title: A functional assessment of handmouthing among persons with severe and profound intellectual disability.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Pinecrest Developmental Center, USA.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Swender
authors.forename: Johnny L
authors.initials: JL
authors.lastname: Matson
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Mayville
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Gonzalez
authors.forename: Donald
authors.initials: D
authors.lastname: McDowell
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology; D006225:Hand / Q000502:physiology*; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D008297:Male; D009055:Mouth; D009068:Movement / Q000502:physiology*; D015995:Prevalence; D011595:Psychomotor Agitation / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D012720:Severity of Illness Index