Assessing preferences of individuals with developmental disabilities using alternative stimulus modalities: A systematic review

The purpose of this systematic review was to identify investigations comparing the efficacy of alternative modality (e.g., pictorial, verbal, video) stimulus preference assessments for individuals with developmental disabilities. We identified articles by searching peer‐reviewed journals using the PsycINFO and ERIC databases, conducting table of contents searches of common behavioral outlets, and conducting ancestral searches of recent reviews and practitioner summaries of preference assessment methodology. A total of 32 articles met our inclusion criteria. These studies were then coded across a variety of features to gain a better understanding of the efficacy of alternative format preference assessments for individuals with developmental disabilities. In addition, we reviewed this literature for the use of prerequisite‐skill assessments and contingent‐reinforcer access to further investigate the relation between these variables and the accuracy of pictorial, verbal, and video preference assessments. A variety of methodological concerns are discussed as well as suggestions for future research.     

Examination of relative reinforcement effects of stimuli identified through pretreatment and daily brief preference assessments.

Several brief preference assessments have recently been developed to identify reinforcers for individuals with developmental disabilities. One purported advantage of brief assessments is that they can be administered frequently, thus accommodating shifts in preference and presumably enhancing reinforcement effects. In this study, we initially conducted lengthy paired‐choice preference assessments and identified a hierarchy of preferred items for 5 individuals with developmental disabilities. Subsequently, brief multiple‐stimulus‐without‐replacement assessments using the same items were completed each day prior to work sessions. On days when results of the daily brief assessment differed from the one‐time lengthy assessment, the relative reinforcing effects of the top items from each assessment were compared in a concurrent‐schedule arrangement. The results revealed that when the two assessments differed, participants generally allocated more responses to the task associated with the daily top‐ranked item.     

The effects of brief and extended stimulus availability on preference

The effects of stimulus availability on preference were evaluated using two conditions of a modified preference assessment. Different preference hierarchies were found in 15-s access conditions than in 15-min access conditions. Subsequent comparisons of a short-availability high-preference stimulus and a long-availability high-preference stimulus verified differential preferences for stimuli based on duration of availability.     

Evaluating the predictive validity of a single stimulus engagement preference assessment.

Most preference assessments require individuals to choose among two or more stimuli. More recently, the duration of engagement with items has been used as an index of preference. In the current study, the predictive validity of a single stimulus engagement (SSE) preference assessment was evaluated with 4 individuals. Stimuli were presented singly for a brief period while engagement with that stimulus was recorded. Although SSE preference rankings closely matched paired stimulus preference assessment rankings for only 2 of the 4 participants, relative preference rankings based on duration of engagement predicted relative reinforcer effectiveness for all participants in a subsequent concurrent‐schedule reinforcer assessment. The SSE procedure took less time to administer than the paired stimulus procedure but produced less stable preference rankings across administrations. The SSE procedure may be appropriate for individuals who have difficulty selecting one stimulus from among two or more stimuli, and it may be well suited for evaluating activities that are difficult to present in a paired stimulus format.     

ON THE RELATION BETWEEN REINFORCER EFFICACY AND PREFERENCE

Most research on stimulus preference and reinforcer assessment involves a preference assessment that is followed by a reinforcer assessment. Typically, the most and least preferred stimuli are tested as reinforcers. In the current study, we first quantified the reinforcing efficacies of six food items and then assessed relative preference for each item. Relative preference ranking and reinforcer efficacies showed almost perfect concordance for 1 participant and partial concordance for the other. Discordance tended to occur with the weakest reinforcers.     

EVALUATION OF A MULTIPLE-STIMULUS PRESENTATION FORMAT FOR ASSESSING REINFORCER PREFERENCES

We compared three methods for presenting stimuli during reinforcer-preference assessments: a paired-stimulus format (PS), a multiple-stimulus format in which selections were made with replacement (MSW), and a multiple-stimulus format in which selections were made without replacement (MSWO). Results obtained for 7 participants showed moderate to high rank-order correlations between the MSWO and PS procedures and a similar number of identified reinforcers. In addition, the time to administer the MSWO procedure was comparable to that required for the MSW method and less than half that required to administer the PS procedure. Subsequent tests of reinforcement effects revealed that some stimuli selected in the PS and MSWO procedures, but not selected in the MSW procedure, functioned as reinforcers for arbitrary responses. These preliminary results suggest that the multiple-stimulus procedure without replacement may share the respective advantages of the other methods.     

Effects of video self-modeling on the preference and reinforcer value of toys for children diagnosed with autism spectrum disorder

A primary characteristic of autism spectrum disorder includes restrictive and repetitive patterns of behavior. Because having few preferred items and activities can lead to social, communicative, and educational barriers, it is important to increase the number of preferred stimuli in the individual's environment. One way to do this is through conditioned reinforcement via observation. Such procedures involve the acquisition of a skill or change in behavior as a result of indirect contact (i.e., observation) with contingencies received by others. While conditioning through observation has been shown to be effective, one novel approach is video self-modeling. The purpose of the current study was to assess the effects of video self-modeling on the preference and reinforcer value of toys for children diagnosed with autism spectrum disorder.     

Predicting the relative efficacy of three presentation methods for assessing preferences of persons with developmental disabilities

Choices were presented to 9 individuals with developmental disabilities using a two-choice format. Each pair of items, selected based on prior preference assessment, was presented to each participant in three conditions (actual items, pictures of the items, and spoken-name presentation) using a reversal design. The evaluation was conducted using food items, and was then repeated using nonfood items. The participants were also given a test to measure their skills on discrimination tasks ranging in difficulty from simple to conditional discriminations. The participants' abilities to make consistent choices with food and nonfood items were predicted, with 94% accuracy, by their discrimination skills. The findings suggest that presentation methods can affect the accuracy of a choice assessment, and that the systematic assessment of basic discrimination skills can be used to predict the effectiveness of different presentation methods in this population.     

