A novel method for testing learning and preferences in people with minimal motor movement.
Two side-by-side switches reveal leisure preferences in clients with almost no movement—single switches often miss them.
01Research in Context
What this study did
Ten adults with severe physical disabilities tried two switch setups. One switch sat on a table. Two switches sat side-by-side. Each switch lit a lamp or played music for five seconds.
Researchers counted how many times each person pressed. They wanted to see if clients could learn the link and show a favorite item.
What they found
Eight people learned the single-switch task. Five of those only showed a clear favorite when they had two switches to pick from.
Single-switch tests missed leisure preferences that the two-choice setup caught.
How this fits with other research
Hastings et al. (2001) used a 30-second watch-and-touch test. Their single-item method predicted reinforcer strength, but it needs arm movement. D et al. added switches so clients with almost no movement can still reveal likes.
Ford et al. (2022) later copied the two-choice idea for elders with dementia. They swapped switches for voice and tablet taps. Both studies show the same lesson: give clients two clear options, not one.
Butler et al. (2021) tracked edible, toy, and social items for a full year. Edible preferences stayed put; toys and praise shifted. If you use D et al.'s switch method, re-test toy or social choices every few weeks, not yearly.
Why it matters
If you serve clients who blink, twitch a finger, or tilt their head, you can still find what they love. Tape two micro-switches near the body part they move most. Let each switch deliver a different 5-second clip of music, vibration, or light. Count presses for five minutes. The higher count is the stronger preference. Use that item as a reinforcer in future teaching trials. Re-run the test every month for leisure items, less often for snacks.
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Join Free →Place two switches within the client’s smallest reliable movement range, pair each with a different 5-s stimulus, and record which switch is hit more in a 5-min probe.
02At a glance
03Original abstract
Ten individuals with profound multiple impairments were given novel tests for learning and preference with adaptive switches and leisure-oriented devices, such as audio tape players. Typically, tests for learning include a baseline or extinction component in which the adaptive switch and device are not connected as a control for incidental or involuntary switch use. As an alternative, conditions were compared in sets of six sessions each in which switch closure caused (a) Activation of a device, (b) Deactivation of an already operating device, and (c) Deactivation of one of two devices and Activation of the other (Two-Choice). Changes in behavior indicative of learning were observed in eight participants in Activation-Deactivation conditions. The Two-Choice Condition produced indices of learning that also showed a preference for one device over the other with five participants. The preferences observed in the Two-Choice Condition had not been seen in the Activation or Deactivation Condition data. People with profound multiple impairments evinced leisure-device preferences, but such preferences may not lead to differential responding across opportunities with only one device at a time.
Research in developmental disabilities, 2005 · doi:10.1016/j.ridd.2004.03.002