The effect of a distraction-based intervention on positive affect and aggressive and distress-related behaviors during morning activities of daily living in an elderly dementia patient was tested. Concurrently, the effectiveness of distractors chosen by staff and family report as compared to those chosen through a stimulus preference assessment (SPA) was tested. An alternating treatment design was used to implement identified distractors and a direct observation system was used to measure outcomes. Though staff reported increases in positive affect when using an edible chocolate distractor, no significant changes in positive affect or distress related behaviors were noted by the end of the final treatment phase when compared to initial baseline responding. This was likely due, in part, to the participant's decline in physical health over the course of the study. With regard to the comparison of methods for identifying distractors, data tended to support the usefulness of a SPA for identifying effective distractors over that of family opinion, but was equally as effective as caregiver opinion. Further research is needed to better understand these outcomes.


Jeffrey A. Buchanan

First Committee Member

Daniel D. Houlihan

Second Committee Member

Donald J. Ebel

Date of Degree




Document Type



Master of Arts (MA)




Social and Behavioral Sciences

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License



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