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Objective: The current study examined trajectories of anxiety during (a) acute treatment and (b) extended follow‐up to better characterize the long‐term symptom trajectories of youth who received evidence‐based intervention for anxiety disorders using a person‐centered approach. Method: Participants were 319 youth (age 7–17 years at enrollment), who participated in a multicenter randomized controlled trial for the treatment of pediatric anxiety disorders, Child/Adolescent Anxiety Multimodal Study, and a 4‐year naturalistic follow‐up, Child/Adolescent Anxiety Multimodal Extended Long‐term Study, an average of 6.5 years later. Using growth mixture modeling, the study identified distinct trajectories of anxiety across acute treatment (Weeks 0–12), posttreatment (Weeks 12–36), and the 4‐year‐long follow‐up, and identified baseline predictors of these trajectories. Results: Three nonlinear anxiety trajectories emerged: "short‐term responders" who showed rapid treatment response but had higher levels of anxiety during the extended follow‐up; "durable responders" who sustained treatment gains; and "delayed remitters" who did not show an initial response to treatment, but showed low levels of anxiety during the maintenance and extended follow‐up periods. Worse anxiety severity and better family functioning at baseline predicted membership in the delayed remitters group. Caregiver strain differentiated short‐term responders from durable responders. Conclusions: Findings suggest that initial response to treatment does not guarantee sustained treatment gains over time for some youth. Future follow‐up studies that track treated youth across key developmental transitions and in the context of changing social environments are needed to inform best practices for the long‐term management of anxiety. [ABSTRACT FROM AUTHOR]

Localized cutaneous leishmaniasis caused by Leishmania braziliensis can either respond well or poorly to the treatment or heal spontaneously; It seems to be dependent on the parasite and/or host factors, but the mechanisms are not fully understood. We evaluated the in situ immune response in eighty-two active lesions from fifty-eight patients prior to treatment classified as early spontaneous regression (SRL-n = 14); treatment responders (GRL-n = 20); and non-responders (before first treatment/relapse, PRL1/PRL2-n = 24 each). Immunohistochemistry was used to identify cell/functional markers which were correlated with the clinical characteristics. PRL showed significant differences in lesion number/size, clinical evolution, and positive parasitological examinations when compared with the other groups. SRL presented a more efficient immune response than GRL and PRL, with higher IFN-γ/NOS2 and a lower percentage of macrophages, neutrophils, NK, B cells, and Ki-67+ cells. Compared to SRL, PRL had fewer CD4+ Tcells and more CD163+ macrophages. PRL1 had more CD68+ macrophages and Ki-67+ cells but less IFN-γ than GRL. PRL present a less efficient immune profile, which could explain the poor treatment response, while SRL had a more balanced immune response profile for lesion healing. Altogether, these evaluations suggest a differentiated profile of the organization of the inflammatory process for lesions of different tegumentary leishmaniasis evolution. [ABSTRACT FROM AUTHOR]

Translation of promising procedures for mitigating treatment relapse has received considerable attention recently from researchers across the basic–applied continuum. One procedure that has demonstrated mixed support involves increasing the duration of treatment as a strategy for blunting resurgence. In a recent translational study, Greer et al. (2020) failed to detect a mitigation effect of increased treatment duration on the resurgence of destructive behavior. However, design limitations may have been responsible. The present study corrected these limitations by (a) employing a sequential design to decrease the possibility of multiple‐treatment interference, (b) evaluating more treatment durations, (c) arranging treatments of fixed durations, and (d) conducting treatments of more extreme duration in a different clinical sample. Despite these improvements in experimental rigor and the testing of more extreme boundary conditions, the present study also failed to detect a mitigation effect of increased treatment duration. Likely explanations are discussed. [ABSTRACT FROM AUTHOR]

Localized cutaneous leishmaniasis caused by Leishmania braziliensis can either respond well or poorly to the treatment or heal spontaneously; It seems to be dependent on the parasite and/or host factors, but the mechanisms are not fully understood. We evaluated the in situ immune response in eighty-two active lesions from fifty-eight patients prior to treatment classified as early spontaneous regression (SRL-n = 14); treatment responders (GRL-n = 20); and non-responders (before first treatment/relapse, PRL1/PRL2-n = 24 each). Immunohistochemistry was used to identify cell/functional markers which were correlated with the clinical characteristics. PRL showed significant differences in lesion number/size, clinical evolution, and positive parasitological examinations when compared with the other groups. SRL presented a more efficient immune response than GRL and PRL, with higher IFN-γ/NOS2 and a lower percentage of macrophages, neutrophils, NK, B cells, and Ki-67+ cells. Compared to SRL, PRL had fewer CD4+ Tcells and more CD163+ macrophages. PRL1 had more CD68+ macrophages and Ki-67+ cells but less IFN-γ than GRL. PRL present a less efficient immune profile, which could explain the poor treatment response, while SRL had a more balanced immune response profile for lesion healing. Altogether, these evaluations suggest a differentiated profile of the organization of the inflammatory process for lesions of different tegumentary leishmaniasis evolution.

