Assessment & Research

A laboratory model for evaluating relapse of undesirable caregiver behavior

Mitteer et al. (2018) · Journal of the Experimental Analysis of Behavior 2018
★ The Verdict

Test caregiver adherence under fake stress right in clinic—three out of four will relapse if you don’t.

✓ Read this if BCBAs teaching FCT to parents in clinic or home programs.
✗ Skip if Clinicians who only run 1:1 staffed therapy rooms.

01Research in Context

01

What this study did

Four adults played caregiver in a lab game. They learned to ignore fake crying and only give toys when the child pressed a card.

Next the researchers pretended the child was sick. Crying no longer produced toys. Three of the four adults quickly went back to giving toys for tears.

The team wanted a safe way to see if caregivers will stick with FCT when real life gets hard.

02

What they found

Caregiver relapse happened fast. Only one adult kept following the plan.

The switch back to old ways took just minutes once the payoff changed.

This shows that even trained adults can fold under mild pressure.

03

How this fits with other research

Shahan et al. (2021) saw the same bounce-back in kids. When they cut rewards too fast, problem behavior returned. Both studies say the same thing: sudden loss of payoff brings back old responses.

Lerman (2024) warns that fancy protocols fail if the user quits. Mitteer’s lab model gives you a quick test bench before you hand the protocol to real families.

Branch (2019) pushes for built-in replication. This single-case design does exactly that—each caregiver is their own control, so you can trust the relapse signal.

04

Why it matters

Before you send Mom home with FCT cards, run a five-minute stress probe in clinic. Have her ignore staged crying while you watch. If she slips, add practice and thinner steps. This cheap check can save weeks of retraining later.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

After the parent masters ignore-toy routine, fake a mini-meltdown and see if they still withhold—note any lapse and rehearse again.

02At a glance

Intervention
functional communication training
Design
single case other
Sample size
4
Population
not specified
Finding
mixed

03Original abstract

The success of behavioral treatments like functional communication training depends on their continued implementation outside of the clinical context, where failures in caregiver treatment adherence can lead to the relapse of destructive behavior. In the present study, we developed a laboratory model for evaluating the relapse of undesirable caregiver behavior that simulates two common sources of disruption (i.e., changes in context and in treatment efficacy) believed to affect caregiver treatment adherence using simulated confederate destructive behavior. In Phase 1, the caregiver’s delivery of reinforcers for destructive behavior terminated confederate destructive behavior in a home-like context. In Phase 2, the caregiver implemented functional communication training in a clinical context in which providing reinforcers for destructive or alternative behavior terminated confederate destructive behavior. In Phase 3, the caregiver returned to the home-like context, and caregiver behavior produced no effect on confederate destructive or alternative behavior, simulating an inconsolable child. Undesirable caregiver behavior relapsed in three of four treatment-adherence challenges.

Journal of the Experimental Analysis of Behavior, 2018 · doi:10.1002/jeab.462