Paul Langthorne

Incorporating “Motivation” Into the Functional Analysis of Challenging Behavior: On the Interactive and Integrative Potential of the Motivating Operation

Sensitivity theory attempts to account for the variability often observed in challenging behavior by recourse to the “aberrant motivation” of people with intellectual and developmental disabilities. In this article, we suggest that a functional analysis based on environmental (challenging environments) and biological (challenging needs) motivating operations provides a more parsimonious and empirically grounded account of challenging behavior than that proposed by sensitivity theory. It is argued that the concept of the motivating operation provides a means of integrating diverse strands of research without the undue inference of mentalistic constructs. An integrated model of challenging behavior is proposed, one that remains compatible with the central tenets of functional analysis.

An Indirect Examination of the Function of Problem Behavior Associated with Fragile X Syndrome and Smith-Magenis Syndrome

Fragile X syndrome (FXS) and Smith-Magenis syndrome (SMS) are associated with a number of specific topographies of problem behavior. Very few studies have examined the function served by problem behavior in these groups. Using the Questions About Behavioral Function scale Matson and Vollmer (User’s guide: questions about behavioral function (QABF). Scientific Publishers Inc., Baton Rouge, LA, 1995) the current study examined group differences in the function of problem behavior displayed by children with FXS and SMS, in comparison to a control group of children with non-specific intellectual and developmental disabilities. Between-group analyses showed children with SMS were more likely to display problem behavior related to physical discomfort. Both within- and between-group analyses showed children with FXS were less likely to display attention-maintained problem behavior. These findings hold implications for the assessment, treatment and prevention of problem behavior associated with both FXS and SMS.

A tutorial on the concept of the motivating operation and its importance to application.

Motivating operations (MOs) exert a powerful influence over operant relations and hold significant implications for those working in applied settings. In this paper, we describe the concept of the MO and provide “real world” examples. Particular emphasis is given to the concept of the conditioned MO (CMO). Implications for intervention are discussed. It is hoped that this endeavour will encourage the utilization of the full conceptual system of the MO.

Functional Analysis of the Early Development of Self-Injurious Behavior: Incorporating Gene-Environment Interactions

The analysis of the early development of self-injurious behavior (SIB) has, to date, reflected the wider distinction between nature and nurture. Despite the status of genetic factors as risk markers for the later development of SIB, a model that accounts for their influence on early behavior-environment relations is lacking. In the current paper we argue that the investigation of gene-environment interactions (GxE) and other forms of gene-environment interplay could potentially enhance current approaches to the study of self-injury. A conceptual model of the early development of SIB based explicitly on such relations is presented. The model is consistent with the basic tenets of functional analysis. Implications for research and the assessment, treatment, and prevention of SIB are discussed.

DISCREPANCY IN FUNCTIONAL ANALYSIS RESULTS ACROSS TWO SETTINGS: IMPLICATIONS FOR INTERVENTION DESIGN

Functional analyses that were conducted in two settings (playground and classroom) indicated that problem behavior was sensitive to adult attention on the playground and tangible items in the classroom. Attention- and tangible-based interventions were designed based on the results from each of the assessment environments and were compared. The attention-based intervention was more effective on the playground, and the tangible-based intervention was more effective in the classroom. Findings are discussed in regards to the generality of functional analysis results across environments.

Towards the Prevention of Behavioural and Psychiatric Disorders in People with Intellectual Disabilities.

Intervention for behavioural and psychiatric disorders in people with intellectual disabilities often only takes place once these conditions are well established and more resistant to change. As an alternative, this paper promotes a public health prevention model and maps out opportunities for intervention at primary, secondary and tertiary levels. The resulting model is partly derived from generic research into these issues and partly on specific evidence on interventions for people with intellectual disabilities; it also contains more theoretical considerations. The additional research that is necessary to demonstrate the efficacy of the interventions identified is also considered. Central to this proposal is a greater integration of issues for people with intellectual disabilities within much broader policy and research agendas.

Examining the function of problem behavior in Fragile X Syndrome: preliminary experimental analysis

Fragile X syndrome is the most common inherited cause of intellectual and developmental disability. The influence of environmental variables on behaviors associated with the syndrome has received only scant attention. The current study explored the function served by problem behavior in fragile X syndrome by using experimental functional analysis methodology with 8 children with fragile X. No child met criteria for attention-maintained problem behavior, 5 children met criteria for escape-maintained problem behavior, and 4 children met criteria for tangible-maintained problem behavior. Results are discussed and compared with previous findings on the function of problem behavior in fragile X syndrome, and implications for intervention are discussed. It is noted that the external validity of these findings is limited by the small sample size.

ASSESSING THE SOCIAL ACCEPTABILITY OF THE FUNCTIONAL ANALYSIS OF PROBLEM BEHAVIOR

Although the clinical utility of the functional analysis is well established, its social acceptability has received minimal attention. The current study assessed the social acceptability of functional analysis procedures among 10 parents and 3 teachers of children who had recently received functional analyses. Participants completed a 9-item questionnaire, and results suggested that functional analysis procedures were socially acceptable.