Resurgence and renewal are treatment‐relapse phenomena in which previously extinguished behavior returns after the conditions for an alternative response worsen or the context changes, respectively. Recently, researchers have evaluated the prevalence of resurgence and renewal when treating destructive behavior with functional communication training. However, resurgence of inappropriate mealtime behavior has yet to be evaluated; perhaps because treatments involve qualitatively different resurgence opportunities (e.g., increased bite‐presentation rate). We evaluated the prevalence of resurgence and renewal of inappropriate mealtime behavior across 22 and 25 applications of extinction‐based treatments, respectively. Resurgence occurred in 41% (9/22) of applications, most often following presentation‐rate increases. Renewal occurred in 52% (13/25) of applications, most often following feeder changes from therapist to caregiver. We discuss these findings in terms of their ability to inform relapse‐mitigation strategies for resurgence and renewal of inappropriate mealtime behavior. [ABSTRACT FROM AUTHOR]

Prior studies on treatment relapse have typically examined the prevalence of resurgence or renewal of target behavior (e.g., destructive behavior) in isolation. This study analyzed both types of relapse during 25 consecutive treatments involving functional communication training during worsening reinforcement conditions for alternative behavior (i.e., schedule thinning) or following context changes. We also examined disruption of alternative behavior (i.e., functional communication requests, compliance). Resurgence and renewal of destructive behavior occurred in 76% and 69% of treatments, respectively, and in approximately a third of changes in reinforcement or context. Relapse of destructive behavior predicted alternative‐response disruption and vice versa; the co‐occurrence of these two events always exceeded the background probabilities of either event occurring in isolation. General reductions in treatment efficacy occurred across changes in reinforcement or context, with no apparent decrease in likelihood in later transitions. We discuss implications of our findings with respect to future studies examining treatment durability. [ABSTRACT FROM AUTHOR]

Sweet syndrome is a neutrophilic dermatosis that may be associated with malignancy, particularly haematological malignancy. Considering its rarity, the clinical characteristics of Sweet syndrome are still unclear. We aimed to analyse clinicopathological characteristics, treatment, and outcomes of patients with Sweet syndrome according to concurrent malignancy. We retrospectively reviewed patients with Sweet syndrome at the Department of Dermatology from January 2001 to August 2021. We identified 66 patients (median age: 58 years old; 57.6% male) with Sweet syndrome: 24.2% with the classic form, 36.3% with the malignancy-associated form, and 15.1% with the drug-induced form. Idiopathic Sweet syndrome was most common in the non-malignancy group (18.1%). Leukopenia (p = 0.008), anaemia (p = 0.004), and thrombocytopenia (p = 0.013) were significantly associated with malignancy. No significant difference in histopathology was identified between patients with and without haematological malignancy. Systemic corticosteroids were the most commonly used therapy (n=44, 66.6%). Relapse of Sweet syndrome was more prevalent in the malignancy group. Patients with Sweet syndrome who have laboratory evidence of leukopenia, anaemia and thrombocytopenia should be investigated for malignancy. Sweet syndrome often occurs as a paraneoplastic feature.

Functional communication training (FCT) is highly effective for treating socially maintained problem behavior when based on the results of functional analyses (FA). Research suggests that combining relevant antecedents and consequences of problem behavior during FCT can be an efficient approach to treatment for behavior that is multiply controlled. However, no studies have evaluated whether treatment effects under combined conditions would transfer to single, or isolated, conditions. Participants were 5 children with autism, aged 3 years to 6 years, who engaged in problem behavior maintained by both escape from demands and access to tangibles. An experimenter coached their caregivers via video conferencing to implement FA and FCT in their homes. All participants received FCT under a combined condition, followed by brief exposure to sessions with isolated antecedents and consequences. Treatment effects for just 1 of the 5 participants immediately persisted under isolated conditions. These results suggest that, when caregivers combine variables relevant to multiple functions during FCT, exposure to isolated conditions may at least temporarily produce treatment failures. [ABSTRACT FROM AUTHOR]

