Assessment & Research

A comprehensive evaluation of reinforcer identification processes for persons with profound multiple handicaps.

Green et al. (1991) · Journal of applied behavior analysis 1991
★ The Verdict

A quick approach test finds longer-lasting reinforcers than caregiver guesses for clients with profound multiple handicaps.

✓ Read this if BCBAs and RBTs serving teens or adults with profound multiple handicaps in day or residential programs.
✗ Skip if Clinicians working with verbal clients who can self-report preferences.

01Research in Context

01

What this study did

The team worked with people who have profound multiple handicaps.

They compared two ways to find reinforcers: caregiver opinion and a short systematic test.

In the test, the learner simply approached one of two items.

The study ran several trials to see which items held up as true reinforcers over time.

02

What they found

Caregiver guesses were often wrong.

The systematic approach test picked items that kept their power weeks later.

Items chosen by the test increased behaviors when used as reinforcers.

03

How this fits with other research

Buskist et al. (1988) asked the same question three years earlier and got the same answer: test beats opinion.

Fritz et al. (2020) later showed the quicker MSWO method works for most clients, updating the toolkit.

Kangas et al. (2011) extended the idea to adults who can press only one switch, proving the rule still holds when you tweak the format.

Donahoe et al. (2000) showed you can embed the same brief trials inside daily routines instead of running separate sessions.

04

Why it matters

Stop asking staff, "What does he like?" Run a two-item approach test for two minutes.

Use the winners right away and recheck every few weeks.

This simple habit saves session time, reduces problem behavior, and keeps treatment strong.

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→ Action — try this Monday

Pick two items, place them apart, let the client approach, and record the choice for five trials—use the top item first in teaching.

02At a glance

Intervention
preference assessment
Design
single case other
Sample size
18
Population
intellectual disability
Finding
positive

03Original abstract

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.

Journal of applied behavior analysis, 1991 · doi:10.1901/jaba.1991.24-537