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Preference Assessment Procedures for Individuals with Developmental Disabilities

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Abstract

Significant advancements have been made in the development of procedures to systematically identify preferred stimuli that may function as reinforcers for persons with developmental disabilities. Indirect assessment procedures include care provider and client interviews, whereas direct assessment procedures involve systematically exposing participants to stimuli while recording their responses. These types of direct assessment procedures can be categorized as either approach-based or engagement-based. Approach-based procedures involve recording the individuals' approach responses to stimuli presented singly or concurrently with other stimuli, whereas engagement-based procedures involve recording duration of engagement with stimuli. Although the predictive validity of indirect preference assessment procedures has yet to be established, using them in combination with direct measures of preference may be most efficacious for identifying potential reinforcers. Recent research on preference assessment procedures used with persons with developmental disabilities is reviewed and the variables that one might consider prior to selecting which procedure to use in a given situation are discussed.
10.1177/0145445503259836BEHAVIOR MODIFICATION / September 2004Hagopian et al. / PREFERENCE ASSESSMENT PROCEDURES
Preference Assessment Procedures
for Individuals With
Developmental Disabilities
LOUIS P. HAGOPIAN
ETHAN S. LONG
KARENA S. RUSH
Johns Hopkins University School of Medicine
The Kennedy Krieger Institute
Significant advancements have been made in the development of procedures to systematically
identify preferred stimuli that may function as reinforcers for persons with developmental dis-
abilities. Indirect assessment procedures include care provider and client interviews, whereas
direct assessment procedures involve systematically exposing participants to stimuli while
recording their responses. These types of direct assessment procedures can be categorized as
either approach-based or engagement-based. Approach-based procedures involve recording the
individuals approach responses to stimuli presented singly or concurrently with other stimuli,
whereas engagement-based procedures involve recording duration of engagement with stimuli.
Although the predictive validity of indirect preference assessment procedures has yet to be estab-
lished, using them in combination with direct measures of preference may be most efficacious for
identifying potential reinforcers. Recent research on preference assessment procedures used
with persons with developmental disabilities is reviewed and the variables that one might
consider prior to selecting which procedure to use in a given situation are discussed.
Keywords: competing items; preference assessment; stimulus engagement
Significant advancements have been made in the development of
procedures to systematically identify preferred stimuli that may func
-
tion as reinforcers for persons with developmental disabilities (e.g.,
DeLeon & Iwata, 1996; Fisher et al., 1992). For those working with
this population, conducting some type of preference assessment is a
routine part of the assessment and treatment development process.
The purpose of this article is to summarize relevant literature on pref
-
668
BEHAVIOR MODIFICATION, Vol. 28 No. 5, September 2004 668-677
DOI: 10.1177/0145445503259836
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erence assessment procedures potentially useful with adults with
developmental disabilities.
Prior to any discussion about preference assessment procedures, it
is important to note the distinction between preference and reinforcer
assessments. During a reinforcer assessment, the reinforcing effects
of stimuli are directly evaluated by determining the extent to which
those stimuli increase the occurrence of the targeted behaviors when
provided contingently. Preference assessments generally attempt to
determine client preferences for certain stimuli on the basis of care
provider opinions (Green et al., 1988), or client responses during brief
presentations of those stimuli (e.g., Pace, Ivancic, Edwards, Iwata, &
Page, 1985). Although preference assessments do not directly mea
-
sure a stimulus’ reinforcing properties, they permit one to evaluate a
large number of stimuli in a relatively brief period of time. Although
the predictive validity of some preference assessment procedures has
been empirically demonstrated (e.g., Piazza, Fisher, Hagopian, Bow-
man, & Toole, 1996), one cannot assume that highly preferred stimuli
will function as effective reinforcers. Furthermore, reinforcement
effects are not absolute, but are a function of a number of contextual
variables, including the targeted response, the availability of other
reinforcement, and recent history of access to (or deprivation from)
reinforcement. Therefore, one should regard high-preference stimuli
as being “potential” reinforcers.
INDIRECT MEASURES
Preference assessments can be categorized as being either indirect
or direct, on the basis of whether client responses to stimuli are
directly observed. Indirect preference assessments rely on the opin
-
ions of care providers or others who know the participants and involve
the use of structured and unstructured interviews or checklists (Fisher,
Piazza, Bowman, & Amari, 1996; Matson et al., 1999). Stimuli are
then ranked on the basis of care provider endorsements of how much
the client appears to prefer or engage with each stimulus.