Quantitative models of resurgence (e.g., Behavioral Momentum Theory, Resurgence as Choice) suggest that resurgence is partly a function of the duration of extinction exposure, with longer histories of extinction producing less resurgence. This prediction is supported by some laboratory research and has been partially supported by clinical translations that did not isolate the effects of extinction exposure prior to testing for resurgence. The degree to which different histories of extinction impact the likelihood of treatment relapse in therapeutic applications of differential reinforcement is of great interest to the clinical community, including insurance carriers and other financial providers. In the present study, we isolated the effects of extinction history for severe destructive behavior across 6 participants referred for treatment services and examined resurgence of destructive behavior when alternative reinforcement terminated. Our within‐subject evaluation showed no difference in the level of resurgence or persistence of destructive behavior following short and long exposures to differential reinforcement with extinction. We discuss our failure to replicate in relation to experimental‐design considerations for investigating this and other relapse phenomena in future research with clinical populations. [ABSTRACT FROM AUTHOR]

Operant renewal is a form of relapse in which a previously extinguished response recurs due to a change in context. We designed two experiments to examine the impact of differential reinforcement of alternative behavior on ABA renewal in a translational model of relapse with 12 children. We compared levels of renewal in two 3‐phase arrangements. In one arrangement, we reinforced target responding in Context A, extinguished responding in Context B, and returned to Context A while continuing to implement extinction. In a second arrangement, an alternative response produced reinforcement in Context B and during the return to Context A. Results across the 2 experiments indicated 3 general findings. First, extinction plus differential reinforcement disrupted target behavior more consistently in Context B relative to extinction alone. Second, renewal tended to be greater and more persistent during extinction alone relative to extinction plus differential reinforcement. Third, the renewal effect appeared to depend on whether the alternative response had a history of extinction in Context A. We discuss methodological implications for the treatment of severe destructive behavior. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACE) are a public health concern and strong predictor of substance abuse, but no studies to date have explored the association between ACE and opioid relapse during medication-assisted treatment. Using an observational design, we examined this relationship using archived medical records of 87 patients who attended opioid use disorder treatment (buprenorphine-naloxone and group counseling) at a rural medical clinic. All variables were collected from medical files. ACE scores were derived from a 10-item screening questionnaire administered at intake, a regular procedure for this clinic. The primary outcome was opioid relapse observed at each visit, as indicated by self-reported opioid use, positive urine drug screen for opioids, or prescription drug database results for opioid acquisition. The sample was 100% Caucasian and 75% male. A total of 2052 visit observations from the 87 patients were extracted from the medical records. Patients had an average of 23.6 (SD = 22) treatment visits. Opioid relapse occurred in 54% of patients. Results indicated that for every unit increase in ACE score, there was an increase of 17% in the odds of relapse (95% CI: 1.05-1.30, p = .005). Additionally, each treatment visit was associated with a 2% reduction in the odds of opioid relapse (95% CI: 0.97-0.99, p = .008). We conclude that ACE may increase the risk for poor response to buprenorphine-naloxone treatment due to high rates of opioid relapse during the first treatment visits. However, consistent adherence to treatment is likely to reduce the odds of opioid relapse. [ABSTRACT FROM AUTHOR]

The present study examined whether resurgence of a previously reinforced target response upon removing alternative reinforcement would be greater when (1) returning to the original training context (ABA context changes) versus (2) remaining in the analogue treatment context in which the alternative response was differentially reinforced (ABB context changes). Experiment 1 arranged reinforcement of button pressing with points exchangeable for money in university students. Experiment 2 arranged reinforcement of lever pressing with food for rats. Experiment 3 arranged reinforcement of responses to a touchscreen with small bites of food with children diagnosed with ASD. Overall, resurgence of target responding tended to be greater when returning to the original training context (A) than when remaining in the analogue treatment context (B). These findings suggest context changes with differential reinforcement treatments could exacerbate the recurrence of problem behavior resulting from reductions in treatment integrity through failure to reinforce appropriate behavior. [ABSTRACT FROM AUTHOR]

