1
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Yassa RR, Mitteer DR, Greer BD, Angley SM, McCabe LH, Elwasli OM. Teaching trainees to implement functional communication training with multiple schedules: An evaluation of training effects and durability. J Appl Behav Anal 2024. [PMID: 39323390 DOI: 10.1002/jaba.2915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 09/05/2024] [Indexed: 09/27/2024]
Abstract
We evaluated the effects of behavioral skills training on improving participant implementation of functional communication training with multiple schedules when working with a confederate. Behavioral skills training produced mastery-level responding for all six participants who required training, providing the first empirically supported training for this functional communication training approach. Next, we assessed durability during training challenges with (a) procedural changes to the original protocol, (b) a novel confederate with different discriminative stimuli and reinforcers, and (c) relapsed confederate destructive behavior. Training effects degraded at least once for all participants and in 62% of training challenges, although continuing to expose the participant to the challenging situations or providing postsession booster training resolved the degradation in most cases. We discuss these findings in relation to their clinical implications and directions for future research.
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Affiliation(s)
- Rana R Yassa
- Department of Applied Psychology, Rutgers University, New Brunswick, NJ, USA
| | - Daniel R Mitteer
- Severe Behavior Program, Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Brian D Greer
- Severe Behavior Program, Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers Brain Health Institute, Piscataway, NJ, USA
| | - Shannon M Angley
- Severe Behavior Program, Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
| | - Liam H McCabe
- Severe Behavior Program, Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
| | - Omar M Elwasli
- Severe Behavior Program, Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES), Somerset, NJ, USA
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2
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Muething C, Cariveau T, Bottini S, Slocum S, Williams C, Gillespie S, Scheithauer M. Descriptive characteristics of extinction bursts: A record review. J Appl Behav Anal 2024; 57:372-382. [PMID: 38226687 DOI: 10.1002/jaba.1054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/10/2023] [Indexed: 01/17/2024]
Abstract
Procedural extinction is sometimes associated with a temporary increase in responding known as an extinction burst. Extinction bursts present unique challenges in the context of treating behavior targeted for reduction. The present study updates the prevalence of extinction bursts using a clinical sample (N = 108) receiving treatment for targeted behavior. The prevalence of extinction bursts in our sample (24%) was consistent with that in prior literature. The extinction-burst magnitude decreased across sessions after extinction was contacted during treatment, but this sample did not demonstrate decreased persistence or magnitude of extinction bursts across successive transitions from baseline to treatment. We also examined the prevalence and magnitude of extinction bursts based on the function and topography of targeted behavior and treatment components and found no consistent relation among these variables. These findings should lead clinicians to prepare for transient extinction bursts when implementing extinction-based treatment for challenging behavior.
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Affiliation(s)
- Colin Muething
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Tom Cariveau
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Summer Bottini
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah Slocum
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Catherine Williams
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Scott Gillespie
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Mindy Scheithauer
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
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3
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Nuhu NN, Muething C, Gillespie SE, Mevers JL, Scheithauer M. Individualized Parent-Mediated Behavioral Treatment for Challenging Behavior: A Program Description. Behav Modif 2024; 48:111-127. [PMID: 37864323 DOI: 10.1177/01454455231201957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Past research suggests behavioral treatments are effective for challenging behavior in children and young adults with neurodevelopmental disorders, such as autism spectrum disorder (ASD). However, access to these services can be limited and require substantial resources. To address this issue, the current study provides a programmatic description of an individualized parent-mediated service model targeting moderate challenging behavior. In the program, therapists coached parents to implement functional analyses and individualized function-based treatment packages. Forty-one families of children and young adults with neurodevelopmental disorders participated. Most clients (75.6%) met all admission treatment goals and parents reported significant decreases in frequency and severity of challenging behaviors at discharge. Parents also reported less stress at discharge. Outcomes of the study suggest this parent-mediated treatment model is a viable option to treating moderate challenging behavior in children and young adults with intellectual and developmental disorders.