A standardized checklist of potential reinforcers for individuals
with severe or profound mental retardation was developed by Matson
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et al. (1999). The checklist, consisting of 49 edible and nonedible pre
-
ferred stimuli identified by direct care staff familiar with 185 partici
-
pants, was developed via interviews. Test-retest reliability was
assessed approximately 3 weeks after the initial interview with the
same direct care staff, and a significant correlation was found between
the test and retest total scores (r = .54, p .001). However, the validity
of this checklist in predicting whether stimulus rankings predict rein
-
forcing effectiveness was not examined in that study.
Fisher et al. (1996) developed the Reinforcer Assessment for Indi
-
viduals With Severe Disabilities (RAISD), a structured interview
designed to generate a list of potential preferred stimuli. In that study,
Fisher et al. examined the correspondence between the RAISD and a
direct preference assessment procedure (the paired stimulus proce
-
dure, described below). Correlations between care provider rankings
of stimuli identified on the RAISD and rankings derived from the
paired stimulus preference assessment were low but statistically sig-
nificant (r
s
= .32, p < .005). However, the utility of the RAISD was
demonstrated as potent reinforcers were found among the stimuli
identified by care providers.
Other studies have examined indirect procedures for assessing
preference, and have directly compared the results with preference
rankings derived from direct methods. For example, Green, Reid,
Canipe, and Gardner (1991) used a Likert-type survey, with scale val-
ues ranging from 1 (least preferred)to5(most preferred), to assess
direct-care staffs opinions regarding the participant’s apparent pref
-
erence for certain stimuli. The results were compared with a direct
measure of preference. Similarly, Parsons and Reid (1990) compared
a caregiver survey of participant’s food preferences to a direct mea
-
sure of preference. Surveys, consisting of a 5-point rating scale for tar
-
get food/drink pairs, asked staff what they thought a particular partici
-
pant’s response would be when provided with a choice between two
respective food or drink items. In both of these studies, researchers
found a lack of concordance between care provider report of prefer
-
ence for stimuli and direct observations of preferences (e.g., Green et
al., 1991; Parsons & Reid, 1990). For example, Green et al. found sig
-
nificant Spearman correlations between caregiver rankings and direct
preference assessment rankings for only 2 of 6 participants. Parsons
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and Reid reported that staff opinions did consistently correspond with
the direct preference rankings; however, correlation coefficients were
not reported.
DIRECT MEASURES
Direct measures of preference generally involve systematically
exposing the client to stimuli for a brief period and then recording his
or her approach responses or levels of engagement with each stimulus
across multiple trials. The approach or engagement data are then sum
-
marized across trials, and a preference hierarchy is derived.
APPROACH-BASED MEASURES
The single-stimulus (SS) procedure described by Pace et al. (1985)
involves presenting each stimulus individually, and the client is given
the opportunity to approach or briefly consume that stimulus. Prefer-
ence ratings are based on the percentage of trials in which each stimu-
lus was approached or consumed. Pace et al. provided some support
for the predictive validity of the SS procedure by demonstrating that
high-preference stimuli were more effective reinforcers than non-
preferred stimuli in a subsequent reinforcer assessment for 6 individu-
als with profound mental retardation between the ages of 3 and 18
years. In addition, Roscoe, Iwata, and Kahng (1999) further demon
-
strated the predictive validity of the SS procedure by evaluating stim
-
uli identified as highly preferred by the SS procedure in a single-oper
-
ant reinforcer assessment. For 6 of 7 adult participants (ages ranging
from 25 to 65 years), stimuli found to be highly preferred via the SS
procedure were effective as reinforcers.
In the paired-stimulus (PS) procedure described by Fisher et al.
