Stereotypic Behaviors and Feeding Difficulties in Adults With Developmental Disabilities

Summary

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.

Conditions

• Harmful Stereotypies
• Feeding Difficulties

Interventions

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.

Sponsors & Collaborators

• Oslo Metropolitan University

  collaborator OTHER

• Oslo University Hospital

  lead OTHER

Principal Investigators

• Petur I Petursson, MS, BCBA · Oslo University Hospital

• Sigmund Eldevik, PhD, BCBA-D · Oslo Metropolitan University

Study Design

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-04-08

Primary Completion

2030-08-26

Completion

2030-08-26

Countries

• Norway

Study Locations