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Affiliation(s)
- Nadrat N Nuhu
- Emory University School of Medicine, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
- Children's Healthcare of Atlanta, GA, USA
| | - Colin Muething
- Emory University School of Medicine, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
- Children's Healthcare of Atlanta, GA, USA
| | | | - Joanna Lomas Mevers
- Emory University School of Medicine, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
- Children's Healthcare of Atlanta, GA, USA
| | - Mindy Scheithauer
- Emory University School of Medicine, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
- Children's Healthcare of Atlanta, GA, USA
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4
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Muething C, Ritchey CM, Call NA, Hardee AM, Mauzy CR, Argueta T, McMahon MXH, Podlesnik CA. A retrospective analysis of the relation between resurgence and renewal of behavior targeted for reduction. J Appl Behav Anal 2024; 57:455-462. [PMID: 38438320 DOI: 10.1002/jaba.1069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 02/15/2024] [Indexed: 03/06/2024]
Abstract
Functional communication training (FCT) is an evidence-based treatment for behavior targeted for reduction that often combines extinction for target responses and arranges functionally equivalent reinforcement for alternative behavior. Long-term effectiveness of FCT can become compromised when transitioning from clinic to nonclinic contexts or thinning reinforcement schedules for appropriate behavior. Such increases in targeted behavior have been conceptualized as renewal and resurgence, respectively. The relation between resurgence and renewal has yet to be reported. Therefore, the present report retrospectively analyzed the relation between renewal and resurgence in data collected when implementing FCT with children diagnosed with developmental disabilities. We found no relation when evaluating all 34 individuals assessed for resurgence and renewal or a subset of individuals exhibiting both resurgence and renewal. These findings suggest that one form of relapse may not be predictive of another form of relapse.
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Affiliation(s)
- Colin Muething
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Nathan A Call
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Alexandra M Hardee
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Courtney R Mauzy
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Tracy Argueta
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Meara X H McMahon
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
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5
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Falligant JM, Kranak MP, Piersma DE, Benson R, Schmidt JD, Frank-Crawford MA. Further evidence of renewal in automatically maintained behavior. J Appl Behav Anal 2024; 57:490-501. [PMID: 38239100 PMCID: PMC10984774 DOI: 10.1002/jaba.1055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024]
Abstract
Renewal is a relapse phenomenon that refers to the recurrence of a previously reduced behavior following a change in stimulus conditions. Muething et al. (2022) examined the phenomenology of renewal among individuals with automatically maintained challenging behavior treated at an outpatient clinic. We replicated their findings by retrospectively examining renewal across various topographies of automatically maintained behavior treated at an inpatient hospital, and we extended their work by also examining differences across subtypes of automatically maintained self-injurious behavior. The prevalence of renewal was comparable to that observed by Muething et al., supporting the notion that automatically maintained challenging behavior is susceptible to relapse phenomena. Furthermore, renewal was twice as likely to occur for individuals with Subtype 2 versus Subtype 1 self-injurious behavior, providing additional evidence of behavioral differentiation between subtypes. Our findings suggest that even after apparent stability in treatment, practitioners should remain vigilant for the recurrence of automatically maintained behavior during generalization.
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Affiliation(s)
- John Michael Falligant
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Michael P. Kranak
- Department of Human Development and Child Studies, Oakland University, Rochester, MI, USA
- Center for Autism, Oakland University, Rochester, MI, USA
| | - Drew E. Piersma
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Ryan Benson
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jonathan D. Schmidt
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Michelle A. Frank-Crawford
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
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6
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Williams CL, Montague KL, Bernstein AM, Call NA, Slocum SK. Expanding a laboratory model for evaluating relapse of caregiver nonadherence. J Exp Anal Behav 2023; 120:363-375. [PMID: 37464554 DOI: 10.1002/jeab.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023]
Abstract
Caregiver adherence to treatment plans is likely maintained by negative reinforcement and can contact extinction when child responding relapses. When caregiver adherence contacts extinction, caregiver nonadherence, such as reinforcing their child's challenging behavior, relapses, threatening treatment efficacy. Previous laboratory models demonstrating the relapse of caregiver nonadherence only evaluated treatment for behavior maintained by social-positive reinforcement, not that maintained by social-negative reinforcement. These models only measured caregiver nonadherence as discrete events, which cannot capture the magnitude of each error. The present study was an evaluation of the relapse of caregiver nonadherence during simulated treatments for escape-maintained challenging behavior. First, caregivers placed demands in a home-like setting and a research confederate responded to these demands in a manner mimicking clinical clients. Next, caregivers were taught to implement treatment in a clinical setting and the confederate's behavior gradually improved. Last, caregivers returned to the home-like setting and confederate challenging behavior relapsed. Nonadherence relapsed for all caregivers, demonstrating the need for additional research on methods for mitigating caregiver relapse during treatment of children's challenging behavior and the usefulness of the proposed measurement system for future research.
