About this trial
Although behavioral treatments for decreasing destructive behavior, such as differential reinforcement of alternative behavior (DRA), are effective in the clinic, problem behavior often returns when a caregiver does not give the child their way in the natural environment (e.g., caregiver is busy with an infant sibling). This form of treatment relapse is known as resurgence. The goal of the current study is to evaluate whether alternating sessions in which the child can have their way (i.e., "on" sessions) with sessions in which the child can not have their way (i.e., "off" sessions) helps to mitigate resurgence.
Eligibility criteria
Qualifiers
boys and girls from ages 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 who do not meet the inclusion criteria;
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;
Trial design
Treatments tested in this trial
- CDT
- Control