and with fewer participants experiencing resurgence than those in the control group.
This condition emulates a traditional approach to treatment in which the clinician does not alternate sessions with reinforcement for the alternative response and sessions without reinforcement for the alternative response during extinction treatment of problem behavior. The investigators predict that resurgence of problem behavior will higher, longer lasting, and with more participants experiencing resurgence than those in the CDT group.