Preventing Relapse of Problem Behavior Through Behavioral Economics: A Translational Analysis

NCT06651606 | Recruiting DMC

• 1 other identifier: 1R21HD113794-01A1
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 2

Brief Summary

The goal of this clinical trial is to compare a novel tactic for mitigating reinstatement compared to the current standard of care approach using a translational-treatment model. The main questions it aims to answer are:

1. 1.how well does progressive ratio training mitigate response-dependent reinstatement compared to the standard of care approach?
2. 2.how well does progressive ratio training mitigate response-independent reinstatement compared to the standard of care approach?

Conditions

Problem Behavior

Outcome Measures

Primary Outcomes (1)

• Treatment Effectiveness

  The number of individuals for whom treatment remains effective (either progressive ratio training or current standard-of-care), which investigators will determine by comparing the mean rate of responding in baseline and subsequent conditions (Treatment and Reinstatement Tests 1 and 2). If investigators find at least an 80% reduction in target behavior in a condition (a standard clinical target for problem behavior), they will conclude that the treatment is effective (or remains effective).

  2 years

Secondary Outcomes (1)

• Proportional and Comparative Effectiveness

  2 years

Study Arms (2)

Progressive Ratio Training

EXPERIMENTAL

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.

Behavioral: Progressive Ratio Training (PRT)

Standard of Care

EXPERIMENTAL

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.

Behavioral: Differential Reinforcement of Alternative (DRA) Behavior with Extinction

Interventions

Progressive Ratio Training (PRT) BEHAVIORAL

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.

Progressive Ratio Training

Differential Reinforcement of Alternative (DRA) Behavior with Extinction BEHAVIORAL

In DRA with extinction, the proxy for problem behavior is placed on extinction and no longer produces reinforcement. The proxy for communication behavior produces reinforcement on a fixed-ratio 1 schedule of reinforcement.

Standard of Care

Eligibility Criteria

• Age: 6 Years - 21 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Boys and girls from ages 6 to 21
• Engage in problem behavior
• Diagnosis of some type of intellectual and developmental disability

Sponsors & Collaborators

• Oakland University: lead
• Auburn University: collaborator

Study Sites (2)

Auburn University

Auburn, Alabama, 36849, United States

RECRUITING

Oakland University

Rochester, Michigan, 48309, United States

RECRUITING

MeSH Terms

Conditions

Problem Behavior

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Child Behavior

Study Officials

• Michael P Kranak, PhD

  Oakland University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Michael P Kranak, PhD

CONTACT

248-370-4251; kranak@oakland.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 18, 2024
• First Posted: October 22, 2024
• Study Start: September 30, 2024
• Primary Completion: March 10, 2026
• Study Completion (Estimated): September 10, 2026
• Last Updated: August 21, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will share
• Time Frame: Data will become available at the completion of the study as specified in the approved Data Management and Sharing Plan.
• Access Criteria: Data will be accessible as specified in the approved Data Management and Sharing Plan.

Locations

US (2)