The assessment and modification of verbal behaviour in people with dementia
The number of people surviving into old age, is increasing rapidly, bringing attendant social care problems, such as a rise in the number of people suffering from dementia. It is important that research resources be made available to investigate the causes of dementia and the provision of therapeutic measures. The symptomatic role of language disorders in the dementias of old age has already been well established, and is a primary cause of distress to carers and sufferers alike. Strategies for remediation of such language disorders were investigated. Analysis of verbal behaviour, within Skinner's (1957) framework, was selected as a route for further understanding, description, and therapeutic intervention. The deficits in verbal behaviour found, included the echoic, the textual and the tact, mand compliance, and naming, also understanding and production of prepositional relations, and conditional responding or conditional mand compliance. Performance on matching to sample tasks was also found to be poor. The outcome of reinforcement procedures was moderately successful, but modelling of correct responses was found to reduce frequency of correct non-imitative responses, and was not successful. The application of the textual prompt for naming and mand compliance responding was successful, in that increases in correct textual responses to stimuli were produced. It was not clear, however, whether this success would have resulted in lasting positive behaviour change. Language deficits were discussed in terms of a breakdown in functional relationships between verbal responses and stimuli which under normal circumstances would control them, and in terms of deficits in conditional responding. A number of suggestions were made for the improvement of therapeutic practice in this area, based on the results obtained.