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Affiliation(s)
- Catherine L Williams
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
- University of North Carolina Wilmington, Wilmington, NC, USA
| | - Kyleigh L Montague
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
- University of Florida, Gainesville, FL, USA
| | - Alec M Bernstein
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
- Children's Mercy Kansas City, UMKC School of Medicine, Kansas City, MO, USA
| | - Nathan A Call
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah K Slocum
- Marcus Autism Center, Emory University School of Medicine, Atlanta, GA, USA
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7
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Kimball RT, Greer BD, Fuhrman AM, Lambert JM. Relapse and its mitigation: Toward behavioral inoculation. J Appl Behav Anal 2023; 56:282-301. [PMID: 36715533 PMCID: PMC10121865 DOI: 10.1002/jaba.971] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 12/03/2022] [Indexed: 01/31/2023]
Abstract
Relapse following the successful treatment of problem behavior can increase the likelihood of injury and the need for more intensive care. Current research offers some predictions of how treatment procedures may contribute to relapse, and conversely, how the risk of relapse can be mitigated. This review describes relapse-mitigation procedures with varying levels of support, the quantitative models that have influenced the research on relapse mitigation, different experimental methods for measuring relapse mitigation, and directions for future research. We propose that by viewing the implementation of relapse-mitigation procedures as a means of producing behavioral inoculation, clinicians are placed in the proactive and intentional role of exposing their client's behavior to an array of reinforcement and stimulus conditions during treatment with the goal of decreasing the detrimental impact of future treatment challenges.
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Affiliation(s)
- Ryan T. Kimball
- Department of Counseling and Applied Behavioral Studies, University of Saint Joseph
| | - Brian D. Greer
- Rutgers Brain Health Institute
- Severe Behavior Program, Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
| | - Ashley M. Fuhrman
- Severe Behavior Program, Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
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8
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Kimball RT, Salvetti EL, Day LE, Karis R, Silveira J, Kranak MP. Operant ABA renewal during dense and lean schedules of differential reinforcement. J Exp Anal Behav 2023; 119:529-538. [PMID: 36945863 DOI: 10.1002/jeab.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/09/2023] [Indexed: 03/23/2023]
Abstract
Renewal is a type of relapse that occurs due to a change in context. Previous research has demonstrated that renewal of target responding may occur despite the availability of differential reinforcement for an alternative response (DRA). Nevertheless, the current literature on renewal presents mixed findings regarding the effects of dense and lean schedules of DRA on the magnitude of renewal. We used a translational approach with undergraduate college students and a task on a touchscreen tablet device to study the effects of dense and lean schedules of DRA during repeated renewal tests. All participants experienced two, three-phase ABA renewal arrangements. In the dense and lean renewal arrangements, we differentially reinforced alternative behavior in Context B and the renewal test in Context A on a VI 3-s or a VI 12-s schedule, respectively. Overall, we observed renewal in 31/36 (86%) renewal tests regardless of the density of reinforcement for the alternative response. Furthermore, the results showed that although renewal occurred in both arrangements, we found slightly higher magnitudes of renewal during DRA with lean schedules of reinforcement relative to dense schedules. We discuss the implications of these findings as they relate to the treatment of problem behavior.
