Using preferred communication tools to reduce challenging behavior

Harnessing Communication Preferences to Enhance Its Persistence and Mitigate Relapse of Challenging Behavior

This project will test whether using a person's favored communication tool (for example a touch talker or picture cards) helps keep behavior improvements and prevents relapse in people with intellectual or developmental disabilities who have little or no verbal speech.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 60 (estimated)
• Ages: 2 Years to 90 Years
• Sex: All
• Sponsor: University of Georgia (other)
• Locations: 2 sites (Athens, Georgia and 1 other locations)
• Trial ID: NCT07278544 on ClinicalTrials.gov

What this trial studies

The study will recruit about 60 individuals with intellectual or developmental disabilities who engage in challenging behaviors and have little to no functional verbal communication. Investigators will identify two device-based augmentative and alternative communication (AAC) strategies for each participant using validated proficiency and preference assessments, then label them as preferred and lesser-preferred modalities. Participants will receive functional communication training (FCT) with both the preferred and non-preferred AAC strategies and researchers will compare how well each approach maintains gains and resists relapse when interventions are disrupted. The trial will also examine whether age, baseline symptom severity, or communication functioning predict which modality produces more persistent benefits.

Who should consider this trial

Good fit: Ideal candidates are people aged 2 years and older with an intellectual or developmental disability who engage in challenging behavior, have little to no functional verbal communication, and can demonstrate proficiency with two device-based AAC strategies.

Not a fit: People who communicate functionally with vocal speech, cannot be safely observed during assessment, or can only use a single AAC strategy are unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, this work could help caregivers and clinicians choose communication methods that better maintain behavioral improvements and reduce relapse risk.

How similar studies have performed: Functional communication training and AAC approaches have strong evidence for reducing challenging behavior, but using a person's communication preference to improve treatment maintenance and prevent relapse is a relatively novel question with limited prior data.

Eligibility criteria

Inclusion Criteria:

* 2 years old and older.
* Diagnosis of intellectual or developmental disability.
* Referred for assessment and treatment of challenging behavior.

Exclusion Criteria:

* Challenging behavior does not occur within the context of structured assessment, eliminating the ability to identify its operant function, or the behavior is deemed too dangerous to safely observe during assessment.
* Communicate functionally using vocal/verbal communication.
* Can only identify one proficient AAC strategy.

Where this trial is running

Athens, Georgia and 1 other locations

• University of Georgia — Athens, Georgia, United States (RECRUITING)
• University of Iowa — Iowa City, Iowa, United States (RECRUITING)

Study contacts

• Study coordinator: Joel Ringdahl, PhD

Conditions: Intellectual Disability, Autism Spectrum Disorder, Self-Injurious Behavior, Communication Disabilities, Communication, Nonverbal, Functional communication training, Treatment maintenance, Behavioral relapse