Aggressive behavior in individuals with moderate to borderline intellectual disabilities who live in a residential facility: an evaluation of functional variables.

Staff filled out the Questions About Behavior Function (QABF) for 87 adults living in a state facility. All clients had moderate to borderline intellectual disability and showed aggression.

The survey asked what usually happens right after an aggressive episode. Choices were attention, escape, tangible items, sensory input, or pain attenuation.

Social consequences topped the list. Attention, escape, and tangible functions were picked far more often than sensory or pain-related ones.

In plain words, the aggression usually pays off with people — either someone looks at them, helps them avoid a task, or gives them stuff.

Gaily et al. (1998) saw the same pattern earlier. Their QABF study also flagged attention as the lead function for aggression in adults with ID. The new data repeat that finding in a larger residential sample.

Lawer et al. (2009) extend the idea to kids. Their review of 32 autistic outpatients showed most problem behavior was socially reinforced, too. Social functions seem to rule across ages and diagnoses.

Firth et al. (2001) watched caregivers in real time. They saw staff most often respond to aggression with — you guessed it — attention. The natural consequence matches the survey result, closing the loop.

If you work with adults who have ID and hit, kick, or spit, start with a quick QABF. Odds are the behavior is working because of people, not pain. Write plans that give attention, breaks, or items for safe behavior instead. Train staff to withhold reactive attention and teach the client a polite way to ask for the same payoff.