The Motivating Operation and Negatively Reinforced Problem Behavior A Systematic Review

The concept of motivational operations exerts an increasing influence on the understanding and assessment of problem behavior in people with intellectual and developmental disability. In this systematic review of 59 methodologically robust studies of the influence of motivational operations in negative reinforcement paradigms in this population, we identify themes related to situational and biological variables that have implications for assessment, intervention, and further research. There is now good evidence that motivational operations of differing origins influence negatively reinforced problem behavior, and that these might be subject to manipulation to facilitate favorable outcomes. There is also good evidence that some biological variables warrant consideration in assessment procedures as they predispose the person’s behavior to be influenced by specific motivational operations. The implications for assessment and intervention are made explicit with reference to variables that are open to manipulation or that require further research and conceptualization within causal models.

Rehabilitation issues for children with Prader–Willi syndrome

Prader–Willi syndrome (PWS) is a complex neurodevelopmental disorder first described in 1956 [1]. Almost three decades later, PWS was the first recognized microdeletion syndrome identified in humans (previously microdeletion was found only in plants) [2, 3]. PWS is caused by an error in genetic imprinting, specifically, in the region of 15q11–q13 [4–6]. A paternal interstitial deletion is found in approximately 70% of individuals with PWS, approximately 25% have maternal disomy and the remaining 5% have microdeletions, epimutations or chromosome 15 translocations [5–8]. Two subtypes of deletions have been suggested. Type I involves longer deletions and Type II shorter deletions, relative to the breakpoints on the gene [7]. However, additional research is required to determine potential behavioural or developmental differences between these subtypes. The male to female ratio is about equal, and PWS is not associated with any particular ethnic group, geographic region or socioeconomic class [9–11]. Prevalence estimates range between 1 in every 8000 to 1 in every 29,000 live births [10–12]. Perhaps, because of its relatively low prevalence, PWS has received relatively little attention from rehabilitation researchers and professionals. The aim of this editorial is to raise awareness of PWS by providing a brief overview of the associated developmental and behavioural characteristics. We hope that this overview will stimulate interest and research into the rehabilitation of children with this syndrome. To stimulate research, we offer suggestions for areas in need of empirical investigation. In 1956, Prader, Labhart and Willi described five males and four females who, as infants, experienced hypotonia, weak or absent reflexes, a general lack of movement and an inability to cry or suck. Around 2 years of age, movement and hypotonia had improved, but obesity, growth deficiency (e.g. short stature) and intellectual disability emerged [1, 11]. Currently, diagnosis of PWS is made using consensus clinical criteria and is confirmed via genetic testing [13]. PWS is a multiphase disorder and can be classified within three different phases (i.e. Hyptonic Phase, Hyperphagic Phase and Adolescene/Adult Phase) with developmental and behavioural concerns emphasized within each stage [13]. The Hypotonic Phase (prenatal to infancy) is characterized by reduced foetal activity, low weight, weak muscle tone, hypogonadism, cryptorchidism, respiratory difficulty and general delay in developmental milestones. Treatment during this phase is likely to be focused on feeding difficulties and physical therapy [13–15]. The Hyperphagic Phase (childhood) is characterized predominately by the emergence of maladaptive behaviours including tantrums and aggression related to obtaining food, self-injurious behaviour (skin-picking) and insistence on routines. Obesity, short stature and cognitive dysfunction are also likely to become apparent. Education and treatment in this phase may include weight management, behavioural therapy, social skills training, speech therapy, medication and physical/occupational therapy. The Adolescents to Adulthood Phase is characterized by infertility, delayed sexual development, Scoliosis and glucose intolerance or diabetes. Life expectancy does not often exceed 60 years with the leading causes of death being cardio-respiratory failure [10, 12, 13]. Research regarding the medical treatment of PWS is extremely sparse. One recent approach involves the use of growth hormones (GH). Because individuals with PWS have a body pattern similar to individuals with GH deficiency, GH therapy has been evaluated as one potential treatment for characteristics associated with PWS [16]. Although improvements in height, lean body mass, muscle strength and agility have been reported, GH therapy may also be associated with the increased risk of obstructive sleep apnea (OSA) [17]. It has been suggested that OSA resulting from GH therapy may be one factor contributing to sudden death in children with PWS [17]. Treatment studies concerning the range of behavioural and psychological issues commonly associated with PWS are also lacking. For example, the prevalence of chronic skin-picking in samples of individuals with PWS has been found to be as high as 75–85% [13, 18]; however, no published research has investigated a behavioural treatment for skinpicking with this population. Other behaviour concerns commonly associated with PWS in which intervention research is warranted include verbal perseveration, stubbornness, obsessive food seeking