Behavior and Behavior Mechanisms
Conditions
Keywords
behavioral sciences, reinforcement schedule, motivation, economics, behavioral, developmental disability, intellectual disability, problem behavior, extinction bursts
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.
Interventions
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).
Sponsors
Study design
Masking description
Participants will be randomized to one of four baseline reinforcement conditions. They will not be informed of which condition they have been assigned to, or why they have been assigned to it.
Intervention 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.
Eligibility
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 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
| Measure | Time frame | Description |
|---|---|---|
| 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. |
Countries
United States
Participant flow
Recruitment details
Recruitment entailed flyer distribution through relevant program directors. Directors vetted interest and only passed along contact information of individuals from their organization who expressed interest in the study.
Pre-assignment details
Prior to randomization, all participants completed an assessment (i.e., the progressive-ratio analysis) that generated our matching variable (i.e., the breakpoint produced by the targeted reinforcer). Five participants dropped out during this assessment (prior to randomization). The reasons for dropping out were scheduling conflicts (x4) and a significant health concern unrelated to this study (x1).
Participants by arm
| Arm | Count |
|---|---|
| Cheap Unit Price, Establishing Operation 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.
Demand Informed Moderator Analysis: 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). | 15 |
| Cheap Unit Price, Abolishing Operation 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.
Demand Informed Moderator Analysis: 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). | 19 |
| Expensive Unit Price, Establishing Operation 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.
Demand Informed Moderator Analysis: 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). | 18 |
| Expensive Unit Price, Abolishing Operation 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.
Demand Informed Moderator Analysis: 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). | 17 |
| Total | 69 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Overall Study | Protocol Violation | 1 | 0 | 0 | 1 |
| Overall Study | Withdrawal by Subject | 4 | 1 | 2 | 3 |
Baseline characteristics
| Characteristic | Cheap Unit Price, Abolishing Operation | Total | Expensive Unit Price, Abolishing Operation | Expensive Unit Price, Establishing Operation | Cheap Unit Price, Establishing Operation |
|---|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 3 Participants | 7 Participants | 1 Participants | 1 Participants | 2 Participants |
| Age, Categorical Between 18 and 65 years | 16 Participants | 62 Participants | 16 Participants | 17 Participants | 13 Participants |
| Disability Autism Spectrum Disorder | 4 Participants | 12 Participants | 4 Participants | 2 Participants | 2 Participants |
| Disability Deaf-Blindness | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Disability Deafness | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Disability Emotional Disturbance | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Disability Hearing Impairment | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Disability Intellectual Disability | 16 Participants | 59 Participants | 15 Participants | 17 Participants | 11 Participants |
| Disability Multiple Disabilities | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Disability Orthopedic Impairment | 1 Participants | 2 Participants | 0 Participants | 0 Participants | 1 Participants |
| Disability Other Health Impairment | 2 Participants | 9 Participants | 5 Participants | 2 Participants | 0 Participants |
| Disability Specific Learning Disability | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Disability Speech or Language Impairment | 1 Participants | 2 Participants | 0 Participants | 1 Participants | 0 Participants |
| Disability Traumatic Brain Injury | 0 Participants | 2 Participants | 0 Participants | 0 Participants | 2 Participants |
| Disability Visual Impairment, Including Blindness | 0 Participants | 2 Participants | 0 Participants | 1 Participants | 1 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 1 Participants | 0 Participants | 1 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 19 Participants | 68 Participants | 17 Participants | 17 Participants | 15 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 2 Participants | 2 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 5 Participants | 1 Participants | 3 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 16 Participants | 61 Participants | 16 Participants | 15 Participants | 14 Participants |
| Region of Enrollment United States | 19 Participants | 69 Participants | 17 Participants | 18 Participants | 15 Participants |
| Sex: Female, Male Female | 10 Participants | 29 Participants | 6 Participants | 5 Participants | 8 Participants |
| Sex: Female, Male Male | 9 Participants | 40 Participants | 11 Participants | 13 Participants | 7 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 15 | 0 / 19 | 0 / 18 | 0 / 17 |
| other Total, other adverse events | 0 / 15 | 0 / 19 | 0 / 18 | 0 / 17 |
| serious Total, serious adverse events | 0 / 15 | 0 / 19 | 0 / 18 | 0 / 17 |
Outcome results
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.
