Assessment & Research

Functional properties of behaviour problems depending on level of intellectual disability.

Medeiros et al. (2014) · Journal of intellectual disability research : JIDR 2014
★ The Verdict

Expect escape and tangible functions for self-injury in severe ID more than in mild ID.

✓ Read this if BCBAs doing functional assessments in adult day or residential programs.
✗ Skip if Clinicians working only with children or mild ID where functions stay mixed.

01Research in Context

01

What this study did

Researchers asked 210 support staff to rate why adults with ID show challenging behaviors.

They grouped clients by IQ: mild, moderate, severe, or profound disability.

Staff filled out a quick checklist for self-injury, aggression, and stereotypy.

02

What they found

Self-injury changed with IQ level.

In severe and profound ID, staff saw escape and tangible items as the main drivers.

In mild ID, self-injury served many roles at once.

Aggression and stereotypy stayed multi-purpose across all IQ levels.

03

How this fits with other research

Perez et al. (2015) tracked the same adults over time.

They found that when interest in activities drops, self-injury rises months later.

This extends Hsieh et al. (2014) by showing feelings can predict future self-injury, not just describe current function.

Saville et al. (2002) looked only at mild-moderate ID and staff emotions.

That earlier work is a stepping-stone; the new study widens the lens to all ID levels and actual functions.

Willner (2015) reviews drug trials for aggression.

It reminds us that knowing the function matters more than reaching for pills.

04

Why it matters

When you assess an adult with severe or profound ID, expect escape and tangible functions for self-injury.

Probe for these first in your FA.

For mild ID, cast a wider net—behaviors likely serve many needs at once.

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Add extra escape and tangible test conditions when you FA self-injury in adults with severe or profound ID.

02At a glance

Intervention
not applicable
Design
survey
Sample size
115
Population
intellectual disability
Finding
not reported

03Original abstract

BACKGROUND: Behaviour problems are common among individuals with intellectual disabilities (ID) especially in those with more severe forms. The determination of the functional profile of a targeted behaviour has important implications for the design of customised behavioural interventions. METHOD: We investigated the relationship between the level of ID and the functional profile of aggression, stereotypy and self-injurious behaviour (SIB) using the Questions about Behavioural Function (QABF). Two staff members at two time points completed the QABF for each of 115 adults with varying levels of ID participating in a day training and habilitation programme. RESULTS AND CONCLUSIONS: Our results suggest that there is a differential relationship between the functions of behaviour problems and level of ID. While SIB is more often seen by raters to be maintained by escape of social demands and by attaining access to tangible items with the decline of the intellectual level, aggressive and stereotypic behaviours were identified more often as serving multiple functions equally across functioning level.

Journal of intellectual disability research : JIDR, 2014 · doi:10.1111/jir.12025