Stereotypic Behaviors and Feeding Difficulties in Adults With Developmental Disabilities

ConditionsHarmful Stereotypies Feeding Difficulties

Trial statusRecruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexAll

Age18+

SponsorOslo University Hospital

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.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

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.

Disqualifiers

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,

Trial design

Design model

Sequential

Treatments tested in this trial

Fading and chaining combined with differential reinforcement
Behavioral
Intervention Treatment will involve backward chaining, fading and differential reinforcement.
Differential reinforcement of high rate
Behavioral
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.
Response interruption with redirection
Behavioral
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.
Chained schedules
Behavioral
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.

Treatment groups

8 Participants

are divided into 3 treatment groups

Group A: Intake refusalExperimental treatment 1 intervention

Group B: Slow pace of self-feedingExperimental treatment 1 intervention

Group C: Debilitating stereotypiExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

Frequency recording

Each target behavior in the study will be measured with a frequency recording and graphed as behavior change over time.

Time frame

Each experimental phase will last until there is a stable-state performance of the target behavior, typically within 4-8 weeks.

Sponsors and contacts

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Oslo University Hospital

Lead sponsor

Oslo Metropolitan University

Collaborator

Source ClinicalTrials.gov

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