Basic and Applied Research on Extinction Bursts
Problem Behavior, Aggression, Self Injury
About this trial
This is an interventional treatment trial for Problem Behavior
Eligibility Criteria
Inclusion Criteria: children aged 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 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
Arm 3
Arm 4
Experimental
Experimental
Experimental
Experimental
Clinical (Human) Study on Effects of Reinforcement-Rate Drop
Clinical (Human) Study on Effects of Reinforcement-Magnitude Drop
Clinical (Human) Study on Effects of Reinforcement-Quality Drop
Clinical (Human) Study on Counteracting Reinforcement-Rate Drop with Quality Increase
Based on the TWML, we hypothesize that a large drop in reinforcement rate at the start of treatment with extinction alone or with FCT will increase the probability of an extinction burst. Preventing such drops will lessen the probability of an extinction burst. We will test the effects of eliminating reinforcement in the extinction-only condition and the effects of substantially decreasing the rate of reinforcement in the rate-drop condition. We will compare these two suboptimal treatments with one in which we ensure that the rate of reinforcement remains equal to baseline, called the rate-hold condition, which the TWML predicts will prevent an extinction burst.We will equate reinforcement magnitude (i.e., each reinforcer delivery will be 20 s) and quality (i.e., the functional reinforcer identified during the functional analysis) across the baseline and the rate-drop and rate-hold conditions (no reinforcement will be delivered in the extinction-only condition).
Based on the TWML, we hypothesize that a large drop in reinforcement magnitude at the start of treatment will increase the probability of an extinction burst. Preventing drops will lessen the probability of an extinction burst. We will test the effects of eliminating reinforcement in the extinction-only condition and the effects of substantially decreasing the magnitude of reinforcement in the magnitude-drop condition. We will compare these two suboptimal treatments with one in which we ensure that the magnitude of reinforcement remains equal to baseline, called the magnitude-hold condition, which the TWML predicts will prevent an extinction burst. We will equate reinforcement rate (i.e., independent, VI 1.5-s schedules) and quality (i.e., the functional reinforcer identified during the functional analysis) across baseline and both FCT conditions (no reinforcement will be delivered in the extinction-only condition).
Note: We will conduct Ex 3 with participants who display destructive behavior reinforced by access to tangible items so that we can vary reinforcement quality using the results of a paired-stimulus preference assessment. Based on the TWML, we hypothesize that a large drop in reinforcement quality at the start of FCT will increase the probability of an extinction burst. Preventing such drops will lessen the probability of an extinction burst. Therefore, we will program a large drop in the quality of reinforcement in our quality-drop condition and ensure that the quality of reinforcement remains equal to the quality of reinforcement in baseline in the quality-hold condition. In Experiment 3, we will equate reinforcement rate (i.e., independent, VI 1.5-s schedules) and magnitude (i.e., each reinforcer delivery will be 20 s) across baseline and both FCT conditions.
Based on the TWML, we hypothesize that a large drop in reinforcement rate at the start of FCT will increase the probability of an extinction burst but that simultaneously increasing reinforcement quality will counteract the negative effects of a drop in reinforcement rate. We will program a large drop in the rate of reinforcement in the rate-drop-only condition, and in the rate-drop/quality-increase condition we will program the same drop in reinforcement rate but also program a large increase in reinforcement quality.