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Affiliation(s)
| | - Emily L Salvetti
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, NE, USA
| | | | | | | | - Michael P Kranak
- Oakland University, Rochester, MI, USA
- Oakland University Center for Autism, Rochester, MI, USA
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9
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Podlesnik CA, Ritchey CM, Waits J, Gilroy SP. A Comprehensive Systematic Review of Procedures and Analyses Used in Basic and Preclinical Studies of Resurgence, 1970-2020. Perspect Behav Sci 2023; 46:137-184. [PMID: 37006602 PMCID: PMC10050505 DOI: 10.1007/s40614-022-00361-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/24/2022] Open
Abstract
Resurgence is the return of a previously reinforced response as conditions worsen for an alternative response, such as the introduction of extinction, reductions in reinforcement, or punishment. As a procedure, resurgence has been used to model behavioral treatments and understand behavioral processes contributing both to relapse of problem behavior and flexibility during problem-solving. Identifying existing procedural and analytic methods arranged in basic/preclinical research could be used by basic and preclinical researchers to develop novel approaches to study resurgence, whereas translational and clinical researchers could identify potential approaches to combating relapse during behavioral interventions. Despite the study of resurgence for over half a century, there have been no systematic reviews of the basic/preclinical research on resurgence. To characterize the procedural and analytic methods used in basic/preclinical research on resurgence, we performed a systematic review consistent with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We identified 120 articles consisting of 200 experiments that presented novel empirical research, examined operant behavior, and included standard elements of a resurgence procedure. We reported prevalence and trends in over 60 categories, including participant characteristics (e.g., species, sample size, disability), designs (e.g., single subject, group), procedural characteristics (e.g., responses, reinforcer types, control conditions), criteria defining resurgence (e.g., single test, multiple tests, relative to control), and analytic strategies (e.g., inferential statistics, quantitative analysis, visual inspection). We make some recommendations for future basic, preclinical, and clinical research based on our findings of this expanding literature. Supplementary Information The online version contains supplementary material available at 10.1007/s40614-022-00361-y.
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Affiliation(s)
- Christopher A. Podlesnik
- Department of Psychology, University of Florida, 114 Psychology Building, 945 Center Drive, Gainesville, FL 32611-2250 USA
| | | | - Jo Waits
- Louisiana State University, Baton Rouge, LA USA
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10
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Fisher WW, Greer BD, Shahan TA, Norris HM. Basic and applied research on extinction bursts. J Appl Behav Anal 2023; 56:4-28. [PMID: 36193974 PMCID: PMC9868065 DOI: 10.1002/jaba.954] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/15/2022] [Indexed: 01/26/2023]
Abstract
Discontinuation of the contingency between a response and its reinforcer sometimes produces a temporary increase in the response before its rate decreases, a phenomenon called the extinction burst. Prior clinical and basic studies on the prevalence of the extinction burst provide highly disparate estimates. Existing theories on the extinction burst fail to account for the dynamic nature of this phenomenon, and the basic behavioral processes that control response bursting remain poorly understood. In this paper, we first review the basic and applied literature on the extinction burst. We then describe a recent refinement of the concatenated matching law called the temporally weighted matching law that appears to resolve the above-mentioned issues regarding the extinction burst. We present illustrative translational data based conceptually on the model. Finally, we discuss specific recommendations derived from the temporally weighted matching law regarding procedures clinicians could implement to potentially mitigate or prevent extinction bursts.
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Affiliation(s)
- Wayne W. Fisher
- Rutgers Brain Health Institute
- Children's Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services
- Department of PediatricsRutgers Robert Wood Johnson Medical School
| | - Brian D. Greer
- Rutgers Brain Health Institute
- Children's Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services
- Department of PediatricsRutgers Robert Wood Johnson Medical School
| | | | - Halle M. Norris
- Children's Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services
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11
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ABA and ABC Renewal during Ongoing Omission Training. PSYCHOLOGICAL RECORD 2022. [DOI: 10.1007/s40732-022-00524-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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12
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Greer BD, Fisher WW, Fuhrman AM, Mitteer DR. Conducting Translational Research in the Context of Patient Care. Perspect Behav Sci 2022; 45:383-398. [PMID: 35719871 PMCID: PMC9163257 DOI: 10.1007/s40614-022-00333-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 10/18/2022] Open
Abstract
Although much has been written on the importance of translational research for bridging the continuum of basic science to clinical practice, few authors have described how such work can be carried out practically when working with patient populations in the context of ongoing clinical service delivery, where the priorities for patient care can sometimes conflict with the methods and goals of translational research. In this article, we explore some of the considerations for conducting this type of work while balancing clinical responsibilities that ensure high-quality patient care. We also discuss strategies we have found to jointly facilitate translational research and improve routine, clinical service delivery. A primary goal of this article is to encourage others working in applied settings to contribute to the increasingly important role that translational research plays in our science and practice by helping to better characterize and potentially lessen or remove barriers that may have impeded such investigations in the past.