(1992), stimuli are presented in pairs, and the client is given an oppor
-
tunity to select one of the stimuli. Preference is determined by calcu
-
lating the percentage of trials in which each particular stimulus was
chosen across the trials in which it was presented. Participants in the
Fisher et al. study were all children. However, the PS procedure has
been applied in a number of studies with adults (e.g., DeLeon & Iwata,
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1996). This procedure has been shown to have good test-retest reli
-
ability across multiple administrations ranging from a 1-week period
(DeLeon & Iwata, 1996) to over the course of a 2-month period
(Windsor, Piche, & Locke, 1994), with mean Kendall rank coeffi
-
cients of concordance administrations, w, ranging from .63 to .81. In
addition, it has been shown to have good predictive validity in several
studies as it can yield a preference hierarchy that predicts relative rein
-
forcer effectiveness (Fisher et al., 1992; Piazza et al., 1996). The main
limitation of the PS procedure is that it requires a relatively longer
period of time to administer than other types of direct preference
assessments (see DeLeon & Iwata, 1996; Roane, Vollmer, Ringdahl,
& Marcus, 1998).
With the multiple-stimulus (MS) presentation procedure (Windsor
et al., 1994), the client is instructed to select one among several stimuli
presented simultaneously in an array. Preference using the MS proce-
dure is determined by calculating the percentage of trials in which
each stimulus was selected. Eight adults with severe to profound dis-
abilities participated in the study, which compared the MS procedure
to the PS procedure. Stimuli were selected on the basis of staff report
of client preference and consisted of various foods and beverages.
Results suggested that the MS presentation method required less time
to administer; however, it resulted in less stable stimulus preference
rankings over a 2-month period when compared with the PS proce-
dure (Windsor et al., 1994). The mean reliability Kendall rank coeffi-
cients of concordance across multiple administrations, w, were .49 for
the MS presentation.
DeLeon and Iwata (1996) developed a variation of the MS proce
-
dure on the basis of observation that a high rate of false negatives can
result when the client consistently selects only one stimulus on each
trial. In the multiple-stimulus without replacement (MSWO) proce
-
dure, once a stimulus is selected, it is removed from the array on sub
-
sequent trials. Preference is determined by calculating the percentage
of trials each stimulus was selected relative to the number of trials it
was presented. Seven adults with various levels of developmental dis
-
abilities participated in the study comparing MSWO, PS, and MS pro
-
cedures. Relative to the MS procedure, the MSWO procedure had
better predictive validity in a subsequent reinforcer assessment. In
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addition, the MSWO was shown to have good concurrent validity with
the PS procedure for 5 of the 7 participants, with Kendall rank-order
coefficients between the MSWO and the PS ranging from .71 to .86.
The MSWO procedure was shown to have the predictive validity of
the PS procedure but required less than half the time to administer.
Test-retest reliability of the MSWO appears adequate: Mean Kendall
rank-order coefficients of concordance across administrations, w,
over a 1-week period were .81.
ENGAGEMENT-BASED MEASURES
Duration of engagement with stimuli rather than approach has also
been used to obtain indices of preference (e.g., DeLeon, Iwata,
Conners, & Wallace, 1999; Hagopian, Rush, Lewin, & Long, 2001;
Ringdahl, Vollmer, Marcus, & Roane, 1997; Roane et al., 1998). For
example, Roane et al. described a procedure that involved presenting
an array of stimuli already identified as preferred via a PS assessment.
A free-operant (FO) preference assessment was conducted with 10
participants, ranging in age from 3 to 37, with diagnoses ranging from
moderate to profound mental retardation. The procedure involved
presenting an array of 10 to 11 stimuli to the participant and allowing
him or her free access to all the items during 5-minute sessions. Item
engagement with each stimulus was recorded, and a preference hierar-
chy was developed on the basis of the percentage of 10-second inter-
vals in which engagement occurred with each stimulus. In a subse
-
quent concurrent-schedule reinforcer assessment, the highest ranked
stimulus was shown to function as a more effective reinforcer than the
lowest ranked stimulus for 8 of 10 cases. These findings provided sup
-
port for the predictive validity of the FO preference assessment;
however, reliability data were not reported.
DeLeon et al. (1999) described a procedure that involved present
-
ing stimuli singly for a period of 2 minutes, during which time
engagement was recorded. Four individuals ranging in age from 32 to
52 years diagnosed with severe behavior disorders participated in the
study. The results of the single stimulus engagement (SSE) procedure
were compared with the results of an MSWO assessment. The SSE
produced a more differentiated hierarchy than the MSWO procedure.
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The predictive validity of the SSE was demonstrated, as stimuli that
were highly preferred were shown to function as reinforcers in a sub
-
sequent single-schedule reinforcer assessment.
