Teaching Mands to Older Adults with Dementia

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 environmental variables (Alzheimer's Association, Alzheimer's & Dementia: The Journal of the Alzheimer's Association 8:131-168 2012; American Psychiatric Association, 2000; Engelman et al., Journal of Applied Behavior Analysis 32:107-110, 1999; Engelman et al., Journal of Applied Behavior Analysis 36:129-132, 2003) Traditional language tests are not likely to assess or inform treatment for deficits in manding (Esch et al., The Journal of Speech-Language Pathology and Applied Behavior Analysis 5:166-191, 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.