NCT05790668

Motivational Refinements for Facilitating Reinforcement Schedule Thinning

Recruiting now NA Last updated 24 July 2025

What this trial tests

NA trial testing Traditional Schedule Thinning in Decreasing Destructive Behavior in 30 participants. Currently enrolling.

Timeline

24 October 2023

Primary endpoint
31 May 2028

31 August 2028

Quick facts

Lead sponsor	Rutgers, The State University of New Jersey
Phase	NA
Status	Recruiting now
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	single
Primary purpose	treatment
Enrollment	30
Start date	24 October 2023
Primary completion	31 May 2028
Estimated completion	31 August 2028
Sites	2 locations across United States

Drugs / interventions tested

• Traditional Schedule Thinning
• PIA-Informed Schedule Thinning
• PIA-Informed Schedule Thinning with Competing Stimuli

Conditions studied

• Decreasing Destructive Behavior — all drugs for Decreasing Destructive Behavior →
• Increasing Functional Communicative Behavior — all drugs for Increasing Functional Communicative Behavior →

Sponsor

Rutgers, The State University of New Jersey

Who can join

Adults 3 to 17, any sex, with Decreasing Destructive Behavior or Increasing Functional Communicative Behavior. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Destructive behavior represents a comorbid condition of developmental disability for which risk increases with intellectual disability severity, communication deficits, and co-occurring autism spectrum disorder. Destructive behavior, such as self-injurious behavior and aggression, causes harm to the child and others and increases the risk for institutionalization, social isolation, physical restraint, medication overuse, and abuse. Clinicians have used functional analyses to identify the variables that reinforce destructive behavior and to develop effective, function-based treatments. Functional communication training (FCT) is an empirically supported, function-based treatment that decreases destructive behavior. Using FCT, the clinician teaches the child to use a functional communication response (FCR) to request the reinforcer maintaining destructive behavior, while placing destructive behavior on extinction. For example, if functional analysis results showed that attention reinforced destructive behavior, the clinician would provide attention when the child used the FCR ("Play with me, please") and would not provide attention for destructive behavior. Two limitations of FCT are that (a) schedules of reinforcement maintaining the FCR must often be thinned gradually to levels that are practical for caregivers to implement consistently in the home and in the community, and (b) this necessary process of reinforcement schedule thinning regularly causes destructive behavior to increase following initially effective treatment, a form of treatment relapse called resurgence. The current project aims to improve these limitations of FCT by (a) hastening the process of reinforcement schedule thinning by removing unnecessary schedule-thinning steps using the results of a progressive interval assessment and (b) mitigating the resurgence of destructive behavior by providing stimuli that highly compete with the reinforcer maintaining destructive behavior. The investigators will conduct a randomized clinical trial to evaluate the extent to which these two promising refinements to FCT improve the process of reinforcement schedule thinning, and an exploratory experiment will examine the interactive effects of these two approaches. This novel project has the potential to substantially improve standards of care guiding the treatment of severe destructive behavior and to improve the long-term outcomes for children and families afflicted by these debilitating behavior disorders.

Publications & conference data

No peer-reviewed publications indexed yet for this trial.