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Affiliation(s)
- Brian D. Greer
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
| | - Wayne W. Fisher
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
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13
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Keevy M, Bai JY, Ritchey CM, Podlesnik CA. Examining combinations of stimulus and contingency changes with children diagnosed with autism spectrum disorder and pigeons. LEARNING AND MOTIVATION 2022. [DOI: 10.1016/j.lmot.2022.101806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Finch KR, Kestner KM, Amanieh H. ABA and ABC Renewal during an Ongoing Fixed-Time Schedule. PSYCHOLOGICAL RECORD 2022. [DOI: 10.1007/s40732-022-00513-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Falligant JM, Chin MD, Kurtz PF. Renewal and resurgence of severe problem behavior in an intensive outpatient setting: Prevalence, magnitude, and implications for practice. BEHAVIORAL INTERVENTIONS 2022. [DOI: 10.1002/bin.1878] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- John M. Falligant
- Department of Behavioral Psychology Kennedy Krieger Institute Baltimore Maryland USA
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Michelle D. Chin
- Department of Behavioral Psychology Kennedy Krieger Institute Baltimore Maryland USA
| | - Patricia F. Kurtz
- Department of Behavioral Psychology Kennedy Krieger Institute Baltimore Maryland USA
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USA
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16
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Haney SD, Greer BD, Mitteer DR, Randall KR. Relapse during the treatment of pediatric feeding disorders. J Appl Behav Anal 2022; 55:704-726. [PMID: 35318658 PMCID: PMC10091143 DOI: 10.1002/jaba.913] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/16/2021] [Accepted: 01/25/2022] [Indexed: 01/05/2023]
Abstract
Resurgence and renewal are treatment-relapse phenomena in which previously extinguished behavior returns after the conditions for an alternative response worsen or the context changes, respectively. Recently, researchers have evaluated the prevalence of resurgence and renewal when treating destructive behavior with functional communication training. However, resurgence of inappropriate mealtime behavior has yet to be evaluated; perhaps because treatments involve qualitatively different resurgence opportunities (e.g., increased bite-presentation rate). We evaluated the prevalence of resurgence and renewal of inappropriate mealtime behavior across 22 and 25 applications of extinction-based treatments, respectively. Resurgence occurred in 41% (9/22) of applications, most often following presentation-rate increases. Renewal occurred in 52% (13/25) of applications, most often following feeder changes from therapist to caregiver. We discuss these findings in terms of their ability to inform relapse-mitigation strategies for resurgence and renewal of inappropriate mealtime behavior.
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Affiliation(s)
| | - Brian D Greer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES).,Rutgers Robert Wood Johnson Medical School
| | - Daniel R Mitteer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES).,Rutgers Robert Wood Johnson Medical School
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17
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Mitteer DR, Greer BD, Randall KR, Haney SD. On the scope and characteristics of relapse when treating severe destructive behavior. J Appl Behav Anal 2022; 55:688-703. [PMID: 35290666 DOI: 10.1002/jaba.912] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 01/10/2023]
Abstract
Prior studies on treatment relapse have typically examined the prevalence of resurgence or renewal of target behavior (e.g., destructive behavior) in isolation. This study analyzed both types of relapse during 25 consecutive treatments involving functional communication training during worsening reinforcement conditions for alternative behavior (i.e., schedule thinning) or following context changes. We also examined disruption of alternative behavior (i.e., functional communication requests, compliance). Resurgence and renewal of destructive behavior occurred in 76% and 69% of treatments, respectively, and in approximately a third of changes in reinforcement or context. Relapse of destructive behavior predicted alternative-response disruption and vice versa; the co-occurrence of these two events always exceeded the background probabilities of either event occurring in isolation. General reductions in treatment efficacy occurred across changes in reinforcement or context, with no apparent decrease in likelihood in later transitions. We discuss implications of our findings with respect to future studies examining treatment durability.
