Teaching Mands to Older Adults with Dementia

Abstract

Millions of Americans are diagnosed with dementia, and that number is only expected to rise. The diagnosis of dementia comes with impairments, especially in language. Furthermore, dementia-related functional declines appear to be moderated by environ- 2010), and the mand is a verbal operant about which little is known among this population. The current study evaluated whether contriving an establishing operation within a preferred activity using a prompt-probe intermix procedure and a transfer of stimulus control procedure was effective in establishing mands in older adults with dementia. The procedure was demonstrated to be effective with one participant, but results were inconsistent with the second participant. Modifications were made throughout training for both participants, showing the importance of individualizing interventions.

Cognition and language in dementia patients: Contributions from behavior analysis

“…Of the nine studies on verbal behavior in dementia patients, four investigated verbal operants (Gross, Fuqua, & Merritt, ; Henry & Horne, ; Oleson & Baker, ; Trahan, Donaldson, McNabney, & Kahng, ). Other studies related to verbal behavior focused on disruptive vocalizations (Beaton, Peeler, & Harvey, ; Buchanan & Fisher, ; Locke & Mudford, and Trahan, Donaldson, McNabney, & Kahng, ).…”

“…Also, a common limitation of laboratory studies of mands, specifically, is that the responses were actual mands only if the setting was effective to establish the missing stimuli as reinforcers. Trahan et al () and Oleson and Baker () addressed this common problem in the experimental study of mands, namely, that it is necessary to assure that the requested item is reinforcing, or, in lay terms, that participants want the item. To increase the ecological validity of the procedure to teach mands to dementia participants and ensure that requested items really functioned as reinforcers, Trahan et al conducted a preference test to identify preferred activities.…”

“…Just as investigation on verbal operants, studies concerning the role of antecedents and consequences are still limited in number and in need of more replication, but it is possible that verbal behavior assessed in those experiments was maintained by high‐magnitude reinforcers (self‐stimulatory or automatic). In this case, investigations of high‐magnitude reinforcers such as used by Trahan et al () and Oleson and Baker () would be a promising research program to address the question about the sensitivity of this population to reinforcers. As a consequence, an option for intervention could be the manipulation of antecedent conditions and the use of powerful consequences to establish more effective communication.…”

Preference for leisure items over edible items in individuals with dementia: A replication

“…For example, Margaret's most highly preferred stimulus was playing snap with the experimenter. Accompanying social interaction was not controlled for, and previous researchers have demonstrated the reinforcing value of attention during preference assessments as a variable that affects preference with adults with dementia (Oleson & Baker, 2014). Future research could directly compare the results of preference assessments in which leisure items are available with or without accompanying social attention to evaluate whether the leisure item or contingent social attention is the more reinforcing stimulus.…”

Memory deficits in older adults: Evaluating spaced retrieval with multiple probe techniques.

“…Function-based interventions have also been successfully used to address hoarding (Baker, Leblanc, Raetz, & Hilton, 2011), disruptive vocalizations (Buchanan & Fisher, 2002), promote increased independence in ADL routines by training staff to use least-to-most prompting techniques (Engelman, Altus, Mosier, & Mathews, 2003), and re-establish vocal mands (Oleson & Baker, 2014). Methods to increase activity engagement have included structured choice making (Leblanc, Cherup, Feliciano, & Sidener, 2006) and descriptive verbal prompts (Engelman, Altus, & Mathews, 1999), to name a few.…”