Hagopian et al. (2001) described an SSE preference assessment
similar to that described by DeLeon et al. (1999). Four individuals
ranging in age from 7 to 20 years exhibiting severe problem behaviors
participated. Each stimulus was presented individually to each partic
-
ipant for 2 minutes on three different occasions over the course of 1
week. A preference hierarchy was derived on the basis of the percent
-
age of time the participant engaged with each stimulus. Spearman cor
-
relations between preference rankings based on the first administra
-
tion were moderately correlated with the average of all
administrations (range: r
s
= .42 to .81). The predictive validity of the
SSE procedure was demonstrated in a concurrent reinforcer assess-
ment. Across all participants, high-preference stimuli were more
potent reinforcers relative to both medium- and low-preference stim-
uli; and medium-preference stimuli were more potent reinforcers
relative to low-preference stimuli.
CONCLUSIONS AND RECOMMENDATIONS
A variety of indirect and direct measures of preference have been
described in the literature in recent years. In determining the type of
preference assessment to employ, one should take several things into
consideration: the resources available in the setting, the type of stimuli
being examined, the client’s level of functioning, and the client’s
visual or physical impairments.
Indirect measures of preference are often the method of choice
because they are easy to implement and can be employed with limited
resources. Given that the predictive validity of indirect preference
assessments has yet to be established, however, routine use of these
procedures as the sole method to identify potential reinforcers cannot
be recommended at this time. Additional research on the
psychometric properties of indirect preference assessments is needed
given ease of administration and apparent popularity. The extant data
suggest that utilizing both indirect and direct measures of preference
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Hagopian et al. / PREFERENCE ASSESSMENT PROCEDURES 675
may be most efficacious for identifying potential reinforcers for both
children and adults with developmental disabilities. Specifically, it
may be beneficial to first use an indirect method to narrow down a list
of potential preferred stimuli, followed by a direct preference assess
-
ment to obtain more precise relative rankings of stimuli. This
approach was exemplified by Piazza et al. (1996), who utilized a
structured interview to first develop a list of potential preferred stimuli
and subsequently used a direct measure to assess preference.
When determining which direct measure of preference to employ, a
number of variables should be considered, including the type of stim
-
uli to be assessed. For example, approach-based procedures may be
more appropriate than engagement-based procedures when assessing
preference of food items because providing free access to preferred
edible items for several minutes may be both unnecessary and unde-
sirable. On the other hand, engagement-based procedures may be
more appropriate when assessing preference of stimuli that require a
longer access period for the individual to contact the reinforcing prop-
erties of those stimuli (e.g., playing a video game) or of stimuli/activi-
ties that may not lend themselves to the choice presentation format
used with approach-based procedures (e.g., going for a walk, singing
songs).
Finally, specific characteristics of the individual should be consid-
ered when choosing a preference assessment method. In general,
lower functioning or physically impaired individuals may have
greater difficulty choosing among stimuli presented simultaneously.
Thus, approach-based procedures that require the individual to make
a choice from a wide array of stimuli (e.g., MSWO) or even two stim
-
uli (PS) may not be as appropriate as engagement-based procedures
(e.g., SSE). For some clients, it may be necessary to modify some pro
-
cedures. For example, Paclawskyj and Vollmer (1995) describe a
modification of the PS procedure (Fisher et al., 1992) for visually
impaired individuals. The procedure involved physically guiding the
participants to touch and explore the two stimuli prior to each trial.
Conversely, for relatively higher functioning individuals, procedures
involving the simultaneous presentation of multiple stimuli (e.g.,
MSWO) may be desirable given that these procedures require less
time to administer. In addition, for individuals who demonstrate prob
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676 BEHAVIOR MODIFICATION / September 2004
lem behavior or become agitated when preferred stimuli are removed
or when access is limited to a brief period, engagement-based proce
-
dures may be more desirable than approach-based procedures (which
allow only brief access periods) (Roane et al., 1998).
Although major advancements have been made in the development
of preference assessment procedures in recent years, a number of
questions about these procedures remain. In particular, additional
research is needed to further develop and validate indirect preference
assessment procedures. Many of the suggestions provided above
regarding the selection of preference assessment procedures are spec
-
ulative and require formal empirical investigation.
REFERENCES
DeLeon, I. G., & Iwata, B. A. (1996). Evaluation of a multiple-stimulus presentation format for
assessing reinforcer preferences. Journal of Applied Behavior Analysis, 29, 519-533.