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Affiliation(s)
- Daniel R Mitteer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES).,Rutgers Robert Wood Johnson Medical School
| | - Brian D Greer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES).,Rutgers Robert Wood Johnson Medical School
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18
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Martinez-Perez CN, Ritchey CM, Kuroda T, Podlesnik CA. Blackouts can serve as a contextual feature and enhance resurgence. Behav Processes 2022; 195:104587. [DOI: 10.1016/j.beproc.2022.104587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 11/02/2022]
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19
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Smith SW, Greer BD. Phase duration and resurgence. J Exp Anal Behav 2022; 117:91-104. [PMID: 34762309 PMCID: PMC8908731 DOI: 10.1002/jeab.725] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/21/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022]
Abstract
Resurgence, the recurrence of responding due to a worsening of reinforcement conditions for current behavior, is a prevalent form of treatment relapse. Resurgence as Choice in Context predicts that increasing the duration of exposure to reinforcement for target responding during Phase 1 will increase resurgence magnitude, whereas increasing the duration of exposure to reinforcement for alternative responding and extinction for target responding during Phase 2 will decrease resurgence magnitude. We conducted an experiment evaluating these predictions with human participants recruited through Amazon's Mechanical Turk platform. We varied Phase 1 and Phase 2 durations across 4 experimental groups. Resurgence as Choice in Context successfully predicted the differences in resurgence magnitude across these groups, and fitting the quantitative model to the obtained data yielded an exceptional coefficient of determination. We discuss the implications of these results for using Resurgence as Choice in Context to inform experiments with human participants and the feasibility of using human-operant preparations to evaluate resurgence.
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Affiliation(s)
- Sean W. Smith
- Munroe-Meyer Institute, University of Nebraska Medical Center
- Severe Behavior Program, Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
| | - Brian D. Greer
- Severe Behavior Program, Children’s Specialized Hospital–Rutgers University Center for Autism Research, Education, and Services (CSH–RUCARES)
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
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20
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Ritchey CM, Kuroda T, Podlesnik CA. Evaluating effects of context changes on resurgence in humans. Behav Processes 2021; 194:104563. [PMID: 34871750 DOI: 10.1016/j.beproc.2021.104563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/23/2021] [Accepted: 12/01/2021] [Indexed: 12/29/2022]
Abstract
Laboratory models of relapse provide methods for evaluating challenges to behavioral treatments with differential reinforcement of an alternative response (DRA). Resurgence occurs with the worsening of conditions of reinforcement for appropriate behavior and renewal occurs when transitioning out of a treatment context. Across five experiments, participants recruited via online crowdsourcing pressed onscreen buttons to earn points exchangeable for money and contexts sometimes changed through changes in the background image. Returning to the training context (ABA, Experiment 1) and transitioning to a novel context (ABC, Experiment 2) produced greater resurgence when removing alternative reinforcement in comparison with remaining in the treatment context (ABB). In contrast, we observed little difference in resurgence among AAA, ABB, and AAC context manipulations (Experiment 3) and ABA, ABC, and AAC context manipulations (Experiment 4). In Experiment 5, we evaluated relative contributions of the presence versus absence of context changes (ABA vs. ABB) in combination with or without the removal of alternative reinforcement. Both changing context and removing alternative reinforcement increased responding in isolation and the combination produced greater-than-additive effects. Overall, the present findings demonstrate a consistent effect of removing alternative reinforcement on relapse that, under certain conditions, can be enhanced by context change.
