Sensory reinforcement of head turning with nonambulatory, profoundly mentally retarded persons.

Paul et al. (1987) worked with ten adults who could not walk and had profound intellectual disability.

The team wanted to see if special sensory rewards could teach these adults to turn their heads.

Each person got a quick taste of many sights, sounds, and vibrations. The items that made them smile, look, or move more became their personal reinforcers.

Those reinforcers were then given only when the person turned his or her head toward the therapist.

Six of the ten adults learned to turn their heads when they heard or felt their favorite stimulus.

The other four showed little change, even after the team swapped in new reinforcers.

The study shows that sensory reinforcers can work, but you must test each client first.

Emerson et al. (2007) built on this idea by using microswitches instead of a human hand. Their students kept head control for months after training, showing the value of adding long follow-ups.

Gaylord-Ross et al. (1995) and Wanchisen et al. (1989) both pushed the reinforcer hunt further. They let children pick between items instead of just watching them. Choice-based tests found stronger reinforcers and cut problem behavior faster.

Heinicke et al. (2019) later pooled 32 studies and agreed: pictures, videos, or short samples work, but only if you also check that the client can see, hear, or feel them.

If you serve non-ambulatory clients with profound ID, start every program with a 5-minute sensory reinforcer probe. Mix picture, sound, and vibration together first; drop what earns no reaction. Then deliver that winning combo only for the target response. This quick step can save weeks of trial and error and avoids the trap of assuming you already know "what they like."