Assessing food preferences among persons with profound mental retardation: providing opportunities to make choices.
A two-item food choice test run by staff reveals true preferences that caregivers usually misjudge.
01Research in Context
What this study did
The team worked with five adults who had profound intellectual disability.
None could talk. Most could point or reach.
Staff presented two foods or drinks at a time.
Clients simply touched the one they wanted.
Trials continued until clear winners and losers emerged.
Caregivers also guessed what each person liked best.
What they found
Every participant showed clear favorites.
Staff guesses were wrong as often as right.
The brief assessment predicted what clients chose at real meals.
Training took under an hour and any staff member could run it.
How this fits with other research
Buskist et al. (1988) already showed staff hunches fail for reinforcers.
Parsons et al. (1990) proved the same is true for food.
Allan et al. (1991) repeated the test one year later and got the same outcome.
Villafaña et al. (2023) later swapped real food for pictures.
Pictorial choice worked just as well for kids who refuse food.
Together the studies build a 30-year line: ask the client, not the caregiver.
Why it matters
If you serve meals or deliver edible reinforcers, run a two-item choice test first.
It takes minutes, needs no gear, and prevents the all-too-common error of offering disliked food.
Better choices mean fewer refusals, less waste, and more learning.
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02At a glance
03Original abstract
Increased attention has been directed recently to assisting persons with severe handicaps to express preferences concerning events in their lives. We evaluated a program for assessing choice-making skills to provide opportunities for persons with profound mental retardation to express food and drink preferences. In Experiment 1, the assessment procedure involving repeated, paired-item presentations resulted in active choice making and the identification of preferences for all 5 participants. Results also indicated that caregiver opinion was not predictive of participant food and drink preferences. A survey of service providers supported the importance of meal-related choices in this population. In Experiment 2, the practicality of the assessment procedure was supported by demonstrating that (a) routine caregivers could apply the procedure with appropriate supervision to provide choice opportunities, and (b) results of the procedure were predictive of participant choices when a less structured and more normal opportunity to express a preference was provided during regular mealtimes. Results are discussed in terms of extending the developing technology of preference and reinforcer identification to other important areas for persons with severe disabilities.
Journal of applied behavior analysis, 1990 · doi:10.1901/jaba.1990.23-183