ABA renewal is one type of operant renewal in which a target response is reinforced in a unique context (i.e., Context A), extinguished in novel context (i.e., Context B), and then recurs following a transition back to the original context. Recently, researchers have examined the robust phenomenon of ABA renewal when differential reinforcement of an alternative response is included in Context B and the renewal test. One method to mitigate ABA renewal is to program common stimuli so as to increase the similarity between Context A and Context B. This stimulus control strategy may support the generalization of behavior change between contexts. Currently, no studies exist on how to empirically derive the selection of the stimuli to program into Context B. We conducted a preliminary investigation using eye-tracking software to empirically determine which common stimulus to program into a three-phase ABA renewal arrangement that included differential reinforcement for 12 undergraduate students in a translational preparation. Our results replicate previous research demonstrating ABA renewal despite differential reinforcement contingencies. Further, ABA renewal may be less robust and more variable when common stimuli selected for programming are empirically determined using eye-tracking software. [ABSTRACT FROM AUTHOR]

Concepts from behavioral momentum theory, along with some empirical findings, suggest that the rate of baseline reinforcement may contribute to the relapse of severe destructive behavior. With seven children who engaged in destructive behavior, we tested this hypothesis in the context of functional communication training by comparing the effects of different baseline reinforcement rates on resurgence during a treatment challenge (i.e., extinction). We observed convincing resurgence of destructive behavior in four of seven participants, and we observed more resurgence in the condition associated with high‐rate baseline reinforcement (i.e., variable‐interval 2 s in Experiment 1 or fixed‐ratio 1 in Experiment 2) compared to a low‐rate baseline reinforcement condition. We discuss the implications of these results relative to schedules of reinforcement in the treatment of destructive behavior and strategies to mitigate resurgence in clinical settings. [ABSTRACT FROM AUTHOR]

Following reduction, behavior may recur when organisms are exposed to new or different environments. Such recurrences, called treatment relapse, are characterized by an increase of a previously reduced behavior. Renewal is a type of treatment relapse resulting from changes in stimulus contexts despite the ongoing maintenance of treatment. Renewal types include varying arrangements, such as ABA and ABC renewal, where each letter represents a different context. In the present series of translational analyses, we evaluated both ABA and ABC renewal and assessed whether these two renewal arrangements may be present in a single participant's behavior. Results produced evidence of both ABA and ABC renewal, and both types of renewal were detected in an individual participant's behavior. [ABSTRACT FROM AUTHOR]

Renewal is a relapse phenomenon that occurs when previously treated target behavior re-emerges as a result of context change. Typically, a target response is reinforced in Context A, extinguished in Context B, and then re-emerges in Context A - despite the continuation of the extinction procedure. In the current study, we initially reinforced inappropriate mealtime behavior or aggression in Context A across three children diagnosed with Autism Spectrum Disorder. Next, therapists either differentially reinforced an alternative response or extinguished responding by terminating the relationship between problem behavior and the reinforcer in Context B. Problem behavior re-emerged upon the return to Context A even though treatments continued. Finally, we tested repeated exposure to Context A and pairing Contexts A and B for mitigating renewal. Results suggested that modification of the training conditions can effectively mitigate renewal of responding. [ABSTRACT FROM AUTHOR]

Resurgence and reinstatement are laboratory models of relapse following treatments for problem behavior that arrange alternative sources of reinforcement, such as differential reinforcement of alternative behavior and noncontingent reinforcement. Resurgence models the elimination or reduction of reinforcers during treatment and reinstatement models the re‐presentation of reinforcers previously maintaining problem behavior. The present study examined individual and combined effects of resurgence and reinstatement in a translational model of treatment relapse with three children diagnosed with Autism Spectrum Disorder. We first reinforced and then extinguished an arbitrary response while providing access to a preferred toy to model a version of noncontingent reinforcement with extinction. In the following phases, we examined resurgence by removing the toy, reinstatement by presenting the training reinforcer response‐independently, and a combination of resurgence and reinstatement. Overall, relapse of target responding reliably exceeded functionally similar responses never reinforced in the experimental situation. Most importantly, relapse tended to be greater when combining resurgence and reinstatement than when assessing either alone. These findings support previous studies showing that combinations of operations can increase treatment relapse. This translational model arranging simulated problem behavior with arbitrary tasks provides a platform from which to thoroughly and systematically assess methods for understanding and improving behavioral treatments. [ABSTRACT FROM AUTHOR]

