A functional assessment of handmouthing among persons with severe and profound intellectual disability

• Published in: Journal of intellectual & developmental disability Vol. 31; no. 2; pp. 95 - 100
• Main Authors: Swender, Stephen L., Matson, Johnny L., Mayville, Stephen B., Gonzalez, Melissa L., McDowell, Donald
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01-06-2006; Routledge; Taylor & Francis, Ltd
• Subjects: Adult; Behavior Disorders; Behaviour; Clinical Diagnosis; Comorbidity; Correlation; Diseases; Female; functional assessment; Functional Behavioral Assessment; Gastro-Esophageal Reflux Disorder; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - epidemiology; Hand - physiology; Handmouthing; Humans; intellectual disability; Intellectual Disability - epidemiology; Male; Mouth; Movement - physiology; Prevalence; Psychological tests; Psychomotor Agitation - diagnosis; Psychomotor Agitation - epidemiology; Psychomotor Agitation - psychology; Reinforcement; Self Destructive Behavior; Severe Mental Retardation; Severity of Illness Index; Sex role; Statistics; United States
• ISSN: 1366-8250; 1469-9532
• DOI: 10.1080/13668250600710880

Background The behavioural function of handmouthing has been assessed across various studies utilising analogue functional analyses. The aim of the current study was to expand upon research on this relatively understudied behaviour by examining the relationship between handmouthing and Gastro-Esophageal Reflux Disorder (GERD), and the potential variables maintaining this challenging behaviour in 30 individuals with intellectual disability.
Method First, the relationship of GERD to handmouthing was examined. Second, the behavioural function of handmouthing was assessed with an indirect functional assessment, the Questions About Behavioral Function (QABF).
Results We found that a diagnosis of GERD was present with greater frequency among individuals with handmouthing than among matched peers who did not engage in handmouthing. Non-social reinforcement was most frequently endorsed as a behavioural function of this challenging behaviour.
Discussion Although individuals with handmouthing exhibited more GERD than those who did not handmouth, the findings suggest that handmouthing was most often maintained by non-social reinforcement. The importance of utilising functional assessment methodology for the assessment and treatment of handmouthing is discussed.