Descriptive functional analysis of behavioral excesses shown by adults with Down syndrome and dementia

OBJECTIVES: The study examined the hypothesis that a functional relationship exists between social environmental events and behavioral excesses in individuals with Down syndrome and dementia. DESIGN: A case-series design was employed (n = 4) using an direct observation-based descriptive functional assessment procedure. METHODS: Observations were conducted in the natural environments of four participants over periods ranging from 11 to 15.4 hours. Data were collected on non-verbal and verbal behavioral excesses, appropriate engagement and verbal interaction with others. Social environmental events observed including both staff and peer behavior. RESULTS: Analysis of co-occurrence for behavioral excesses and social environmental events indicated significant relationships for some behaviours consistent with operant reinforcement processes. Sequential analysis showed that changes in the probability of social contact occurred in the period directly preceding and following verbal behaviors. CONCLUSIONS: Results support the hypothesis that, consistent with literature for older adults with dementia in the general population, some behavioral excesses were functional in nature and not randomly occurring events. No relationship was found between appropriate engagement and staff contact. Evidence of the functional nature of target behavioral excesses indicates that behavioral interventions have potential for this client group.