Behavioral Economics Strategies for Problem Behavior

Recruiting at 1 trial location

Overseen By Michael P Kranak, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Oakland University

Disqualifiers: Not meeting inclusion criteria

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 24 months

24 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to test a new method to reduce problem behaviors in children and young adults with intellectual and developmental disabilities. It will compare the usual treatment, which rewards positive behaviors while ignoring negative ones, with a new approach called Progressive Ratio Training. This method gradually increases the effort needed to receive a reward, potentially preventing the return of problem behaviors. Ideal candidates for this trial are individuals aged 6 to 21 who have been diagnosed with an intellectual or developmental disability and frequently exhibit problem behaviors. As an unphased trial, this study offers participants the opportunity to contribute to innovative research that could lead to more effective treatments.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these behavioral strategies are safe for participants?

Research has shown that Differential Reinforcement of Alternative Behavior with Extinction (DRA) is generally well-tolerated. This approach rewards positive behaviors while ignoring negative ones. Studies indicate that it reduces unwanted behaviors by encouraging positive ones instead.

Early findings suggest that Progressive Ratio Training (PRT) is safe and effective. This method gradually increases the effort needed to earn rewards, helping to decrease problem behaviors over time. Some research highlights its ability to manage responses when mistakes occur, without causing harm.

Both treatments focus on changing behaviors through rewards, which typically ensures safety for participants. Existing studies report no significant side effects with these methods. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these strategies because they use innovative behavioral approaches to manage problem behavior. Differential Reinforcement of Alternative Behavior with Extinction (DRA with extinction) focuses on rewarding positive behaviors while ignoring the negative ones, which is different from many current methods that might rely on more punitive measures. Progressive Ratio Training (PRT) is another novel technique that gradually increases the effort required for a problematic response to earn a reward, potentially leading to more sustainable behavior change. These methods aim to provide more effective and lasting solutions for individuals struggling with problem behaviors by focusing on positive reinforcement and strategic behavior modification.

What evidence suggests that this trial's treatments could be effective for problem behavior?

Research has shown that Differential Reinforcement of Alternative Behavior with Extinction (DRA), which participants in one arm of this trial will receive, can help reduce problem behaviors by encouraging positive ones. Studies have found that rewarding good behaviors while not reinforcing problem behaviors leads people to adopt positive behaviors more consistently. Another method tested in this trial is Progressive Ratio Training (PRT). Participants in the PRT arm will experience this approach, which involves gradually increasing the effort needed to earn rewards, thereby helping to decrease negative behaviors. Research suggests that with PRT, harmful behaviors noticeably drop as individuals learn to work for their rewards. Both methods have successfully promoted positive behavior changes. ^{1 3 4 5 6}

Who Is on the Research Team?

Michael P Kranak, PhD

Principal Investigator

Oakland University

Are You a Good Fit for This Trial?

This trial is for boys and girls aged 6 to 21 who show problem behavior and have been diagnosed with an intellectual or developmental disability, including learning disabilities or expressive language disorder. Those who do not meet these specific criteria cannot participate.

Inclusion Criteria

Engage in problem behavior

Diagnosis of some type of intellectual and developmental disability

I am between 6 and 21 years old.

Exclusion Criteria

Not meeting the inclusion criteria

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either the standard of care approach or progressive ratio training to mitigate problem behavior

24 months

Reinstatement Tests

Participants undergo tests to evaluate the effectiveness of the treatment in preventing reinstatement of problem behavior

24 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4-8 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Differential Reinforcement of Alternative Behavior with Extinction
• Progressive Ratio Training

Trial Overview The study is testing two methods: Progressive Ratio Training (PRT) and Differential Reinforcement of Alternative Behavior with Extinction, to see how they prevent the return of problem behaviors compared to standard treatments.

How Is the Trial Designed?

Group I: Standard of Care Experimental Treatment 1 Intervention

Participants in the standard of care Arm will receive an analogue to the standard of care approach for problem behavior: differential reinforcement of alternative behavior (DRA) with extinction. In DRA with extinction, the proxy for problem behavior will cease to produce reinforcement while the proxy for communication behavior will produce reinforcement on a fixed-ratio 1 schedule of reinforcement.

Group II: Progressive Ratio Training Experimental Treatment 1 Intervention

Participants in the progressive ratio training Arm will experience the novel reinstatement-mitigation tactic: Progressive Ratio Training (PRT). Progressive ratio training (PRT) is used to prevent recurrence of the proxy response when extinction errors occur. PRT involves providing a reinforcer for the proxy response on a geometric progressive ratio (PR) scale. The schedule requirement will increase for the target response each time a reinforcer is delivered. For example, once a reinforcer is delivered on the PR-2 schedule, the requirement will increase to a PR-4, then to a PR-8, -16, -32, etc.

Who Is Running the Clinical Trial?