DeLeon, I. G., Iwata, B. A., Conners, J., & Wallace, M. D. (1999). Examination of ambiguous
stimulus preferences with duration-based measures. Journal of Applied Behavior Analysis,
32, 111-114.
Fisher, W. W. Piazza, C. C., Bowman, L. G., & Amari, A. (1996). Integrating caregiver report
with a systematic choice assessment. American Journal on Mental Retardation, 101, 15-25.
Fisher, W. W., Piazza, C. C., Bowman, L. G., Hagopian, L. P., Owens, J. C., & Slevin, I. (1992). A
comparison of two approaches for identifying reinforcers for persons with severe and pro-
found disabilities. Journal of Applied Behavior Analysis, 25, 491-498.
Green, C. W., Reid, D. H., Canipe, V. S., & Gardner, S. M. (1991). A comprehensive evaluation
of reinforcer identification processes for persons with profound multiple handicaps. Journal
of Applied Behavior Analysis, 24, 537-552.
Green, C. W., Reid, D. H., White, L. K., Halford, R. C., Brittain, D. P., & Gardner, S. M. (1988).
Identifying reinforcers for persons with profound handicaps: Staff opinion versus systematic
assessment of preferences. Journal of Applied Behavior Analysis, 21, 31-43.
Hagopian, L. P., Rush, K. S., Lewin, A. B., & Long, E. S. (2001). Evaluating the predictive valid
-
ity of a single stimulus engagement preference assessment. Journal of Applied Behavior
Analysis, 34, 475-486.
Matson, J. L., Bielecki, J. A., Mayville, E. A., Smalls, Y., Bamburg, J. W., & Baglio, C. S. (1999).
The development of a reinforcer choice assessment scale for persons with severe and pro
-
found mental retardation. Research in Developmental Disabilities, 20, 379-384.
Pace, G. M., Ivancic, M. T., Edwards, G. L., Iwata, B. A., & Page, T. J. (1985). Assessment of
stimulus preference and reinforcer value with profoundly retarded individuals. Journal of
Applied Behavior Analysis, 18, 249-255.
Paclawskyj, T. R., & Vollmer, T. R. (1995). Reinforcer assessment for children with developmen
-
tal disabilities and visual impairment. Journal of Applied Behavior Analysis, 28, 219-224.
at JOHNS HOPKINS UNIVERSITY on July 29, 2015bmo.sagepub.comDownloaded from
Parsons, M. B., & Reid, D. H. (1990). Assessing food preferences among persons with profound
mental retardation: Providing opportunities to make choices. Journal of Applied Behavior
Analysis, 23, 183-195.
Piazza, C. C., Fisher, W. W., Hagopian, L. P., Bowman, L. G., & Toole, L. (1996). Using a choice
assessment to predict reinforcer effectiveness. Journal of Applied Behavior Analysis, 29, 1-9.
Ringdahl, J. E., Vollmer, T. R., Marcus, B. A., & Roane, H. S. (1997). An analogue evaluation of
environmental enrichment: The role of stimulus preference. Journal of Applied Behavior
Analysis, 30, 203-216.
Roane, H. S., Vollmer, T. R., Ringdahl, J. E., & Marcus, B. A. (1998). Evaluation of a brief stimu
-
lus preference assessment. Journal of Applied Behavior Analysis, 31, 605-620.
Roscoe, E. M., Iwata, B. A., & Kahng, S. W. (1999). Relative versus absolute reinforcement
effects: Implications for preference assessments. Journal of Applied Behavior Analysis, 32,
479-493.
Windsor, J., Piche, L. M., & Locke, P. A. (1994). Preference testing: A comparison of two presen
-
tation methods. Research in Developmental Disabilities, 15, 439-455.
Louis P. Hagopian received his Ph.D. in psychology (child clinical) at Virginia Polytech
-
nic Institute and State University. He is presently the program director of the Neuro-
behavioral Unit at the Kennedy Krieger Institute, and an associate professor in the
Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University
School of Medicine.
Ethan S. Long received his Ph.D. in psychology (child clinical) at West Virginia Univer-
sity. He is presently project director of the AUCD-CDC cooperative agreement at the
Association of University Centers on Disabilities. His research interests include the
assessment and treatment of severe behavior disorders in individuals with developmental
disabilities, habit disorders, and applied behavior analysis.
