A laboratory model for evaluating relapse of undesirable caregiver behavior
Test caregiver adherence under fake stress right in clinic—three out of four will relapse if you don’t.
01Research in Context
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.
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.
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.
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.
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02At a glance
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