Preference for leisure items over edible items in individuals with dementia: A replication

Lucock et al. (2020) ran a paired-stimulus preference test with adults who have dementia. They held up two items at a time and asked the person to pick one.

They compared leisure items like music players and puzzles against snack foods. The team also watched how long each person stayed engaged with the chosen item.

Every adult picked leisure items over edibles when the two were side-by-side. Higher-ranked leisure items also kept them busy for longer periods.

The link between preference rank and engagement time gives you a quick way to spot the best reinforcers.

Ortega et al. (2012) saw the same leisure-first pattern eight years earlier. Lucock et al. (2020) adds the new twist that higher preference predicts longer engagement.

Conine et al. (2019) and Sipila‐Thomas et al. (2021) show the opposite trend in kids with autism: edibles usually win or can displace leisure choices. The clash is about population, not method. Dementia favors leisure; ASD favors food.

Slanzi et al. (2020) found a middle ground in Italian kids with ASD, where 44% preferred leisure items most. Even that high rate still falls short of the universal leisure preference seen in dementia.

If you work with adults who have dementia, stock your preference bag with leisure items first. Skip the cookies until you know they outperform a radio or a stress ball. Track engagement seconds during the test; the items they pick fastest are likely to keep them busy longest when you use them as reinforcers in daily activities.