Karena S. Rush received her Ph.D. in psychology (child clinical) at Louisiana State Uni
-
versity. Her research interests include the assessment and treatment of psychopathology
and severe behavior disorders in individuals with developmental disabilities, treatment
acceptability and integrity, and skill acquisition.
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... Preference for feedback has previously been assessed using indirect methods, such as surveys, questionnaires, and rating scales (Doll et al., 2007;Gravina et al., 2008;Hardesty et al., 2018;Slowiak & Lakowske, 2017). Although the use of indirect methods may be more practical within organizational settings (Simonian et al., 2020), they may not be as reliable as objective measures of preference, such as providing employees a direct choice of feedback either before or after completing a task (Bacotti et al., 2021;Carr et al., 1999;Ferguson et al., 2018;Hagopian et al., 2004;Northup, 2000;VanStelle et al., 2012). Indirect measures of preference between positive and corrective feedback may be especially prone to noncorrespondence with choice behavior due to the words 'positive' and 'corrective' being commonly paired with reinforcement and punishment, respectively. ...
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Feedback is an effective strategy for improving performance and consists of multiple characteristics. One characteristic that can influence feedback efficacy is its nature (whether feedback is positive or corrective) and little is known about the conditions under which individuals may prefer corrective over positive feedback. Thus, the purpose of this study was to assess the efficacy of and preference for positive and corrective feedback during the acquisition of novel tasks. In the first phase, participants received either positive, corrective, or no feedback across three novel tasks. Participants only mastered the task in which they received corrective feedback. In the second phase, participants chose to receive either positive or corrective feedback after completing trials of the previous phase's control task. All participants chose to receive corrective feedback more frequently than positive feedback. We discuss the implications of the results for feedback delivery in the workplace and provide suggestions for future research.
... Preferred stimuli are typically those an individual selects or interacts with most in an SPA, and it is hypothesized that the most preferred stimuli are likely to be the most potent reinforcers (e.g., Butler & Graff, 2021;Pace et al., 1985). Various SPAs have been used to identify preferred stimuli and activities (see Hagopian et al., 2004 andSaini et al., 2021 for a review of SPAs) and generally involve presenting one or more stimuli to an individual and measuring some response (e.g., selection response or interaction with stimuli). ...
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A variable that may influence the outcomes of stimulus preference assessments (SPAs) is whether social interaction is provided during the stimulus access period. In Experiment 1, we compared the outcomes of a Solitary paired stimulus preference assessment (PSPA) (toys only), Social PSPA (toys plus social interaction), and Combined PSPA (toys alone and toys plus social interaction) to determine whether the addition of social interaction influenced preference for toys in preschool children. In Experiment 2, we conducted a concurrent-operant reinforcer assessment to compare the reinforcing efficacy of stimuli with and without social interaction. Experiment 1 showed preference for toys was stable across assessments (Solitary and Social PSPAs) and most participants preferred toys plus social interaction when compared in a single assessment (Combined PSPA). Experiment 2 showed that results of the Combined PSPA in Experiment 1 predicted the outcome of most participants' reinforcer assessments.
... Abbreviated preference assessment procedures (e.g., single-trial preference assessment; DeLeon et al., 2001), are useful when frequent preference assessments are needed. Hagopian et al. (2004) provide a thorough review of the preference assessment literature. ...
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Children with autism often engage in challenging behavior such as physical aggression or restrictive and repetitive behavior that interfere with the delivery of medical procedures. Although researchers have described best practices for providing services to individuals with autism within medical settings, many of these recommendations lack empirical support, especially as they relate to overcoming challenging behavior. In contrast, applied behavior analysis offers evidence of best practices, but translation of these findings to medical settings is limited. We conducted a scoping review of the existing medical literature on best practices for treating children with autism who engage in challenging behavior within hospital settings and discuss how the behavior-analytic literature may contribute to best practices recommendations.
Chapter
The questions posed in this chapter involve the relevance of reinforcement and punishment schedules, the properties of which researchers have analyzed and systematized in laboratories under controlled conditions, and in practical applications. A schedule is a two-term contingency that prescribes the arrangement of reinforcers or punishers in time and in relation to responses (Zeiler, 1984). Schedules are not esoteric constructions artificially created to investigate equally esoteric problems in laboratories. They are both ubiquitous in every environment that living organisms inhabit and fundamental to the understanding of behavior. Schedules also do not require translation into practice in any usual sense of that expression because schedules already were there-schedules maintain or suppress responding even before an applied behavior analyst intervenes. The job of the applied behavior analyst is to identify the likely schedule maintaining the targeted behavior and draw from research on that schedule to modify it to the client's benefit. Because every intervention involves a schedule of reinforcement, punishment, or both, knowledge of these schedules is essential to best practices.
