Utility of the multiple-stimulus without replacement procedure and stability of preferences of older adults with dementia.
MSWO picks reinforcers for adults with dementia, yet preferences can drift—plan to re-assess every couple of months.
01Research in Context
What this study did
The team ran MSWO preference tests with older adults who have dementia.
They wanted to see if the top picks stayed the same three to five months later.
Each person handled six items and ranked them by reaching or looking.
What they found
MSWO gave a clear order of liked items for most participants.
About half of the group kept the same top items months later.
The rest shifted favorites, so stability was mixed.
How this fits with other research
Bigwood et al. (2026) later showed that slower pacing and mood checks make the same test easier and happier for adults with dementia.
MacNaul et al. (2021) reviewed many studies and say to re-test every eight to thirty days for best stability.
That advice seems to clash with Goulardins et al. (2013), yet the gap closes when you note MacNaul mixed many diagnoses while dementia may drift more slowly.
Verriden et al. (2016) also found MSWO ranks steadier than free-operant in people with ASD or TBI, backing the tool itself.
Why it matters
You can trust MSWO to find reinforcers for adults with dementia, but mark a calendar to re-check every two months.
A quick five-minute re-test beats guessing when favorites fade.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Schedule a brief MSWO re-test eight weeks after the first one and graph any rank changes.
02At a glance
03Original abstract
Paired-stimulus preference assessments have been used effectively with individuals with dementia to identify stimuli to increase engagement and to minimize negative affect and problem behavior.We evaluated whether a multiple-stimulus without replacement preference assessment could be used with older adults with dementia and whether preferences remained stable over time. Seven participants completed preference assessments and confirmatory engagement analyses every few weeks for 3 to 5 months; 1 participant failed to complete any preference assessments. Five of the 7 remaining participants displayed higher levels of engagement with the highest ranked stimuli than with the lowest ranked stimuli, confirming the hierarchy in the preference assessment. For the other 2 participants, lowest ranked items resulted in higher levels of engagement than the highest ranked items. Four participants exhibited stable patterns of preference over 3 to 5 months with correlation coefficients exceeding r¼.5, suggesting that preferences may remain stable for some individuals with dementia.
Journal of applied behavior analysis, 2013 · doi:10.1002/jaba.88