Caregiver adherence to treatment plans is likely maintained by negative reinforcement and can contact extinction when child responding relapses. When caregiver adherence contacts extinction, caregiver nonadherence, such as reinforcing their child's challenging behavior, relapses, threatening treatment efficacy. Previous laboratory models demonstrating the relapse of caregiver nonadherence only evaluated treatment for behavior maintained by social-positive reinforcement, not that maintained by social-negative reinforcement. These models only measured caregiver nonadherence as discrete events, which cannot capture the magnitude of each error. The present study was an evaluation of the relapse of caregiver nonadherence during simulated treatments for escape-maintained challenging behavior. First, caregivers placed demands in a home-like setting and a research confederate responded to these demands in a manner mimicking clinical clients. Next, caregivers were taught to implement treatment in a clinical setting and the confederate's behavior gradually improved. Last, caregivers returned to the home-like setting and confederate challenging behavior relapsed. Nonadherence relapsed for all caregivers, demonstrating the need for additional research on methods for mitigating caregiver relapse during treatment of children's challenging behavior and the usefulness of the proposed measurement system for future research.

中文翻译：

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扩展用于评估护理人员不依从复发的实验室模型

照顾者对治疗计划的遵守可能是通过负强化来维持的，并且当儿童反应复发时可能会濒临灭绝。当看护者的依从性接近消失时，看护者的不依从性（例如强化孩子的挑战性行为）、旧病复发、威胁治疗效果。先前证明看护者不依从复发的实验室模型仅评估了对社会积极强化维持的行为的治疗，而不是对社会消极强化维持的行为的治疗。这些模型仅将护理人员不依从性作为离散事件进行测量，无法捕捉每个错误的严重程度。本研究是对逃避维持挑战性行为的模拟治疗期间看护者不依从复发的评估。首先，护理人员在类似家庭的环境中提出要求，研究同盟以模仿临床客户的方式回应这些要求。接下来，护理人员被教导如何在临床环境中实施治疗，同伙的行为逐渐改善。最后，护理人员回到了像家一样的环境，并且同盟的挑战性行为再次出现。所有看护者的不依从性都会复发，这表明需要对在治疗儿童挑战性行为期间减轻看护者复发的方法进行额外的研究，以及所提出的测量系统对未来研究的有用性。