Time frame: This measure was obtained throughout the primary assessment (i.e., the extinction challenge)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Cheap Unit Price, Establishing Operation | Peak Response Rate During Extinction | 1.58 Proportion of baseline (frequency) | Standard Deviation 1.77 |
| Cheap Unit Price, Abolishing Operation | Peak Response Rate During Extinction | 0.85 Proportion of baseline (frequency) | Standard Deviation 0.85 |
| Expensive Unit Price, Establishing Operation | Peak Response Rate During Extinction | 1.3 Proportion of baseline (frequency) | Standard Deviation 0.87 |
| Expensive Unit Price, Abolishing Operation | Peak Response Rate During Extinction | 0.43 Proportion of baseline (frequency) | Standard Deviation 0.41 |
Response Latency
This term describes the latency from session onset to eventual response cessation during the extinction challenge.
Time frame: This measure was obtained throughout the primary assessment (i.e., the extinction challenge)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Cheap Unit Price, Establishing Operation | Response Latency | 213.3 seconds | Standard Deviation 185.6 |
| Cheap Unit Price, Abolishing Operation | Response Latency | 96 seconds | Standard Deviation 114.4 |
| Expensive Unit Price, Establishing Operation | Response Latency | 467.4 seconds | Standard Deviation 607.9 |
| Expensive Unit Price, Abolishing Operation | Response Latency | 119.8 seconds | Standard Deviation 132.1 |
Schedule Value at Breakpoint
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.
Time frame: PRA breakpoints were obtained during pre-assessment and were used as a matching variable prior to random assignment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Cheap Unit Price, Establishing Operation | Schedule Value at Breakpoint | 16.45 Schedule Value at Breakpoint | Standard Deviation 13.24 |
| Cheap Unit Price, Abolishing Operation | Schedule Value at Breakpoint | 15.14 Schedule Value at Breakpoint | Standard Deviation 10.21 |
| Expensive Unit Price, Establishing Operation | Schedule Value at Breakpoint | 16.94 Schedule Value at Breakpoint | Standard Deviation 14.53 |
| Expensive Unit Price, Abolishing Operation | Schedule Value at Breakpoint | 18.82 Schedule Value at Breakpoint | Standard Deviation 15.07 |
The Schedule Value Designated as Pmax
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.
Time frame: Pmax values were obtained during pre-assessment and were used as a scaling variable to set baseline schedule parameters.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Cheap Unit Price, Establishing Operation | The Schedule Value Designated as Pmax | 7.6 The Schedule Value Designated as Pmax | Standard Deviation 4.42 |
| Cheap Unit Price, Abolishing Operation | The Schedule Value Designated as Pmax | 7.32 The Schedule Value Designated as Pmax | Standard Deviation 4.23 |
| Expensive Unit Price, Establishing Operation | The Schedule Value Designated as Pmax | 9 The Schedule Value Designated as Pmax | Standard Deviation 4.12 |
| Expensive Unit Price, Abolishing Operation | The Schedule Value Designated as Pmax | 7.71 The Schedule Value Designated as Pmax | Standard Deviation 4.44 |
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.
Time frame: This measure was obtained throughout the primary assessment (i.e., the extinction challenge)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Cheap Unit Price, Establishing Operation | Number of Sessions in Extinction | 1.2 Number of sessions in extinction | Standard Deviation 0.41 |
| Cheap Unit Price, Abolishing Operation | Number of Sessions in Extinction | 1.05 Number of sessions in extinction | Standard Deviation 0.23 |
| Expensive Unit Price, Establishing Operation | Number of Sessions in Extinction | 1.89 Number of sessions in extinction | Standard Deviation 1.94 |
| Expensive Unit Price, Abolishing Operation | Number of Sessions in Extinction | 1.06 Number of sessions in extinction | Standard Deviation 0.24 |
Overall Session Duration
The investigators will measure the total duration of PFRA sessions (in seconds) at Pmax to establish baseline-session parameters.
Time frame: Duration values were obtained during pre-assessment and were used as a scaling variable to set baseline schedule parameters.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Cheap Unit Price, Establishing Operation | Overall Session Duration | 630.87 seconds | Standard Deviation 462.36 |
| Cheap Unit Price, Abolishing Operation | Overall Session Duration | 687.84 seconds | Standard Deviation 843.27 |
| Expensive Unit Price, Establishing Operation | Overall Session Duration | 668.89 seconds | Standard Deviation 757.57 |
| Expensive Unit Price, Abolishing Operation | Overall Session Duration | 788.88 seconds | Standard Deviation 930.85 |