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21
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Muething C, Call N, Ritchey CM, Pavlov A, Bernstein AM, Podlesnik CA. Prevalence of relapse of automatically maintained behavior resulting from context changes. J Appl Behav Anal 2021; 55:138-153. [PMID: 34734646 DOI: 10.1002/jaba.887] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/07/2022]
Abstract
Increases in behavior due to context changes are common and are known as instances of renewal. Clinically relevant examples from the literature highlighting renewal often include socially mediated problem behaviors. This report retrospectively analyzed data during context changes for individuals who engaged in problem behavior maintained by automatic reinforcement, to evaluate the prevalence of relapse. Problem behavior reemerged during changes both in the person implementing treatment (e.g., introducing a caregiver; 36%) and in the setting (e.g., introducing treatment in the home; 26%). Most prevalence studies report greatest relapse immediately following context changes but the highest level of relapse was observed after 5 sessions following person changes and no systematic pattern with setting changes. These patterns of relapse likely reflect differences in the function of settings and people relative to automatically reinforced behavior in the present study. Implications of relapse for treatments of problem behavior maintained by automatic reinforcement are discussed.
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Affiliation(s)
- Colin Muething
- Marcus Autism Center, Emory University School of Medicine
| | - Nathan Call
- Marcus Autism Center, Emory University School of Medicine
| | | | - Alexis Pavlov
- Marcus Autism Center, Emory University School of Medicine
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22
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Mitteer DR, Greer BD, Randall KR, Kimball RT, Smith SW. Empirically Deriving Omission and Commission Errors for Relapse Tests: A Demonstration of Reverse Translation. BEHAVIOR ANALYSIS (WASHINGTON, D.C.) 2021; 21:351-363. [PMID: 35005218 DOI: 10.1037/bar0000218] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Most studies examine treatment relapse by programming contextual changes with perfect treatment integrity or with omission errors in the absence of a context change (i.e., all alternative responses placed on extinction). Recently, Mitteer et al. (2018) examined caregiver behavior in response to a confederate playing the role of a child with destructive behavior, providing the opportunity for researchers to empirically derive reinforcement schedules and test caregiver error patterns within future relapse tests with children. The present study represents a pilot demonstration of methods for reverse translating findings from caregivers to relapse preparations with children. We used a human-operant arrangement with three children with autism spectrum disorder in which they (a) emitted a target response (i.e., pad touch) for a preferred item in a home-like context, (b) emitted an alternative response (e.g., card touch) for the item in a clinic context while the target response was extinguished, and (c) experienced a relapse test in which the experimenter programmed the same low-rate omission and commission errors that caregivers made in the prior study within the home-like context. During the relapse test, target responding approximated or exceeded baseline ranges for all cases, and alternative behavior extinguished for two of the three cases. We discuss how researchers might incorporate similar translation processes in future relapse research.
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Affiliation(s)
| | - Brian D Greer
- Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES).,Rutgers Robert Wood Johnson Medical School
| | - Kayla R Randall
- University of Nebraska Medical Center's Munroe-Meyer Institute
| | | | - Sean W Smith
- University of Nebraska Medical Center's Munroe-Meyer Institute
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23
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Kranak MP, Falligant JM. Further investigation of resurgence following schedule thinning: Extension to an inpatient setting. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Michael P. Kranak
- Department of Human Development and Child Studies Oakland University Rochester Michigan USA
- Oakland University Center for Autism Rochester Michigan USA
| | - John Michael Falligant
- Department of Behavioral Psychology Kennedy Krieger Institute Baltimore Maryland USA
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USA
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24
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Effects of delay of reinforcement on ABA renewal. Behav Processes 2021; 189:104440. [PMID: 34102272 DOI: 10.1016/j.beproc.2021.104440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/15/2021] [Accepted: 06/02/2021] [Indexed: 01/10/2023]
Abstract
ABA renewal was assessed by decreasing response rates by means of extinction or a 12-s delay of reinforcement in one experiment with rats. In a first phase, rats were trained to lever press for water in Context A. Rats were exposed to a second phase in Context B, where lever-pressing decreased for all rats; for one group of rats, lever-pressing decreased by means of extinction, while lever-pressing decreased by means of a 12-s delay for the other group. During a third phase, both groups were once again exposed to Context A with no reinforcer deliveries for lever-pressing. Once rats were exposed to the latter phase, renewal was observed for both groups. Results suggest that delay of reinforcement can be used as an alternative procedure to help reduce behavior and mitigate relapse.
