Assessing Preference and Stability of Preference for Individuals with Neurocognitive Disorder
Use single-stimulus preference assessments—not rank-order—to reliably pick activities that will engage older adults with neurocognitive disorder.
01Research in Context
What this study did
Ford et al. (2022) worked with older women who had neurocognitive disorder.
They compared three ways to find out what activities the women liked.
The team used single-stimulus (show one item at a time), caregiver ranking, and MSWO (pick from many items).
They watched which method best predicted later engagement in the activity.
What they found
Single-stimulus testing won.
When staff showed one activity at a time, the choices matched later real engagement.
Rank-order lists from caregivers or MSWO did not match as well.
Preferences stayed mostly the same over time for the single-stimulus picks.
How this fits with other research
This study extends Hastings et al. (2001).
P et al. first showed that single-stimulus works for clients who struggle with choice formats.
Ford et al. now show it also works for older adults with dementia.
Wilson et al. (2024) looked at video versus picture modes and found video gave the most stable choices.
Ford used verbal and multimedia modes and still saw stability, so the mode may matter less than the method.
Butler et al. (2021) found edible items stayed stable over the study period.
Ford saw activity preferences stay stable too, adding leisure items to the list of things you can test less often.
Why it matters
If you serve adults with dementia, drop the long rank-order forms.
Just show one activity at a time and watch the response.
You will pick better reinforcers and you will not need to re-test every week.
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02At a glance
03Original abstract
Poor engagement can lead to a reduced quality of life for individuals with neurocognitive disorder (NCD). Research on determining preference and increasing engagement with this population is limited. The purpose of this study was to compare the accuracy of four preference assessment formats in identifying preferred activities and predicting engagement for six females with NCD and to measure the stability of preference and engagement over time. We compared the predictability of single-stimulus(SS) verbal and multimedia assessments, caregiver ranking (CR) assessments, and multiple-stimulus without-replacement (MSWO) assessments. Participants responded consistently on SS assessments, but we noted inconsistencies between the CR and MSWO assessments. SS assessments predicted engagement during engagement analyses, but rank-order assessments did not predict engagement for moderately ranked activities. The rank-order assessments predicted engagement for highly ranked activities for most participants and for low-ranked activities for two participants. We also evaluated the stability of preferences and engagement over time. Participants responded consistently on SS assessments and inconsistently on MSWO assessments across time. SS assessments consistently predicted engagement during engagement analyses for five participants, but when activity rank is considered, the MSWO was inconsistent in predicting engagement across time for most participants. These results suggest that SS assessments may be useful for identifying preferred activities and engagement, and preferences may remain stable for some individuals with NCD.
Behavior Analysis in Practice, 2022 · doi:10.1007/s40617-021-00648-7