Basic and translational research provides the opportunity to evaluate variables that may be difficult to examine thoroughly with clinical populations. For example, practitioners report that problem behavior treated with differential reinforcement of alternative behavior (DRA) is often prone to treatment relapse . We sought to assess resurgence in the context of an animal model of a clinical DRA treatment with pigeons. In Experiment 1, we demonstrated that an animal model of a clinical DRA preparation produced a resurgence of a previously extinguished target response when extinguishing a more recently trained alternative response. In Experiment 2, we found that repeatedly reversing reinforcement and extinction contingencies between target and alternative responding tended to increase the likelihood of resurgence of target responding relative to no contingency reversals. The resurgence of target responding in both experiments is discussed in the context of developing novel animal models closely approximating applied conditions as a platform to assess manipulations relevant to designing better behavioral treatments for problem behavior. [ABSTRACT FROM AUTHOR]

Maintenance and generalization have been inconsistently defined in the behavior analytic literature. The term treatment relapse is used commonly in the medical and mental health literature to refer to the return of a condition that was previously considered successfully treated. Basic behavioral researchers have studied relapse related to behavioral momentum theory (BMT). The present authors discuss the differences in terminology and propose the field adopt the term treatment relapse when treatments are no longer effective or when their effects are not present in settings in which the treatment was not originally implemented. The implications BMT has for designing behavioral interventions to minimize or avoid treatment relapse are discussed along with a brief review of applied studies that demonstrate BMT may be useful for practitioners and applied researchers. [ABSTRACT FROM AUTHOR]

Chronic hepatitis C virus (HCV) infection can now be treated with oral directly acting antiviral agents, either with or without ribavirin (RBV). Virologic relapse after treatment can occur, and in some studies was more common in cirrhotic subjects. We previously observed changes in hepatic immunity during interferon (IFN)-free therapy that correlated with favourable outcome in subjects with early liver disease. Here, we compared changes in endogenous IFN pathways during IFN-free, RBV-free therapy between cirrhotic and noncirrhotic subjects. mRNA and micro RNA (miRNA) expression analyses were performed on paired pre- and post-treatment liver biopsies from genotype-1 HCV subjects treated with sofosbuvir/ledipasvir (SOF/LDV) for 12 weeks ( n = 4, 3 cirrhotics) or SOF/LDV combined with GS-9669 or GS-9451 for 6 weeks ( n = 6, 0 cirrhotics). Nine of ten subjects achieved a sustained virologic response (SVR), while one noncirrhotic subject relapsed. Hepatic IFN-stimulated gene expression decreased with treatment in the liver of all subjects, with no observable impact of cirrhosis. Hepatic gene expression of type III IFNs ( IFNL1, IFNL3, IFNL4-ΔG) similarly decreased with treatment, while IFNA2 expression, undetectable in all subjects pretreatment, was detected post-treatment in three subjects who achieved a SVR. Only the subject who relapsed had detectable IFNL4-ΔG expression in post-treatment liver. Other IFNs had no change in gene expression ( IFNG, IFNB1, IFNA5) or could not be detected. Although expression of multiple hepatic mi RNAs changed with treatment, many mi RNAs previously implicated in HCV replication and IFN signalling had unchanged expression. In conclusion, favourable treatment outcome during IFN-free HCV therapy is associated with changes in the host IFN response regardless of cirrhosis. [ABSTRACT FROM AUTHOR]

Treatment relapse, defined as the reemergence of problem behavior after treatment, is a serious difficulty faced by clinicians. Failures of treatment integrity (i.e., failure to implement interventions as intended) are often invoked to explain the reemergence of problem behavior. Basic studies suggest that the prevailing stimulus context might also contribute. We conducted 2 experiments in which reinforcement for a target response was followed by 2 phases of extinction with different or identical stimulus contexts relative to baseline (ABA renewal). In Experiment 1, pigeons served as subjects using procedures typical of those used in basic behavioral research. Experiment 2 was designed as a translational replication of Experiment 1, and children who had been diagnosed with autism served as participants. Returning to the previously reinforced stimulus context in both species produced a clear and immediate increase of extinguished responding. These findings are consistent with previous studies that have suggested that both reinforcement contingencies and stimulus context influence the reemergence of extinguished behavior. [ABSTRACT FROM AUTHOR]

The relapse of problem behavior after apparently successful treatment is an enduring problem for the field of applied behavior analysis. Several theoretical accounts of treatment relapse have emerged over the years. However, one account that has received considerable recent attention is based on behavioral momentum theory (BMT). BMT has shown that behavior is more persistent in contexts that are correlated with higher rates of reinforcers after disruption of the response-reinforcer relation. Accordingly, relapse after successful treatment can be viewed as the persistence of behavior when treatment is compromised in some manner. We review basic BMT research, alternative accounts of treatment relapse, and translational research studies derived from BMT research. The implications for applied behavior analysis in practice are discussed along with potential solutions to the problem of treatment relapse. [ABSTRACT FROM AUTHOR]

