Children's Specialized Hospital-Rutgers University Center for Autism Research, Education, and Services (CSH-RUCARES).
Rutgers Robert Wood Johnson Medical School.
J Appl Behav Anal. 2022 Jun;55(3):688-703. doi: 10.1002/jaba.912. Epub 2022 Mar 15.
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.
先前关于治疗复发的研究通常单独检查目标行为（例如，破坏性行为）的重现或恢复的流行率。本研究在 25 次连续治疗中分析了这两种类型的复发，这些治疗涉及在替代行为（即时间表变薄）的强化条件恶化或在环境变化后进行功能沟通训练。我们还检查了替代行为（即功能沟通请求，依从性）的中断。破坏性行为的重现和恢复分别发生在 76%和 69%的治疗中，大约三分之一的强化或环境变化中。破坏性行为的复发预测了替代反应的中断，反之亦然；这两个事件的同时发生总是超过了这两个事件单独发生的背景概率。在强化或环境变化中，治疗效果普遍降低，后期过渡的可能性没有明显降低。我们根据我们的发现讨论了未来研究中关于治疗持久性的意义。