Longitudinal analysis of leisure-item preferences.

Twenty‐two individuals with developmental disabilities participated in two leisure‐item preference assessments, spaced approximately 16 months apart. Results showed (a) an overall increase in item contact across assessments for 13 participants and (b) at least some overlap across assessments in the five most highly ranked items for every participant. These results highlight individual differences in the stability of preference over time and suggest the need for research to identify the determinants of temporal shifts in preference.     

On the displacement of leisure items by food during multiple-stimulus preference assessments

Previous studies have demonstrated that when food and leisure stimuli are combined in multiple-stimulus preference assessments, individuals typically select food more often, although the leisure stimuli also have known reinforcing properties. The purpose of the current study was to replicate this effect and determine its durability by examining the effect after mealtimes. Four adults who had been diagnosed with severe mental retardation were given three initial multiple-stimulus (without replacement) preference assessments (i.e., food, leisure stimuli, and combined). All participants selected food items as the most preferred stimuli in the combined assessments. Combined assessments were then administered immediately before and after the evening meal for each participant for 1 week. The results showed similar data both before and after mealtimes.     

Web‐based stimulus preference assessment and reinforcer assessment for videos

This study replicated and extended the use of a web‐based multiple‐stimulus‐without‐replacement preference assessment (Curiel, Curiel, Li, Deochand, & Poling, 2018) by adding a web‐based single‐operant reinforcer assessment. Five adults diagnosed with autism spectrum disorder participated in this study. The web‐based program identified preference hierarchies for 4 of the 5 participants, and the single‐operant reinforcer assessment confirmed that the highly preferred videos functioned as reinforcers. Advantages of computer‐based stimulus preference and reinforcer assessments are discussed.     

Further evaluation of low-ranked items in stimulus-choice preference assessments

The generality of the findings reported by DeLeon, Iwata, and Roscoe (1997) was examined by conducting two stimulus-choice preference assessments, the second of which evaluated low-ranked items from the initial assessment. Results for the 2 participants suggested that supplementary assessments of low-ranked items may be useful for identifying a wider variety of reinforcing stimuli.     

Assessing the efficacy of pictorial preference assessments for children with developmental disabilities

Past research has demonstrated that pictorial preference assessments can predict subsequent reinforcement effects for individuals with developmental disabilities only when access to the selected stimulus is provided contingent on a pictorial selection. The purpose of the present investigation was to assess more comprehensively the feasibility of the pictorial format with children with developmental disabilities. In Experiment 1, prerequisite skill assessments were conducted, and the role of a contingent reinforcer was assessed by comparing the results from the pictorial assessment without contingent access to a reinforcer assessment. If contingent access was found to be necessary, the effects of schedule thinning were evaluated to determine whether a pictorial format could be made more practical in Experiment 2. The pictorial format without contingent access was successful with only some participants. However, schedule thinning was found to be an effective method to establish conditioned reinforcement properties for pictorial stimuli to create a more practical assessment for a subset of participants.     

USING A CHOICE ASSESSMENT TO PREDICT REINFORCER EFFECTIVENESS

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.     

EVALUATION OF A BRIEF STIMULUS PREFERENCE ASSESSMENT

We evaluated the utility of a brief (5-min) stimulus preference assessment for individuals with developmental disabilities. Participants had noncontingent (free) access to an array of stimuli and could interact with any of the stimuli at any time. Stimuli were never withdrawn or withheld from the participants during a 5-min session. In Experiment 1, the brief preference assessment was conducted for 10 participants to identify differentially preferred stimuli, and reinforcer assessments were conducted to test the reinforcing efficacy of those stimuli identified as highly preferred. In Experiment 2, a comparison was conducted between the brief preference assessment and a commonly used paired-stimulus preference assessment. Collectively, results demonstrated that the brief preference assessment identified stimuli that functioned as reinforcers for a simple operant response, identified preferred stimuli that were differentially effective as reinforcers compared to nonpreferred stimuli, was associated with fewer problem behaviors, and required less time to complete than a commonly used paired-stimulus preference assessment.     

Response-restriction analysis: I. Assessment of activity preferences

We used procedures based on response-restriction (RR) analysis to assess vocational and leisure activity preferences for 3 adults with developmental disabilities. To increase the efficiency of the analysis relative to that reported in previous research, we used criteria that allowed activities to be restricted at the earliest point at which a preference could be determined. Results obtained across two consecutive RR assessments showed some variability in overall preference rankings but a high degree of consistency for highly ranked items. Finally, we compared results of the RR assessment with those of an extended free-operant assessment and found that the RR assessment yielded (a) more differentiated patterns of preference and (b) more complete information about engagement with all of the target activities.     

The effects of providing access to stimuli following choice making during vocal preference assessments

Two variations of a vocal paired-stimulus preference assessment were evaluated to determine whether the verbal reports of preference, given by individuals with developmental disabilities when no access to the activity was given, matched their verbal reports when access to the activity was given contingent on their choice. The results indicated different outcomes between the two methods for 6 of the 7 participants. Subsequent reinforcer assessments, conducted for 2 participants, showed that activities identified in the preference assessments that provided access contingent on selection resulted in more responding than did activities identified in the preference assessment that did not include access to items following their selection.