Behavioral Momentum Theory (BMT) has inspired animal models of treatment relapse. We translated the models of reinstatement and resurgence into clinical procedures to test whether relapse tests would replicate behavior pattern found in basic research. Following multiple schedule baseline reinforcement of a 16-year-old male's problem behavior at equal rates by two therapists, treatment was introduced using a variable-interval, variable-time (VI VT) schedule arrangement with therapists delivering reinforcers at different rates. Despite the differing rates of VI VT reinforcers, the treatment produced comparable reductions in problem behavior. Following successful treatment, the two therapists discontinued treatment and resumed reinforcement of problem behavior at equal rates that constituted a reinstatement of baseline conditions. As predicted by BMT, reinstatement resulted in an immediate return of high rates of problem behavior but was 2.6 times higher for the therapist using the higher rate VI VT treatment. A second treatment phase was implemented followed by a test of resurgence in a single extended extinction session conducted separately for each therapist. The unequal VI VT treatment rates by therapists resulted in 2.1 times greater responding in the resurgence test for the therapist who implemented the higher rate VI VT procedure. These results are consistent with basic research studies and BMT. [ABSTRACT FROM AUTHOR]

This review concerned the important pediatric studies published between April 2012 and March 2013. Symptomatology in Helicobacter pylori-positive children is nonspecific, except for those suffering from peptic ulcer diseases. Investigation of H. pylori status in children and adolescents with sideropenic anemia is recommended, and it is the aim of several studies worldwide. Associations of H. pylori with plasma ghrelin levels as well as the negative association of H. pylori with atopic disease were interesting objectives for several studies this year. Success rates of sequential therapy tended to be lower in recent studies than in previous trials, which probably reflects the increase in macrolide resistance. A beneficial effect of probiotics was reported although not all trials supported this result in children. Intrafamilial transmission and young age could be major risk factors associated with reinfection in children. [ABSTRACT FROM AUTHOR]

This study assessed the stability of the headgear-activator combination treatment, followed by edgewise mechanotherapy, 5.75 years after treatment. The experimental group consisted of 23 patients who were evaluated during treatment and after treatment. Two compatible control groups consisting of 15 Class II, division 1 patients and 24 normal occlusion individuals were used. This enabled us to evaluate the changes during treatment and after treatment, respectively. Results showed that the anteroposterior dentoalveolar changes and the maxillary and the mandibular positions remained stable in the long term. However, there was a slight relapse of the maxillomandibular relationship probably because the maxilla resumed its normal development and the mandibular growth rate was smaller than in the control group. The overbite demonstrated a statistically significant relapse that was directly proportional to the amount of its correction. There were low but significant inverse correlations between the changes in Go-Gn during and after treatment. These included the uprighting of the maxillary incisors, labial tipping of the mandibular incisors, and the amount of molar relationship correction during treatment and their stability. Active retention time, length of posttreatment period, initial Class II malocclusion severity (ANB and Wits), and initial molar relationship did not present any correlation with molar relationship and overjet relapse. However, the initial overjet presented a low but statistically significant correlation with molar relationship relapse and overjet relapse. [ABSTRACT FROM AUTHOR]

Most studies examine treatment relapse by programming contextual changes with perfect treatment integrity or with omission errors in the absence of a context change (i.e., all alternative responses placed on extinction). Recently, Mitteer et al. (2018) examined caregiver behavior in response to a confederate playing the role of a child with destructive behavior, providing the opportunity for researchers to empirically derive reinforcement schedules and test caregiver error patterns within future relapse tests with children. The present study represents a pilot demonstration of methods for reverse translating findings from caregivers to relapse preparations with children. We used a human-operant arrangement with three children with autism spectrum disorder in which they (a) emitted a target response (i.e., pad touch) for a preferred item in a home-like context, (b) emitted an alternative response (e.g., card touch) for the item in a clinic context while the target response was extinguished, and (c) experienced a relapse test in which the experimenter programmed the same low-rate omission and commission errors that caregivers made in the prior study within the home-like context. During the relapse test, target responding approximated or exceeded baseline ranges for all cases, and alternative behavior extinguished for two of the three cases. We discuss how researchers might incorporate similar translation processes in future relapse research.