Translational Research to Inform Interventions for Challenging Behavior

Study Overview
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Brief Summary
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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
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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.

Official Title
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Translational Research to Inform Interventions for Severe Challenging Behavior for Individuals With Intellectual and Developmental Disabilities

Conditions
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Behavior and Behavior Mechanisms

Intervention / Treatment
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* Behavioral: Demand Informed Moderator Analysis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 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. Exclusion Criteria: 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.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: The investigators will enroll 80 adults with developmental disabilities in a low-stakes translational investigation employing a 2x2 factorial, crossed, and randomized matched blocks design, with batched randomization logic. Procedures will include: (a) matching participants within batches according to progressive ratio reinforcer analysis results, and (b) randomly assigning participants to one of four experimental conditions to determine whether information about reinforcer value can be used to set baseline parameters that either promote or eliminate bursts during extinction.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cheap Unit Price, Establishing Operation<br>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. | Behavioral: Demand Informed Moderator Analysis<br>* This analysis is designed to determine the degree to which relative price, and the timing of extinction, interact to increase or abate responding during extinction (thereby highlighting mechanisms of control).<br>|
| Experimental: Cheap Unit Price, Abolishing Operation<br>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. | Behavioral: Demand Informed Moderator Analysis<br>* This analysis is designed to determine the degree to which relative price, and the timing of extinction, interact to increase or abate responding during extinction (thereby highlighting mechanisms of control).<br>|
| Experimental: Expensive Unit Price, Establishing Operation<br>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. | Behavioral: Demand Informed Moderator Analysis<br>* This analysis is designed to determine the degree to which relative price, and the timing of extinction, interact to increase or abate responding during extinction (thereby highlighting mechanisms of control).<br>|
| Experimental: Expensive Unit Price, Abolishing Operation<br>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. | Behavioral: Demand Informed Moderator Analysis<br>* This analysis is designed to determine the degree to which relative price, and the timing of extinction, interact to increase or abate responding during extinction (thereby highlighting mechanisms of control).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Peak response rate during extinction | 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. | Immediately post-baseline extinction challenges | 
| Breakpoint | Reinforcement schedule which preceded the last obtained reinforcer prior to response cessation during progressive-ratio reinforcer analysis. Often used as a proxy measure to establish reinforcer value. | Pre-Assessment | 
| Demand | This term describes the number of reinforcers obtained prior to response cessation during progress fixed-ratio reinforcer analysis. Often used as a proxy measure to establish reinforcer value. | Pre-Assessment | 
| Pmax | This term describes the unit price that produces the highest target-response output during progressive fixed-ratio reinforcer analysis. | Pre-Assessment | 
| Response latency | This term describes the latency from session onset to delivery of the first programmed reinforcer during progressive fixed-ratio reinforcer analysis. | Pre-Assessment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of sessions in extinction | 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. | Immediately post-baseline extinction challenges | 
| Overall session duration | The investigators will measure the total duration of reinforcer-analysis sessions (in seconds) to establish baseline-session parameters. | Pre-assessment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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behavioral sciences, reinforcement schedule, motivation, economics, behavioral, developmental disability, intellectual disability, problem behavior, extinction bursts