Clinical decision making and preference assessment for individuals with intellectual and developmental disabilities.

Individuals with intellectual or developmental disabilities are able to reliably express their likes and dislikes through direct preference assessment. Preferred items tend to function as rewards and can therefore be used to facilitate the acquisition of new skills and promote task engagement. A number of preference assessment methods are available and selecting the appropriate method is crucial to provide reliable and meaningful results. The authors conducted a systematic review of the preference assessment literature, and developed an evidence-informed, decision-making model to guide practitioners in the selection of preference assessment methods for a given assessment scenario. The proposed decision-making model could be a useful tool to increase the usability and uptake of preference assessment methodology in applied settings.

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.

Discrimination Skills Predict Effective Preference Assessment Methods for Adults with Developmental Disabilities.

We examined the relationship between three discrimination skills (visual, visual matching-to-sample, and auditory-visual) and four stimulus modalities (object, picture, spoken, and video) in assessing preferences of leisure activities for 7 adults with developmental disabilities. Three discrimination skills were measured using the Assessment of Basic Learning Abilities Test. Three participants mastered a visual discrimination task, but not visual matching-to-sample and auditory-visual discriminations; two participants mastered visual and visual matching-to-sample discriminations, but not auditory-visual discrimination, and two participants showed all three discriminations. The most and least preferred activities, identified through paired-stimulus preference assessment using objects, were presented to each participant in each of the four modalities using a reversal design. The results showed that (1) participants with visual discrimination alone showed a preference for their preferred activities in the object modality only; (2) those with visual and visual matching-to-sample discriminations, but not auditory-visual discrimination, showed a preference for their preferred activities in the object but not in the spoken modality, and mixed results in the pictorial and video modalities; and (3) those with all three discriminations showed a preference for their preferred activities in all four modalities. These results provide partial replications of previous findings on the relationship between discriminations and object, pictorial, and spoken modalities, and extend previous research to include video stimuli.

Predicting learning ability of people with intellectual disabilities: assessment of basic learning abilities test versus caregivers' predictions.

Two sets of predictions were compared concerning the ability of 20 adults with profound, severe, or moderate intellectual disabilities to learn 15 everyday tasks. Predictions were made by caregivers who had worked with the participants for a minimum of 24 months and consideration of participant performance on the Assessment of Basic Learning Abilities (ABLA) test. Standardized training procedures were used to attempt to teach each task to each participant until a pass or fail criterion was met. Ninety-four percent of predictions based on ABLA performance were confirmed, and the ABLA was significantly more accurate for predicting client performance than were the caregivers. The utility of these results is discussed.

SENSITIVITY OF PASSIVE APPROACH DURING PREFERENCE AND REINFORCER ASSESSMENTS FOR CHILDREN WITH SEVERE AND PROFOUND INTELLECTUAL DISABILITIES AND MINIMAL MOVEMENT.

We evaluated the use of passive approach to assess preferences of two children, with severe and profound intellectual disabilities. Both children had physical challenges and exhibited minimal physical movement. We also compared the relative reinforcing effects of the identified high and low preference stimuli for a switch pressing response, and for a more passive looking response. High and low preference stimuli were identified for both children. Moreover, the high preference stimulus maintained higher rates of responding than the low preference stimulus for both children for the passive looking response, but not for switch pressing. The study extended the use of passive approach to assess preferences and identified the choice of target response as a potential limiting factor during reinforcer tests for these children.