About this trial
Although highly effective, treatments like FCT include extinction, which can have adverse side effects. The extinction burst, an increase in the frequency or intensity of destructive behavior at the start of treatment, is the most common side effect of extinction, and can increase the risk of harm to the patient and others. The goal of the current study is to evaluate the prevalence of extinction bursts when various parameters of reinforcement (i.e., rate, magnitude, quality) are manipulated.
Eligibility criteria
Qualifiers
children aged 3 to 17;
problem behavior that occurs at least 10 times a day, despite previous treatment;
problem behavior maintained by social positive reinforcement;
stable protective supports for self-injurious behavior (e.g., helmet) with no anticipated changes during enrollment;
Disqualifiers
patients currently receiving 15 or more hours per week of treatment for their problem behavior;
DSM-5 diagnosis of Rett syndrome or other degenerative conditions (e.g., inborn error of metabolism);
a comorbid health condition or major mental disorder that would interfere with study participation;
occurrence of self-injury during study assessments that presents a risk of serious or permanent harm (e.g., detached retinas) based on our routine clinical-risk assessment;
Trial design
Treatments tested in this trial
- Extinction-only condition
- Rate-drop condition
- Rate-hold condition
- Magnitude-drop condition
- Magnitude-hold condition
- Quality-drop condition
- Quality-hold condition
- Rate-drop/quality-increase condition