Chapter
Individuals with autism spectrum disorder (ASD) frequently present with comorbid anxiety and obsessive-compulsive disorders (OCD), which leads to elevated levels of impairment and unique treatment challenges. There is strong evidence that exposure therapy, with some modifications, is an effective treatment for individuals with ASD and comorbid anxiety and OCD. Core symptoms associated with ASD (i.e., social skills deficits, rigidity and resistance to change, and sensory sensitivities) present unique treatment challenges that make individualized and modified exposure therapies an ideal treatment approach for these individuals. Recommended modifications when treating patients with ASD and comorbid anxiety or OCD include involving parents and other caregivers in sessions, using contingency reward systems, and utilizing teaching strategies such as prompting, modeling, and visual aids. Treatment planning recommendations and case examples are provided.
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The development of effective training programs for persons with profound mental retardation remains one of the greatest challenges for behavior analysts working in the field of developmental disabilities. One significant advancement for this population has been the reinforcer assessment procedure developed by Pace, Ivancic, Edwards, Iwata, and Page (1985), which involves repeatedly presenting a variety of stimuli to the client and then measuring approach behaviors to differentiate preferred from nonpreferred stimuli. One potential limitation of this procedure is that some clients consistently approach most or all of the stimuli on each presentation, making it difficult to differentiate among these stimuli. In this study, we used a concurrent operants paradigm to compare the Pace et al. (1985) procedure with a modified procedure wherein clients were presented with two stimuli simultaneously and were given access only to the first stimulus approached. The results revealed that this forced-choice stimulus preference assessment resulted in greater differentiation among stimuli and better predicted which stimuli would result in higher levels of responding when presented contingently in a concurrent operants paradigm.
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To determine client preferences, we asked caregivers to rank-order, according to predicted client preference, a standard list of items and a list generated using a structured interview for caregivers, the Reinforcer Assessment for Individuals with Severe Disabilities. Systematic choice assessments were then conducted with both sets of stimuli. A concurrent operants paradigm was used to compare the reinforcing effects of the highest preference stimulus identified from each list. Results indicated that caregiver predictions of client preferences were slightly better for the set of stimuli they generated than for the standard set, and the choice assessment identified more potent reinforcers from the set of stimuli generated by the caregivers than from the standard set.
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To evaluate the effects of environmental enrichment on stereotypic self-injurious behavior (SIB), we conducted an assessment of preference for manipulating alternative stimuli rather than engaging in SIB. First, for each of 3 participants, a functional analysis of SIB was conducted in Phase 1. Participants were selected for Phase 2 if the functional analysis showed that SIB persisted in the absence of social consequences. In Phase 2, a preference assessment was conducted in which participants were observed manipulating preferred stimuli in a free-operant format. A measure was taken of time spent manipulating each stimulus and time spent engaging in SIB. In Phase 3, environmental enrichment was evaluated using stimuli that were preferred over the target response, and alternative treatments were evaluated in the event of environmental enrichment failure. Results suggested that the free-operant preference assessment (a) predicted the efficacy or inefficacy of an environmental enrichment procedure and (b) suggested possible treatment alternatives when environmental enrichment was ineffective. Collectively, the results may provide a basis for interpreting the idiosyncratic effects of environmental enrichment and a rationale for treatment selection when behavioral function is unknown.
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We evaluated a procedure for identifying potential reinforcers with profoundly retarded individuals. In Experiment 1, six persons were repeatedly exposed to 16 stimuli, and approach behaviors to each stimulus were used to identify preferred and nonpreferred stimuli. In Experiment 2, we examined the reinforcing properties of preferred and nonpreferred stimuli by delivering them contingently on the occurrence of arbitrarily selected responses. Results revealed that the preferred stimulus conditions typically produced higher rates of responding than did either the baseline or the nonpreferred stimulus conditions, suggesting that the procedure can be used to assess reinforcer value for individuals with limited behavioral repertoires.
