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

Millichap, David; Oliver, Chris; McQuillan, Sharna; Kalsy, Sunny; Lloyd, Vicki; Hall, Scott S.

doi:10.1002/gps.930

Cited by 23 publications

(16 citation statements)

References 35 publications

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“…A time-based sequential analysis model was used to determine the temporal associations between challenging behaviour and environmental events (Emerson, Thompson, Reeves, Henderson, & Robertson, 1995;Emerson et al, 1996;Forman, Hall, & Oliver, 2002;Millichap et al, 2003). It calculated the conditional probability of escape delivery, attention delivery and tangible delivery occurring, given an episode of challenging behaviour.…”

Section: Discussionmentioning

confidence: 99%

Use of the structured descriptive assessment to identify possible functions of challenging behaviour exhibited by adults with brain injury

Rahman

Alderman

Oliver

2013

Neuropsychological Rehabilitation

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Behaviour modification procedures for challenging behaviour, based on principles of operant learning, benefit from an accurate appraisal of behavioural function. Numerous methods of direct and indirect functional assessment exist, which have relative strengths and weaknesses. In this study, structured descriptive assessments were used to identify the function of challenging behaviour. The application of this hybrid approach has been unexplored in the neurobehavioural literature. The structured descriptive assessments involved the systematic manipulation of antecedent variables (only) that were conducted by typical caregivers in the normal environment. Also, observational software was used to provide a high degree of analytical detail. The methodology was found to be effective in generating hypotheses of behavioural function and also efficient as a clinical research tool. Only just over 2.25 hours of assessment data were collected for each participant, on average, and yet functional relationships emerged in respect of all four participants. The aggression exhibited by two participants was deemed to serve a demand escape function and the challenging behaviours of the other two participants were attributed to an attention gaining function. Future studies should implement additional validity measures by corroborating findings with other (experimental) functional assessment techniques or by implementing treatment programmes based on its results.

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Section: Discussionmentioning

confidence: 99%

Use of the structured descriptive assessment to identify possible functions of challenging behaviour exhibited by adults with brain injury

Rahman

Alderman

Oliver

2013

Neuropsychological Rehabilitation

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“…Given the possibility of operant reinforcement and the empirical evidence for the drive to seek adult attention in children with Angelman syndrome, it may be predicted that aggressive behavior in these children will be socially positively reinforced, thus demonstrating an interaction between one aspect of the behavioral phenotype of Angelman syndrome and operant learning. Models incorporating interaction between genetic disorders and environmental factors offer a plausible account of the development of behaviors such as aggression and self-injury in Angelman, Prader-Willi, Lesch-Nyhan, Rett, Down, Cornelia de Lange, and Smith-Magenis syndromes (see respectively : Oliver et al, 2007;Woodcock, Oliver & Humphreys, 2009;Hall, Oliver & Murphy, 2001;Oliver, Murphy, Crayton & Corbett, 1993;Millichap, Oliver, McQuillan, Kalsy, Hall & Lloyd, 2003;Arron et al, 2006;Taylor and Oliver, 2008). Social attention may act as a particularly effective reinforcer for aggressive behavior in children with…”

Section: Introductionmentioning

confidence: 99%

Experimental functional analysis of aggression in children with Angelman syndrome

Strachan

Shaw

Burrow

et al. 2009

Research in Developmental Disabilities

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“…This likely relates to the difficulty in diagnosing psychotic symptoms in people with DS, as their language ability often does not allow them to describe internal experiences [49]. Moreover, selftalk and experiencing imaginary persons/friends or a fantasy world [74][75][76] needs to be distinguished from true hallucinations. Whether the few changes in psychotic symptoms in DS can be explained by an actual infrequent occurrence or underdiagnosis requires further study.…”

Section: Discussionmentioning

confidence: 99%

The behavioral and psychological symptoms of dementia in Down syndrome (BPSD-DS) scale: Comprehensive assessment of psychopathology in Down syndrome

Dekker

Deyn

2019

European Neuropsychopharmacology

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People with Down syndrome (DS) are prone to develop Alzheimer's disease (AD). Behavioral and psychological symptoms of dementia (BPSD) are core features, but have not been comprehensively evaluated in DS. In a European multidisciplinary study, the novel Behavioral and Psychological Symptoms of Dementia in Down Syndrome (BPSD-DS) scale was developed to identify frequency and severity of behavioral changes taking account of life-long characteristic behavior. 83 behavioral items in 12 clinically defined sections were evaluated. The central aim was to identify items that change in relation to the dementia status, and thus may differentiate between diagnostic groups. Structured interviews were conducted with informants of persons with DS without dementia (DS, n = 149), with questionable dementia (DS+Q, n = 65), and with diagnosed dementia (DS+AD, n = 67). First exploratory data suggest promising interrater, test-retest, and internal consistency reliability measures. Concerning item relevance, group comparisons revealed pronounced increases in frequency and severity in items of anxiety, sleep disturbances, agitation & stereotypical behavior, aggression, apathy, depressive symptoms, and eating/drinking behavior. The proportion of individuals presenting an increase was highest in DS+AD, intermediate in DS+Q, and lowest in DS. Interestingly, among DS+Q individuals, a substantial proportion already presented increased anxiety, sleep disturbances, apathy, and depressive symptoms, suggesting that these changes occur early in the course of AD. Future efforts should optimize the scale based on current results and clinical experiences, and further study applicability, reliability, and validity. Future application of the scale in daily care may aid caregivers to understand changes, and contribute to timely interventions and adaptation of caregiving.

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

Cited by 23 publications

References 35 publications

Use of the structured descriptive assessment to identify possible functions of challenging behaviour exhibited by adults with brain injury

Use of the structured descriptive assessment to identify possible functions of challenging behaviour exhibited by adults with brain injury

Experimental functional analysis of aggression in children with Angelman syndrome

The behavioral and psychological symptoms of dementia in Down syndrome (BPSD-DS) scale: Comprehensive assessment of psychopathology in Down syndrome

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