Guest Blog Authored By: Jonathan Baker, Ph.D., BCBA-D
Western Michigan University
Dr. Jonathan Baker is an Associate Professor and Chair of the Department of Psychology at Western Michigan University. Prior to joining WMU, he was a faculty member in the behavior analysis and therapy program in the Rehabilitation Institute at Southern Illinois University as well as the coordinator of the SIU gerontology certificate program. He received a certificate in gerontology from the University of Kansas, a masters in applied behavior science from the University of Kansas, and a Ph.D. from Western Michigan University. Dr. Baker served as a member (2014-2019) and Vice President (2020) of the Board of Directors for the Behavior Analyst Certification Board and serves on the editorial board for The Journal of Applied Behavior Analysis and The Analysis of Verbal Behavior. He is an Associate Editor at Behavior Analysis: Research and Practice. He has served as a guest reviewer for the American Journal of Alzheimer’s Disease and Related Dementias and The Gerontologist. Dr. Baker is the former president of the Mid-American Association of Behavior Analysis and former chair of the Behavioral Gerontology Special Interest Group with ABAI. Dr. Baker’s main research interest is behavioral gerontology, including the assessment/treatment of behavioral excesses and developing programs that remediate behavioral deficits in older adults with neurocognitive disorder, as well as treatment adoption. His interests also extend to adults and older adults with developmental disabilities and staff training.
As our global population ages, understanding how language and communication change across our lifespan becomes increasingly important—not just for scientists and practitioners but anyone interacting with older adults.
Have you ever wondered why some people seem to maintain sharp communication skills well into their later years while others experience more difficulty? As our physical abilities change with age, so do our language abilities. Some of those changes are for the better: Our vocabulary can continue to grow, our general knowledge expands, our social communication skills remain strong, and our grammar and sentence structure typically stay intact (Salthouse, 2019). However, some people experience declines in communication as they age (Wingfield & Grossman, 2006). For example, word-finding (or the feeling of having a word “on the tip of your tongue”) can become more challenging. Likewise, following along with someone who speaks rapidly may take more time and effort (if you can keep up!), as well as understanding complex sentences.
If aging alone accounted for changes in communication, we would expect similar levels of impact across an aging population. For example, presbyopia which makes it difficult to see up close, is a biologically-based age-related change in vision to be expected as people age into their 40s and beyond. It is actually rare for someone above 65 to not have some level of presbyopia., Research suggests that communication changes are not as universal for human beings. Many environmental actors within a person’s lifetime impact communication decline as we age, including health, education, and life experiences, to name a few (Stern, 2009). When environmental factors impact behavior, there is room not only to further our understanding through a behavior analytic account, but also to develop effective interventions.
A Different Way of Looking at Language
Behavior analysts view language (or “verbal behavior” as we call it) differently than traditional linguists. Instead of focusing on what’s happening inside the brain, we look at how people interact with their environment. We are more focused on the specific stimuli that occasion and maintain a response than the formal properties of the response. For example, behavior analysts would focus more on what stimuli evoke a response like “what time is lunch?” (e.g., seeing a clock, smelling food, or seeing a potential listener) and the stimuli that maintain such a response (e.g., information about the time or just general social interaction), than they would on the structure of noun, verb, and punctuation of the sentence. Skinner (1957) described verbal operants, or classes of responses with similar evocative and reinforcing stimuli, as a way to understand verbal behavior and explain differences in language that seemed unexplainable when focusing solely on the form. This perspective helps us understand communication changes in aging in a unique way.
In his analysis, Skinner (1957) argued that the order of verbal behavior decline in communication deficits might be correlated with the deducible level of difficulty of the minimal repertoire required for the response. Skinner described a minimal unit for each of his operants, indicating the requisite repertoires for the development of the operant.
For example, operants with a lower level of difficulty require more simple minimal repertoires (e.g., the minimal repertoire of echoics is speech sounds), whereas operants with a higher level of difficulty require more complex repertoires (e.g., here, the minimal repertoire for intraverbals “greatly exceeds the number of different forms of response in that repertoire,” 1957, p. 76) and are maintained by generalized reinforcers (e.g., tokens or money that can be exchanged for a wide variety of specific reinforcing food, activities, etc.). Echoics, transcripts, and textuals primarily require a simple minimal repertoire (e.g., echoics require a single sound repertoire) and survive longer (given adequate sensory functioning) while intraverbals and tacts, which require more complex minimal repertoires, appear to be more vulnerable. Second-order behaviors like grammar and syntax (intraverbals and autoclitics) are most vulnerable and can become “excessive and usually confused (paragrammatism) or lacking (agrammatism)” (Skinner, 1957, p. 219). Skinner also hypothesized that operants maintained by more generalized reinforcers would be more affected than operants maintained by specific reinforcers.
Building on Skinner’s (1957) analysis, Sundberg (1991) wrote an entire paper suggesting 301 verbal behavior research topics, with ten suggested areas of study per topic. One of his topic areas was older adult populations, with four areas specific to how language changes as we age:
- The role of the aged person’s verbal community (the people in their environment that reinforce their verbal behavior).
- Procedures for strengthening stimulus control (how to get people to say the ‘right thing’ at the ‘right time’).
- Textual behavior as a way to maintain intraverbal behavior (reading to promote conversation).
- Procedures for reducing the verbal errors of the aged individuals (how to reduce making mistakes).
While the body of behavior analytic research on verbal behavior and aging is relatively small, there are some promising areas of understanding and future directions that have built upon Skinner (1957) and Sundberg (1991), such as stimulus control, the impact of a verbal community, and procedures for addressing communication deficits.
What Research Tells Us
Our understanding of verbal behavior, as we experience older adulthood, is informed by research from several areas. For example, although the authors often use arbitrary stimuli, research in stimulus equivalence provides valuable insight into learning equivalence relations, which are a key part of verbal behavior.
