The impact of menstruation on reinforcer effectiveness and challenging behaviour in women with profound autism

During certain times in the menstrual cycle, increases in challenging behaviour or physical aggression are observed frequently in women with autism and intellectual/developmental disabilities (IDD). The present study explored the role of the menstrual cycle in relation to reinforcer efficacy and the function of challenging behaviour. Preference and functional assessments were carried out at mid-cycle (i.e., ovulation phase) and menstruation phase to identify behavioural patterns across the cycle in a young woman with profound autism and IDD. Results indicate that preferences and behavioural function varied in a predictable pattern depending on the phase of the menstrual cycle. Recommendations for intervention are identified.