Oakland University

Lead Sponsor

Trials

15

Recruited

3,300+

Auburn University

Collaborator

Trials

81

Recruited

14,600+

Published Research Related to This Trial

In a study with 32 college students, manipulating reinforcement dimensions (magnitude, immediacy, and quality) for appropriate behavior significantly reduced problem behavior during a button-pressing task.

The most effective results were observed when all three dimensions of reinforcement were combined, suggesting that enhancing the appeal of alternative behaviors can improve treatment outcomes without the need for extinction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Varying reinforcer dimensions during differential reinforcement without extinction: A translational model. Iannaccone, JA., Jessel, J.[2023]

Differential reinforcement of alternative behavior (DRA) can be effective without requiring the extinction of problem behaviors, which expands its applicability in behavioral treatments.

The proposed definition of DRA emphasizes providing greater reinforcement for desired behaviors while minimizing reinforcement for undesired behaviors, allowing for flexibility in treatment approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

On the definition of differential reinforcement of alternative behavior. Vollmer, TR., Peters, KP., Kronfli, FR., et al.[2021]

The study demonstrated that differential reinforcement of alternative behavior (DRA) can be effectively implemented without using extinction, which is often necessary but can be counterproductive if not done correctly.

By assessing individual sensitivities to reinforcement parameters like quality, magnitude, and immediacy, the researchers tailored interventions that significantly reduced problem behavior in all participants, highlighting the importance of personalized approaches in behavioral treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Manipulating parameters of reinforcement to reduce problem behavior without extinction. Kunnavatana, SS., Bloom, SE., Samaha, AL., et al.[2019]

In a study involving 4 participants, one of two preferred stimuli was found to be more effective in promoting responses as the effort required increased, indicating that not all reinforcers work equally under different conditions.

The findings suggest that using progressive-ratio schedules can help identify which reinforcers are more effective for treating destructive behavior, particularly as the effort needed to obtain them increases.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing reinforcers under progressive schedule requirements. Roane, HS., Lerman, DC., Vorndran, CM.[2018]

The study involved seven children with developmental disabilities and explored how different aspects of reinforcement (duration, quality, and delay) could encourage appropriate behavior over problem behavior without using extinction methods.

The most significant and consistent improvements in behavior were achieved when multiple reinforcement strategies were combined, indicating that a comprehensive approach can effectively reduce problem behaviors and promote appropriate ones.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An investigation of differential reinforcement of alternative behavior without extinction. Athens, ES., Vollmer, TR.[2021]

Differential reinforcement of alternative behavior (DRA) can effectively reduce destructive behavior without using extinction, by adjusting the quality and magnitude of reinforcement for compliance in participants.

Maintaining the effectiveness of DRA during reinforcement schedule thinning often requires a combination of both the magnitude and quality of reinforcement, highlighting the need for tailored approaches in behavioral interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Further investigation of differential reinforcement of alternative behavior without extinction for escape-maintained destructive behavior. Briggs, AM., Dozier, CL., Lessor, AN., et al.[2020]

Differential reinforcement of alternative behavior (DRA) has been effective in reducing a wide range of unwanted behaviors, from minor issues like communication difficulties to serious problems such as failure to thrive, based on a review of 116 studies over 30 years.

DRA has a strong track record for treating destructive behaviors in individuals with developmental disabilities and is also effective in addressing food refusal, indicating its versatility as a behavioral intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A review of empirical support for differential reinforcement of alternative behavior. Petscher, ES., Rey, C., Bailey, JS.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2998250/

AN INVESTIGATION OF DIFFERENTIAL ... Abstract. We manipulated relative reinforcement for problem behavior and appropriate behavior using differential reinforcement of alternative behavior (DRA) ...

2. nu.edu nu.edu/blog/what-is-differential-reinforcement/

What is Differential Reinforcement? Exploring its Applications Explore differential reinforcement, a technique that promotes positive behaviors and discourages negative ones, and learn its benefits here.

3. howtoaba.com howtoaba.com/dro-procedure/

Understanding DRO (Differential Reinforcement of Other ... DRO is an ABA technique used to reduce or eliminate challenging behaviors by reinforcing any behavior other than the negative behavior.

4. quizlet.com quizlet.com/ca/691104523/week-11-differential-reinforcement-flash-cards/

week 11 - differential reinforcement Flashcards Differential reinforcement schedules (check this) are schedules that reinforce specific rates of responding. They may be used to reinforce high or low response ...

5. iris.peabody.vanderbilt.edu iris.peabody.vanderbilt.edu/module/bi2-elem/cresource/q1/p08/

Page 8: Differential Reinforcement of Alternative Behavior Differential reinforcement involves either giving, reducing, or withholding reinforcement, depending on whether the behavior is desirable or undesirable.

6. ebip.vkcsites.org ebip.vkcsites.org/differential-reinforcement/

Differential Reinforcement | EBIP - VKCSites.org Differential reinforcement consists of two parts: (1) withholding reinforcement for the challenging behavior, and (2) providing reinforcement for an ...