Many functional assessment procedures have been developed and validated for use with people with intellectual and developmental disabilities. However, there is a paucity of research exploring the utility and social acceptability of functional assessment methods for people with dementia. We conducted direct observations in the natural environment to produce data for conditional probability analyses and an experimental functional analysis of the behavior of two women with dementia. We found that the conditional probability analysis yielded similar conclusions about function as the data from the experimental functional analysis for both participants. Importantly, staff rated the direct observations as more socially acceptable. We also report barriers to conducting both methods in older adult settings that warrant further exploration, including the use of the assessments with people with dementia and intact vocal verbal repertoires.

Behavior analysis has made contributions in the development of evidence-based interventions for people with intellectual and developmental disabilities (IDD), and there is a growing evidence base for behavior-analytic interventions for older adults with dementia. As there is an increased number of adults with IDD living to old age, and an increased prevalence of comorbid dementia in people with IDD, a review of the behavior-analytic contributions with this population is warranted. We searched Web of Science and PsycInfo and manually reviewed the last 20 years of five behavioral journals. Six behavior-analytic studies with people with IDD and dementia were identified, and all but one were published outside of core behavior-analytic journals. These articles were analyzed in terms of Baer, Wolf, and Risley's (Journal of Applied Behavior Analysis, 1, 91-97, 1968) seven dimensions of applied behavior analysis (ABA). The possible explanations and implications of these findings are discussed with consideration of the unique features of a comorbid diagnosis of IDD and dementia that may make it appropriate for increased focus in behavior-analytic research and practice.

We replicated previous research in which adults with dementia tended to show a preference for leisure items over edible items when presented in the same array. Additionally, we conducted engagement analyses with the highest, middle, and lowest preference leisure items to determine whether relative preference corresponded to engagement in the natural environment. The most highly preferred stimulus for six out of seven participants was a leisure item, and for each of those six the top three preferred stimuli were leisure stimuli. For four participants, the most preferred stimulus also produced the longest duration of engagement. We discuss the issues we encountered when conducting preference assessments with adults with intact vocal verbal repertoires, and suggest potential explanations for the displacement of edibles by leisure stimuli in older adults with dementia.