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25
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Implementing Automated Nonparametric Statistical Analysis on Functional Analysis Data: A Guide for Practitioners and Researchers. Perspect Behav Sci 2021; 45:53-75. [DOI: 10.1007/s40614-021-00290-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 11/25/2022] Open
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26
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Muething C, Pavlov A, Call N, Ringdahl J, Gillespie S. Prevalence of resurgence during thinning of multiple schedules of reinforcement following functional communication training. J Appl Behav Anal 2020; 54:813-823. [DOI: 10.1002/jaba.791] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Colin Muething
- Marcus Autism Center Emory University School of Medicine
| | - Alexis Pavlov
- Marcus Autism Center Emory University School of Medicine
| | - Nathan Call
- Marcus Autism Center Emory University School of Medicine
| | - Joel Ringdahl
- Center for Autism and Behavioral Education Research University of Georgia
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27
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Kranak MP, Falligant JM, Hausman NL. Application of automated nonparametric statistical analysis in clinical contexts. J Appl Behav Anal 2020; 54:824-833. [PMID: 33084039 DOI: 10.1002/jaba.789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 01/10/2023]
Abstract
Functional analyses (FAs) provide clinicians with results upon which they design behavioral treatments. Unfortunately, interrater reliability of visual analysis of FA results can be inconsistent. Accordingly, researchers have designed quantitative metrics and visual aids to supplement visual analysis. Recently, Hall et al. (2020) provided a proof of concept for using automated nonparametric statistical analysis (ANSA) to interpret FA data. Their results show promise for ANSA as a supplemental tool. However, they evaluated ANSA with only published FA datasets, which may not be representative of FAs commonly encountered in clinical care. Therefore, the purpose of this replication was to compare ANSA to another validated supplemental aid (i.e., the structured criteria method) and investigate its utility with unpublished clinical FA data. Our results were consistent with Hall et al.'s, indicating ANSA may augment clinical interpretation of FA data. Recommendations for clinical applications of ANSA and future directions for researchers are discussed.
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Affiliation(s)
| | | | - Nicole L Hausman
- Kennedy Krieger Institute.,Johns Hopkins University School of Medicine
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28
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Kuroda T, Gilroy SP, Cançado CR, Podlesnik CA. Effects of punishing target response during extinction on resurgence and renewal in zebrafish (Danio rerio). Behav Processes 2020; 178:104191. [DOI: 10.1016/j.beproc.2020.104191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 12/13/2022]
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29
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Falligant JM, Kranak MP, McNulty MK, Schmidt JD, Hausman NL, Rooker GW. Prevalence of renewal of problem behavior: Replication and extension to an inpatient setting. J Appl Behav Anal 2020; 54:367-373. [PMID: 32578889 DOI: 10.1002/jaba.740] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 11/09/2022]
Abstract
Individuals with intellectual and developmental disabilities who exhibit problem behavior often receive behavioral assessment and treatment in specialized inpatient and outpatient clinics. However, problem behavior sometimes reemerges as a function of changes in contexts and stimulus conditions, such as returning to the home environment. This reemergence is called renewal. Recently, Muething et al. (2020) found that renewal occurred in over half (67%) of cases from an outpatient clinic. Their sample was obtained exclusively from an outpatient setting and despite the applied relevance of renewal, its clinical prevalence in other populations is unknown. Accordingly, we replicated Muething et al.'s procedures and analyzed renewal in 37 inpatient treatment applications across 34 cases via consecutive-controlled case series. Renewal was present in 59% of cases; however, we found that renewal occurred in only 24% of context changes compared to 42% reported by Muething et al. Various factors related to the prevalence of renewal were evaluated.
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Affiliation(s)
| | - Michael P Kranak
- Kennedy Krieger Institute.,Johns Hopkins University School of Medicine
| | | | | | - Nicole L Hausman
- Kennedy Krieger Institute.,Johns Hopkins University School of Medicine
| | - Griffin W Rooker
- Kennedy Krieger Institute.,Johns Hopkins University School of Medicine
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