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We assessed the applicability of two previously developed reinforcer assessment procedures to children with developmental disabilities and visual impairments. Greater differentiation between stimuli was observed with a choice procedure than with a preference procedure. Measurement of compliance and rate of responding in adaptive skill training confirmed that the choice procedure accurately identified reinforcing stimuli. The preference procedure produced false positive predictions of reinforcer efficacy.
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A choice assessment has been found to be a more accurate method of identifying preferences than is single-item presentation. However, it is not clear whether the effectiveness of reinforcement varies positively with the degree of preference (i.e., whether the relative preference based on the results of a choice assessment predicts relative reinforcer effectiveness). In the current study, we attempted to address this question by categorizing stimuli as high, middle, and low preference based on the results of a choice assessment, and then comparing the reinforcing effectiveness of these stimuli using a concurrent operants paradigm. High-preference stimuli consistently functioned as reinforcers for all 4 clients. Middle-preference stimuli functioned as reinforcers for 2 clients, but only when compared with low-preference stimuli. Low-preference stimuli did not function as reinforcers when compared to high- and middle-preference stimuli. These results suggest that a choice assessment can be used to predict the relative reinforcing value of various stimuli, which, in turn, may help to improve programs for clients with severe to profound disabilities.
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We evaluated comprehensively a preference assessment for identifying reinforcers for persons with profound multiple handicaps. Four experiments were conducted involving 18 individuals. Results of Experiment 1 replicated previous findings in that the assessment identified student preferences for respective stimuli, and caregiver opinion of preferences did not coincide with the systematic assessment. Results of Experiment 2 indicated highly preferred stimuli were likely to function as reinforcers in training programs, whereas stimuli not highly preferred did not function as reinforcers. Results of Experiment 3 suggested the 12 stimuli used in the assessment represented a comprehensive stimulus set for identifying preferences, although the utility of the set sometimes could be enhanced by caregiver opinion. Results of Experiment 4 indicated the assessment identified preferences likely to be maintained over time. Overall, results are discussed in terms of identifying limits and alternatives to a behavioral teaching technology when applied to persons with profound multiple handicaps.
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Increased attention has been directed recently to assisting persons with severe handicaps to express preferences concerning events in their lives. We evaluated a program for assessing choice-making skills to provide opportunities for persons with profound mental retardation to express food and drink preferences. In Experiment 1, the assessment procedure involving repeated, paired-item presentations resulted in active choice making and the identification of preferences for all 5 participants. Results also indicated that caregiver opinion was not predictive of participant food and drink preferences. A survey of service providers supported the importance of meal-related choices in this population. In Experiment 2, the practicality of the assessment procedure was supported by demonstrating that (a) routine caregivers could apply the procedure with appropriate supervision to provide choice opportunities, and (b) results of the procedure were predictive of participant choices when a less structured and more normal opportunity to express a preference was provided during regular mealtimes. Results are discussed in terms of extending the developing technology of preference and reinforcer identification to other important areas for persons with severe disabilities.
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We evaluated a systematic means of determining stimulus preferences among seven profoundly handicapped persons. Preferences were determined by observing student approach responses to individual stimuli. Results indicated that there were differential stimulus preferences across the multiply handicapped participants. However, results of the systematic assessment did not coincide with the results of a more traditional, caregiver-opinion method of assessing student preferences. A second experiment was then conducted with five participants to evaluate whether stimuli that were assessed to consistently represent preferences would function as reinforcers in skill training programs. Results indicated that stimuli that were systematically assessed to represent student preferences typically functioned as reinforcers when applied contingently. However, preferred stimuli as reflected by caregiver opinion did not function as reinforcers unless those stimuli were also preferred on the systematic assessment. Results are discussed in terms of assisting profoundly handicapped persons by (a) improving the effectiveness of training programs by increasing the likelihood of using stimuli that have reinforcing value and (b) increasing the overall quality of life by providing preferred stimuli in the routine living environment.
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Paired and group presentation methods of preference testing were compared with eight learners with severe-profound developmental disabilities. Each presentation method was also compared with staff rankings of learners' preferences. Similar preferences were identified with both presentation methods. Although the paired presentation took more time to administer, it elicited more consistent preference information than the group presentation. Staff preference rankings were not highly correlated with either the group or paired presentation. However, items identified as most preferred by staff and by both presentation methods were similar.