As Steingrimsdottir and Arntzen (2011) note, researchers have demonstrated several important age-related findings through stimulus equivalence research. First, researchers have demonstrated that older adults can form equivalence classes, but require more trials and show slower acquisition rates than younger adults. This suggests changes in the speed of forming verbal relations rather than an inability to form them. Second, older adults maintain previously established equivalence classes, supporting that existing learned relations remain relatively stable with age. Third, careful arrangement of training sequences can facilitate learning. Steingrimsdottir and Arntzen (2011) investigated the effects of different stimulus arrangements on equivalence class formation in older adults, demonstrating that certain arrangements enhance learning outcomes. Taken together, these studies not only provide evidence of the age-correlated declines noted in the broader gerontology research; they also provide information on how to modify learning environments to maintain or re-establish behavior.
Other researchers have focused on specific language deficits and intervention approaches grounded in Skinner’s (1957) analysis. Oleson and Baker (2014) extended tested assessment procedures for verbal behavior in older adults with cognitive impairment. This study provided a systematic way to evaluate different types of verbal responses, helping practitioners identify which language skills remain strong and which might need support. Trahan et al. (2014) examined how different types of prompts and reinforcement affected requests in older adults with dementia. Results of this study showed that certain prompting strategies were more effective than others in establishing picture exchanges, particularly when combined with appropriate reinforcement. More recently, Ritchie et al. (2021) used a comprehensive assessment and investigated how to maintain and improve specific verbal operants in older adults with memory impairments. This research demonstrated that systematic training procedures can help maintain certain types of verbal responses, even in the presence of cognitive decline. Once again, these studies support that behavior-analytic approaches can be used to address language deficits, even when there is a disease-related etiology for the deficit.
Finally, other researchers have looked at specific problem-solving approaches to improve language and remembering.. Walmsley and Fuqua (2018) evaluated remembering strategies with older adults diagnosed with a neurocognitive disorder. During baseline, they provided a discriminative stimulus (e.g., “tell me who this is”) and looked at correct responding, as well as correct responding following a delay from one presentation to the next. Most participants either failed to correctly answer after the initial discriminative stimulus, or after just a few seconds delay during baseline sessions. The researchers used spaced retrieval – an intervention that involves providing a discriminative stimulus – followed by a prompt (e.g., “This is Linda”) to ensure a correct response in the presence of that stimulus. They then systematically increased the interval of time between discriminative stimuli presentations following correct responses and reduced the time following incorrect responses. This led to increases in recall by as much as 10 minutes! They also assessed the efficacy of other strategies to build on the effects of spaced retrieval, including exemplar training, prompted orienting responses, and textual prompts (c.f., Sundberg, 1991). Overall, the collection of individualized approaches resulted in improved recall across all participants in the study.
Moving Forward in Supporting Aging Communication
Understanding verbal behavior in older adults through a behavioral lens offers hope and direction for supporting communication throughout aging. While some changes in language abilities may occur with age, the research to date from the field of behavior analysis clearly demonstrates that these changes are not inevitable or uniform. More importantly, behavior analysis provides practical approaches for maintaining and improving communication skills later in life. From teaching new verbal relations to creating effective environmental supports to implementing specific memory strategies, behavior-analytic interventions can help older adults maintain meaningful connections with their verbal communities. As our population ages, this understanding becomes increasingly valuable. The future of this field holds exciting possibilities for developing even more effective, individualized approaches to support verbal behavior in older adults. If you are interested in learning more, I recommend looking into the Behavioral Gerontology Special Interest group of ABAI for resources.
References
Oleson, C. R., & Baker, J. C. (2014). Teaching mands to older adults with dementia. The Analysis of Verbal Behavior, 30(2), 113–127. https://doi.org/10.1007/s40616-014-0018-7
Ritchie, H., Reuter-Yuill, L., Perez, A., & Baker, J. (2021). Assessment-informed intervention for aphasia in an older adult: Transfer of stimulus control procedure considerations. The Analysis of Verbal Behavior, 37, 226 – 236. https://doi.org/10.1007/s40616-021-00153-6
Salthouse, T. A. (2019). Trajectories of normal cognitive aging. Psychology and Aging, 34(1), 17-24. https://doi.org/10.1037/pag0000288
Skinner, B.F. (1957). Verbal behavior. Appleton-Century-Crofts. https://doi.org/10.1037/11256-000
Steingrimsdottir, H. S., & Arntzen, E. (2011). Using conditional discrimination procedures to study remembering in an adult with dementia. Behavioral Interventions, 26 (3), 179-192. 10.1002/bin.334
Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47(10), 2015-2028. doi:10.1016/j.neuropsychologia.2009.03.004
Sundberg, M. L. (1991). 301 research topics from Skinner’s book Verbal Behavior. The Analysis of Verbal Behavior, 9, 81-96. doi: 10.1007/BF03392862
Trahan, M. A., Donaldson, J. M., McNabney, M. K., & Kahng, S. (2014). Training and maintenance of a picture-based communication response in older adults with dementia: picture-based communication in dementia. Journal of Applied Behavior Analysis, 47(2), 404–409. https://doi.org/10.1002/jaba.111
Walmsley, C. & Fuqua, W. (2018). Memory deficits in older adults: Evaluating spaced retrieval with multiple probe techniques. Behavior Analysis: Research and Practice, 18, 62-77. http://dx.doi.org/10.1037/bar0000081
Wingfield, A., & Grossman, M. (2006). Language and the aging brain: Patterns of neural compensation revealed by functional brain imaging. Journal of Neurophysiology, 96 (6), 2827-3558. doi:10.1152/jn.00628.2006