Research suggests that different types of challenging behavior (CB) may be maintained by different contingencies of reinforcement. In this study, we examined functional variables for nine types of CB (physical aggression, verbal aggression, self-injury, tantrums, non-compliance, property destruction, disruptive behavior, stereotypes and inappropriate verbal behavior) in 300 people with intellectual disabilities. The Questions About Behavioral Function (QABF) instrument was administered to 183 direct care staff members to assess a total of 328 challenging behaviors. Results of non-parametric analyses distinguished significant differences across behavioral functions. CBs associated with each subscale of the QABF were identified. Results were consistent with previous research, stereotypic behavior was scored significantly higher across the non-social functions measured by the QABF, whereas other types of CB (such as aggressive behavior) were scored significantly higher across social functions. The results of this study extend the literature on this issue, and implications for future research and direct care professionals are discussed.
Challenging behavior (CB) is one of the most studied issues in the field of intellectual disabilities (ID; Matson et al., 2011). Although prevalence rates can vary greatly according to the ages studied and the data collection methods and criteria used to define the behavior assessed (Cooper et al., 2009), high rates of CB among people with ID have been identified in several studies (i.e., Benson and Brooks, 2008, Collins and Cornish, 2002, Didden et al., 2007, Jones et al., 2008 and Murphy et al., 2009).
Research on treatment of CB among people with ID has long demonstrated that psychotropic medication (i.e., Deb et al., 2007 and Tsiouris et al., 2013) and applied behavior analysis (i.e., Davis et al., 2014, Fragale et al., 2012, Lomas et al., 2010, McGinnis et al., 2010 and O’Reilly et al., 2009) are frequently used (Matson et al., 2011). The effectiveness of psychotropic medication (and specifically antipsychotic drugs) in reducing CB is questionable in light of their side effects (Matson, Tureck, & Rieske, 2012) and a lack of rigorous empirical evidence (Brown, Brown, & Dibiasio, 2013). However, there is a growing body of literature demonstrating the effectiveness of applied behavior analysis in reducing the occurrence of CB (i.e., Brosnan and Helay, 2011, Campbell, 2003, Cannella et al., 2005, English and Anderson, 2004, Hanley et al., 2003, Lloyd and Kennedy, 2014, Matson et al., 2011, Tiger et al., 2009 and Van Camp et al., 2000).
Behavioral interventions involve antecedent and consequent-based interventions (O’Reilly et al., 2012). Antecedent-based intervention involves a wide range of strategies that typically entail the manipulation of certain environmental events to reduce the occurrence of the behavior (Kern and Clemens, 2007 and Smith, 2011). Additionally, consequent-based interventions are specifically designed according to the maintaining contingencies of reinforcement (O’Reilly et al., 2012 and Smith, 2011); that is, the functional properties of the behavior (Medeiros, Rojahn, Moore, & van Ingen, 2014). Maintaining variables identified in the literature include attention; escape or avoidance; and tangible, non-social and physical functions (Matson et al., 2011). Results from several studies stated that problem behaviors were significantly reduced when treatments were based on a particular behavioral function (i.e., Brosnan and Helay, 2011, Campbell and Anderson, 2011 and Campbell et al., 2013); thus, research suggests that identifying an underlying behavioral function can play an important role in designing effective intervention plans (Dixon, Jang, Chung, Jung, & Matson, 2013).
