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RECRUITINGINTERVENTIONAL

Stereotypic Behaviors and Feeding Difficulties in Adults With Developmental Disabilities

Stereotypi in Motor-, Vocal- and Feeding Behaviors: Novel Extensions to Adults

Important: This information is not medical advice. Talk to your doctor about whether a clinical trial is right for you.

About This Trial

Adults with developmental disabilities (DD) and autism represent a vulnerable demographic that transitions into adulthood with diverse etiologies, exhibiting a significantly higher prevalence of various challenging behaviors. These problematic behaviors can lead to adverse health outcomes and a diminished quality of life. Addressing these issues often necessitates an interdisciplinary approach to continuity of care, focusing on enhancing functional skills, empowerment, and independence, as well as preventing and mitigating challenging behaviors. The current research proposal comprises of three studies designed to evaluate the efficacy of behavioral interventions for problematic behaviors in adults with DD and autism. If left unaddressed, these behaviors may worsen over time, potentially hindering community involvement, educational opportunities, and employment prospects. These include harmful stereotypies and feeding difficulties.

Who May Be Eligible (Plain English)

Who May Qualify: - Participants will be recruited through referrals at the Department of Neurohabilitation, or from other hospitals in the Oslo Region. - be 18 years or older, - have a DD, autism spectrum disorder or a PDD-NOS diagnosis - and be referred to the specialist habilitation service for adults. Who Should NOT Join This Trial: - If there are medical causes of the participant's behavioral problem or - a reasonable possibility that the referred problem is caused by medical variables - if the client participant receives communal care services and if those are not in accordance with Norwegian standards of services for individuals with DD. - This could include inappropriate staff-to-client ratio, - lack of stimulating activities, - or if on-site training is insufficient. - the exclusion criteria do not exclude health care from The Oslo University Hospital. Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language
Inclusion Criteria: * Participants will be recruited through referrals at the Department of Neurohabilitation, or from other hospitals in the Oslo Region. * be 18 years or older, * have a DD, autism spectrum disorder or a PDD-NOS diagnosis * and be referred to the specialist habilitation service for adults. Exclusion Criteria: * If there are medical causes of the participant's behavioral problem or * a reasonable possibility that the referred problem is caused by medical variables * if the client participant receives communal care services and if those are not in accordance with Norwegian standards of services for individuals with DD. * This could include inappropriate staff-to-client ratio, * lack of stimulating activities, * or if on-site training is insufficient. * the exclusion criteria do not exclude health care from The Oslo University Hospital.

Treatments Being Tested

BEHAVIORAL

Fading and chaining combined with differential reinforcement

Intervention Treatment will involve backward chaining, fading and differential reinforcement.

BEHAVIORAL

Differential reinforcement of high rate

This will be identical to baseline, except a DRH will be introduced: The participant will be instructed to complete his whole meal within set time criteria to receive an identified reinforcer.

BEHAVIORAL

Response interruption with redirection

RIRD involves physically blocking a movement from occurring using the least amount of physical contact for max 3 s, and then redirecting behavior to an ongoing activity or movement. Stereotypi that is verbal or not possible to block physically will involve a demand to answer a verbal question or a motor task that sufficiently interrupts the behavior and then redirecting.

BEHAVIORAL

Chained schedules

The following procedures are based on Slaton et al. (2016): At the start of each session, the candidate or therapist will hold up the red card, prompt the participant to touch the card, while saying "we are in red now, time to work". The participant will have to perform age- or function appropriate tasks without stereotypi to gain access to the green phase. Demand will be designated with a token economy, where each token represents completion of a certain amount of task-related responses. The participant will not be prompted to perform the tasks. If the participant makes an error in a task (e.g. answer a math question incorrectly), this will lead to an error correction and no token will be presented. If stereotypi occurs, it will be blocked for up to 3 s, and then all demands will be reset by removing all earned tokens.

Locations (1)

Department of Neurohabilitation, Oslo University Hospital
Oslo, Oslo County, Norway